May 17, 2024 • 18 mins
A conversation on diabetes care and education in South Africa with Michael Brown, RN, Head of the CDE Academy and co-host of the "not ARTIFICIALLY Sweetened" diabetes podcast.
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Speaker 1 (00:03):
Welcome to Diabetes Technology Report, co-hosted by
endocrinologist David Klonofffrom UCSF and David Kerr from
Sutter Health.
Hello, welcome to the DiabetesTechnology Society podcast,
Diabetes Technology Report.
I'm David Klonoff, anendocrinologist at Sutter Health
(00:26):
and UCSF, and I'm here with myco-moderator, Dr David Kerr, who
will introduce our specialguest.
Speaker 2 (00:34):
Thanks, david, and hello to everyone.
I'm David Kerr.
I'm a UK-trained physician, butI'm now living in Santa Barbara
working at Sutter Health aswell.
I'm now living in Santa Barbara, working at Sutter Health as
well.
This is a really important dayfor Diabetes Technology Reports,
as we're expanding our globalfootprint, and, in order to do
that, the first person thatcomes to mind from my
(00:56):
perspective is Michael Brownfrom South Africa.
Michael, a huge welcome to youand thanks for taking the time
For our listeners.
Could you just give us a littlebit of a background about what
you're up to down in SouthAfrica when it comes to diabetes
technologies and media andgetting the message out?
Speaker 3 (01:15):
Right, david.
Thank you so much for your verywarm introduction.
I appreciate it.
Speaking out of South Africa,it's a great privilege to
connect with colleagues fromacross the world and, yes, I've
been in diabetes nearly for 30years now.
I started working with Dr LarryDistiller back in 1996, joined
(01:37):
his very fledgling Center forDiabetes and Endocrinology back
then to take over theireducation arm, and I've stayed.
I found my passion and I founda purpose in helping health
practitioners and people withdiabetes to change lives and
practice.
Speaker 2 (01:57):
Just for the audience , can you give us a kind of
picture of the use and abuse, ifyou want, of diabetes
technologies?
What is access like for peoplewith, say, type 1 diabetes,
adults and children to closedloops or CGMs or this type of
thing?
Speaker 3 (02:16):
Access to technology in South Africa is quite limited
and probably it's the best inAfrica and probably it's the
best in Africa, but it'srelatively poor compared to the
rest of the world.
The main barrier?
I think well, there are twomajor barriers.
One is the cost relative to howmuch people earn, and we have a
(02:38):
very damaged, let's say,healthcare system.
About 85% of the populationmake use of public health
services, which areoverstretched largely and
underfunded.
Underfunding is often not somuch because they're not getting
the tax allocation, but there'smismanagement, fraud, wastage
(03:00):
and abuse which is unfortunatelyplaguing our country.
And then we have a privatehealthcare system that about 15%
of the population access andthat costs anywhere from around
30% to 40% of your monthlysalary to fund your own
healthcare.
So for those two reasons,healthcare technologies such as
(03:24):
continuous glucose monitoringand insulin pumps are really not
in great supply and not usedgreatly.
However, in our center, being atertiary high-level center, we
use them frequently.
(03:47):
My wife, who works with me andhas worked with me for nearly 29
years, she is an expert oninsulin pump therapy and on
continuous glucose monitoringand all the technologies
associated with diabetes.
So I'm very privileged in ourparticular setting to be
well-versed with thesetechnologies, but unfortunately
this is not the case for mostSouth Africans.
But unfortunately this is notthe case for most South Africans
.
The second reason I think thatmost healthcare practitioners
(04:10):
are not well-versed in diabetes.
We come out of university and Ican speak from personal
experience.
I came out of medical school asa registered nurse.
We did a lot of our lecturestogether with the doctors, but
as a registered nurse I came outof med school and I knew zero
about diabetes and everythingthat I've learned has been in
the postgraduate setting withinthe organization that I've grown
(04:32):
up in in diabetes.
Unfortunately, most healthcareprofessionals have not had the
mentoring and the exposure thatI've had over the last 30 years.
So that's another, let's say,barrier, major barrier to the
institution of technology inSouth Africa.
Speaker 1 (04:50):
Well, Michael, what you said is also true in the US
that people don't learn enoughin their training.
If a patient comes to yourcenter and needs education, what
kind of experience do they have?
What do you do with them?
Speaker 3 (05:07):
we hope that they have a very good experience.
We pioneered diabetes education30 years ago as an organization
and we've kept that going.
Unfortunately, just due to theeconomic environment, the
political environment, thestructure of the health
environment, most of oureducators have not been replaced
(05:27):
and so most of us are gettingold and in fact that patterns
the rest of the South Africanhealthcare profession.
Most nurses are over the age of50.
And within the next 15 yearsthe majority will have retired,
with no prospect of them beingreplaced.
In our center, as I said, we dohave registered nurses who have
(05:50):
studied long and hard tospecialize in diabetes and they
get a full service in terms ofunderstanding their condition,
the various treatments that maybe applied to the management of
their condition and how tomanage it in the context of
their physical, social,psychological, economic, work
(06:12):
and school environments.
So we really do try and offer ateam-based approach, working on
outcomes of studies like thediabetes control and
complications trial from manyyears ago.
We really try to put intopractice the outcomes of the
evidence that we see in theliterature and we have very good
outcomes.
(06:32):
Another thing that I think hasbeen our differentiator
worldwide for the last 30 yearsis that we run a 24-hour hotline
.
So if any of our clientsexperience any issues 24 hours a
day, they can pick up a phoneand they can phone us and they
get help.
So we can abort something likeketosis from sliding to
(06:53):
ketoacidosis, which wouldrequire admission.
Speaker 1 (06:57):
Michael, what sort of specialists or specialties are
working at your education centerand also who staffs the hotline
?
Speaker 3 (07:06):
Yeah, we have a reasonably large
multidisciplinary teamendocrinologists, specialist
physicians, also general orfamily physicians, registered
nurses, registered dieticians,podiatrists, ophthalmologists,
audiologists.
Until recently, we had abiokinetic center.
(07:28):
Unfortunately, that is nolonger in operation.
It wasn't bringing in theincome to sustain it,
unfortunately, and I thinkthat's a great pity because we
recognize that physical activityis a major component of
diabetes care.
Sorry, the last question.
I just forgot that.
(07:48):
Oh, who starts the hotline?
Well, our doctors are veryprivileged.
They never do call theregistered nurses and registered
dieticians do the 24-hour calland once or twice a year I may
need to phone one of ourphysicians for help.
Otherwise we run it and we haveover the years, years,
(08:09):
prevented literally tens ofthousands of admissions.
We have saved literallyhundreds of lives and we have
made diabetes something that ismanageable in the community and
we've taken away much of theanxiety that people with
diabetes may face in anunsupported setting.
Speaker 2 (08:30):
Michael.
Can I just expand on that,Because I find this absolutely
fascinating.
What are the sort of commonquestions that people with
diabetes are asking when theyphone up the hotline?
Are they really close to theedge of catastrophe or are they
asking very reasonable,practical lifestyle questions or
drug questions?
(08:50):
What are the sort of commonthemes?
Speaker 3 (08:53):
It's a full gamut so, ranging from a 2 o'clock in the
morning phone call saying I'mout to dinner.
I've just had a slice ofcheesecake.
How many units should I injectTo?
I have been vomiting for thelast five hours to.
I have been vomiting for thelast five hours.
I have three plus ketones andI've got chest pain and you can
(09:20):
hear them puffing like a steamtrain on the other end of the
line through to.
My husband is in a hypoglycemiccoma on the carpet.
What do I do?
First question I ask is hebreathing?
And that's something that mosthealthcare professionals forget
is that cardiovascular diseaseis one of the highest forms of
causes of mortality in type 2diabetes, and so we must never
forget those basics.
(09:41):
Once I've established that heis actually breathing and has a
pulse, then we can get on andtreat the hypoglycemia or start
CPR and treat the hypoglycemiaor start CPR?
Speaker 2 (09:49):
What about in children, do you say?
Parent families of childrenwith diabetes, do they use this
hotline?
Speaker 3 (09:56):
Yes, yes.
So in the past we saw bothchildren children from about the
age of eight years and all theway through to the older person.
In the last 10 years we'velimited well, our doctors have
limited the practice to peopleover the age of 16 years.
So I have in the past hadextensive experience in managing
(10:18):
a hotline in a pediatricsetting and again we had a whole
gamut of experience.
But again I can proudly saythat we were able to calm down
very hot temperatures within afamily setting to enable
children to continue theirschool life, to attend exams,
(10:40):
and maybe that was one of thereasons why they phoned the
hotline was to try and get outof doing the exam.
We are pretty good at what wedo and they could attend this
exam, much to their chagrin, Ithink.
But our job is to help peopleto attain the optimum sense of
balance in their diabetesself-management and to achieve
(11:02):
their optimum potential as humanbeings, and we do that with
great passion.
Speaker 1 (11:08):
Michael, you're in Africa.
Do you see a different mix ofpatients than what you've read
are seen in other parts of theworld, or are there any types of
diabetes that might be unusualin the US that might be common
in Africa?
Speaker 3 (11:25):
I don't think so, david.
I think we have.
You know, with the massmigration that has taken place
across the world, I think thatmost healthcare professionals
are seeing a wide gamut ofethnicities and country origins
(11:53):
very mixed society for decades,so we see a wide range of people
.
I think what we do have quite alot of experience in South
Africa in is in the treatment ofSouth Asian or Indian people,
given that we have lower cutpoints for determination of what
we might call obesity oroverweight in that population
and waist circumference and soon.
And we see a lot of people whophenotypically are slim but they
(12:16):
have excess visceral fat andthey would present with type 2
diabetes.
So within our Asian populationwe see high rates of diabetes.
I think the other thing that,with our large population with
an African ancestry, we are veryattuned to cultural differences
in how we perceive the causesof health issues.
(12:40):
So in Africa there's oftenideas of fatalism, that things
just happen to you and thatthere's nothing, you have no
personal agency over whathappens to you, or that maybe
there's been some sort ofwitchcraft involved, in which
case you may need a traditionalhealer or sangoma to help guide
(13:02):
you through the treatment, andso we're very well aware of
these kinds of phenomena.
We realize that about 80% ofour clients of African ancestry
will, concurrently seeing us,will see a traditional healer,
and so that means we've got tobe aware of this.
We don't judge it.
And we don't judge it becausewe want them to tell us about
(13:24):
all the herbs and traditionalremedies that they are taking,
so that we can assess anypotential interactions between
those therapies and our moretraditional therapies.
Speaker 1 (13:36):
Are there any foods that are popular in Africa that
affect glucose either favorablyor unfavorably, that are not so
common in other parts of theworld?
Speaker 3 (13:46):
I don't think so.
I think the experience isfairly universal.
One of the staples here?
Don't think so.
I think the experience isfairly universal.
One of the staples here is cornor maize we would call it
mealies here which is groundinto a flour or eaten off the
cob, which is obviously ahealthy alternative if it's
grilled.
But most of our foods are basedon maize meals and there's a
(14:11):
large intake of carbohydrates,large intake of sweetened cold
drinks yeah, very largecarbohydrate intake and also
high or large portion sizes,which obviously doesn't help.
Speaker 2 (14:26):
Very similar to what we see here in the United States
.
Absolutely, yeah, sadly that'sthe case.
Michael, what about what you'redoing with your education
program and your podcast series?
Do you want to just tell us alittle bit about what you're
doing in that space, getting themessage out For sure?
Speaker 3 (14:48):
So that's something I have learned over the years
that life changes more rapidlythan you can conceive, and with
COVID, we as an academy had todo an about turn on how we
traditionally did education.
So before that, we did contactcourses both with people with
(15:09):
diabetes and with healthcarepractitioners.
The COVID pandemic and thesubsequent lockdowns, which were
quite prolonged in South Africa, stopped that and to keep us
sustainable, because we had tokeep the lights on somehow, we
pivoted very quickly to onlinelearning.
We started an online course forhealthcare practitioners.
We started an online course forhealthcare practitioners and
(15:37):
then last year, following thepandemic, we realized that we
needed to get with the programin terms of electronic
communication.
So we started our podcast, notArtificially Sweetened, which is
currently now has listeners in32 countries.
We're very grateful to knowcountries we're very grateful to
know, and the podcast, I think,is unique in that it is a that
is designed to bring both healthcare practitioners who have an
(15:58):
interest in diabetes and peoplewith diabetes and their families
together in one environment sothat we can speak to each other.
We can learn from each other.
We also know that a lot oflearning nowadays in the modern
world takes place through audioor video sources, and that much
learning is social.
(16:19):
And so we thought that was anatural extension of modern
learning techniques, and that'swhy we went to Dr Stan Landau,
who I work with.
He came to me end of Januarylast year and he said Mike, I
think we need to start a podcast.
I didn't know the first thingabout podcasting.
By 16th of January, 16th ofFebruary last year, I think, we
(16:40):
all released our first one, andwe are.
Yes, last night we recordedepisode 54.
So it's been a lot of hard work, but I've been absolutely
amazed by the quality of theguests we have featured over
(17:01):
those 54 episodes, whether theybe healthcare practitioners,
whether they be policymakers andespecially people with diabetes
, because what we want toshowcase, especially for people
living with diabetes, is thatdiabetes does not need to hold
you back.
And so we've interviewed acommercial airline pilot,
(17:24):
jonathan collins, who is acaptain of a commercial airliner
in south af, and his advocacyfight to regain his wings after
he lost them after the diagnosisof type 1 diabetes.
So, drawing on policy from allover the world for similar cases
, he was able to change theSouth African law regarding
(17:46):
pilots and commercial flying andmany other extreme athletes,
people who are academics,artists, whatever just
incredible people, and I thinkthrough their stories we've been
able to provide some realanswers to some of the questions
that many people with diabetesand their practitioners face on
(18:08):
a daily basis with diabetes andtheir practitioners face on a
daily basis.
Speaker 1 (18:14):
Michael, this is a very interesting story that
you've told us today about beingan educator in South Africa,
and I would like to thank youfor spending this time with us.
I plan to listen toArtificially Sweetened now that
I've learned about it, and we'llkeep in touch.
Thank you, david.
So, on behalf of Dr Kerr andMichael and myself, thank you
(18:36):
for listening to DiabetesTechnology Report.
This podcast is available onSpotify and the Apple Store and
the Diabetes Technology Societywebsite.
So until our next DiabetesTechnology Report, have a nice
day.
Goodbye everybody.
Speaker 2 (18:52):
Thank you, thank you very much indeed.
Welcome to Diabetes Technology Report, co-hosted by
endocrinologist David Klonofffrom UCSF and David Kerr from
Sutter Health.
Hello, welcome to the DiabetesTechnology Society podcast,
Diabetes Technology Report.
I'm David Klonoff, anendocrinologist at Sutter Health
(00:26):
and UCSF, and I'm here with myco-moderator, Dr David Kerr, who
will introduce our specialguest.
Speaker 2 (00:34):
Thanks, david, and hello to everyone.
I'm David Kerr.
I'm a UK-trained physician, butI'm now living in Santa Barbara
working at Sutter Health aswell.
I'm now living in Santa Barbara, working at Sutter Health as
well.
This is a really important dayfor Diabetes Technology Reports,
as we're expanding our globalfootprint, and, in order to do
that, the first person thatcomes to mind from my
(00:56):
perspective is Michael Brownfrom South Africa.
Michael, a huge welcome to youand thanks for taking the time
For our listeners.
Could you just give us a littlebit of a background about what
you're up to down in SouthAfrica when it comes to diabetes
technologies and media andgetting the message out?
Speaker 3 (01:15):
Right, david.
Thank you so much for your verywarm introduction.
I appreciate it.
Speaking out of South Africa,it's a great privilege to
connect with colleagues fromacross the world and, yes, I've
been in diabetes nearly for 30years now.
I started working with Dr LarryDistiller back in 1996, joined
(01:37):
his very fledgling Center forDiabetes and Endocrinology back
then to take over theireducation arm, and I've stayed.
I found my passion and I founda purpose in helping health
practitioners and people withdiabetes to change lives and
practice.
Speaker 2 (01:57):
Just for the audience , can you give us a kind of
picture of the use and abuse, ifyou want, of diabetes
technologies?
What is access like for peoplewith, say, type 1 diabetes,
adults and children to closedloops or CGMs or this type of
thing?
Speaker 3 (02:16):
Access to technology in South Africa is quite limited
and probably it's the best inAfrica and probably it's the
best in Africa, but it'srelatively poor compared to the
rest of the world.
The main barrier?
I think well, there are twomajor barriers.
One is the cost relative to howmuch people earn, and we have a
(02:38):
very damaged, let's say,healthcare system.
About 85% of the populationmake use of public health
services, which areoverstretched largely and
underfunded.
Underfunding is often not somuch because they're not getting
the tax allocation, but there'smismanagement, fraud, wastage
(03:00):
and abuse which is unfortunatelyplaguing our country.
And then we have a privatehealthcare system that about 15%
of the population access andthat costs anywhere from around
30% to 40% of your monthlysalary to fund your own
healthcare.
So for those two reasons,healthcare technologies such as
(03:24):
continuous glucose monitoringand insulin pumps are really not
in great supply and not usedgreatly.
However, in our center, being atertiary high-level center, we
use them frequently.
(03:47):
My wife, who works with me andhas worked with me for nearly 29
years, she is an expert oninsulin pump therapy and on
continuous glucose monitoringand all the technologies
associated with diabetes.
So I'm very privileged in ourparticular setting to be
well-versed with thesetechnologies, but unfortunately
this is not the case for mostSouth Africans.
But unfortunately this is notthe case for most South Africans
.
The second reason I think thatmost healthcare practitioners
(04:10):
are not well-versed in diabetes.
We come out of university and Ican speak from personal
experience.
I came out of medical school asa registered nurse.
We did a lot of our lecturestogether with the doctors, but
as a registered nurse I came outof med school and I knew zero
about diabetes and everythingthat I've learned has been in
the postgraduate setting withinthe organization that I've grown
(04:32):
up in in diabetes.
Unfortunately, most healthcareprofessionals have not had the
mentoring and the exposure thatI've had over the last 30 years.
So that's another, let's say,barrier, major barrier to the
institution of technology inSouth Africa.
Speaker 1 (04:50):
Well, Michael, what you said is also true in the US
that people don't learn enoughin their training.
If a patient comes to yourcenter and needs education, what
kind of experience do they have?
What do you do with them?
Speaker 3 (05:07):
we hope that they have a very good experience.
We pioneered diabetes education30 years ago as an organization
and we've kept that going.
Unfortunately, just due to theeconomic environment, the
political environment, thestructure of the health
environment, most of oureducators have not been replaced
(05:27):
and so most of us are gettingold and in fact that patterns
the rest of the South Africanhealthcare profession.
Most nurses are over the age of50.
And within the next 15 yearsthe majority will have retired,
with no prospect of them beingreplaced.
In our center, as I said, we dohave registered nurses who have
(05:50):
studied long and hard tospecialize in diabetes and they
get a full service in terms ofunderstanding their condition,
the various treatments that maybe applied to the management of
their condition and how tomanage it in the context of
their physical, social,psychological, economic, work
(06:12):
and school environments.
So we really do try and offer ateam-based approach, working on
outcomes of studies like thediabetes control and
complications trial from manyyears ago.
We really try to put intopractice the outcomes of the
evidence that we see in theliterature and we have very good
outcomes.
(06:32):
Another thing that I think hasbeen our differentiator
worldwide for the last 30 yearsis that we run a 24-hour hotline
.
So if any of our clientsexperience any issues 24 hours a
day, they can pick up a phoneand they can phone us and they
get help.
So we can abort something likeketosis from sliding to
(06:53):
ketoacidosis, which wouldrequire admission.
Speaker 1 (06:57):
Michael, what sort of specialists or specialties are
working at your education centerand also who staffs the hotline
?
Speaker 3 (07:06):
Yeah, we have a reasonably large
multidisciplinary teamendocrinologists, specialist
physicians, also general orfamily physicians, registered
nurses, registered dieticians,podiatrists, ophthalmologists,
audiologists.
Until recently, we had abiokinetic center.
(07:28):
Unfortunately, that is nolonger in operation.
It wasn't bringing in theincome to sustain it,
unfortunately, and I thinkthat's a great pity because we
recognize that physical activityis a major component of
diabetes care.
Sorry, the last question.
I just forgot that.
(07:48):
Oh, who starts the hotline?
Well, our doctors are veryprivileged.
They never do call theregistered nurses and registered
dieticians do the 24-hour calland once or twice a year I may
need to phone one of ourphysicians for help.
Otherwise we run it and we haveover the years, years,
(08:09):
prevented literally tens ofthousands of admissions.
We have saved literallyhundreds of lives and we have
made diabetes something that ismanageable in the community and
we've taken away much of theanxiety that people with
diabetes may face in anunsupported setting.
Speaker 2 (08:30):
Michael.
Can I just expand on that,Because I find this absolutely
fascinating.
What are the sort of commonquestions that people with
diabetes are asking when theyphone up the hotline?
Are they really close to theedge of catastrophe or are they
asking very reasonable,practical lifestyle questions or
drug questions?
(08:50):
What are the sort of commonthemes?
Speaker 3 (08:53):
It's a full gamut so, ranging from a 2 o'clock in the
morning phone call saying I'mout to dinner.
I've just had a slice ofcheesecake.
How many units should I injectTo?
I have been vomiting for thelast five hours to.
I have been vomiting for thelast five hours.
I have three plus ketones andI've got chest pain and you can
(09:20):
hear them puffing like a steamtrain on the other end of the
line through to.
My husband is in a hypoglycemiccoma on the carpet.
What do I do?
First question I ask is hebreathing?
And that's something that mosthealthcare professionals forget
is that cardiovascular diseaseis one of the highest forms of
causes of mortality in type 2diabetes, and so we must never
forget those basics.
(09:41):
Once I've established that heis actually breathing and has a
pulse, then we can get on andtreat the hypoglycemia or start
CPR and treat the hypoglycemiaor start CPR?
Speaker 2 (09:49):
What about in children, do you say?
Parent families of childrenwith diabetes, do they use this
hotline?
Speaker 3 (09:56):
Yes, yes.
So in the past we saw bothchildren children from about the
age of eight years and all theway through to the older person.
In the last 10 years we'velimited well, our doctors have
limited the practice to peopleover the age of 16 years.
So I have in the past hadextensive experience in managing
(10:18):
a hotline in a pediatricsetting and again we had a whole
gamut of experience.
But again I can proudly saythat we were able to calm down
very hot temperatures within afamily setting to enable
children to continue theirschool life, to attend exams,
(10:40):
and maybe that was one of thereasons why they phoned the
hotline was to try and get outof doing the exam.
We are pretty good at what wedo and they could attend this
exam, much to their chagrin, Ithink.
But our job is to help peopleto attain the optimum sense of
balance in their diabetesself-management and to achieve
(11:02):
their optimum potential as humanbeings, and we do that with
great passion.
Speaker 1 (11:08):
Michael, you're in Africa.
Do you see a different mix ofpatients than what you've read
are seen in other parts of theworld, or are there any types of
diabetes that might be unusualin the US that might be common
in Africa?
Speaker 3 (11:25):
I don't think so, david.
I think we have.
You know, with the massmigration that has taken place
across the world, I think thatmost healthcare professionals
are seeing a wide gamut ofethnicities and country origins
(11:53):
very mixed society for decades,so we see a wide range of people
.
I think what we do have quite alot of experience in South
Africa in is in the treatment ofSouth Asian or Indian people,
given that we have lower cutpoints for determination of what
we might call obesity oroverweight in that population
and waist circumference and soon.
And we see a lot of people whophenotypically are slim but they
(12:16):
have excess visceral fat andthey would present with type 2
diabetes.
So within our Asian populationwe see high rates of diabetes.
I think the other thing that,with our large population with
an African ancestry, we are veryattuned to cultural differences
in how we perceive the causesof health issues.
(12:40):
So in Africa there's oftenideas of fatalism, that things
just happen to you and thatthere's nothing, you have no
personal agency over whathappens to you, or that maybe
there's been some sort ofwitchcraft involved, in which
case you may need a traditionalhealer or sangoma to help guide
(13:02):
you through the treatment, andso we're very well aware of
these kinds of phenomena.
We realize that about 80% ofour clients of African ancestry
will, concurrently seeing us,will see a traditional healer,
and so that means we've got tobe aware of this.
We don't judge it.
And we don't judge it becausewe want them to tell us about
(13:24):
all the herbs and traditionalremedies that they are taking,
so that we can assess anypotential interactions between
those therapies and our moretraditional therapies.
Speaker 1 (13:36):
Are there any foods that are popular in Africa that
affect glucose either favorablyor unfavorably, that are not so
common in other parts of theworld?
Speaker 3 (13:46):
I don't think so.
I think the experience isfairly universal.
One of the staples here?
Don't think so.
I think the experience isfairly universal.
One of the staples here is cornor maize we would call it
mealies here which is groundinto a flour or eaten off the
cob, which is obviously ahealthy alternative if it's
grilled.
But most of our foods are basedon maize meals and there's a
(14:11):
large intake of carbohydrates,large intake of sweetened cold
drinks yeah, very largecarbohydrate intake and also
high or large portion sizes,which obviously doesn't help.
Speaker 2 (14:26):
Very similar to what we see here in the United States
.
Absolutely, yeah, sadly that'sthe case.
Michael, what about what you'redoing with your education
program and your podcast series?
Do you want to just tell us alittle bit about what you're
doing in that space, getting themessage out For sure?
Speaker 3 (14:48):
So that's something I have learned over the years
that life changes more rapidlythan you can conceive, and with
COVID, we as an academy had todo an about turn on how we
traditionally did education.
So before that, we did contactcourses both with people with
(15:09):
diabetes and with healthcarepractitioners.
The COVID pandemic and thesubsequent lockdowns, which were
quite prolonged in South Africa, stopped that and to keep us
sustainable, because we had tokeep the lights on somehow, we
pivoted very quickly to onlinelearning.
We started an online course forhealthcare practitioners.
We started an online course forhealthcare practitioners and
(15:37):
then last year, following thepandemic, we realized that we
needed to get with the programin terms of electronic
communication.
So we started our podcast, notArtificially Sweetened, which is
currently now has listeners in32 countries.
We're very grateful to knowcountries we're very grateful to
know, and the podcast, I think,is unique in that it is a that
is designed to bring both healthcare practitioners who have an
(15:58):
interest in diabetes and peoplewith diabetes and their families
together in one environment sothat we can speak to each other.
We can learn from each other.
We also know that a lot oflearning nowadays in the modern
world takes place through audioor video sources, and that much
learning is social.
(16:19):
And so we thought that was anatural extension of modern
learning techniques, and that'swhy we went to Dr Stan Landau,
who I work with.
He came to me end of Januarylast year and he said Mike, I
think we need to start a podcast.
I didn't know the first thingabout podcasting.
By 16th of January, 16th ofFebruary last year, I think, we
(16:40):
all released our first one, andwe are.
Yes, last night we recordedepisode 54.
So it's been a lot of hard work, but I've been absolutely
amazed by the quality of theguests we have featured over
(17:01):
those 54 episodes, whether theybe healthcare practitioners,
whether they be policymakers andespecially people with diabetes
, because what we want toshowcase, especially for people
living with diabetes, is thatdiabetes does not need to hold
you back.
And so we've interviewed acommercial airline pilot,
(17:24):
jonathan collins, who is acaptain of a commercial airliner
in south af, and his advocacyfight to regain his wings after
he lost them after the diagnosisof type 1 diabetes.
So, drawing on policy from allover the world for similar cases
, he was able to change theSouth African law regarding
(17:46):
pilots and commercial flying andmany other extreme athletes,
people who are academics,artists, whatever just
incredible people, and I thinkthrough their stories we've been
able to provide some realanswers to some of the questions
that many people with diabetesand their practitioners face on
(18:08):
a daily basis with diabetes andtheir practitioners face on a
daily basis.
Speaker 1 (18:14):
Michael, this is a very interesting story that
you've told us today about beingan educator in South Africa,
and I would like to thank youfor spending this time with us.
I plan to listen toArtificially Sweetened now that
I've learned about it, and we'llkeep in touch.
Thank you, david.
So, on behalf of Dr Kerr andMichael and myself, thank you
(18:36):
for listening to DiabetesTechnology Report.
This podcast is available onSpotify and the Apple Store and
the Diabetes Technology Societywebsite.
So until our next DiabetesTechnology Report, have a nice
day.
Goodbye everybody.
Speaker 2 (18:52):
Thank you, thank you very much indeed.
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