I just heard of a child in our town who has diabetes for 2 years now. He is 12 years old and his parents took him out of school because they do not have any control. My heart is bleeding for them.
I phone the mother (they are government patients - poor). It seems that when he was diagnosed they only saw a dietician and did not recieve much training. The child is still on an insulin mix (actraphane) similar to novomix. The clinic just tells them vereytime to inject more… They are coming to see me me on monday. I hope I can really help them. What is your suggestions regarding the insulin… I feel they should change to Levemir/Lantus and novorapid. The problem is I don’t know what insulin the goverment sponser… Then I have to get them to a docter who can subscribe it and the state docters (and others as well) here does’nt have much knowledge on the subject…
If they read:
Download information so they can have it in hand on Levemir/Lantus, Novorapid, and/or whatever is available in the pharmacies there. Tell them to feel free to ask questions.
Meanwhile, you can ask a pharmacist what the government will supply, given a prescription, for diabetes.
Download some of Bernstein’s information, or some of Diabetes 101 as starters.
Talk directly to the 12 year old so he has a measure of grown-up ownership and an in-charge feeling toward his diabetes.
Let him know this is treatable and that millions of people are going to school and living employed lives.
Let him know he can get more information and he can give information to the administrator of the school, too, so his parents are not the only ones learning about it and making decisions. Pharmacists are sources of information, too.
Some people send their children to live with relatives in large cities in order that they are seen by up-to-date physicians and deal with knowledgeable school administrators, teachers, and nurses. Start their minds thinking. And good luck with your project!
thank you for helping Riette. You are a gem.
Thanks for the info. I found out the some government hospitals do give out other insulins - depending on the level of the hospital. Our hospital is a level 2 - and a pharmacist-friend here will find out what insulins they do give out. It seems that the larger hospitals give out Acrapid/Humalin R and Protophane/Humalin N . So that is what I have to work with. I think I’m going to talk to them tomorrow and if they agree go with them to the clinic and presuade the doctor to prescribe other insulin. (This government docors are way way behind on diabetes…not to mention the phamacists.)
Regarding the school-our school does not take responsibility for diabetic children. Our system is totaly different from the US. It is up to the parents to check their children.
Thanx I’m trying to get more involved in our town… Started a support group a while back as well.
Nope - we’re in a small town 340 km (about 3,5 hours drive) from the nearest city I have a lot of info - thats not a problem - I can teach them a lot but its the thing handling the goverment patient - our government health is really not up to scratch - in that way were still in many ways the same as a third world country - especially in a rural area such as ours… If you are poor you’re in bad luck…
2 books. Imperative.
“Think Like a Pancreas”. Gary Scheiner $11 on Amazon Click here
“Calorie King” Amazon $9 Click here
Diabetes will forever be a self-managed disease, they need to get the tools so they can manage for themselves, not depend on calling doctors for hypos and hypers and everyday management things.
I used N and R for many years and although it’s not great, control can be achieved. Some manufacturers have assistance programs to help you with buying medicine. You have to learn to use what’s available, I think.
Best of luck!
Thanx I do agree - people should be learned to manage it themselves. They must be empowered to handle any situation- but - I also experience that diabetes is such a difficult disease to manage that lots of people leave it to their trainer/consultant/doctor to sort out problems and it’s those who normally start to develop complications first…
Would it help to contact IDF.org.( International Diabetes Federation ) , South Africa ( I googled this ) …e-mail national@diabetes.co.za and discuss your concerns . Website www.diabetessa.co.za . When I read your request I very much realize how fortunate I am, living in Canada .And yet we complain . Another example: I have posted a request for members in my Province to contact our Candidates before the next Provincial Election, held on May 12 and share with them the Canadian Diabetes Association’s ASK for better meds, devices etc. and no one has responded yet. I hope , they do contact their Candidates.
And Thank You, Riette , for advocating for this young child in your community . I pray you will be succesful
I am not familiar with insulin mixes they may have gone out of fashion in Canada. A few years ago I was on NPH a 4 hour insulin and I wuld inject it every 4 hours or have no control, horrid stuff. In progressive provinces in Canada ( not our right wing paradise) the Govt sponsor and encourages pumps. But a viable alternative would be the slow acting insulins like levemir and lantus combined with a fast acting insulin. I find I can manage with 2/3 of the total daily dose as slow acting split into morning and bedtime shots. Some people may go low with such a high percentage of slow acting so it might be a good idea to start at 45% of TDD and ramp it up to see what happens. TDD total daily dose is the amount of units per day that a diabetic requires to keep the BG close to normal. The rest as fast acting insulin mostly before meals and a bit for corrections.
Our Govt refuses to subsidize the lantus or levemir inspite of my Endo talking to the health minister and showing him that it would save the province money. Let us know if south africa is more progressive than canada.
Our government defnitely do not sponser the “new generation” insulins. They will propably in the next 100 years not sponser insulin pumps. Insulin pump has only now begun to emerge in SA - with relatively few medical aid (insurance companies) that pays it… So they will have to do with the “older” insulins and we have to make it work somehow…
Our diabetes foundation is not as active as those in the US - there are support groups in larger cities. We have had no support where I live. Thats why I decided to start a support group and that is how I found out about this child.
Dear Nel. tell them to get with it do they want to end up with the same uncarring Govt as in alberta.
That is hard to find books that explain how to use the old insulins. I will try to go to our library and see if there are any ancient diabetic books. Not sure if they would be relevant to the south african preparations. Of course a low carb diet if practical or at least a high glycemic index diet helps. I used to eat boiled rye instead of rye bread much better but not as yummy. Yam better than patotoe. May be you can look at the foods available to the child and chose as low glycemic index as possible this would help control.
Ok here is an update:
I saw both the child and the mother. They had NO training since the child was diagnosed (2 years ago), every month they just go to the clinic and get more insulin from the governement. The state docter also supscribed metformin to the child!!!.. He weighs 45 kg he is 13 he injects 27 units in the morning and 18 at night.
They didn’t know what diabetes actually was- only that it has something to do with sugar and bloodsugar and he has to take insulin. I think they knew less than the normal person on the street. I basically saw them for about 2 hours during which I explained what diabetes is, what insulin does, what ketones are, what to hypo- and hyperglycemia are- and the normal stuff and what to do in an emergency. So I only gave info and very little trianing per se. I told them to try and get new insulin from the doctor then I will help with the dosages, carb countings etc… I also said I’m willing to go them to the doctor. So its now up to them to decide whether they want my help further.
The one thing that gave me hope out of this whole situation was the boys face when they left. The way he looked at me. I can’t really describe it - so much admiration. I made my day… no my year… I think (hope) that he now knows there’s someone where he can go to if he need help.
Riette,
Thank you for doing this from the bottom of my heart. !! You were able to tell them a lot in those 2 hours you met with them . You have not mentioned anything about glucose monitoring , that I can see. Is the family doing this regularly ? Are they able to record results, eating plan , exercise ?? Are you thinking as I am , that metformin may not be the required medication for the child ??
Did I read somewhere in one of your resonses, that Apidra, which is a new generation insulin , is available in your part of the world ?
I am really clear, reading your post, that IDF needs my support , esp. in countries like yours. Still worth trying to communicate with the South Africa Diabetes ■■■’ n ??? .
Have faith , the family just may contact you ; on the other hand what stops you from at least one follow -up ?? And thanks for your up-date …I know you have done wonders 
No I haven’t talked about glucose monitoring that much. I did tell them when to test and why they do have to test at that specific time - (other than testing for lows & highs-etc) I dont think they have a monitoring system (they did not over much info but I do think his BG’s are out of control.
Our state hospital does not supply apidra - it’s only available for private patients and those with medical aid (insurance). SADA is really not as active as the ADA or IDF in America. (one other thing you should remember were living a a rural town. Our nearest “large” town is about 180 miles away.) Our diabetes association- SADA- is more active in large cities like Johannesburg, Pretoria, Cape Town. That webpage of SADA was not updated during the last year or so… The CDE centers is much more active - but also more in the larger cities. That is the main reason I started a support group - I did send the e-mail to that e-mail address on the SADA webpage - they did not even respond at that time.
I know that it is uncomprehensible for you to understand that our country does not have the same facilities as America or Canada or Brittain for that matter - you must remember the media that goes out into the world is not always correct and really does paint another picture of what is really going on here…
Yes I also think that metformin is not the required medication (metformin is normally subscribed for overweight type 2 diabetes) - that is why I was so shocked when I learn that he was subscribed that. It just confirms the fact that the doctors in this town does not know anything about this condition…
My support group does meet again in a weeks time - I’m going to use that as an excuse to contact them again.