My mother has dealt with Type II Diabetes for over seven years now. These are the years I know of. We do not know for how long she was in denial. Perhaps reality struck her when a low blood glucose episode hit her so hard that she collapsed on the streets of Soweto slums, Kayole. She was rushed to the hospital by touts and drivers plying the Kayole-Soweto-Central Business District route in Nairobi.

Later, she would start taking anti-diabetes medications. You may think that being a nurse, I should have been fully equipped to understand and manage this condition for mother dear. I was not. In fact, unless a healthcare provider intentionally studies diabetes and its new guidelines in management, we continue offering obsolete  and archaic care to our patient. New hard drives with old software. Disastrous.

Pointedly, I was not sure what the target blood glucose for mum was and nobody bothered to explain it to her. Sometimes in 2020, mum would get a severe infection of a tooth. This particular tooth had been giving her terrible nights and uncertain days. It managed to get infected. This was during the biting pangs of Covid-19 when Kenya was fighting back as the resilient nation she is. Part of this war against the unseen enemy, Covid-19, was travel restrictions between counties. Mother dear would not be able to cross from Murang’a County to Kiambu County where I wanted her to get attended from.

My sisters frantically explained how sick mum was and how worried they were. I appealed for help in a Kenyan Nurses’ WhatsApp group. Through the intervention of the Kiambu County Director of Nursing Services madam Betty Kasyoka, Mum was attended to. Further, Betty referred me to a Diabetes Nurse at Thika Level 5 hospital. I did not even know we had those in Kenya.

After healing her tooth, mum met with the Diabetes Nurse at Thika level 5 hospital as advised. I remember how worried I was about her. I love my mother. Perhaps you do too. However, my relationship with mother dear was not always peachy. Since restoration, I became quite attached to her and anything messing with her well-being messes with my head. This naturally rattled me.

Mum’s medications were changed, and this was a new lease of life for her. She started  actively managing diabetes. At the same time, I enrolled for a short diabetes course with the Kenya Diabetes Study Group. Further, I took a module at the University of Derby, England  on Diabetes. I deliberately opened myself up to allow new knowledge on Diabetes to seep into my brain. Of all the good decisions I have made in my life, this was one of the best.

As the wonderful team at Thika Level 5 followed up on my mother, I buried myself in books. I wrapped myself in Diabetes’ news and updates. I listened and soaked in a tub of sweet lectures and questions. I decided to not only know something about kidney disease but also pay extra attention to diabetes. I desired to know what is current and applicable to my mother. I did this for her. For us.

One of the topics covered by the diabetologists that I interacted with was food. How there was nothing like a diabetic diet. This was a shocker for me. I mean, was I not taught that people living with diabetes have a diabetic diet? Piece by piece, renowned dietitians and nutritionists from Kenya and the United Kingdom busted my myths and toxic beliefs.

I kept sharing this information with my mother. Mum’s dream was to be a nurse. She therefore loves everything medical. However, I am still one of her babies. Babies do not know anything. They are to be seen and not heard. There is no winning for me with mother dear.

Having been taught on self-monitoring of blood glucose, mum kept a diary of the blood glucose trends. I would ask about them  every once in a while. One day, she told me her fasting blood glucose was 19.0mmol/l. For anyone, this is HIGH. High blood glucose exposes you to several complications including heart disease. I was not having it. I know of a great diabetologist somewhere in Nairobi City. I felt it was time for an immediate review for mother dear. I felt that her medications were not working as they should. This was my honest opinion.

My two sisters would then take mum for her review. I particularly want to talk about my younger sister, Miriam. Miriam studied Nutrition and Dietetics. She outdid herself in college. She patiently accompanied mum for the review. Later on, the diabetologist prescribed an additional medication for two weeks and informed mum that at the rate were going, we would need to add some more medications. Her glycated haemoglobin level, the ultimate test that tells us how the blood glucose has been for the past three months beyond the normal limit. This test is what predicts the susceptibility to diabetes complications. The consultant was rightfully concerned as I was.

What followed remains to be one of the proudest moments of my life. Miriam had just completed her studies and so she was staying home with mother dear. She called me one day.

“Shishterr’” she started. ‘Shishterr’ is how we address one another. “Mum’s problem is not the medications. It is the food.” She declared.

“You have been to school Shishterr, what can you do about it?” I challenged.

That was the fuel Miriam needed for the fire. She came up with a meal plan for mum. She bought plates to measure food portions. She helped mum to know which food items were high in glucose content.

When I attended the Diabetes training programs, the examples of food mentioned were all too expensive to buy. Naturally, I had my Black Tax concerns.

Miriam changed my perspective, she worked with what was available at home. The ugali, rice, vegetables, dry legumes, occasional fruits, water and every other edible item at home is what she used to revolutionize mum’s diet. Mum was taught the practical meaning of food portion and glycaemic index. She knows that sugar is not to be feared but controlled. We are to avoid both high sugars and low sugars in the body. Everyone living with diabetes must know this. Everyone caring for someone with diabetes must live this truth.

After the two weeks, mum had to stop the extra medication the diabetologist had prescribed as she was now experiencing severe lowering of the glucose. This is because bespoke food intake was the miracle mother dear needed. I am proud of the trend of blood glucose.

Later on, a friend would disclose to me that her dad was diabetic as well and needed advice on food intake. I was so proud of my kid sister that I happily gave out her number to my friend. Miriam worked with what was already available at my friends’ home.  Needless to say, there has been a massive shift from high blood sugars towards normal blood glucose in my friend’s dad.

Miriam has so far helped three children in our rural village get medical attention for severe malnutrition. Closer home, I always thought my nephew was of a small build. Miriam the professional dietitian and nutritionist diagnosed him as underweight which she attacked with all the love of an aunt. My nephew gained three kilograms in a month! His appetite has also improved. There is no special diet that was employed. Miriam simply works with what is there and to me, this is her magic.

As a fresh graduate, she is yet to land formal employment. Yet her hands are not folded, and head cast down in despondency courting handouts. She has the zeal I wish I had as a fresh nursing graduate. I am sure I could have employed myself. Miriam is a breath of crispy clean air in the youths of today. She motivates and challenges me. Just do not tell her lest she gloats.

“Shishterr,” she quipped when I asked her why nutrition and not nursing like myself. “I believe food is medicine if we treat it well. I just want to know how to go about that.”

I could write a book on this girl. Yet I will let her work speak for her. For all your nutritional concerns, Miriam Maina, a pocket-friendly,  professional nutritionist/dietitian is the person you are looking for.

Reach her on +254 727 213 299.

Email Address: nyawemaina@gmail.com