Living with diabetes

Ashmika Balram explains how she manages type 2 diabetes. This is a chronic condition that causes her body to resist the effects of insulin, a hormone that regulates the movement of sugar into her cells.

 “When I was first diagnosed with type 2 diabetes in September 2016, I was really disappointed,” says Ashmika Balram, a teller at Absa in Durban. “Although I liked pastries, hot chips and ice cream, I never ate them in excess. I’ve always watched my weight, stuck to an exercise programme and never really had a taste for sweets or desserts. I never added sugar to tea or coffee, I don’t drink alcohol and I’ve never smoked. I thought I was managing my health very carefully and I must say, I thought it was bit unfair that I now had to deal with this condition.”

But the 40-year-old is no stranger to the dangers of unstable blood sugar levels. Her husband, Rakesh, suffered from undiagnosed diabetes for years until a heart attack landed him in hospital. “After an angiogram, the doctors explained that his arteries were too narrow and damaged for them to perform a bypass operation or insert a stent,” Ashmika explains. “He now monitors his blood sugar levels constantly – and injects himself with insulin daily.” Ashmika’s mother, father and grandmother all had the condition. As diabetes can be hereditary, this placed her at high risk of developing the illness.

“After Rakesh’s health scare, I began checking my blood sugar levels with him every day, even before I realised I also had diabetes,” Ashmika says. “I wanted to support him and encourage him to be responsible.” Then, shortly after returning from holiday and a bit of over-indulgence at the hotel buffet, she noticed her blood sugar levels were too high. “I chose to go for tests because Rakesh’s heart attack showed us how dangerous it can be if you don’t manage the condition,” she explains. “His kidneys have also been affected and he is unable to process a lot of protein. Once I was officially diagnosed – and then fell pregnant – it became even more important for us to monitor our health.”

According to Diabetes South Africa, it’s vital to have normal glucose levels during the first seven weeks of your pregnancy as this is the time your baby’s organs are formed. Abnormal glucose levels during this period increases the risk of birth defects and miscarriages.

“I monitored my sugar levels three times a day, every day, and recorded it in the diabetes log book,” the first-time mother recalls. “Every time I visited my gynae, he’d check the log book. At one point, I was hospitalised for two days and put onto insulin. Because it was a high-risk pregnancy, I also had numerous scans to identify any potential defects or complications.”

Rivash is now seven months old. He’s a healthy, happy baby who is the joy of his parents’ lives. “We are so grateful that he wasn’t born with diabetes,” Ashmika says. “Although he was kept in hospital a bit longer because he had low blood sugar when he was born, he stabilised quickly.”

Today, the couple are vigilant about eating correctly – and chips, pies, pastries and sweets are a thing of the past. “We now eat six smallish meals a day – and if we do need to snack, we opt for a piece of fruit, a few rice cakes or small packet of pretzels or corn chips,” she says. “If we eat bread or potatoes, we do so sparingly. We no longer have big fry-ups with toast and jam for breakfast; we eat a bowl of cereal. And main meals usually include lean protein with steamed butternut, broccoli and cauliflower.”

The Balrams also make a point of exercising regularly together. “We go for walks around the neighbourhood, do sit-ups and work out with dumbbells at home. It helps doing things as a team – it makes it easier to manage our diabetes. As soon as Rakesh’s blood sugar levels drop, his feet start tingling and his vision gets blurry. My signs aren’t as severe, but my eyesight has been affected by the condition. Thankfully, it hasn’t deteriorated since I’ve been taking the medication.”

Ashmika is on the Bankmed Basic Plan and is eternally grateful that all her hospital bills, medication and doctor’s bills were covered. “But I know it’s up to me to be sensible about my condition for the rest of my life,” she says.

Get tested

Did you know that a quick finger-prick test, performed by your Network GP, Network Pharmacy or onsite workplace clinic can mean a great deal for your long-term health? This test shows your blood sugar levels and might indicate that you have diabetes. This is a chronic condition that causes your body to resist the effects of insulin, a hormone that regulates the movement of sugar into your cells.

In South Africa, it is estimated that 1.4 million people have undiagnosed diabetes. By the time these patients are diagnosed, up to 30% of them will have already developed complications. These include heart disease, stroke, blindness, amputations and kidney failure. In most cases, these complications could have been avoided entirely by early diagnosis and proper treatment.

What the numbers mean

Normal fasting blood glucose is about 5.6 mmol/litre. Once your fasting blood glucose is 7 mmol/litre, you are likely to be diagnosed with diabetes. Depending on your symptoms, your doctor may request further glucose tests such as an HbA1c or an oral glucose tolerance test (OGTT) to confirm the diagnosis.