“We only have one body”: how to fight diabetes

Helping patients control diabetes

“Diabetes has always been an area of interest for me as it’s a lifelong disease and there’s a tremendous amount that we can offer patients to help them gain control of their diabetes,” says Dr Joanna Skelton, an endocrinologist and diabetologist based in Umhlanga in KwaZulu-Natal.

“I believe in holistic medicine and in seeing a patient in their entirety, and tackling all areas of health. There’s nothing more rewarding for me than watching a patient transform from being scared of their disease to gaining control of their lives and living more positively.”

Dr Joanna Skelton, Discovery Foundation alumna, endocrinologist and diabetologist

We have one body. Looking after it is essential.

November is Diabetes Awareness Month and in South Africa, there are over 1.8 million adults living with diabetes, while around 1.5 million adults are living with undiagnosed diabetes. The World Health Organization estimates that by 2030, diabetes will be the seventh leading cause of death worldwide.

• Read: 5 Diabetes myths and misconceptions: the good, the bad and the ugly

Now more than ever, it’s important to start educating patients and healthcare workers on how to better manage the condition. “Getting back to the basics is important,” says Dr Skelton. “The biggest challenge I see in South Africa is the one aspect that patients themselves can improve on: lifestyle, lifestyle, lifestyle!

The obesity pandemic is real, and so often patients make poor dietary choices and they do minimal exercise. We have one body. Looking after it, and appreciating it, is essential.”

Early treatment means early control

“Taking responsibility for your health starts with making healthy food choices, watching portion sizes, exercising, taking your prescribed medicine and following up with your clinics. Educate yourself about diabetes as much as you can,” Dr Skelton advises.

“The first thing that I tell my patients when they’re seeing me for the initial consult is that they don’t need to fear their diabetes. I promise them that they are able to gain control of their blood sugars and be empowered. We aim for health, not disease,” she adds.

“Get your sugar tested if you are overweight or have a strong family history of diabetes. And seek help if the sugar is elevated: early treatment means early control. We aim to prevent complications and to allow a patient to lead a full and healthy life.”

Diabetes myths and misconceptions

Dr Skelton says people need to understand that:

1. Type 1 and type 2 diabetes are not the same.

“Type 1 is a lack of insulin being produced by the pancreas: these patients are often not overweight and need treatment with insulin from the start. Type 2 tends to run in families, is often associated with being overweight and most of these patients respond well to oral medicine, although down the line they may need insulin,” she explains.

2. Insulin does not harm organs!

“Being placed on insulin does not mean that you’re about to die! So often, I’ve heard patients express their reluctance to be started on insulin for this reason and the belief that insulin will harm their organs. Insulin is simply the replacement of a hormone that your body is lacking: not taking insulin when you need it can lead to serious complications because your blood sugar is running high. Insulin will bring your sugar down to the normal range and help to protect your organs from complications.”

Discovery Foundation alumna uses her platform to raise awareness

In 2012, Dr Skelton received a Discovery Foundation Academic Fellowship to study the phenotype of patients with diabetic ketoacidosis – a life-threatening problem that can happen when the body has a lack of insulin – at the University of Cape Town. Today, she is a diabetologist and one of a few female endocrinologists in South Africa.

“With the Fellowship, I was able to research an area of diabetes not well understood in the South African context: type 2 diabetes presenting with a complication that was initially thought to occur exclusively in type 1 patients. This has helped us to understand specific treatments and develop treatment protocols that are in fact somewhat different to those in other countries.”

In addition to her clinical work in Umhlanga, Dr Skelton regularly gives talks to doctors and healthcare workers on how to manage and treat diabetes. “We need to make sure that our GPs are experienced and knowledgeable in the diabetes arena – empowering them to empower their patients.” She also features on Lotus FM where she educates the community on diabetes.

On 9 December 2019, Dr Skelton will be live on Lotus FM from 19:00 to 20:00 talking about the treatments available for diabetes.