Diabetes Spring 2016

Diabetes Spring 2016

Living well with diabetes

Brett McGregor

ON FOOD, FRIENDS, FAMILY & DIABETES

T1 or T2?

Diabetes differences matter

Support4kids SUMMER CAMPS ROCK

your stories + eyes on diabetes + incidental exercise

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Diabetes: the national magazine of Diabetes New Zealand | Vol 28 no 3 Spring 2016

INSIDE spring 2016 From the President

Care and prevention

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22 Stroke: Think FAST and

Here to help

save a life

Upfront

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32 Diabetes in a disaster: Are you prepared?

Diabetes news

Your Diabetes NZ

COVER PHOTO: BRETT MCGREGOR © AARON MCLEAN WWW.AARONMCLEAN.COM

Cover story

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28

rett McGregor: Tackling B diabetes for his friend

Community

10 27 Foot check competition The Good Samaritan

18 Donate4Diabetes Living with diabetes

19 Raewyn Bhana: Still here!

33 Jenni Rowell: 60 years on insulin

Food and nutrition

Opinion

12 Diabetes differences matter Families and children

14 Kids’ diabetes book 23 Summer camp support International

20 The high fat/low carb

Recipes

Gardening

28 Heart-healthy breakfasts

diet debate

24 Herbs in small spaces Branch spotlight

26 Otago: Heart of the

16 World Diabetes Day:

community

Eyes on diabetes

Let’s get active

30 Get jiggy: Incidental exercise The Ruby McGill column

34 We’re having a baby!

Giveaway We have 10 packs of Scholl Eulactol Heel Balm Gold 120ml to give away.

The heel balm effectively restores rough, dry and cracked skin. It promises to work in seven days with visible results in three days. To enter please email your name and address to admin@diabetes.org.nz by 1 October 2016 with the keyword FEET.

Diabetes magazine EDITOR Caroline Wood editor@diabetes.org.nz PUBLISHER Diabetes New Zealand DESIGN AND PRINTING Kraftwork, Wellington ADVERTISING John Emmanuel john@affinityads.com or 09 473 9947 MAGAZINE DELIVERY ADDRESS CHANGES Freepost Diabetes NZ, PO Box 12 441, Wellington 6144 Telephone 0800 342 238 Email: admin@diabetes.org.nz ISSN 1176-4406 Disclaimer: Every effort is made to ensure accuracy, but Diabetes NZ accepts no liability for errors of fact or opinion. Information in this publication is not intended to replace advice by your health professional.

Editorial and advertising material do not necessarily reflect the views of the Editor or Diabetes NZ. Advertising in Diabetes does not constitute endorsement of any product. Diabetes NZ holds the copyright of all editorial. No article, in whole or in part, should be reprinted without permission of the Editor.

Diabetes New Zealand is a national charity trusted to provide leadership, information, advocacy and ongoing support to people with diabetes, their families, and those at risk.

Our aim is to help all New Zealanders with diabetes live well and have access to high-quality services that meet their needs.

We have a network of branches across the country that offer diabetes information and support in their local community.

Donate now online

www.diabetes.org.nz

or call

0800 DIABETES (0800 342 238)

E D I TO RI A L | F R OM T HE PRES IDEN T

Here to help As I write this we are entering the coldest part of the year and what is proving to be a very busy period for Diabetes New Zealand.

It is the time of year that financial budgets are confirmed and work plans commenced for the coming year. As a charity, work plans are just that – plans – until we are able to source the funding to make them a reality. There is an ongoing need to fundraise to help our branches continue to provide support and information.

This is where you can help.

Your donations, large and small, keep the doors open and help branch staff and volunteers to be there when they are needed with advice, support, information and programmes for people with diabetes, their families and friends.

There are many examples of programmes, past and current, that have only been made possible by the generosity of members and non-members alike. Those who have dropped money in a fundraising bucket, sent in a donation or left a bequest to a local branch, or to the wider organisation of Diabetes New Zealand.

For example, your donations helped establish and support the Dunedin Community Exercise Programme for people with diabetes, now in its eighth year.

Your donations have also enabled support groups to continue to operate across the Auckland region. They have helped fund a drop-in centre in Invercargill, which is staffed by a Field Officer on a weekly basis. Donations and bequests have helped fund our Horowhenua branch’s awareness work by allowing its volunteers to have a presence at many public events in its area. There are many more similar examples from across New Zealand.

There are now more than 260,000 people in New Zealand with diabetes and every day more people are diagnosed. Diabetes New Zealand is there for all people affected by diabetes at both a national and a local level. We need the continued support of people like you to maintain and improve the services we offer.

On another matter, we are in the middle of the consultation period on the proposed changes to the Constitution, and as you read this we will be in the process of collating all of the feedback received. Once this is done a final version will be made available and put to the AGM in November for approval.

Finally, stay warm and safe for the remainder of winter and ready yourself for the refreshed and exciting new look magazine that will be coming your way for the next issue. We hope you will like it as much as we do.

Thank you to all of you for your ongoing support.

Deb Connor President, Diabetes New Zealand

See our website for advice, tips and ideas on how to live well with diabetes: www.diabetes.org.nz

JOIN DIABETES NZ TODAY! Diabetes New Zealand PATRONS Lady Beattie and Sir Eion Edgar PRESIDENT Deb Connor CHIEF EXECUTIVE: Steve Crew DIABETES NEW ZEALAND INC. NATIONAL OFFICE Level 7, 15 Murphy Street Thorndon, Wellington 6144 Postal Address PO Box 12 441, Wellington 6144 Telephone 04 499 7145 Fax 04 499 7146 Freephone 0800 342 238 Email admin@diabetes.org.nz

Our great value membership includes a free subscription to Diabetes magazine, regular newsletters and support from your local branch. Members also receive a 10% discount on any product at our shop: www.diabetesauckland.org.nz/shop Join now online www.diabetes.org.nz or call 0800 342 238

Check out Diabetes NZ on Facebook and Twitter for latest news and events

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DIABETES | Spring 2016

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U P F R O N T | DI ABET ES NEWS

New Zealand’s Diabetes Action Month kicks off on 1 November 2016 and will incorporate this year’s global theme Eyes on Diabetes. The aim is to raise nationwide awareness and understanding of diabetes and raise funds so Diabetes New Zealand can continue its vital work supporting people with diabetes.

Please have a think about how you could help raise awareness about diabetes and encourage people to live a healthy lifestyle during Diabetes Action Month, either by supporting your local branch or as an individual.

“We are currently planning for this year’s events and encourage branches to use this as an opportunity to organise local fundraisers and get out into the community during November to raise awareness, make people aware of the vital face-to-face support they offer and rouse their networks to Join the MoveMeant.”

PHOTO WWW.ATTITUDELIVE.COM

DIABETES ACTION MONTH

Show exposes harsh reality

Chief Executive Steve Crew said: “We were bowled over by the success of our first ever Diabetes Action Month last year. We were able to connect with thousands of Kiwis from all over the country during our Join the MoveMeant roadshow and raise the profile of diabetes in many communities. We were pleased with how many people connected with our messages about the need for everyone with diabetes, whether it’s type 1or type 2, to keep active and live a healthy lifestyle.

How can you help?

• Offer a few hours of your time to help your local branch organise a Diabetes Action Month event.

• Organise a mini diabetes awareness event during November in your community/ workplace/school.

• Download the IDF’s posters and distribute in your community, see www.idf.org/wdd-index/ • Share your diabetes story with Diabetes NZ – contact admin@diabetes.org.nz.

• Fundraise for your local Diabetes New Zealand branch.

• Donate to Diabetes New Zealand via www.diabetes.org.nz and • During November, take part in a Diabetes Action Month event near you.

First world leader

Diabetes Conference and AGM

The new Conservative British Prime Minister, Theresa May, is the first ever world leader with type 1 diabetes.

Dr Tom Mulholland is on a mission to make New Zealand healthier and happier. He is also the keynote speaker at Diabetes NZ’s conference and AGM on 26 November at the West Plaza Hotel, in Wellington.

The appointment of a British Prime Minister who just happens to have type 1 diabetes will likely provide inspiration for people with diabetes who feel limited by the condition, says the website Diabetes.co.uk.

The Auckland City hospital Emergency Department doctor decided to go on the road for five years in his retro ambulance trying to prevent health problems before they get to a crisis point.

The Disease That’s Killing My Family is a five-part series from Attitude that explores the rise of type 2 diabetes in New Zealand, debunks some myths and tells intimate personal stories.

One person featured is Once Were Warriors actor Brian Kairau, who describes his battle with a host of diabetes-related health issues. Sadly he died in June aged just 52 shortly after the show aired.

The series also features experts Sir Peter Gluckman and Dr Michael Mosley who discuss their views on the current food environment and visit Samoa, where diabetes rates have skyrocketed in recent years.

If you missed the original shows, you can still see them on AttitudeLive.com.

Dr Tom promises to be one of the highlights of the conference, which also includes a workshop on the latest technologies, including Dexcom 5, a branch poster competition and the chance to meet leaders in the diabetes community.

Registrations will be open soon – visit our website for more details www.diabetes.org.nz.

Keep up to date: Sign up for regular Diabetes New Zealand email updates – email admin@diabetes.org to go on the list

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DIABETES | Spring 2016

D IA BE T E S N E WS | U P F R O NT

Diabetes up by a third

Auckland’s health inequities

More than 260,000 people are now living with diabetes in New Zealand according to the latest government estimates. That is an increase of nearly 33% in the five years since 2010 and equates to an additional 64,000 people. The table below shows where they live.

Residents of South Auckland are nearly two times more likely to suffer from diabetes than those who live 25km across Auckland on the North Shore. In a study that looked at diabetes distribution across electoral districts in the Auckland region, researchers found that geography matters.

The Virtual Diabetes Register is an estimate of national diabetes prevalence. It doesn’t differentiate between people with type 1 and people with type 2 diabetes.

Nor does it include people with prediabetes. The figures are collated annually at the end of March and represent an estimate as at 31 December of the previous year.

VIRTUAL DIABETES REGISTER 2010 AND 2015 YEARS DHB domicile

2010

2015

Auckland

19,615

27,484

Bay of Plenty

10,162

12,016

Canterbury

18,625

22,558

Capital and Coast

9,798

13,861

Counties Manukau

28,565

41,982

7,028

8,612

6,112

8,281

Lakes

4,608

6,080

MidCentral

7,032

9,026

Nelson Marlborough

5,437

6,432

Northland

8,705

11,845

South Canterbury

2,952

3,452

Southern

12,534

15,355

Tairawhiti

2,824

4,364

Taranaki

6,587

7,616

Waikato

17,151

22,497

Wairarapa

2,036

2,357

Waitemata

21,447

30,931

West Coast

1,228

1,388

Whanganui

3,249

3,913

439

408

Hawkes Bay Hutt

Unknown/Unassigned Total

196,134 260,458

The highest rate of diabetes was 17.3 percent in Mangere and the lowest was 3.2 percent on the North Shore. This difference persisted after adjusting for age, gender and ethnicity.

at the University of Auckland. The research results were published in June in the NZ Medical Journal.

The study looked at the data from 63,000 people aged 30 years and over who were diagnosed with type 1 or type 2 diabetes in 2011. The diabetes prevalence in the Auckland region was close to the national average at 8.5 percent.

“To our knowledge, this was the first study to look at the diabetes distribution by electorate and we found those with the greatest risk of diabetes fell within the boundaries of the Counties Manukau DHB,” says study leader, Dr Daniel Exeter from Epidemiology and Biostatistics

Diabetes NZ Annual General Meetings West Coast Branch 24 August 2016, 1.30pm St. Patrick’s Parish Centre, High St, Greymouth Ashburton Branch 25 August 2016, 7.30pm Senior Citizen Hall, Cameron St, Ashburton Taupo Branch 12 September 2016, 10.00am Central Plateau REAP, 73 Titiraupenga St, Taupo Auckland Branch 20 September 2016, 5.30pm Diabetes NZ Auckland Office, Level 2, 92-94 Beachcroft Ave, Onehunga Waikato Branch 27 September 2016, 7.00pm Hamilton Combined Returned Services Club, 50 Rostrevor St, Hamilton

Horowhenua Branch 28 September 2016, 7.00pm Memorial Hall, Chamberlain Street, Levin Southland Branch 29 September 2016, 5.30pm Invercargill Workingmen’s Club, 154 Esk St, Invercargill Taranaki Area Branch 11 October 2016, 1.30pm St John Hall, Regan St, Stratford Diabetes New Zealand 26 November 2016, 11.00am West Plaza Hotel, 100 Wakefield St, Wellington Diabetes Youth New Zealand 26 November 2016, 10.00am West Plaza Hotel, 100 Wakefield St, Wellington

Spring 2016 | DIABETES

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COV E R STO RY | BRET T McGREGOR

Celebrity chef Brett McGregor lost one of his best friends to diabetes and decided he needed to do something to help. By Caroline Wood.

Brett McGregor is a dynamo, when he’s not cooking up a storm on TV, he’s writing books, developing new food products, volunteering in schools, being a trade ambassador, and most recently travelling to China to promote New Zealand’s sustainable seafood.

When I talk to him on the phone, he’s just finished a TV series Taste of a Traveller and is about to jet off to Thailand to help build stronger trade relations. His next book Chop Chop comes out in August and he’s working with KidsCan to develop a new app. At some point later this year he will fit in a holiday to America with his family.

It’s clear that family, friends and children play a central role in Brett’s

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DIABETES | Spring 2016

life, which was transformed in 2010 when the former deputy principal won New Zealand’s first series of MasterChef and became a household name overnight. TV appearances, books and product endorsements followed. But he also donates a lot of his time to good causes.

Brett has been a men’s health ambassador for several years and promotes healthy eating in schools.

More recently he has turned his attention to diabetes after one of his best friends died of type 2 related complications.

He teamed up with Diabetes Projects Trust in South Auckland to deliver its Keep Calm and Learn to Cook programme, which sees Brett going into schools to encourage kids to think outside the square and try new food.

“We achieve that by getting them involved with a cooking demonstration, they get to sample all the food and take simple recipes home, along with a spice rack and goody bag.

PHOTO © GUY QUARTERMAINE

KEEP CALM AND LEARN TO COOK “It’s about trying to get our younger generation thinking about making the right choices, understanding what they put into their bodies and eating seasonally. We find that many are inexperienced when it comes to nutrition.”

So far Brett has visited 20 schools over two years, engaging with more than 3,000 children at both primary and high school. He hopes that some will be encouraged to cook and eat homemade foods, rather than nip to the corner dairy to buy a pie or fizzy drink.

“High school kids are harder to change as habits are ingrained.

But if I can get in to see younger kids I can see more of a change in them,” he says.

And Brett should know because he was a teacher before he won MasterChef and his brother is still a teacher in Wellington.

Brett explains why he teamed up with Diabetes Projects Trust two years ago.

BR E T T McGR E GOR | COV E R STO RY

“I got involved because one of my best friends had type 2 diabetes but he didn’t make the right choices and he didn’t look after himself and was probably lacking a bit of knowledge and skill in the kitchen.

He liked convenience food.

“He was 42 years old when he died of diabetes-related health complications late last year. He lost half his leg above the knee, he lost the vision in one eye, his kidneys failed and finally his heart gave way.

“I didn’t want to see anyone else go through that, it impacted hugely on his wife and family. But… it was preventable. I think it motivated me to try to get that message out there. There is help available, it’s about learning simple things.”

Brett acknowledges that this is incredibly difficult to do. Everyone is different so he just tries to

connect with people to help them make better choices themselves.

Family support is also important.

Brett first met his friend at the age of five. He was later diagnosed with type 2 diabetes as a teenager but didn’t actively manage his condition and control his blood sugars. He also struggled with his weight.

“I look at my friend and he was told many times by many doctors and others but they never connected with him.

“It’s important for the individual to realise what’s happening to their body, they have to want to make the change and understand what will happen if they don’t.”

Brett is determined to try to help the next generation of young people avoid the same fate as his friend.

Eating healthily on a budget Many New Zealanders are becoming more aware about healthy eating but money is an issue for a huge number of people and food is expensive, says Brett.

He promotes three key messages for eating healthily on a budget: Eat real – real homemade food, not convenience ready-made foods or takeaways Eat in season – seasonal food is cheaper to buy Eat Fresh – fresh is best when it comes to healthy eating Cooking is a skill that needs to be learned like other skills and Brett wants to be in that space – connecting with people and helping them cook simple, fresh, seasonal meals.

MEN’S HEALTH Brett has been a men’s health ambassador for seven years, working for a number of good causes, including prostate cancer awareness. He thinks it’s important for men, particularly in New Zealand’s many and varied cultures, to talk more about their health and try new food.

“I think the way men view food is different. My generation grew up with meat and three veg. The men I meet have been making a change, we’re talking more about our health and it’s out in the open.

Life has been nothing short of amazing for Brett McGregor following his 2010 MasterChef win. The former teacher now follows his childhood dream of working with food.

“I know when I was growing up it was very difficult but I do think men are getting better at it. I can see it in my son, and his friends, they are a lot more open to talking about their health and trying new foods. They are more conscious about their health.”

He says family support is important when it comes to improving men’s health through healthy eating and exercise.

For example, Brett admits he wasn’t a great exerciser but recently that has changed thanks to the influence of his wife.

He’s taken up running and completed his first half-marathon.

He was given a Fitbit to try during Men’s Health Week and that has been enlightening, he says, because he can see how little he sleeps! But he can also see how easy it is to keep active at home – he’s done 15,000 steps today and he’s not left the house.

Spring 2016 | DIABETES

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COM M U N I T Y | HE LP IN G E AC H OTHER

Would you stop to help someone who was staggering around looking drunk?

Jade Howard did and this is what happened next.

THE GOOD

SAMARITAN The 25-second video and Facebook post has done more to raise awareness of type 1 diabetes and how to treat a hypo than any other news story this year.

But Jade Howard says she’s no hero. She’s just glad she stopped to help, telling Diabetes NZ’s Chief Executive Steve Crew, when he called to congratulate her, “All I did was put it up on Facebook to raise awareness. I didn’t expect such a huge response.”

Back in May, Jade was driving in her car when she saw a woman staggering over the road and collapsing on the footpath.

“I would have been about 10 cars back before I actually noticed her stumbling about. I did initially think she was drunk or on drugs,” she told TV3 Story.

Pregnant mum Theresa Ale, who has type 1 diabetes, was on her hands and knees with people driving around her yelling abuse, tooting their horns assuming she was drunk.

Theresa was picking up her youngest son Jonasin, 6, from school when it happened. Her pregnancy was affecting her blood glucose levels,

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DIABETES | Spring 2016

masking the normal hypo signs.

“I couldn’t move and I knew I needed help,” she says.

Jade was the only one to stop out of dozens of people who saw Theresa in trouble.

“As I got closer I saw her son’s face and saw how scared he was and then I thought OK this isn’t right,” said Jade.

“Her son said very clearly, which I was really proud of, ‘my mum has diabetes, she needs something sweet’.

“I thought OK I need to get into action and get something done.”

Jade put Theresa into her car, gave her lollies and took her and Jonasin home.

Jade and Theresa were reunited on national TV in a touching Story episode about the kindness (and unkindness) of strangers.

Theresa seemed prepared to forgive people for not stopping to help, saying: “I’m sure people wouldn’t have shouted if they knew what was wrong with me”.

FACEBOOK

The short video of a young Kiwi woman stopping to help a pregnant mum having a hypo in Auckland’s East Mangere went viral and global, with 1.4 million views, 18,000 shares and nearly 8,000 comments.

Jade's 25-second video and Facebook post has done more to raise awareness of type 1 diabetes and how to treat a hypo than any other news story this year. my heart! …My reason for sharing this isn’t for likes or to boast. I guess it’s to raise awareness, to more or less say COME ON PEOPLE! love a little more! help a little more! be a little more selfless. What if it were your mum, aunt, sister or daughter!?”

But the fact people ignored Theresa, who could have fallen into a diabetic coma and died, makes Jade angry.

Jade says it’s important that people shouldn’t be judgemental or afraid to take action.

As she wrote on her now famous Facebook post: “While driving her home [Theresa] said ‘thank you so so much. I was AFRAID for my life but no-one would help me’. This broke

*You can see the video that went viral on www.diabetes.org.nz

“Even if you think you might come off as nosy, just do it anyway and you might save someone’s life.”

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O PINI ON | T I ME FO R A C HA N G E

DIABETES DIFFERENCES

MATTER

Diabetes Youth President Jacqui van Blerk calls for an end to the stigma attached to the generic term “diabetes” in the media.

It’s impossible to miss the news headlines broadcasting the increasing cost of lifestyle-driven obesity to the world at large. We’re constantly reminded of the growing diabetes epidemic, its longterm complications, and most significantly, its projected cost to the over-burdened tax system. Faced with this onslaught, we’re also advised to exercise more, cut back on sugar, and adopt healthier lifestyle choices…

Easy then to understand the confusion when I whip out a glucose meter and test my six-year old’s glucose levels.

“Isn’t she a bit young to have diabetes?”

“But she’s thin?”

“Did she have too many lollies as a baby?”

Sometimes, when it’s been a rough day, I shrug my shoulders and walk away, but mostly, I use the opportunity to educate.

Because sometimes, it’s important to know the difference between type 1, type 2 and gestational diabetes.

Because there IS a difference, and the more awareness there is, the less likely our type 1 kids and adults are to be diagnosed as a result of life-threatening DKA (diabetic ketoacidosis).

Diabetes is not just a lifestyle disease – the result of years of indulging in fast foods and couch-surfing. It’s a complex metabolic disorder with multiple causes, centred around the body’s inability to provide or process the correct levels of insulin for optimal health.

The tools we use to control all kinds of diabetes are similar – frequent blood glucose monitoring, injectable insulin, metformin and sulfonylureas. And the consequences of long-term erratic control (heart, eye, nerve, kidney and other diabetes-related complications) are devastatingly identical.

So why is it so important that we distinguish between the different types and causes?

Some would argue that the social stigma of the generic label of “diabetes” is sufficient to warrant more specific naming – that an auto-immune condition should not be lumped together with a condition sometimes brought on by overindulgence.

Jacqui’s daughter Melissa, who has type 1 diabetes, is constantly asked whether she “ate too many lollies as a baby”.

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DIABETES | Spring 2016

Perhaps there’s a measure of comfort in being able to declare that the diagnosis was not something we brought upon ourselves, or our children? In much the same way that terminology has changed to describe a “person with diabetes” rather than a “diabetic” – the condition doesn’t define the patient, because the current media definition of diabetes is a skewed, stigmatised, caricature of a much more serious disease.

TIME FOR A CHANGE | OP I NI ON

“Is that the ‘bad’ kind?”

There is no good kind of diabetes – each subset has its own set of challenges.

A woman with gestational diabetes faces the consequences of erratic control and its impact on her unborn child, and the equally uncertain future prognosis of developing type 2 diabetes later in life.

Children with type 1 diabetes and their carers deal with the challenge of a lifetime reliance on insulin (either by injection or pump) and the emotional impact of a chronic health condition. Most will experience diabetes burnout at various stages of their lives.

“We need to demand that the media and the Ministry of Health specifically state which form of the disease they are referring to.”

People with type 2 diabetes deal with the burden of the media crusade against sugar and the increasing perception that this is something they should be able to shake as easily as a head cold, simply by signing up to the local gym and eating more leafy greens. And let’s not forget the cinnamon…

It’s abundantly clear that there’s a lot of confusion and misinformation about what causes diabetes, and how to successfully manage it, and that this confusion is causing a rift amongst the people who deal with its impact on a daily basis.

The Ministry of Health’s 2015 Living Well with Diabetes plan clearly indicates a requirement for dealing with the growing incidence of type 2 diabetes and the importance of meeting the needs of adults and children with type 1 diabetes. In particular around coding and data collection to differentiate between outcome measures for type 1 and type 2 diabetes. It also talks about the need to upskill the health workforce to improve its knowledge and treatment of type 1 diabetes.

As a community, we should unite despite our differences, providing the support and empathy that comes from sharing the indignities of finger-pricks and unexpected hypos, from bodies that refuse to comply even with military control.

We all deserve compassion and dignity, regardless of the cause of our condition. And yet, we need to demand that the media and the Ministry of Health specifically state which form of the disease they are referring to. A good start would be the Ministry of Health’s Virtual Diabetes Register differentiating between type 1 and type 2 diabetes rather than lumping them both together.

www.diabetes.org.nz

Corporate Membership Diabetes New Zealand’s mission is to provide support for all New Zealanders with diabetes, or at high risk of developing type 2 diabetes, to live full and active lives.

Being a corporate member of Diabetes New Zealand connects you with over 260,000 New Zealanders living with diabetes and the one in four with prediabetes.

Our website attracts nearly 400,000 users per year with over 1,000,000 page views. Our magazine has a readership of 45,000 people (and growing with the launch of our digital edition).

Corporate membership packages have been structured in three tiers so your business can contribute and benefit at a relationship level best suited to your organisation.

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x

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20 copies of Diabetes, magazine, delivered to your office Access to a digital copy of Diabetes Your logo on our website

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Your logo in our magazine

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Workplace wellness presentation by Diabetes NZ

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There are many ways your organisation could help support all New Zealanders affected by diabetes. If you would like to invest in a corporate membership, or hear more about other opportunities, contact Business Development Manager Sue Brewster. Email sue@diabetes.org.nz or call her on 09 810 7047.

We can only overcome the stigma attached to the generic term “diabetes” when we start to educate people on the differences; when they learn to see beyond the current media hype and appreciate the complexity of the disease that is anything but sweet.

Spring 2016 | DIABETES

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FA M I L I ES A N D CH ILDREN | H ELPING YOUN G KIDS UN D E R STA N D D IA BE T E S

Former IDF youth champion and Diabetes contributor Carrie Hetherington has written her first children’s book. By Caroline Wood.

DIABETIC DEEP SEA DIVER When I catch up with Carrie she tells me she has eight days to finish her Masters degree in international development and move house before she heads off overseas to the UK. In the meantime her first children’s book has hit Amazon.com and is getting great reviews.

Carrie represented New Zealand at the International Diabetes Federation conferences in 2013 and 2015, and wrote several articles about diabetes in developing countries profiling some of the young people she met there. Carrie, who was diagnosed with type 1 when she was 19 years old, was an active member of Diabetes Youth.

As part of this voluntary work, she attended diabetes camps, where she was inspired to write books to help small children.

“I decided to write this children’s book because I felt that a lot of the books around were solely focused upon learning about diabetes in real-life settings, for example, in a school.

“I wanted everyone to remember that despite having diabetes, children are still children! We all spent our childhoods living in fantasy worlds, listening to brilliantly imaginative stories – so why not pen a book where the main characters are on an adventure under the ocean, with fish as their best friends?

“Having this condition often steals a little part of your youth and children with diabetes have to

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DIABETES | Spring 2016

mature a little faster than other kids, but learning can still happen in less serious settings. This was my main motivation.”

Little Lisette is a deep sea diver who has type 1 diabetes. She is invited to a party under the ocean but when she has a low blood sugar she decides to ignore it. As the party goes on she has to face her fears and treat her blood sugar in front of her new friends.

Carrie says this book is about being brave and telling people about your diabetes. It shouldn’t hold you back from your dreams. It is also raising money to help children with diabetes in Africa.

Carrie explains: “I collaborated with a friend, Adejumo Hakeem, who lives in Nigeria. We met over in Australia at the 2013 International Diabetes Federation conference and have since

kept in touch and talked about this project. For each book sold $2 goes towards providing insulin for a child in need of help. He chooses the children in most need of aid and buys a month’s worth of insulin for them. For me this creates the perfect cycle – it’s not a traditional donation process as you’re simultaneously providing our kids with a resource.”

Carrie has penned a second children's book, which is currently being illustrated, and is writing another for adults. “Diabetes is not fun, but I’m hoping these books will bring a bit of joy!” says Carrie. “I’ve had some wonderful feedback so far from people all over the world, so it’s reassured me that there is definitely a niche for these books. I’m really enjoying the process too.”

“Diabetes is not fun, but I’m hoping these books will bring a bit of joy.”

CHILDREN'S BOOK AUTHOR CARRIE HETHERINGTON

Little Lisette is available at www.amazon.com (It costs $15 for the paperback or $3.87 for the Kindle version).

For more about Carrie and her book, see: www.healthline.com/diabetesmine/little-lisette-kids-book-giveaway.

RECORD WORKOUTS

The Fitbit family of trackers helps motivate you to get active which can help manage type 1 diabetes and prevent or delay type 2 diabetes. They also track every part of your day including activity, exercise, food, weight and sleep – to help you find your fit and stay healthy.

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IN T E R NAT I O N A L | WO R L D DIA BETES DAY

Serious about

SCREENING This year’s World Diabetes Day is focusing on screening.

How can you help spread the message this November?

The theme for World Diabetes Day on Monday 14 November is Eyes on Diabetes and this year’s activities will focus on promoting the importance of screening.

This includes screening to ensure early diagnosis of type 2 diabetes and screening to reduce the risk of serious complications for people with all kinds of diabetes.

World Diabetes Day is organised by the International Diabetes Federation (IDF), which is an umbrella organisation of over 230 national diabetes associations in 170 countries, including New Zealand.

The IDF has been leading the global diabetes community since 1950. It represents the interests

of the growing number of people with diabetes and those at risk. Its mission is to promote diabetes care, prevention and a cure worldwide.

As a member organisation Diabetes New Zealand supports the IDF’s key messages and is incorporating eye health into the next Diabetes Action Month, which kicks off on 1 November 2016.

Chief Executive Steve Crew said: “Diabetes eye damage is sometimes called a silent disease because the damage can be happening a long time before you notice any change in your sight. Don’t wait until that happens, it’s important to get a full diabetes eye check when you first find out you have diabetes and regular eye checks after that.”

EYES ON DIABETES

Over 400 million people currently live with diabetes.

One in two is undiagnosed.

Screening for type 2 diabetes is important to ensure early diagnosis and treatment to reduce the risk of serious complications.

ACT TODAY TO CHANGE TOMORROW www.worlddiabetesday.org

Raising awareness: You can download these IDF posters and others from www.idf.org. They are free and people are encouraged to put them up in their local libraries and community centres.

The huge and growing global burden DIAGNOSIS

COMPLICATIONS

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415 million adults were living with diabetes in 2015 and this number is expected to increase to around 642 million or one in ten adults by 2040.

One in two adults with type 2 diabetes is undiagnosed. More of us will develop and live with type 1 diabetes.

Many people live with type 2 diabetes for a long period of time without being aware of their condition.

By the time of diagnosis, diabetes complications may already be present.

Up to 70 percent of type 2 diabetes cases can be prevented or delayed by adopting healthier lifestyles, equivalent to up to 160 million cases by 2040.

DIABETES | Spring 2016

•

•

•

Screening for diabetes complications is an important part of effective management of the disease, to ensure optimal health.

In many countries diabetes is a leading cause of blindness, cardiovascular disease, kidney failure and lower-limb amputation.

Of the 415 million adults worldwide living with diabetes in 2015, over one-third will develop some form of diabetic retinopathy – a complication of diabetes that can lead to vision impairment and blindness.

Global health spending to treat diabetes and manage complications was estimated at US$673 billion in 2015.

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FreeStyle Optium range of products are used in the testing or monitoring of blood glucose and blood ketone levels for people diagnosed with diabetes. People with diabetes with elevated blood ketone levels should seek medical advice. Reference 1. Evaluation of the FreeStyle Optium Neo Blood Glucose and Ketone Monitoring System, sponsored

by Abbott Diabetes Care, 2013. Data on file. 2. Clinical Evaluation of a Faster, Smaller Sample Volume Blood ß-Ketone Test Strip, sponsored by Abbott Diabetes Care, 2006.

Data on file. For more information call Abbott Diabetes Care Customer Service 1800 801 478 or visit www.myfreestyle.com.au. FreeStyle and related brand marks are trademarks of Abbott Diabetes Care Inc. in various jurisdictions. Information contained herein is for distribution outside of the USA only. Abbott Diabetes Care, 666 DoncasterSpring Road, Doncaster, Victoria 3108, Australia. www.myfreestyle.com.au. Always read the label and follow the manufacturer’s instructions. ABN 95 000 180 389 MSE140506114551

2016 | DIABETES

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YO U R D I A B E TE S N Z | DO N ATE 4DIABETES

MAKING A DIFFERENCE Business development manager Sue Brewster explains how supporting New Zealand’s leading diabetes charity can make a real difference.

DONATE4DIABETES To help all people affected by diabetes, make your donation today in any of these ways:

Philanthropy has been alive and well in the world for many centuries and New Zealanders are no slouches when it comes to their generous gifts and philanthropic actions.

Diabetes New Zealand is an organisation that is very privileged to be on the receiving end of your and other New Zealanders’ generosity.

With very little government funding, we rely heavily on donations from people like you, community organisations and businesses to help us deliver our vital work.

We need your help now more than ever before Every time you hear the word diabetes at the moment, it is referred to as a ‘tsunami’ or a ‘pandemic’ with all types of diabetes on the increase. The rise of diabetes has been described as a disaster of the 21st century and, as nearly all of you reading this will know, diabetes not well managed is a disaster: a disaster with tragic and multiple health consequences.

How would your donation help someone affected by diabetes?

We know from studies and everything we hear from people with diabetes that early and ongoing information and support can help people live so much better with their diabetes. Or in the case of type 2 diabetes, even prevent or delay it.

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DIABETES | Spring 2016

Online at www.diabetes.org.nz Direct credit to the Diabetes NZ bank account: 03-0584-0197985-00 Phoning 0800 DIABETES (0800 342 238) Posting a cheque to: Freepost Diabetes NZ, PO Box 12441, Wellington.

Your donation will help in the creation and distribution of information and resources that are proving so beneficial to increasing peoples’ understanding of diabetes and helping them better manage their condition.

Your donation will help launch information campaigns that are proving to be just as effective.

During just one month of Diabetes Action Month last November, our campaign provided the Know Your Risk brochure to 17,500 people with 2,900 of those people finding out that they were at high risk of developing type 2 diabetes. And in that same one month, nearly 50,000 people came to our website seeking information on diabetes management.

Your donation will support a newly launched ‘Diabetes Chat’ which is designed to provide the latest in expert advice on areas we know

can be very challenging for people with type 1 and type 2 diabetes. Our Diabetes Chat sessions have helped answer questions ranging from the availability of diabetes medications in New Zealand through to what type of footcare is needed for an active 11-year-old boy with type 1.

Your donation will help us represent the needs of people with diabetes.

We recently received plaudits from the diabetes community for our Chief Executive Steve Crew calling for the public funding of pumps and medication in an interview on National Radio.

So from us, a big thank you for taking the time to pause and reflect on how your donation can help New Zealanders impacted by the pandemic called diabetes and we look forward to you joining us in our mission, responding to the urgent and growing needs of our country’s diabetes community.

RAEWYN'S STORY | LI VI NG WI TH DI AB E T E S

NEW SUPPORT MEMBERSHIP Diabetes New Zealand has launched a new kind of membership to connect with more Kiwis and raise awareness about diabetes.

A free Support Membership category was launched in July with a range of online benefits, including digital access to our flagship magazine Diabetes and affiliation with the leading Kiwi charity for diabetes.

I'm still here Raewyn Bhana and her husband George Ngatai, from Auckland, can stand inside a pair of his old jeans having lost a massive amount of weight – over 170kg between them!

In 2005, Raewyn Bhana was in her late 30s and morbidly obese, weighing 130kg. But she started eating healthily and exercising and managed to lose 70kg. This saved her life, as she explains in a new video recorded for Diabetes New Zealand.

“I remember when I went to the doctor and he said to me I wouldn’t live past 50. At the time I didn’t have grandchildren,” she says.

“He told me if I wanted to see my grandchildren, I needed to do something about my weight.

I’m now past 50 and I am alive and I look after seven of my grandchildren.”

Her doctor’s words kickstarted Raewyn’s journey back to wellness. She started exercising and changed her diet radically.

And her husband, George, who also has type 2 diabetes, has benefited too, shedding a massive 100kg of his body weight.

Raewyn says she used to eat two McDonald’s bacon and egg combos for breakfast, savouries or cake for morning tea, then

pizza for lunch and fish and chips for dinner. There wasn’t a lot of fresh fruit and veges in her “before” diet. Now she has lots of veges for dinner and drinks water instead of fizzy drinks and exercises every day.

She introduced exercise into her life slowly, first by parking further from the shops, and using the stairs instead of the lift. These days Raewyn loves going on the treadmill and playing with her grandchildren.

And best of all, she no longer needs insulin injections.

Raewyn, a care worker, has Māori, Indian and Irish heritage and says these cultures put a big focus on food. Now she teaches others how to eat well. She provides vegetable and fruit platters instead of savouries and cakes at staff events, and orders pallets of water instead of fizzy drinks.

“I come from a family of diabetes.

I don’t want my grandchildren to go through what I have.”

Four specially commissioned short videos have been produced to promote the new membership category.

Digital Communications Manager Rose Gawn said: “We wanted to share stories from people in the diabetes community, so others can be prompted to take action to better manage their type 1 or type 2 diabetes, or get proactive about preventing type 2 diabetes.

“All the stories are inspiring and told from the heart. Everyone who was featured gave their time voluntarily to the project and we really appreciate their help.”

Diabetes New Zealand will still offer paid membership options for those who want to financially support our work and receive the full range of member benefits, including face-to-face support from your local branch and a hard copy of Diabetes magazine delivered to your door quarterly.

Please share the videos and encourage your friends and family to join Diabetes NZ. Together we can help people with diabetes live full and active lives.

The videos can be seen on www.diabetes.org.nz

JOIN DIABETES NZ TODAY

Spring 2016 | DIABETES

19

FOO D AN D NUTR ITIO N | HIGH FAT/LOW CARB DIETS

A controversial UK report claims eating more fat and less carbs will help people lose weight and reverse type 2 diabetes. But health experts in New Zealand disagree, as Helen Gibbs explains.

The diet debate In the popular press recently there have been many articles and opinion pieces that support a reduced carbohydrate/high fat diet. In May, a seemingly authoritative report from the UK’s National Obesity Forum received worldwide coverage, giving the appearance that a number of prominent health professionals endorsed the consumption of fat and reduction of carbohydrates to combat the obesity and diabetes crisis.

This report caused concern and confusion for many people struggling with their weight and/or trying to manage their type 2 diabetes.

Superficially this report looks credible due to the authorship, but it is worth considering two matters overlooked in most media reports.

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DIABETES | Spring 2016

Zealand, for example, we typically eat too much high fat and high sugar foods, and fail to get enough vegetables, fruit and fibre. This is why we have an obesity problem.

Reduced carbohydrate diets can result in weight loss. Weight loss will occur with any energy intake restriction, regardless of how it is achieved. But long-term studies of those following restricted carbohydrate diets show that they are no more effective than a healthy eating approach after 12 months. Why is this? Quite simply, to be successful at weight loss, the energy restriction must be sustained through long-term behaviour change (ie you have to stick to the diet) and humans are poor at long-term behaviour change.

First, it was published as a report rather than a peer-reviewed study in a scientific journal. After the publication, many eminent health professionals and nutrition experts including Professor Mann, from the University of Otago (see panel), commented that research articles with evidence contrary to the authors’ stance were not included in this report, and the report lacked balance in how it reported the papers that it had cited.

So, if both healthy eating and reduced carbohydrate diets are challenging to stick to, why should we follow the healthy eating recommendations such as those in the Ministry of Health’s Eating and Activity Guidelines for New Zealand Adults, in preference to a reduced carbohydrate approach?

Second, the report’s hypothesis is that healthy eating has “failed” and that this is the cause of the obesity epidemic. But many national and international diet surveys show that most people don’t follow the recommended healthy eating guidelines in the first place. In New

A number of the Ministry of Health’s healthy eating recommendations focus on reducing the total amount of saturated fat in the diet. High saturated fat intakes are linked with increased insulin resistance and cardiovascular disease. Some recent research suggests there may be little relationship between

One good reason is that healthy eating has been shown in research to be better at reducing the metabolic problems that lead to and contribute to the health consequences of type 2 diabetes.

HIGH FAT/ LOW CARB DIETS | FOOD AND NUTRI T I ON

Life not that simple

Healthy eating, active living FOOD AND ACTIVITY ADVICE FOR ADULTS FROM 19 TO 64 YEARS

Healthy eating (as described in the Ministry of Health’s guidelines – left) will reduce many of the risk factors associated with diabetes and cardiovascular disease.

See www.health.govt.nz.

saturated fat intake and heart disease death rate, however that same research highlighted that high saturated fat intake was linked with greater disability from cardiovasular events, and the researchers continued to support a reduction in saturated fat in the diet.

Following the Ministry’s healthy eating recommendations will also result in a reduction of “free sugars” in your diet. Free sugars are “those sugars added during manufacturing, preparation and consumption and those from juices, honey and syrups.” This advice, while not as strict as the “no sugar” approach of many reduced carbohydrate diets is likely to be more sustainable.

A reduction in free sugar intake will result in reduced glycaemic load and lower post-meal blood glucose levels, reducing the complications of diabetes.

The Ministry’s healthy eating guidelines also encourage the consumption of a high-fibre diet through eating a wide range of vegetables and fruits, plus wholegrains. Eating a high-fibre diet with a focus on wholegrains will reduce the glycaemic load, and improve cholesterol levels for

people with diabetes. In addition, recent research on fibre and gut bacteria suggests a healthy gut microflora may reduce the risk of both heart disease and diabetes through reducing inflammation, so increasingly we are focusing again on high fibre being key to health improvement, something that is difficult to achieve on a reduced carbohydrate style diet.

So before you go on a reduced carbohydrate/high fat diet, please consider this: • All behaviour change is challenging, so any changes to your diet should be spent on something you can stick with most of the time for the long term.

• Healthy eating (as described in the Ministry of Health’s guidelines) will reduce many of the risk factors associated with diabetes and cardiovascular disease. This kind of eating is not the cause of the obesity epidemic, it is our best chance of leading a healthy lifestyle.

Helen Gibbs is a New Zealand registered dietitian. She is currently working for WellSouth Primary Health Network and has a specialist interest in weight management and diabetes.

The report Eat Fat, Cut The Carbs and Avoid Snacking To Reverse Obesity and Type 2 Diabetes, was published by the Public Health Collaboration and the National Obesity Foundation, two UKbased charities.

Citing a number of studies, the authors conclude that a lowcarbohydrate, high-fat diet of real foods is an “acceptable, effective and safe approach” to weight loss and health.

But Prof Jim Mann, endocrinologist and nutrition expert from the University of Otago (pictured), criticised the report, which he said contains many mistakes, selective research, and wasn’t peer reviewed.

“There is nothing special about high fat diets. People lose weight if they reduce their calorie intake assuming their energy expenditure remains unchanged.

“There are some points in the report which are perfectly reasonable eg ‘you can’t outrun a bad diet’ …and some which are rather more complex than the report suggests.

“For example, it is absolutely true that people at risk of type 2 diabetes need to limit starchy and refined carbohydrates but this may not apply across the board and needs further explanation. In China people are consuming less of their traditional food (ie rice) and more fat and they are getting fatter and diabetes rates are increasing dramatically.

“If only life was as simple as the self-styled experts suggest!”

For more on healthy eating guidelines, download our Diabetes and Healthy Food Choices pamphlet on www.diabetes.org.nz or see our story in the Autumn issue (p27).

Spring 2016 | DIABETES

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CA R E A N D PR E VE N TIO N | STR OKE

Think FAST

and save a life

Stroke is New Zealand’s third largest killer and people with diabetes are at higher risk.

But do you know the signs of stroke and what to do if it happens? By Caroline Wood.

STROKE SIGNS The FAST campaign has been launched to raise awareness that stroke is a medical emergency and encourage people to learn the FAST mnemonic:

Each year 9,000 people have a stroke – that’s around one Kiwi each hour!

But knowing you’ve had a stroke isn’t always easy and sometimes it falls to a loved one or a passerby to spot the signs.

Jane Jackson knows how difficult that can be. Her husband had a massive coughing fit in the bathroom of their Wellington home just after 8am one Saturday morning last year. He had a shower, came into the bedroom and lay down on the bed, saying he felt unwell.

They put his symptoms down to an ongoing chest infection and Jane booked an emergency appointment with their local GP. The appointment was in 30 minutes so they started getting ready to leave the house. Adam put on his t-shirt by himself but couldn’t get his trousers on. And he couldn’t grasp his toothbrush with his left hand.

“At that stage I should have called the ambulance,” recalls Jane.

Learn the FAST checklist and tell others about it. If we all learn to recognise the signs of stroke, we could save a life.

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DIABETES | Spring 2016

“We just didn’t think of it, he’s only 42 years old, and was otherwise healthy. But I knew something was wrong when he couldn’t put on his shoes and had to hold onto the fence walking down to the car. He was talking fine but later he told our doctor he felt drunk.

“The doctor took two minutes to diagnose him as having a stroke and we were sent straight to the hospital.

I didn’t realise how important it is to get people to hospital as fast

The Jacksons are telling their story to remind people to act FAST after a suspected stroke.

as possible – within four hours. I thought I had time to drop off the kids with my sister.

“Wellington hospital was fantastic, we were there by 10.15am and they said it was good he got there fast as he could be treated with medication, and would have a good outcome, which is exactly what happened.”

A year later and the couple still don’t know what caused Adam’s stroke but he has fully recovered and has had an in-depth medical check up to rule out any obvious causes. He has changed his diet, is taking more exercise and keeps an eye on his stress levels.

Jane and Adam now know that a stroke can happen to anyone, anytime – it could be someone you know, or the person next to you on the bus.

They want everyone to know the signs of stroke and how acting FAST can save lives.

For more information, see stroke.org.nz

LOVE LIFE | FAMI LI ES AND CHIL DRE N

SUMMER CAMP SUPPORT Diabetes Youth summer camp leader Andrew Good explains his journey with type 1 diabetes and why the right support matters.

As a Kiwi kid growing up with type 1 diabetes I often felt like my condition defined who I was. I feared that I was being judged by my peers and wouldn’t be able to fit in if they knew that I was a T1.

Common misconceptions like: “Did you eat too much sugar?” or “You’re not the right body type to have diabetes”, really influenced my openness about my condition.

I leaned on my family and close friends for support in the early days as they took the time to really understand what it meant to be living with and growing up with type 1 diabetes. Being around people that could see beyond my diabetes was important from a young age.

As a member of Diabetes Youth Auckland, I had the opportunity to attend summer camp. This is when I really felt like there was support available. At summer camp I was not the kid with diabetes, I was in the majority. I didn’t need to hide who I was or how I was feeling as I was surrounded by peers who really knew what growing up with diabetes meant. Summer camp made me realise that the highs and lows (literally) of diabetes, testing and injecting were a normal part of

life for many children and it was nothing to be ashamed of. It was at camp that I realised I could not let type 1 diabetes define who I was, and through the support of the leaders, peers and instructors it sparked my love for adventure.

on their journey. I walk away from these camps feeling inspired and motivated to give more, having interacted with the campers and other volunteer staff. I am excited to talk about my experiences and continually learn from others.

I walk away from these camps feeling inspired and motivated to give more.

Diabetes support groups don't just involve sitting around talking about diabetes, they provide a great opportunity to form new friendships with people who just “get it”. They are a place to have fun, have a laugh, share your experiences and give back to the diabetes community. My belief is that they are a vital part of being type 1, it’s up to you to decide how involved you want to be.

I have participated in many sporting activities including triathlons, rowing and a marathon.

My diabetes does not hold me back from these achievements and I value the relationships and support I receive from both my peers with type 1 and those who have taken the time to listen and understand what living with type 1 actually means.

I am now a leader at the Diabetes Youth Auckland camps and am glad that I have the opportunity to share my experience with the type 1 youth. After 23 years of having diabetes, I am now able to be a role model to children just starting out

I am a type 1 diabetic, proud of being one and won’t allow it to determine what I can do. Only through the immense support of family, friends (both T1s and not) and the local diabetes organisations have I been able to navigate my way and have a vision toward normality. *Andrew Good is 28 years old and lives in Orewa, Auckland. He runs his own business creating apps and websites and has a passion for outdoor adventure.

Spring 2016 | DIABETES

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GAR D E NI NG | HE R B S

SMALL SPACES TO SAVOUR Our gardening correspondent Rachel Knight explains how to fill your garden with pots of flavour this spring.

Growing as much as possible in a small space means we’ll have less watering, less weeding and less walking to harvest our crops.

Herbs don’t need much space but pack a taste punch way above their weight. The closer they are to where we cook, the more likely we are to use them. They’ll do well in pots by the back door or even on our windowsill. Herbs look lovely while they’re growing and on our plate.

It’s not even a disaster if they go to seed. First we’ll get edible flowers to sprinkle on salads (chives, rosemary, basil) or we can wait for the seeds to use in cooking (coriander, fennel, dill) or to sow for next season’s crop.

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DIABETES | Spring 2016

Mint and parsley are essential for a delicious tabbouleh salad, chopped chives transform the taste and look of a fresh tomato soup and a sprig of fresh thyme in the cavity of a roasting chicken infuses the air and the bird with a delicious scent. Many ingredients are used around the world, but the right combination of herbs and spices changes chicken and rice from a Mexican feast to a Thai or an Indian one. Often we rely on sugar and salt to flavour our food, but we won’t miss them if we choose one or two herbs or spices to enhance the taste of what we cook.

We all have our favourite flavours which we use most often, but it’s worth experimenting with others to keep things interesting. My windowsill holds mint, chives, coriander and parsley – the ones I use most in the kitchen. Some I’ve dug up from the garden, some started from seeds and others

I bought from the supermarket.

Supermarket herbs will last longer if you take them out of their tiny pots and put into larger containers with some extra potting mix to give their roots some room.

I like the flexibility container-growing offers – bigger pots mean less watering and healthier plants. Plastic pots are cheap and lightweight but a half wine barrel or large planter will look better and have enough space for a selection of herbs. Just make sure they’re in the right spot before you fill them as they’ll be too heavy to move once they’re planted. For leafy herbs choose a location with afternoon shade so they don’t wilt in the hottest part of the day.

Let’s bring some herbs into our lives and our kitchens so we can travel the world on culinary adventures without going more than a few steps out of our back door.

HERBS | GARDE NI NG

NEW

LOW

CALORIE SWEETENER Measures spoon-for- spoon like sugar

HERB PESTO Pesto is a great way to preserve herbs in season and add flavour to cooking in an easily accessible form without needing to add salt.

Makes about half a cup.

INSTRUCTIONS Place the ingredients in a mini blender or liquidiser and blend until smooth.

Scrape down the sides at least once to ensure everything is combined.

Taste and adjust seasoning.

Add a little more oil if required to get the consistency you prefer.

Divide into small jars or pottles and store in the fridge for up to a week or in the freezer.

Š2015 MERISANT COMPANY 2, SARL. EQUAL IS A TRADEMARK OF MERISANT COMPANY 2, SARL.

INGREDIENTS Bunch of herbs, tough stalks removed, roughly chopped (basil, coriander, parsley or rocket work well), about 100g 2 or 3 large cloves of garlic, peeled 90g best quality New Zealand olive, avocado or walnut oil 50g tasty cheese 50g nuts (walnuts, cashews, pine nuts or hazelnuts) Salt and pepper to taste Zest and juice of a lemon or lime

Perfect to use in your favourite food or drink recipes. Add a delicious, sweet taste with fewer calories.

For delicious recipes, visit

club

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.co.nz

| DIABETES 16/04/2015 25

1:40 pm

BRANCH SPOTLIGHT: OTAGO

Heart of the community Diabetes NZ’s Otago branch offers a one-stop shop from its new base in Dunedin, as office manager Noeline Wedlock explains.

By the time you read this article, we will at last be installed in our new premises. We have relocated two blocks down the road to 135 Frederick St, Dunedin. It’s a little sad to leave a building that has served us so well for many years, but new beginnings bring new and exciting prospects.

Here in Otago, we are keen to explore new opportunities to grow and develop the diabetes services we provide to best meet the needs of our community. Moving to a new location, and having a different environment to work in, is inspiring and we are already thinking about how we can use the new facilities to develop our outreach services.

The Dunedin centre is the hub and focus of our branch, it’s where we

provide information, education, products, equipment and support to those in our community who are affected by diabetes. We like to think of ourselves as a “one stop shop”: if we don’t have it we will get it and if we don’t know, we’ll find out – well that’s the goal anyway. We are open Monday through to Friday from 10am to 2pm.

We strive to maintain a public profile by being involved in community-based education for sports and health organisations, Māori and Pacific health expos, as well as industry and workrelated wellness initiatives. We attend speaking engagements at various community groups and organisations, which aligns with our awareness and prevention strategy.

For example, earlier this year we attended the Women’s Lifestyle Expo thanks to the support of the Dunedin Casino Charitable Trust.

Over the weekend we had the opportunity to engage with many people and hand out hundreds

Diabetes NZ Otago Branch Drop-in: 135 Frederick Street, Dunedin, Mon-Fri 10am-2pm Phone: +64 3 474 0240 Email: diabetesotago@vodafone.co.nz Website: www.diabetes.org.nz

of information packs about type 2 diabetes. We were supported by Marryllyn Donaldson, Long-term Conditions Community Nurse from Well South, Jenny Rayns, a Diabetes Nurse Specialist from the Southern District Health Board, and Teresa Manahi from Arai Te Uru Whare Hauora.

We don’t just focus on type 2 diabetes, our link with type1 diabetes and Diabetes Youth is essential. With many more children, young people and adults on insulin pumps, having close links with diabetes educators is important to understand exactly what their requirements are in terms of information, products and equipment.

Youth Camps are also an important event on the diabetes calendar as 8-12 year olds take advantage of a summer camp participating in many different events such as cycling, swimming and canoeing while 13-18 year olds don their winter woollies to tackle the ski slopes of Coronet Peak in Queenstown. We have pleasure in assisting Jenny and the team of doctors, nurses, dietitians and support people to make sure these events continue.

Otago branch committee member and Diabetes NZ Advisory Council rep Clare Stedman at a Diabetes Action Month event last year.

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DIABETES | Spring 2016

We are here to help in any way we can, so please let us know if you have any ideas or suggestions, we would love to hear from you, or better still pop in and check out our new place.

COMPETITION TIME | COMMU NI T Y

First foot forward A recent study suggests that almost 50 percent of people are not having their feet checked as part of their annual diabetes review process and diabetes nurse Suzanne Moorhouse wants to improve this statistic.

She has invited the Waikato primary health community to come up with a fun poem, poster or song to remind nurses and GPs to check their patients’ feet. The winning entry in the competition will be published in the next issue of Diabetes magazine.

Suzanne, who is a clinical diabetes nurse at Midlands Health Network, came up with the idea of a competition after attending this year’s New Zealand Society for the Study of Diabetes conference and hearing how few people were getting their feet checked by their GP. She has organised prizes for the winning entries, including a morning tea, New World vouchers, a pair of running shoes and a podiatry pack.

She said: “We really want people to be looked after well and that’s the bottom line. If we all work together – the patient, nurse and GP – I’m sure we can do better. We only have one pair of feet.

“The competition can be a poem, a song, poster or anything that reminds nurses and GPs to check the feet of the patient. I’m hoping people can come up with something creative, fun and memorable.”

Remember to ask for a foot check from your GP or nurse at least once a year, or more often if you have any worrying symptoms like tingling or discomfort. It’s best to catch foot problems early so they can be treated.

Suzanne (left) with Waikato podiatrist Claire O'Shea.

Get creative! Create a fun poem, poster or song to remind nurses and GPs to check their patients’ feet. Email your entry to Suzanne.Moorhouse@pinnacle.health.nz or send it to PO Box 983 Hamilton 3240.

Entries close 25 September. There are prizes for the best entries.

Order our free Diabetes NZ information pamphlets Go to www.diabetes.org.nz, download the order form and email it to pamphlets@diabetes.org.nz or call us on 0800 342 238

ALSO AVAILABLE FREE TO HEALTH PROFESSIONALS

Spring 2016 | DIABETES

27

R E CI P E S | B RE A KFAST

RISE AND SHINE Breakfast can be the highlight of the day with these heart-friendly brunch recipes.

Corncakes with avocado salsa Low kilojoule, low GI Preparation time: 10 minutes Cooking time: 15 minutes Serves 4 (makes 8 corncakes)

¼ cup buckwheat flour ½ teaspoon baking powder ½ teaspoon bicarbonate of soda (baking soda) ½ cup wholemeal plain flour ½ teaspoon brown sugar 1 x 50g (1.oz) egg 1 cup buttermilk 1 cup drained canned sweet corn kernels ¼ cup drained canned lentils 3 teaspoons chopped chives Olive oil spray AVOCADO SALSA ½ cup finely diced red capsicum (pepper) 1 tablespoon drained canned lentils 2 teaspoons chopped chives 1 teaspoon white wine vinegar ½ teaspoon brown sugar 1 small avocado, finely chopped Freshly ground black pepper

Sift the buckwheat flour, baking powder and bicarbonate of soda into a mixing bowl. Stir in the wholemeal flour and sugar.

Beat the egg, mix with the buttermilk and blend into the flour mixture until smooth.

Stir in the corn, lentils and chives. Set aside while preparing the salsa.

Heat a large non-stick frying pan over a medium heat and coat lightly with oil spray.

Place about two tablespoons of mixture in the pan for each corncake and cook until bubbles appear on the top, about 2–3 minutes (cook 2–3 at a time).

Turn the corncakes with a spatula and cook until lightly browned, about 1–2 minutes.

Keep warm and continue cooking with the remaining mixture.

To make the Salsa, place capsicum, lentils, chives, vinegar and sugar in a bowl and mix to combine and set aside to develop.

Serve two corncakes per person, spread with avocado and top with salsa and pepper.

COOK’S TIP Corncakes can be made in advance and will freeze for up to two weeks. The salsa will keep for a day in the refrigerator in a covered container.

NUTRITION TIP Make these gluten-free by using glutenfree flour instead of wholemeal plain flour.

NUTRITION PER SERVE Energy kj (cals) 1295 (309), Protein 12g, Total fat 13g, Saturated fat 3g, Fibre 5g, Carbohydrate 37g, Sodium 433mg

GIVEAWAY – Eat to Beat Cholesterol Looking after your heart never tasted so good! You can lower your cholesterol naturally in as little as three weeks by choosing heart-friendly foods. This updated edition of Eat to Beat Cholesterol will help make healthy living a reality for you and your family.

We have two copies of Eat to Beat Cholesterol by Nicole Senior & Veronica Cuskelly (RRP $34.99) to give away. To enter please email your name and address to admin@diabetes.org.nz by 1 October 2016 with the keywords RECIPE BOOK.

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DIABETES | Spring 2016

BREAKFAST | REC I P E S

Overnight bircher muesli High fibre, low GI, low sodium

A quick and healthy start to the day as most of the preparation can be done the night before. Make double or triple the recipe as it will keep well in the refrigerator for up to three days.

Preparation time: 10 minutes Refrigeration time: Overnight Serves 2

COOK’S TIP Use honey as an alternative to agave syrup.

MUESLI ½ cup traditional rolled oats 2 teaspoons white chia seeds 200g (7oz) grated skin-on green apple ¼ teaspoon ground cinnamon ½ cup low–fat vanilla yogurt

NUTRITION NOTE Make this dairy-free by using soy yogurt and soy milk.

TOPPING ¼ cup low-fat vanilla yogurt ½ cup low-fat milk or soy milk 1 tablespoon unsalted pistachio nuts 1 tablespoon dried goji berries 1 teaspoon raw organic agave syrup

NUTRITION PER SERVE Energy kJ (cals) 1585 (379), Protein 13g, Total fat 10g, Saturated fat 2.6g, Fibre 7g, Carbohydrate 60g, Sodium 108mg

Mix oats, chia seeds, green apple, cinnamon and yogurt in a bowl.

Cover and refrigerate overnight.

To serve: Divide muesli between two bowls and top with yogurt, milk, nuts, berries and drizzle with agave syrup.

Use a jar or glass that can hold 300ml of liquid.

TRY TH IS N EW PRODUCT!

Place 2 tablespoons of Harraways Steel Cut Oats in the jar, cover with boiling water, place 3-4 blueberries or similar amount of any fruit on top.

Then add a layer of low fat yoghurt (1-2 tablespoons).

Repeat the Steel Cut Oats, hot water, fruit and yoghurt for another layer.

*Recipes extracted with permission from Eat to Beat Cholesterol by Nicole Senior and Veronica Cuskelly, published by New Holland, $34.99.

Cover and place in fridge overnight or for 8 hours.

After 8 hours or overnight remove cover and enjoy your breakfast!

Serves one.

Diabetes magazine readers can take advantage of an exclusive offer of $30 including gst, postage and packaging for one copy of Eat to Beat Cholesterol (RRP $34.99). Just enter the promo code ‘diabetesnz’ when you order the book online via the New Holland Publishers’ website www.newhollandpublishers.com.

Spring 2016 | DIABETES

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L E T ' S G ET ACTIVE | GE T MOVING

In our modern lives we are inundated with convenience but sometimes we should re-evaluate whether it’s the best thing for us, says personal trainer Craig Wise.

INCIDENTAL EXERCISE A couple of months ago one of my personal training clients bought herself an activity tracker. After a couple of weeks, during one of her sessions, she told me how she was struggling to reach her goal of 10,000 steps a day. The conversation moved on to whether this was actually an achievable goal for her as a part-time worker/ mother-of-two. Like me, she works between the morning and afternoon school run, however our average daily step numbers were so vastly different. On closer examination, the difference between the two of us was pretty much one factor – the amount of incidental exercise that each of us did.

So what is incidental exercise? It is the stuff you do during your daily life – walking to the water cooler, vacuuming round the house or other household chores. These seem like very small things but when they add up they can make a big difference.

Incorporating more of these incidental activities into your day is a very easy way to improve your general health and fitness. It is especially important if you find it difficult to squeeze regular physical activity into your life. Moving our bodies and doing the normal daily things expends energy, not a lot, but over a period it adds up. Standing up, moving around the house or office, cleaning the windows or

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DIABETES | Spring 2016

Saving time and effort in today’s society seems to be the golden rule, but we shouldn’t let this outweigh the need for a healthy lifestyle that will help us be around to enjoy all this convenience. taking out the rubbish – and all the little things we do to live our lives – nibble away at our activity goal.

Although this may not seem like doing much, keeping ourselves moving can make the difference between maintaining our body weight and that slow creep of the additional kilos.

Saving time and effort in today’s society seems to be the golden rule, but we shouldn’t let this outweigh the need for a healthy lifestyle that will help us be around to enjoy all this convenience. We should look at some of these “conveniences” and consider which are needed and which are luxuries. And then look at how we can make a change to positively affect our lives.

There are many ways to increase our incidental activity, these include: • Parking a little further away from the store when you go to the shops. It’s often easier to find a parking space too – especially at peak shopping times.

• Take the stairs not the lift – many times it’s actually faster than waiting for the elevator to arrive.

• Get off the bus one stop early and walk that little bit further.

• If it’s only a short trip, leave the car at home and enjoy the walk, especially as the good weather is coming – the fresh air is beneficial for the soul too.

• If you work in an office, collect your own printing from the printer rather than wait for someone else to drop it off on your desk.

• If you are emailing a colleague, take a walk and chat face-toface. Not only does it get you moving but it also helps build greater work relationships.

We should also remember that the heavier we are the more energy it takes to move our bodies. So start taking the stairs, stop using remotes and walk to the grocery shop – rather than doing it online or click and collecting – and you will see the results.

GET MOVING | LET'S GET AC T I V E

CRAIG’S TOP SIX WAYS TO INCREASE INCIDENTAL EXERCISE

2 1

Put your best foot forward

Spend more time on your feet, whether you are walking or standing, just by being upright you are benefiting. Take your coffee standing up or try having a walking catch up with a friend (you will both benefit). Ask for a standing desk at work (one you can adjust to use standing or sitting).

3

Do the bum wiggle

Squeezing those muscles in your buttocks, especially one cheek at a time, can reveal imbalances in muscle strength as well as help to give that perky behind. Strengthening and creating a balance in those muscles can affect the way you walk and can relieve stress on the joints.

5

Work remotely

Leave the remote by the TV, so when you want to change channels you need to get up and go to the television, just like we used to.

Create a phone routine

When you make or take a phone call do so on your feet. You could even go as far as investing in a headset so that you free up your hands to be even more active whilst you chat.

4

Get jiggy with it

Dancing is awesome for you – not only can it help with getting the blood pumping (aiding cardiovascular fitness), it can help balance and co-ordination as well as make you feel happier. Crank the music up and dance whilst you are doing the housework for that ever important efficiency.

6

Tip toe teeth

Those two minutes in the morning and night time when we are scrubbing our teeth can also be used. As you scrub try standing up on tip toes and then lowing yourself back down.

Alternately you could try standing on one foot and then the other, lifting your knee up as if you are marching. These also work when you are waiting for the kettle to boil or waiting in line at the supermarket.

Got a question for Craig? Email him at info@getfitandhealthy.co.nz.

Check out his new website for more exercise tips: www.getfitandhealthy.co.nz

Spring 2016 | DIABETES

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CA R E A N D PR E VE N TIO N | D IA BETES IN A DISASTER

GET READY, GET THRU There’s always a chance of some kind of emergency disrupting your routine, usually when you are least prepared for it.

Everyone is advised to have a plan in place in case of an emergency, whether it’s an earthquake, storm, flooding or other natural disaster.

Consider how you would care for yourself and your family. Would you or your child have sufficient diabetes supplies for a couple of weeks? Are they located in an easy to access place?

It’s a good idea to fill in an emergency plan together with other family members so everyone knows what to do, including children. You can download an emergency plan template here: www.getthru.govt.nz/assets/ Uploads/GRG-Checklist.pdf.

Consider storing two weeks of diabetes supplies, which, depending on how you take care of your diabetes, could include oral medication, test strips, insulin, insulin delivery supplies, lancets, extra batteries for your meter and/ or pump, and a quick-acting source of glucose. You may also want to have an extra glucagon emergency kit (see the checklist below).

Insulin is only good for 30 days at room temperature so it’s a good idea to have some kind of rotating system.

All these items should be kept in an easy-to-identify container, and stored in a dry location that is easy to get to in an emergency. Make sure your family knows where to find these supplies. Consider having mini versions at your work or child’s school in case you can’t get home.

Don’t forget to have emergency stocks of food and water. For example tins of beans, spaghetti, veges and fruit (in natural juices), crackers and muesli bars. See www.getthru.govt.nz for more information about what else to include.

Your emergency supply kit should contain a list of emergency contacts, including your GP, local diabetes clinic and emergency health centre (in case you run out of supplies).

If you are a parent of a child with diabetes, it is important that your child's school has clearly identified the school staff members who will assist your child in the event of an emergency evacuation.

For those who are away from home for work or travel, consider informing your colleagues, friends, and family members about your diabetes in case you have a medical emergency or need to go to hospital.

Wearing medical identification will enable colleagues, school staff members, or emergency medical personnel to identify and address your medical needs or those of your child.

Why not take a few minutes right now to gather supplies and inform those around you about your diabetes? It could make a big difference in maintaining blood glucose control and staying healthy under stressful circumstances.

Diabetes in a disaster

CHECKLIST Diabetes NZ recommends you keep at least two weeks’ supply of: • Syringes and/or needles, or pens • Blood glucose meter with spare batteries and test strips (30 days supply – check the date on your strips regularly) • Insulin and/or diabetes medication, eg metformin, in an insulated container if possible • Other medication e.g. blood pressure, allergy, or heart pills • Insulin pump supplies if needed • List of insulin pump settings • Written instructions from your diabetes team for an insulin regimen to use when off an insulin pump (along with appropriate insulins) • Glucagon emergency kit • Alcohol swabs or antibacterial wipes • Blood glucose log book and pencil • Urine ketone sticks or strips • Finger pricker and lancets • Empty sharps container for used lancets and needles • MedicAlert or similar identification

See diabetes.org.nz and www.getthru.govt.nz for more information

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DIABETES | Spring 2016

JENNI'S STORY | LI VI NG WI TH DI AB E T E S

Sue Jones shares her sister Jenni Rowell’s 61-year journey with type 1 diabetes.

Boiling needles and lumpy insulin Brring… brring… Jenni and my brother Ed are not home. A little later I ring back and Jenni answers saying “Good timing, I’m just back from taking our elderly neighbour to do her weekly shopping”. I tell her to sit down, I have a confession, then explain about this article in the magazine and am met with doubt, reluctance and finally acceptance of her inspiration in my life.

We grew up in the days of glass syringes and needles boiling on the coal range and we occasionally enjoyed the scientific experiment of popping a tablet into Jenni’s urine sample in the plastic tube, feeling it heat up and bubble away till it told the answer of blue – no sugar – to green, yellow or orange, where it showed she had eaten too much sugar and had to explain.

I tell her I’m recovering from spinal surgery and Jenni is soon on her way up from Dunedin to spend a week in Hamilton helping me recover in between babysitting the great nieces and nephews.

Back in the 1950s mum often had to roll the insulin bottle in her hands to get rid of the lumps. Excitement came with things like the introduction of plastic disposable syringes, the Clinitest pack, and then the diabetic pen.

Looking back, life has not been easy for Jenni, 72. Born the third of 10 children and with no family history, her diagnosis of type 1 diabetes at the tender age of 11 years was puzzling.

Judy, her older sister, recalls her turning into a gaunt-looking kid who had huge eyes and a sudden craving for water. Our family get togethers see us giggling about Jenni as a child being fed sugar through a teapot spout at night or staying at the altar after communion and blowing sugar over the nun’s habit instead of sipping the sugar in a straw while having a hypo (turn).

Despite her restrictions, Jenni has embraced her life from the early days of calorie counting and weighing all her food to today’s carb counting and eating out. Early in her thirties Jenni developed a melanoma leaving a large hole in the leg muscle but that didn’t stop her belonging to the Dunedin Square Dancers’ Club for 35 years.

At 40 Jenni had heart bypass surgery and spent five months in hospital with some mismanagement and an infection. This put her at risk of losing her leg and resulted in skin grafts from groin to knee.

Jenni Rowell (right) with her sister Sue Jones. Sue works as a surgical preadmission nurse at Waikato Hospital, often seeing patients with diabetes. She says none have inspired her more than Jenni.

She nursed her husband Henry who died of cancer and looked after our Down’s syndrome sister, Trishy, for many years before Trishy’s diagnosis of Alzheimer’s. Jenni only retired at 67, when the family told her to take time to enjoy herself, and she has since had several trips to Australia.

Jenni loves floral art classes, regularly does the church flowers, creates and delivers food parcels and assists with St Vincent de Paul Society activities. She is the treasurer of the local St Vincent de Paul and floral art groups. She loves weekly swimming and cake decorating, and has taken up painting at 70.

My sister has lived a full, more inspiring, life than many and has not let diabetes rule her life. My family are very proud of her for achieving so much and not allowing adversity to define her.

Spring 2016 | DIABETES

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T H E RUBY MCGILL COLUMN |

I’ve had type 1 diabetes for almost 17 years but at the start of 2015 it all started to unravel. Since then, I’ve been on a journey to master diabetes. Surely it’s possible…

WE’RE HAVING A BABY!

I

T'S TAKEN FIVE YEARS, but we’re

finally ready to do it all again. In October, all going to plan, we’ll welcome the newest member to our little whānau. Baby number two!

With every pregnancy there’s a chance things could go wrong, add a type 1 diabetic mother to the mix and the list of complications increases drastically. But I get strength from knowing I’ve done this before.

In December 2010, after what I thought was a relatively straight forward pregnancy and a rather traumatic birth (some of this was due to diabetes, other parts completely unrelated), Olive Mākere arrived.

She was beautiful, round – 9.2lb at 38 weeks – and healthy.

During my first pregnancy I worried about every blood sugar result and rightly so. Poorly controlled blood sugar levels before and during pregnancy increase the risk of: • malformations of the fetus • the fetus becoming overweight • spontaneous premature birth • changed heartbeat which can threaten the foetal life.

And for me, the risks are: • severe hypoglycemia in insulintreated women

• development of hypertension and proteinuria – known as pre-eclampsia (women with preeclampsia can experience greater complications during pregnancy, several of which may be lifethreatening to the mother and/or baby).

It’s frightening to read these risks. I’ve definitely experienced the extreme hypos and to try and avoid getting pre-eclampsia again (diagnosed at 37 weeks last time) I’ve been taking aspirin daily to reduce my risk of heart attacks and strokes (a complication of pre-eclampsia).

Due to the ongoing help of my diabetic team, the majority of my blood sugar levels fell between the target range of 4-8 mmol during my last pregnancy. I thought I had brilliant control. I quickly learnt that pregnant women with diabetes should aim for blood sugar levels between 4-6 mmol before meals.

I still remember one diabetes appointment vividly. I arrived feeling like a diabetic rock star, internally celebrating the best control I’d ever had. Unfortunately, it wasn’t good enough for the experts. I held my head high as I walked out of my

appointment and went straight to the bathroom and burst into tears.

Sobbing in a toilet cubicle I felt like an absolute failure and worried my diabetes was damaging my growing baby.

So what’s changed? Have I mastered diabetes and eliminated blood sugar levels outside the ‘optimum range’?

Of course not! I’m still not convinced this is even possible. I do know that with the help of an insulin pump, a steep learning curve and choosing to focus on my health, my blood sugar levels are better than they’ve ever been. I’m working damn hard to give this baby the best possible start. If things turn to crap, well… we’ll cross that bridge then.

Even though I have more confidence this time, I’m very aware that a type 1 diabetic mother, previous pre-eclampsia and an emergency caesarean mean this is a high-risk pregnancy. However now 31 weeks in with only 11 more to go (it’s pretty standard for diabetic women to be induced at 38 weeks), I think it’s about time I allow myself to breathe a little easier and get excited.

OMG – we’re having a baby! Our little family of three is expanding.

You can follow Ruby’s journey to master diabetes at www.masteringdiabetesnz.com 34

DIABETES | Spring 2016

GlucaGen® HypoKit

Glucagon (rys) hydrochloride

Make sure it’s there when they need it* GlucaGen® HypoKit is used to treat severe hypoglycaemia in people using insulin or taking tablets to control diabetes, who have become unconscious. Available from pharmacy with or without a prescription.

Patient support available The HypoHelp website and app are an important resource for patients at risk of hypoglycaemia and includes a free expiry date reminder service for patients with a GlucaGen® HypoKit. Download the app for free at www.hypohelp.co.nz Also available at Google Play or iTunes.

*Refer to full indications below

GlucaGen® HypoKit is a Pharmacist Only Medicine that is funded through the PHARMAC with a prescription, or available for purchase without a prescription (normal pharmacy charges apply). Ask your Healthcare Professional if GlucaGen® HypoKit is right for you.

Before prescribing, please review full Data Sheet available at www.medsafe.govt.nz GlucaGen® HypoKit. (glucagon [rys] hydrochloride). Presentation: Each pack consists of a vial containing lyophilised glucagon 1 mg (1 International Units) as hydrochloride and a glass syringe pre-filled with 1 mL water for injections. Indications: Therapeutic: Treatment of severe hypoglycaemic reactions in persons with diabetes mellitus treated with insulin or oral hypoglycaemic agents. To prevent secondary hypoglycaemia, oral carbohydrate should be given to restore hepatic glycogen following response to treatment. The treatment of sulfonylurea-induced hypoglycaemia differs from severe insulininduced hypoglycaemia due to the possibility of secondary hypoglycaemia - it is preferable to use intravenous glucose (see full Product Information (PI/Datasheet)). Medical consultation is required for all patients with severe hypoglycaemia. Contraindications: Hypersensitivity to glucagon or lactose, phaeocromocytoma, insulinoma or glucagonoma. Precautions: Glucagon will have little or no effect when the patient is fasting or is suffering from adrenal insufficiency, chronic hypoglycaemia or alcohol-induced hypoglycaemia. When used in endoscopy or radiography, caution should be observed in diabetic patients, or elderly patients with known cardiac disease. Glucagon should not be administered by intravenous infusion. Interactions: Glucagon is an insulin antagonist. When given in large doses, glucagon may potentiate the anticoagulant activity of warfarin. Glucagon can reverse cardiovascular depression of profound ß-blockade. With indomethacin, glucagon may lose its hyperglycaemic effect or even produce hypoglycaemia. Adverse Effects: Nausea; vomiting. Dosage and Administration: The glucagon solution should be prepared immediately before use. Dissolve powder in accompanying solvent and administer by subcutaneous or intramuscular injection. Therapeutic: Adults and children above 25 kg - administer 1 mg; Children below 25 kg - administer 0.5 mg.

Novo Nordisk Pharmaceuticals Ltd., G.S.T. 53 960 898. PO Box 51268 Pakuranga, Auckland, New Zealand. NovoCare® Customer Care Centre (NZ) 0800 733 737. www.novonordisk.co.nz ® Registered trademark of Novo Nordisk A/S. TAPS(DA) 4614RB McK33589/Diabetes NZ 02/15.

GlucaGen® HypoKit Glucagon (rys) hydrochloride

A 24-hour insulin that I can take once a day? 2

“Sweet...!”

Lantus® (insulin glargine) is now fully funded for Type 2 diabetes mellitus patients requiring insulin.1,2 For thousands of Kiwis, this will be something to smile about.

Lantus® is a long-acting basal insulin. ‘Basal’ is a term used to describe the slow, steady release of insulin needed to control your blood glucose between meals and overnight. Lantus® provides a continuous level of insulin over 24 hours, similar to the slow, steady (basal) secretion of insulin provided by the normally functioning pancreas.

This means that only one dose of Lantus®, given at the same time each day, is needed for 24-hour basal control. 2,3 How is Lantus used in people with Type 2 diabetes?

In Type 2 diabetes, Lantus is given by subcutaneous injection once daily and can be used in combination with oral diabetes medications and/or with short or rapid acting insulin as instructed by your doctor. 2,4,5 Talk to your doctor about whether Lantus® could be right for you.

References: 1. February 2012 Pharmaceutical Schedule Update, Pharmac. 2. Lantus Data Sheet, August 2010. 3. Goykham S, et al. Expert Opin. PharmacoTher 2009; 10(4):705-718. 4. Fulcher G, et al. AMJ 2010; 3(12):808-813. 5. Nathan D, et al. Diabetes Care, 2009; 32:193-203.

Lantus® is a Prescription Medicine that is part of the daily treatment of Type 1 & Type 2 diabetes mellitus. Do not use if allergic to insulin glargine or any of its ingredients.

Precautions: for subcutaneous (under the skin) injections only, do not mix or dilute. Close monitoring required during pregnancy, kidney or liver disease, intercurrent illness or stress. Tell your doctor if you are taking any other medicines, including those you can get from a pharmacy, supermarket or health food shop. Interactions with other medicine may increase or decrease blood glucose.

Side Effects: hyper or hypo glycaemia, injection site reactions, lipodystrophy (local disturbance of fat metabolism). Contains insulin glargine 100U/ml.

Use strictly as directed and if there is inadequate control or you have side effects see your doctor, diabetes nurse or educator. For further information please refer to the Lantus® Consumer Medicine Information on the Medsafe website (www.medsafe.govt.nz). Sanofi, Auckland, freephone 0800 283 684. Lantus® is fully reimbursed when prescribed by a medical practitioner. Pharmacy charges and doctors fees apply.

TAPS PP1903

GLA 12.02.001