The balancing actress

Posted on 7 July 2014

Keketso Semoko talks about the many balls she juggles as she walks the fine line that is living with type 2 diabetes.

Words Margot Bertelsmann

In March 2011, actress Keketso Semoko was experiencing one of the busiest periods of her life. Ma Agnes, the character she plays in the SABC3 soap Isidingo, was getting remarried to her rogueish husband, Zeb – which meant huge scenes and long hours on set for Keketso. ‘I wasn’t aware of it, but I’d contracted bronchitis from a colleague,’ she recalls. ‘I became so ill that none of my GP’s interventions and medications was working. I kept having these huge fever spikes and I felt awful.’ Keketso returned to the doctor and was immediately admitted to hospital as she had an irregular heart beat. Keketso, a confirmed type 2 diabetic, who had by then been living successfully with her condition for six years, was told she’d had a mild heart attack. ‘It turned out my beta cells had almost entirely stopped producing insulin – there was nothing sustaining me.’

Turning point
Keketso had been taking oral medication and now needed to start injecting insulin as well. However, she knew she would have to make other changes to preserve her health. In Keketso’s case, diabetes runs in her family. When she was diagnosed in 2006, ‘the first emotion was disappointment: I thought I may have escaped the condition. What helped me was to think of the worst-managed diabetes cases I knew of, and to think, “I have to be better than that. I have to be sensible.” My brother was diagnosed five years before me and he is healthy. He became a mentor to me.’

A nationwide issue
‘While we have no accurate figures, the estimated prevalence of diabetes in South Africa ranges between four and 13% depending on the population group being studied,’ says Dr Alkesh Magan, a specialist endocrinologist who practises at Mediclinic Sandton. ‘This may be an underestimation as some are undiagnosed. It is a racially based disease, with Indian South Africans showing the highest relative incidence.’

Diabetes can be diagnosed by doing a blood or urine test to measure the amount of glucose in your body. Dr Magan says pre-diabetes is  diagnosed at a fasting glucose reading of 6-7mmol/L (millimoles per litre) or a glucose tolerance reading (a reading after having eaten) of higher than 11mmol/L. ‘The consensus is that at this stage of the disease, lifestyle modifications can hugely impact whether or not full-blown diabetes will develop,’ says Dr Magan.

The pillars of a diabetes-friendly lifestyle are monitoring your blood sugar, staying at a healthy weight, getting enough exercise and rest. You also need to eat a diet rich in healthy foods including complex carbohydrates with a low glycaemic index, which release sugar slowly into your blood stream. If you are prepared to make significant adjustments to your lifestyle, attain and maintain a healthy weight, exercise and eat a strict diet, you can counteract your body’s trouble with insulin to some extent. As Keketso says, ‘You can’t walk away from diabetes or be cured. It’s a long-term illness. I have to deal with it and walk the journey every day.’

‘There’s no such thing as a “touch” of diabetes,’ confirms Dr Magan. ‘One of the diabetes myths is that it’s a self-limiting disease. It’s not. It’s different to a cold or a cough. Patients have to accept responsibility for their disease no matter how much they would prefer to remain in denial.’ You can manage the disease even to the extent that you have no symptoms of ill health. But you can’t ‘magic’ away the diabetes diagnosis. To have no symptoms you will have to make significant lifestyle changes, and even so you are probably merely delaying the time until you need to start medication.

Moving on
After the heart attack, Keketso prioritised destressing. While she had been used to following strict rules regarding diet, rest and exercise for the past six years, she knew she was anxious and strained. ‘Last year I started doing yoga. I learnt about breathing, to calm yourself even when you have a shock. It’s become very important to me,’ she says. ‘And every morning, I do stretches, cardio, lift some dumbbells, and I walk. We spend so much time on our feet at work, which can lead to water retention and joints swelling. Exercise really helps with that. And I know that I can’t sleep less than six hours a night. If I’m able to take a nap in the day I do.’ She also guards her downtime. ‘Over weekends, I don’t want to do work or interviews. I just want to be at home. And I insist on doing the cooking at home so I know exactly what’s going into the food!’ she laughs.

You are what you eat
In fact, muses Keketso, ‘Never in my life have I had to think so much about food. With diabetes, you don’t just open the fridge and take. You constantly plan and think, and read the labels. If the restaurant doesn’t have low-GI bread, I have half a slice of the ordinary bread. If I have just so much as a milkshake, I know I need to be extra strict at the next meal, and the one after that, to keep my sugar stable.’ Even at work, if a scene requires Ma Agnes to eat, the art department has to be briefed to ensure it is food Keketso could safely consume. Her new lifestyle required a complete food re-education. Fortunately, she was able to hire a dietician to help her get started.

There’s one last aspect to taking good care of yourself if you have diabetes. ‘Be able to recognise and treat the symptoms of both high and low blood sugar,’ says Dr Magan. ‘Have your feet and vision examined regularly, as retinopathy is associated with diabetes, which can
lead to blindness, as well as peripheral neuropathy, or numbness. A person with poorly controlled diabetes might step onto a nail and not feel it, with obvious infective dangers.’

It’s working for Keketso. She’s full of energy for the year ahead. ‘I’m doing some producing, looking forward to appearing in a theatre play and I’ve just finished shooting the movie Makoti for Multichoice. Plus, there’s the possibility of a cooking show and a magazine column.’

Hidden dangers
Beware of foods that sound benign but aren’t. ‘Fruit juice sounds like a healthy choice, but it isn’t,’ Keketso cautions. ‘One hundred percent juice also means 100% sugar. Avoid! Some days I feel virtuous because I’ve eaten a lot of vegetables, until I remember it was mostly pumpkin. Pumpkin is only a mid-GI food, and I need to be careful with it. It’s constantly a huge balancing act. But because I know it’s worth it, I eat what I know is good for me.’

Live life
As an actress, Keketso is on the road regularly. To guarantee safe eating, she usually has her own travel pack. Here’s what she packs:


• A low-GI peanut-butter sandwich
• A packet of nuts
• A plastic container filled with green salad – no dressing, of course!
• An apple (green, as red ones contain too much sugar)

The information provided in this article was correct at the time of publishing. At Mediclinic we endeavour to provide our patients and readers with accurate and reliable information, which is why we continually review and update our content. However, due to the dynamic nature of clinical information and medicine, some information may from time to time become outdated prior to revision.