In low-income communities, diabetes often goes unacknowledged, like a forgotten guest at a gathering. It’s a health concern that often goes unaddressed due to bad eating habits, stigma, and other barriers such as access to healthcare and poverty.
However, we can make a difference through education and small changes to daily habits. Choices like drinking water instead of sugary drinks and incorporating physical activity can help reduce the risk of diabetes. Simple changes can have a significant impact.
Lifestyle choices
Khethiwe Mhlongo of Honeydew, Gauteng, has struggled with the day-to-day challenges of living with diabetes for the past 13 years. It’s a disease that requires constant vigilance, with even the smallest of dietary choices having the potential to trigger major health complications, she explains.
She has learned how to live with the disease by educating herself. “I can’t just drink anything nor eat anything,” she says.
She notes that living with diabetes involves a variety of concerns, such as stress, which may affect blood sugar levels.
“You must make sure that you manage your emotions and don’t get too angry ’cause when you do, it affects your sugar levels.”
Khethiwe Mhlongo
“I avoid sugary things, drinks, sweets, and fruits that contain lots of sugar, eg bananas. I eat lots of vegetables, and I eat starch in moderation.”
According to Mhlongo, education and awareness are key to managing diabetes, especially in low-income communities where there may be less knowledge and support around healthy eating and lifestyle choices.
Bridging the awareness gap
John Nkuna of Krugersdorp in Gauteng, who has had diabetes for nearly 14 months, says not being able to eat anything you want at your convenience may be stressful.
He believes social media has been quite effective at sharing what people with diabetes can and cannot eat, and that support is working extremely well.
“If we could have devices that don’t require pricking yourself every day to check your blood sugar levels, as doing so can be tiring at times.”
John Nkuna
He says the health department is making efforts to raise awareness about diabetes. However, there’s still much more to do in rural areas to educate people about growing their own food as a means to combat diabetes.
This is especially crucial given food inflation and low-income salaries, which impact what and how people eat.
“I will always follow my healthy diet. I cheat once in a while, but I eat sensible portions,” he says.
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Results of research
The Noakes Foundation has conducted a study in Dunoon, an informal settlement in the Western Cape, to highlight how nutrition education initiatives in under-resourced areas can address the health challenges and social stigma associated with diabetes.
“Diabetes is often viewed as a death sentence in low-income communities because there is a lack of understanding about how to manage it,” says Jayne Bullen, chief operating officer at The Noakes Foundation.
“Our research explored the best ways to inform, engage and support people in these communities when it comes to healthy nutrition, and the benefits of a low-carb, high-fat diet in managing diabetes.”
Jayne Bullen
In partnership with the non-profit organisation Eat Better South Africa (Ebsa), a study was conducted to assess the impact of Ebsa’s nutrition education programme on behaviour and metabolic health changes in people with type 2 diabetes.
The programme focused on reducing refined sugars and carbohydrates while promoting nutrient-dense, accessible alternatives. Bullen explains that the goal was to improve the health of people and families by providing the tools and information needed to make healthier food choices.
“Participants often felt a sense of isolation, because they don’t want to be a burden to loved ones. They found it difficult to maintain a different diet than the rest of their household. Often, people around them were not supportive of their lifestyle changes and holistic approach to their diabetes diagnosis.”
The support group aspect of the programme provided that sense of community and made their journeys to better nutrition easier, explains Bullen.
Lack of support
Bullen says participants highlighted a lack of support from healthcare professionals about dietary interventions as a treatment for diabetes.
“When participants initially received their diagnosis, most of them weren’t aware that diabetes is a disease they could manage with a healthy lifestyle.”
The participants’ blood markers, blood pressure and body measurements were recorded throughout the programme. Baseline test results indicated high levels of blood glucose (sugar) levels; she adds.
Following the programme, significant reductions in weight, waist circumference, and blood pressure were recorded for women. The study also found that the programme had a positive effect on participants’ dietary habits, resulting in them consuming more animal proteins and less refined carbohydrates and sweets, she explains.
“Based on the outcomes, it is clear that when people are empowered with knowledge and support, they are more likely to actively manage their diabetes through dietary changes.
She says, “We are proud to be conducting research that shows the positive impact of holistic diabetes management to address the medical, social and emotional needs of people in under-resourced communities.”
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