What is Diabetes?

Diabetes represents a spectrum of chronic, but treatable, health conditions that cause raised glucose levels in the blood (hyperglycaemia). Long-term hyperglycaemia is toxic and associated with damage to the body and failure of various tissues and organs. Although many specific types of diabetes exist, three main types occur commonly.

This is an autoimmune condition in which the body’s defence system attacks ‘self’ and destroys the beta cells of the pancreas that produce insulin. Although people of any age can develop and have the condition, type 1 diabetes usually develops in children or young adults. Treatment requires ‘hormone replacement therapy’ of two to four or more insulin injections daily for life, to replace the missing insulin and to keep blood glucose levels within a healthy range as much as possible. People with type 1 diabetes are otherwise healthy if blood glucose levels are well managed.

Type 2 diabetes is a complex and progressive disorder in which a relative lack of insulin occurs together with resistance to its action. It affects around 90 % of the population who have diabetes and has a strong correlation with the ‘Westernised lifestyle’ associated with a lack of exercise, poor eating habits and gain of excess fat (particularly around the tummy region). This way of living may result in the development of insulin resistance and eventually, diabetes.

As there is a general lack of symptoms, the diagnosis is often made when a complication appears or when a routine blood or urine glucose test is done. Treatment always begins with lifestyle change (getting active, healthy eating and loss of tummy fat) as a priority, to which a variety of oral (tablet) and injectable (including insulin) therapies may also be added, over time. The good news is that successful lifestyle management resulting in a dramatic loss of excess tummy fat and increased insulin sensitivity can slow this progression dramatically. It may even put your diabetes into ‘remission’ (normal blood glucose values on no treatment). Speak to your diabetes team about how to achieve this.

pregnant lady with heart handsGDM is a form of diabetes first diagnosed during pregnancy and is associated with potential complications to both mother and baby.

Although GDM usually disappears after pregnancy, women with GDM and their children, are at an increased risk for developing type 2 diabetes later in life. Approximately half of women with a history of GDM go on to develop type 2 diabetes within five to ten years after delivery. The good news is that successful lifestyle management resulting in a dramatic loss of tummy fat and increased insulin sensitivity can prevent or delay this progression significantly.

At the CDE we, tend to focus more on causes of health than on causes of illness. We hope this approach will be refreshing and empowering and encourage you and your family to better understand the condition and some of the daily challenges and variables that may arise. We have developed booklets for those living with type 1 diabetes and type 2 diabetes, to provide pertinent information to assist you or your loved one with managing diabetes.

Life will be different with diabetes, but it can still be sweet…

Managing Diabetes

The commonest forms of diabetes, type 1 and type 2 diabetes, are both complex health conditions. They need a specialised management approach and structured programme of care.

Several key principles characterise 'good diabetes care'.

The principles mentioned here are important components of any best-practice diabetes management programme and help in reducing sickness, unnecessary hospitalisation, untimely death, and preventable costs due to diabetes.

Each person is unique in their combination of physiological, lifestyle, cultural, emotional and cognitive needs and responses to experiencing life with diabetes. Never has the requirement for personalised diabetes care been more accepted and possible.

Empowerment to practice self-care

pregnant lady top view holdwombCDE clients understand their doctor or other healthcare professional is not solely responsible to ‘look after’ their diabetes. People with diabetes themselves must make choices and decisions about managing, caring for and coping with their condition dailyThese decisions can significantly affect their health and well-being, positively or negatively.

It is thus vital that people with diabetes are empowered to make informed and insightful choices and decisions.

Unfortunately, funders of healthcare often ignore 'diabetes education', the process by which specially trained health professionals coach people with diabetes to acquire the skills and confidence to perform meaningful self-care across a lifespan of developmental changes and milestones. In contrast, we consider diabetes education to be one of the most important aspects of successful diabetes care. We place significant focus on providing our clients with insight and problem-solving ability in addition to correct information. We encourage each of our clients to consult with their diabetes educator regularly to prevent rather than treat any foreseeable problems.

lady with babyFacilitation of self-care by a passionate Management Team of health care professionals with specialised training and knowledge is essential in the care of diabetes. The members of the Diabetes Team provide diagnosis, counselling, coaching, education, treatment and lifestyle options, support and motivation.

In addition to a doctor, input from a diabetes educator, dietician, podiatrist, ophthalmologist, pharmacist, biokineticist and psychologist (amongst others), is necessary at various times to maximise care and quality of life.

Importantly, the doctor is not the head of this team – it is the person with diabetes and their family.

Community Diabetes Associations like Youth With DiabetesDiabetes South Africa and SA Diabetes Advocacy are a vital part of the wider diabetes team to provide support and advocacy where most diabetes care occurs – in the community.

{slider=Ongoing monitoring (checking)}

lady doctor with scrubs and maskIt is essential to ensure that diabetes and its associated risk factors are 'Treated to a Safe, Individualised Target' – a best-practice approach adopted by the CDE.

The treat-to-target approach ensures that both people with diabetes, as well as their treating healthcare providers, know and understand the individualised health targets to aim for.

Ideally, as clinically indicated, every person with diabetes would know what their targets are for things like:

  • HbA1c
  • Fasting, pre-meal and post-meal (as advised), blood glucose readings
  • ‘Time-in-range’
  • Cholesterol and other serum lipids (fats)
  • Blood pressure
  • Body composition
  • Waist circumference

In addition, kidney function, growth (in children) and eyes and feet need to be checked.

These important parameters need to be measured regularly, and treatment therapies need to be proactively adjusted and fine-tuned by healthcare professionals to help achieve the needed targets. The aim is to prevent ill-health, and promote wellness and best quality of life, using as few scarce health resources as needed.

Your daily self-care revolves around three main things:

  • Sitting less and being as physically active as possible every day
  • Healthy, mindful and sustainable eating and
  • The right medication at the right dose, at the right times in the right way

Speak to your diabetes care team today to work on your personal self-care plan for best health!

food hourglass scale

Diabetes in a Minute

Please click here to access and watch this video series.

CDE Micare Programme

This programme provides members with an opportunity for CDE and their provider team to best manage chronic conditions.  

Click here to learn more