Diabetes Wellness Spring 2024

wellness DIABETES

SPRING 2024 $8.00 INC. GST

DIABETES NEW ZEALAND | DIABETES.ORG.NZ

TRAVELLING WITH TECH • TYPE 2 MARATHON MAN • OUT AND ABOUT IN OUR MOBILE VAN DNZ YOUTH AWARD WINNERS • WALKING GROUPS • DELIVERING DIABETES EDUCATION IN SĀMOAN

MILAN MOALA

A FORCE OF NATURE

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0800 500 226 dexcom@nzms.co.nz dexcom.com Always read the label and follow the directions for use. Read the warnings available on dexcom.com/downloadsandguides before purchasing. Consult your healthcare professional to see which product is right for you. This product is a continuous glucose monitoring system indicated for the management of (type 1, type 2, gestational) diabetes in people age 2 years and older where self-monitoring of blood glucose (SMBG) is indicated. *For a list of compatible smart devices, please visit dexcom. com/compatibility. Dexcom, Dexcom Clarity, Dexcom Follow, Dexcom G6, Dexcom G7, Dexcom ONE+, and any related logos and design marks are either registered trademarks or trademarks of Dexcom, Inc. in the United States and/or other countries. © 2024 Dexcom, Inc. All rights reserved. New Zealand Medical & Scientific Limited is a Dexcom company. 2A Fisher Crescent, Mount Wellington, Auckland 1060. MAT-4158 Rev001 June 2024

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Contents WINTER 2024 VOLUME 36 | NO 3

4 EDITORIAL 5 TECH: Travelling with tech 7 MOVE: Walking with a group 11 YOUTH: Award-winning rangatahi Milan Moala

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16 YOUR DNZ: Award winners 19 NOURISH: Cooking with noodles 22 ADVOCATE: Amanda Deans 24 ADVOCATE: Ruana Taito

25 LIFE WITH T2: Marathon-walker Wayne Hart 30 LIFE WITH T2: Spreading the word 32 CARE: In the mobile van with Susan Moala’eua

15 YOUR DNZ: It's awards time!

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Editorial

K

ia ora koutou. When my husband, who has type 1 diabetes, and I embarked on some holiday travel recently, I was reminded quite abruptly that not only does a change in routine affect blood glucose levels but so do different foods and temperatures, amounts of exercise, sleep, and stress.

I’m very pleased that we included the cost of a Continuous Glucose Monitor in our travel budget. The alarm function proved its worth several times over.

Fortunately, we were in a position to be able to cover the cost of the CGM. I’m extremely grateful to all those who have, and continue to, advocate for funded access to CGMs for all. Your financial circumstances should not dictate the levels of health care you receive, and I congratulate Diabetes NZ, its partners, and the community advocates in their pursuit of equity and accessibility. I look forward to Pharmac’s announcement eagerly.

Our travels also reminded me that our wider diabetes community provides valuable support, knowledge, understanding, and education. Whether it be online groups, local support networks, family camps, whānau, workplace education, or simply a listening ear, our personal ‘villages’ can make a difference for New Zealanders affected by diabetes. By continuing to ask about others or share our own stories, experiences, and knowledge, Diabetes NZ – and each one of us – might just make the difference.

I hope you enjoy the contents of this edition and are able to share it with someone in your community. In this issue, we meet Milan Moala, an awesome rangatahi from Tāmaki Makaurau who has won an award for his slam poetry. We chat with a man who has walked 30 Rotorua marathons and plans to make it up to 50 finishes. We find out the important work the Diabetes NZ crew does when out in the mobile van, testing, educating, and advocating.

Spring is just around the corner and is the perfect time of year to meet up with like-minded people and head out for a stroll together. Walking with a group is one of the cheapest forms of exercise, with surprising health benefits. We talk to a number of people who are thriving after joining local walking groups. Happy hīkoi!

LYNDAL LUDLOW

Advisory Chair, Diabetes NZ

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DIABETES WELLNESS | Spring 2024

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

Our mission is to ensure every person living in Aotearoa New Zealand with diabetes or at risk of diabetes has equitable access to affordable, quality diabetes care and education.

Across the country, Diabetes NZ has staff and volunteers who help people live well with diabetes.

Join us today at www.diabetes.org.nz

DIABETES NEW ZEALAND Patron Professor Sir Jim Mann Board Chair Catherine Taylor Chief Executive Heather Verry Diabetes New Zealand National Office Level 10, 15 Murphy Street, Thorndon, Wellington 6011 Postal address PO Box 12441, Wellington 6144 Telephone 04 499 7145 Freephone 0800 342 238 Email info@diabetes.org.nz Web diabetes.org.nz Facebook facebook.com/diabetesnz Instagram instagram.com/diabetes_nz

DIABETES WELLNESS MAGAZINE Editor Rowena Fry editor@diabetes.org.nz Publisher Diabetes New Zealand Design Rose Miller, Kraftwork Print Blue Star Magazine delivery address changes Freepost Diabetes NZ, PO Box 12 441, Wellington 6144 Telephone 0800 342 238 Email info@diabetes.org.nz Back issues issuu.com/diabetesnewzealand ISSN 2537-7094 (Print) ISSN 2538-0885 (Online)

ADVERTISING & SPONSORSHIP Head of Business Development Jo Chapman Email jo@diabetes.org.nz Telephone 021 852 054 Download the Diabetes Wellness media kit: http://bit.ly/2uOYJ3p 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 Wellness 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.

Tech

The New Zealand Aviation Security Service has joined forces with Diabetes NZ to produce guidance on what to expect at airport security for people living with diabetes.

TRAVELLING

WITH TECH S

ecurity screening at airports can bring uncertainty for travellers with medical conditions due to restrictions on medications, whether screening equipment will impact medical devices, and what happens if an officer needs to inspect a device or other related items.

The New Zealand Aviation Security Service (AvSec) has created an online brochure that aims to educate and prepare people living with diabetes before they arrive at the airport. It explains the screening process and includes relevant tips and helpful information.

The brochure aims to address uncertainty, making the screening process stress-free, and set expectations from the beginning.

This guidance comes after Diabetes NZ reached out to AvSec to produce an informative product to support their community.

‘We received feedback from our community that their experience at airport security was not as smooth or as positive as it could be. We approached AvSec to see whether they would work with us on a resource to reassure and educate people travelling with medical devices about what they can expect as they move through our airports.

‘We know security screening can be daunting, particularly for people with medical devices. There’s a common concern about how those devices interact with our equipment… Our officers are here to help, and we have procedures to deal with all types of situations.’

Navigating airport security screening

MARK WHEELER, GENERAL MANAGER, AVSEC Guidance for people living with diabetes Guidance for people living with diabetes | Aviation Security Service New Zealand in collaboration with Diabetes New Zealand

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‘Happily, AvSec were open to a collaboration and have been a fantastic partner throughout the process, taking time to understand the specific situations the diabetes community faces and welcoming our advice,’ said Heather Verry, Chief Executive, Diabetes NZ. AvSec encourages everyone to communicate openly about their situation with an Aviation Security Officer (ASO) at the earliest opportunity. ASOs are trained to handle a wide range of scenarios that deviate from the standard procedure, including situations involving medical devices.

‘We know security screening

can be daunting, particularly for people with medical devices.

There’s a common concern about how those devices interact with our equipment,’ says AvSec’s General Manager, Mark Wheeler.

‘Medical devices can pass through the walk-through metal detector. However, they can’t be taken into the body scanners or x-ray machines. Our officers are here to help, and we have procedures to deal with all types of situations.’

For more information about the brochure, please visit bit.ly/AvSec-diabetes

DIABETES WELLNESS | Spring 2024

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GUIDANCE FOR TRAVELLERS WITH DIABETES

If you’re travelling internationally, please be aware that advice may vary for other countries due to different procedures and equipment in use. Please contact your airline or the relevant screening authority in each country where you’ll pass through security screening.

TECH PREP FOR TRAVEL

GENERAL ADVICE FOR SAFE TRAVEL

Advice from Diabetes NZ: • Know your device: check your device’s user manual for specific travel instructions. Different brands may have different procedures.

• Doctor’s note and ID: carry a doctor’s letter stating that you have diabetes and the devices you depend on. A medical ID bracelet is also helpful to wear, if you have one.

• Pack spares: bring extra sensors, transmitters, and batteries to handle unexpected situations.

• Inform your airline: some airlines require notification for in-flight medical needs. Check their guidelines well in advance.

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•

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• • •

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Always carry essential supplies and insulin on you and carry twice the quantity you would usually take.

To avoid your insulin freezing, pack it in your carry-on luggage. Don’t expose it to extremes of temperature. If necessary, carry it in an insulated bag.

If you use an insulin pump or CGM, follow the manufacturer's guidelines for flying.

Always obtain medical insurance when travelling.

Check your blood glucose frequently while travelling.

Carry a hypo management kit, including follow-up carbs, and keep it in the seat pocket so you can reach it when you are not allowed to leave your seat.

Check the strength of any insulin you get overseas, as some countries market different strength insulin.

www.diabetes.org.nz/managing-diabetes-travelling-2

When you approach the screening point, please inform an Aviation Security Officer at the earliest opportunity if you have a wireless medical device, such as an insulin pump or Continuous Glucose Monitor. They can arrange an alternative screening procedure for you.

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DIABETES WELLNESS | Spring 2024

For more in-depth information on travelling with diabetes, please head to bit.ly/AvSec-diabetes

Move

Walk of life Weekly Hīkoi, Walky Talky, Steady Steppers, Buggy Walkers, Fast Footers, Silvarados, Net-Walkers. Walking groups have fast becoming a popular and useful way to find friends, get fit, and keep mobile.

I

f you do an internet search for walking groups, you will be met with a deluge of websites.

There are literally hundreds around the motu, with groups catering for every walk of life – from suburban community walkers to marathon run and walk groups. There’s a cardiac care walking group, a lesbian overland and café club, and groups run by tramping clubs, Forest and Bird, and U3A. Want to bring your dog? There’s one for you too.

Every city council in Aotearoa lists an array of walking groups on their web pages, noting where and what time of day they meet, who it’s best suited for, a contact person, and a possible membership cost, if any.

WHY IN A GROUP?

Ten years ago, a study by the University of East Anglia studied 1843 people in 14 countries.

They found that the risk of stroke, coronary heart disease, depression, and other lifethreatening conditions can be reduced through regular outdoor walking in groups. Findings also revealed that people who regularly walk in groups have

You’re never too old to start. Last year, the American Heart Association reported that a study of people ages 70 and older found walking an additional 500 steps per day, or an additional 400 metres of walking, was associated with a 14% lower risk of heart disease, stroke, or heart failure.

lower blood pressure, resting heart rate, and total cholesterol.

The study’s participants had a mix of obesity, heart disease, type 2 diabetes, fibromyalgia, Parkinson’s disease, as well as those with no health complications. A total of 74,000 hours of group walking was recorded.

The study showed that people who joined walking groups registered statistically significant falls in average blood pressure, resting heart rate, body fat,

weight, and total cholesterol.

They also experienced improvements in lung power, overall physical functioning, and general fitness, and they were less depressed than before they started walking regularly. Three-quarters of all participants stuck with the group, and there were few side effects, apart from a handful of falls on roots or wet ground and minor injuries such as calf strain.

DIABETES WELLNESS | Spring 2024

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STEP UP AND FORGE A CONNECTION

interventions appear to have only modest or short-lived success, walking can appeal to the wider population as it does not require particular skill, equipment, or a competitive nature.

But, before adding walking to your daily exercise routine, do make sure your walking shoes

fit properly and provide enough support and cushioning. When you’re ready, start slowly with a 10- to 15-minute walk and then gradually increase your time and distance. Stay hydrated and stretch your calves and hamstrings after every walk to help your muscles recover. Happy walking!

TICKING HEALTH BOXES

exercise programme specifically designed for older people. But it was a few years after shifting to the South Island that Kathy found herself in her doctor’s surgery, being diagnosed with type 1 at the atypical age of 69.

Now 73, she is witnessing the combined benefits of walking, diet alterations, and medications, with her HbA1c halving from 104 to 50.

Each Thursday afternoon, her women’s group, aged 55 to 85, meets at the local library and heads out somewhere different for an hour and a half, topping it all off

with a coffee or drink at a local cafe. The weather, no matter how cold, holds no-one back, although they do draw the line at walking when it’s snowing. Luckily, it doesn’t snow that often in the town centre of Alexandra, and being in the middle of dry Otago it doesn’t rain very much either.

Kathy says she tries to never miss a week because she gets so much out of the outings. ‘I definitely recommend walking with a group.

There’s the friendship, the exercise, and the getting out of the house and off your butt.’

For most people, walking expends enough energy to be considered a moderate intensity activity. Walking is therefore a sensible starting point for people overcoming inactivity. While exercise-based physical activity

Kathy Smith joined a walking group 12 years ago when she and her husband made the move from Auckland to Alexandra. She wanted to meet other people in her new town, make friends, and also exercise, and the local walking group ticked all three boxes.

Kathy isn’t new to moving with a group of like-minded individuals.

When she lived in Auckland, she and her husband both ran with harriers. She also taught tai chi and Steady as you Go, a fun and social strength and balance

Living in Alexandra, the walkers are constantly surrounded by beautiful scenery. The famous Otago Rail Trail is only a stone’s throw away and is flat, wide, and easy, and anywhere by the Clyde River makes a stunning backdrop to any exercise regime.

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DIABETES WELLNESS | Spring 2024

NATURAL HISTORY WALKER

Praemi Perera has been walking with the Auckland Natural History Walking Club for 24 years. This walking group was established 99 years ago by Marguerite Crookes, a botanist at Auckland University. The Marguerite Track in the Waitakere Ranges is named after her.

It was a work colleague who invited Praemi to join them, as she was going through a stressful period at her workplace. She has prediabetes and says walking with the club has helped her both physically and mentally. ‘The regular walks have helped me control my weight, improved my breathing, and improved muscle strength in my legs. And mentally, when you are on a bush walk, you have to concentrate and think about where your next step will be. Even on flat ground, there are trip (and slip) hazards.’

Praemi says the best things about walking with her club are getting to know new people and new places. ‘As we travel together to different places for our walks, we have time to talk to each other along the way and over lunch breaks.’

The club’s walks cover the wider Tāmaki Makaurau Auckland and Kirikiriroa Hamilton areas.

Their website lists all upcoming bi-monthly walks, where groups venture into the Waitakere and Hunua Ranges, as well as various suburbs, and maunga, such as Mt William and Mt Auckland.

Praemi, soon to be 79, credits the regularity of the walks, which has kept her learning about the native flora and fauna of our beautiful country. ‘This extra interest gets me out looking for specimens in locations I have visited before, at different times of the year.’

https://bit.ly/health-benefits-walking

DIABETES WELLNESS | Spring 2024

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DOCTORS ORDERS

Regular walking is frequently the first thing written on a Green Prescription. At his practice in Cannons Creek, Porirua, Dr Bryan Betty often uses the Green Prescription system. This is an initiative administered by the Ministry of Health that allows patients to be prescribed a programme of physical activity that can be done at home and in their community. It includes a tool for Dr Bryan Betty encouraging modest but still beneficial activities, such as walking. ‘ “Do more exercise” is vague and generic, and can be easily dropped’, he says, ‘But writing a prescription to say “Do 10 minutes here and 10 minutes there” is a way of formalising the conversation. It’s like an agreement,’ he says.

BENEFITS OF WALKING

We know that managing diabetes is a journey and we all need a little extra support sometimes. With helpful tips, information, and inspiration, the new My Diabetes Journey app truly is like a friend in your pocket! It’s totally free, so download it today.

• Food diary • Space to record and track movement goals and emotional wellbeing • Diabetes resources • Recipes • Nutrition tips DOWNLOAD IT TODAY

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Strengthen memory.

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Increase vitamin D levels.

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Gain social connections – meet new people and meet up with ones you already know.

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Gain motivation and purpose – the social support you gain from your walking buddies will help you stay accountable and motivated to reach your fitness goals. After all, it’s much harder to skip a workout when you know your friends are expecting you to be there.

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Shake up your daily routine or build walks into it.

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Connect with nature – getting out into nature boosts endorphins, making you feel better than not going out.

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Boost self-esteem and help keep depression and anxiety at bay. Achieve a regular sense of accomplishment.

SOME WALKING GROUPS AROUND THE MOTU

walkingnewzealand.co.nz/walking-groups www.livingstreets.org.nz/regions www.footstepswalkingclub.com www.meetup.com/en-AU/topics/walkers/nz www.aucklandnaturalhistoryclub.org/about-us.html www.forestandbird.org.nz/branches/wellington/trampingand-walking-wellington www.mywalkinggroup.nz

Photo: NZ Doctors

MY DIABETES JOURNEY… A FRIEND IN YOUR POCKET!

Youth

Milan Moala is not only a proficient performer of kapa haka and a wicked waka ama sportsman. This Tāmaki Makaurau rangatahi is also an award-winning slam poet.

SLAM DUNK Photo: Action Education

‘But see ‘cause, I was never born with this, So when being told that these issues may have been my fault, makes you feel less of the man I once was or never got to be.’

MILAN MOALA

DIABETES WELLNESS | Spring 2024

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Milan has a rich whakapapa, with iwi affiliations originating with Ngāti Māhanga Hourua and Ngāti Paoa, and extending to Tongan, Niuean, Chinese, and Pākehā.

A

ucklander Milan Moala (Ngāti Māhanga Hourua, Ngāti Paoa) is a force of nature. His mother, Tara, refers to her 15-year-old as a ‘waka ama freak’, an apt description, considering she’s witnessed him dedicate hours each week to training and racing over summer. But there are more than a few strings to this teen’s bow, with intensive kapa haka practices leading up to competitions that also require his energy.

Milan (pronounced Mee-lahn) is in year 11 at Ngā Puna o Waiōrea Western Springs College, a Te Reo Māori immersion kura.

He’s been doing kapa haka for the last five years, performing with his school group, Te Mura o Tāmaki, and most recent, Ngā Oho, named after Ngā Ohomairangi, a rangatira of Te Arawa, the historical iwi of the Auckland region.

Milan’s love of kapa haka has taken him and Ngā Oho to the Auckland Secondary Schools Māori and Pacific Islands Cultural Festival, more commonly known as ASB Polyfest. The annual four-day festival celebrates dance, music, and speech-making, with thousands of high school students competing across six stages in front of crowds that can reach 80,000 attendees.

Having just knocked off its 49th anniversary, this year Polyfest hosted 239 performing groups from 69 schools around Aotearoa.

Milan and his kapa haka rōpū (troupe) performed in division two, taking out the winning spot. ‘My dream is to perform with the first division group’, he says.

FUEL AND FURY

By the time Ngā Oho is up on stage and competing, everyone involved has already put in a lot of work. Many hours of practice are needed to polish their performance, and everyone wants to be the best they can be.

Milan, who was diagnosed with type 1 diabetes two years ago, says he has to eat a DANCE AND CHOIR IN ONE

Milan shares what the kapa haka judges are looking for. ‘When judging kapa haka, they judge mita te reo, your wiri, which in turn judges your mauri, and waiata, karakia. Then how it holds together as a performance.’

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DIABETES WELLNESS | Spring 2024

Photo: Waka Ama Aotearoa NZ

‘In summer, we do sprints. In long-distance, we go five, 10, 20km. You just paddle non-stop. I’ve even done 30km.’ lot over the weeks of kapa haka practices, continually making sure he doesn’t go low. Tara adds, ‘If he goes low, he feels like crap and can’t perform. So he needs to make sure that he keeps it maintained. Keeping that all going.’

Milan wears both a CGM and a pump, proudly displaying them when in performance attire. But the technology that keeps him healthy doesn’t always cooperate with the furious movements of kapa haka. ‘The pump drops off a lot because it’s a lot of moving up and down with squats and stuff. A bit annoying.’

Tara suggests that kapa haka could be compared with a full-on sport such as rugby, considering it is such an energetic activity.

Milan replies, ‘it’s more like dance and choir, but you’re singing the whole time.’

TAUTOKO

Milan and his mum are grateful for the awesome support they both receive from his many kaiako at kura. The intense practices leading up to the kapa haka competitions inevitably require those involved to noho. Tara explains, ‘So, for every noho, we need to have a teacher or some kind of kaiako who understands diabetes. So we give them one-on-one. They learn to check numbers, how to check the phone, how much is good, and how much is not good. We have kits of food everywhere – in kitchens of different places and offices, and even when on the water for waka ama. The coaches know if he’s not feeling good that he needs to have jelly beans or whatever in his life jacket. Often our coaches will carry muesli bars for him with them. He’s really, really supported and looked after.’

DOUBLE WHAMMY

Both Milan and his younger brother, Lagitupu, were diagnosed with type 1 diabetes in the same year, just a few months apart from each other. First, Milan felt a change in his body and says one day he nearly fainted. This alerted Tara’s suspicions, and she asked their family GP to test Milan’s blood sugar.

Then, three months later, Lagitupu fainted at school, and Tara was flummoxed. ‘I thought, surely not. It’s only been three months. Then Milan said, “Let’s finger-prick him,” and it came back high. He was very close to getting into a ketone state.’

While raising two children with type 1 diabetes can be a stressful occupation, Tara is thankful for the technology and the freedom and autonomy it allows. ‘Neither of the boys could be doing their

DIABETES WELLNESS | Spring 2024

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My Identity

is proud to nominate

kapa haka, waka ama, rugby, or sport without them. They’d just have to stay at home.’

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Nearing the end of the interview, Milan casually slips into the kōrero that he is also a poet. And that he wrote a poem on diabetes that he took to a trans-Tasman competition last year. And that he won. This wasn’t a small competition either. He was part of a group of spoken word poets from school who call themselves Rehekōrero, which translates to the youth slang, ‘let’s gooo’ and ‘kōrero’.

Milan has not only travelled to Melbourne to perform and win this competition, but has also gone on to take the stage at Laneway, Splore, Pasifika, and Matariki festivals.

The four rangatahi that make up Rehekōrero were supported by Action Education, an Auckland-based creative organisation that enables young people to express their authenticity while growing a vibrant community that supports them (actioneducation. co.nz). They offer a range of creative programmes for young people, including spoken word poetry workshops in schools.

Milan wrote his diabetes poem for an Action Education school competition, ‘WORD – The Front Line', where his group won the nationwide competition representing Ngā Puna o Waiōrea. He says he wrote it to raise awareness of people with medical conditions and the toll it can take on their mental health.

As Milan’s poetry is ‘spoken word’, it is therefore best heard rather than read to fully appreciate its power and message.

To watch Milan performing this poem, head to Rehekōrero Instagram page: bit.ly/milan-poetr.y Watch Milan in Word – The Front Line Grand Slam 2023: www.youtube. com/watch?v=6Cjk2CvZr1k.

Watch Rehekōrero perform their new poem about Te Tiriti o Waitangi: www.youtube.com/ watch?v=C6qRSb8LIeA.

KUPU | WORDS

Te reo – Māori language Mita – pronunciation Wiri – The wiri (quivering of the hands) is an integral part of Māori movement, seen in haka, making the movements deceptive, which is essential in the arts of combat.

Mauri – Mauri is the life spark or essence inherent in all living things that has been passed down from ancestors.

Waiata – song, usually commemorative of some important event.

Karakia – prayer, blessing.

Kaiako – teacher.

Kura – school.

Tautoko – support.

Noho – staying away from home, in accommodation.

Kapa haka – Māori performing arts.

Waka ama – outrigger canoe.

Toikupu – poetry.

Kōrero – conversation/talk.

Rehekōrero – slang for ‘let’s go’, talk.

Your DNZ

IT’S AWARDS TIME! Each year, Diabetes NZ celebrates inspiring members of our community. Applications are now open for these important awards.

Please apply if you’re interested or encourage others to do so.

THE JOHN MCLAREN YOUTH AWARDS

Our youth awards celebrate the pursuit of excellence by youth with diabetes. The scholarships recognise the determination and resilience of young people as they strive to achieve their goals in their chosen field, despite the challenges their condition brings. This year, one award of $1,500 will be made in each of three fields: sporting, academic, and arts. Anyone who is 25 or under and lives with diabetes is eligible to apply.

Previous winners in the arts category have been awarded for excellence in photography and fashion, with an example being 2022’s winner, Bridget Dalley, who used the award to help her attend the prestigious University of Applied Arts in Vienna, Austria, to learn knitting and weaving skills.

Arts pursuits could include kapa haka, music, dance, design, fine arts, industrial design, craft, textile arts, mural design, sculpture, theatre, film, architecture, jewellery, literature, floristry, and choir, to name but a few.

THE SILVER MEDAL AWARD

This award, initiated in 2021, is for anyone who can demonstrate that they’ve managed their diabetes for a continuous period of at least 25 years through insulin therapy.

THE SIR CHARLES BURNS MEMORIAL AWARD

Diabetes NZ presents this award to anyone who can demonstrate that they’ve managed their diabetes for a continuous period of at least 50 years through insulin therapy.

THE LIFE MEMBERSHIP AWARD

The Diabetes NZ Life Membership is the organisation’s most prestigious honour.

It is conferred on someone in recognition and appreciation of outstanding service for the benefit of people with diabetes. To ensure this award remains a distinguished and exceptional honour, there are a maximum of 40 Life Members at any one time. If someone you know deserves this, please nominate them.

HOW TO APPLY OR NOMINATE Application forms for all awards are available on Diabetes NZ’s website. Go to www.diabetes.org.nz/awards. Entries for all awards close 5pm, Wednesday, 5 September.

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Your DNZ

AWARD WINNERS Three awesome young people report back on what they’ve each done since winning their John McLaren Youth Award scholarships.

Adi Bhattacharya (Academia) Last year saw Adi graduate from the University of Auckland with a Bachelor of Engineering, specialising in Mechanical Engineering, with First Class Honours. Since being awarded the scholarship, he has been working hard to complete his Diploma in Plastics Engineering, finishing in a couple of weeks.

While studying part time, he has been working as a Product Development Engineer at Fisher and Paykel Healthcare, where his role helps design respiratory and acute care devices for use in hospital ICUs. When completing his Honours year, Adi was offered a place on the Dean's Honours List. This is awarded when a student scores in the top 5% of the cohort, based on their combined grade point average.

As part of that final year, Adi partnered with another student to work with an academic supervisor to develop an engineering research project, write a report (10,000+ words), and present the findings to academic and industry judges, to then be graded.

His project was centred around the 3D-printing of variable density shoe insoles for patients who suffer from foot complications caused by diabetes.

Adi and his project partner developed an engineering process to scan a patient's foot and

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DIABETES WELLNESS | Spring 2024

automatically produce a 3D model of a custom shoe insole that would relieve pressure from sensitive areas of the patient's foot. The design then enabled the pair to 3D print the shoe’s insole for the patient to use.

Insoles were tested in trials, where a significant improvement in pressure reduction was measured when compared with other insoles on the market.

Adi and his partner’s concept was found to be a more effective solution for the treatment and prevention of foot complications caused by diabetes than many current existing therapies. The project won a Best Project Award – a prize awarded to only a handful of the best final year projects presented during the year. This prize was awarded by the Mechanical Engineering Group of New Zealand (MEG NZ), which is the professional body for mechanical engineers in Aotearoa New Zealand.

Furthermore, this project received a 94.5% A+ grade – and is currently being used as an exemplar project for students completing their final year projects this year.

Adi says that receiving the award is allowing him to undertake further developmental opportunities, which include the postgraduate diploma but also a public speaking course, allowing him to develop his speaking skills and give him valuable insights into how to communicate and present his work more effectively.

‘The scholarship has been a big help in supporting me through this financially and has been a big motivating factor for me to seek further education. I am extremely grateful for the support and recognition afforded to me by Diabetes NZ.’

Danica Waters (Arts) Danica is in her second year at Wellington’s Toi Rauwhārangi College of Creative Arts at Massey University. She is halfway through studying Visual Communication Design and has a special interest in photography.

She says the John McLaren Youth Award scholarship has been a huge help for her, paying for some of the many costs involved in studying design, especially the those associated with photographic printing.

Danica says it’s not unusual to discover at the end of the semester that you’ve spent $500 on printing. Other ongoing costs

include specialist card stock and design software subscriptions.

Danica says that while she has never been the most extraordinary student, she makes up for it in resilience, determination, and hard work. ‘I am passionate about my education, and I strive to make sure that everything I turn in is the best it can possibly be.’ Her good grades in art and design throughout high school have transferred over to her university results. She has won scholarships for her photography, including the landscape category for the De Ruiter Young Photographer of the Year and another from Diabetes Nelson Youth.

DREAM DESIGN GIG

Danica’s ultimate goal, once she graduates, is to design for print, and she has one particular project in mind. ‘For the last 17 years, I have been searching for representation in books for type 1 diabetes, but everything I have found has come up short.

One day, I hope to design the cover of the book that finally lets people with diabetes feel seen,the book that helps the rest of the world to understand what we go through every second of every day.’

With feet firmly on the ground, Danica says she realises that success isn’t always about the letters you see on a report card but about the knowledge gained in the process.

DIABETES WELLNESS | Spring 2024

17

Toby Thompson (Sporting) Since 10-year-old Toby received the John McLaren Youth Award, he has gone on to win big.

Last October, he took away first place in the KartSport Rotorua Club Champs, as well as first place in their Points Series. His mum, Megan, says that winning both of these made him the first in the Cadet ROK class to go back to back with these results. (Cadet ROK is a class where competitors must be aged between six and nine years old. The kart’s wheel base is smaller than the more standard 900mm, it has a restricted exhaust header, and an 11,000 RPM limiter.)

Toby didn’t stop there for long.

Later in October, he came away with First in his class for Round Three of the Top Half Series, which took place at KartSport Auckland. Megan explains, ‘This

was a particularly amazing effort, with it being a national event and after he had an absolute shocker the round before.’

Winning the scholarship has also allowed Toby to get some one-onone coaching sessions at KartSport Marlborough, where this year's Nationals were held over Easter. He was able to attend the three club days before Nationals and came away with yet another first place in Cadet ROK for their Summer Series.

Not bad for the then eight year old who only started karting two and a half years ago.

The following year, Toby was diagnosed with type 1, just a few weeks after his eighth birthday, but Megan reports that the resilience and determination that her son has shown since his diagnosis continues to amaze her. ‘The

way he has carried himself from challenge to challenge shows his strength of character and his grit and determination not to let anything get in the way of him doing what he loves.’

If he gets to follow his dream, Toby may well become his generation’s Cameron Waters, racing supercars and sprint cars.

He also has a dream to race Outlaw Karts in the US. This year, Toby is hoping to compete in two national race series. The first is the Top Half Series, where he will complete three rounds at three different racetracks: Tokoroa, Auckland, and Rotorua. The second national race series is the GoldStar Series, which is also run over three rounds but this time at the Taranaki, Hawke's Bay, and Wellington racetracks.

Ten-year-old Toby’s racing heroes are Scott Dixon, Scott McLaughlin, Liam Lawson, and Conor Daly.

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DIABETES WELLNESS | Spring 2024

Nourish

USE YOUR NOODLE! Dietitian Helen Gibbs explains some of the ins and out of the humble noodle.

P

eople with diabetes often hear they need to cut down on carbs. While this is part of managing diabetes, it’s also important to eat balanced meals that are low in saturated fats and salt, and high in fibre.

JOIN THE RESISTANCE!

Resistant starches are our friends. What is resistant starch, you ask? Well, think of starches as long chains of beads (sugar molecules). When starches are cooked, they swell up and get soft, making it easy for our gut to break them into single beads.

When these cooked starches cool down or are dried during processing, they collapse in layers that become resistant to digestive enzymes. This is why they are called resistant starches. They are starches that can’t be softened again, even if cooked a second time.

Our bodies are unable to digest resistant starch, which means it travels to our lower gut and that is where it feeds good bacteria.

Resistant starch counts as fibre, and we know that this helps keep our gut healthy.

Other foods with resistant starches are legumes such as lentils, chickpeas, and red kidney beans. Also in this group are nuts and some seeds, and starchy vegetables such as pumpkin, peas, and kumara.

And whole grains, plantains, avocados, breads, and pasta are another group packed with resistant starches.

Does your blood sugar rise when you eat noodles? Good

point. But it’s eating too many noodles and not enough vegetables that leads to higher blood sugar levels. For example, adding peas, onions, and mushrooms to macaroni and cheese, and decreasing the amount of pasta, would help balance the meal.

To understand how your body handles carbs like noodles, use your glucose meter to check your blood sugar before and two hours after meals. A registered dietitian or nutritionist can help you understand these results and tailor your diet to your needs.

SERVING SIZES

The Eating and Activity Guidelines put out by Te Whatu Ora have recommended numbers of servings of grainbased food, determined by age, gender, and activity level.

Typically, someone with type 2 diabetes who is working on improving their blood glucose would have no more than two servings at a meal. So when it comes to noodles, that would be approximately 1 cup or 200g of cooked noodles.

Always read the serving size on a package of noodles and stick to it. If the portion is small, that’s the perfect opportunity to add more vegetables to your meal.

Ensure the noodles are low in saturated fat (less than 5g per 100g), sugar (less than 5g per 100g), and sodium (less than 120mg per 100g).

DIETITIAN'S TIP:

Compare foods online by looking at the nutritional information panel on supermarket websites.

CARB CONTENT VARIES

BY NOODLE Instant noodles: 30–35g carbs per 100g. These are made from wheat flour, water, and salt. They can be high in sodium (over 400mg/100g), though most of the sodium is in the flavour sachet, so get used to adding less.

Rice noodles: 30g carbs per 100g.

These are made from rice flour and water. Sometimes also cornstarch and tapioca.

Egg noodles: 25g carbs per 100g.

These are made from wheat flour, egg, salt, and water. They are high in protein, which slows digestion.

Vermicelli (glass) noodles: 85g carbs per 100g. These are made from rice flour and water. Some glass noodles are made from mung beans – these are high in resistant starch. Check the ingredients.

Edamame noodles: 15–20g carbs per 100g. These are made from bean flour and water. They are high in protein (40g) and fibre (20g).

Soba noodles: 21–24 carbs per 100g.

These are made from buckwheat, wheat flour, and water.

DIABETES WELLNESS | Spring 2024

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EASY SOBA NOODLE SOUP

Add the stock cubes and ginger to a large saucepan and bring to a boil over high heat.

Stir in the chicken and noodles, return to a boil, then reduce the heat to medium.

Cook, uncovered, until the noodles reach your desired texture, in about 8 minutes.

Stir in the spinach.

Ladle into bowls, sprinkle with the coriander, and serve.

SERVES 6

Soba, or buckwheat noodles, are made entirely or in part with buckwheat flour. Adding wheat flour makes the noodles more durable as well as less expensive to produce. You can buy soba with 40% to 100% buckwheat.

Try this Asian twist on classic chicken noodle soup next time you’re battling a cold. Get creative and add whatever toppings you have on hand: avocado, boiled egg, spring onion, bean sprouts, thinly sliced mushrooms, toasted sesame seeds, lime, or sliced hot chilli peppers all make great toppings.

5 cups of reduced salt Beef stock 1 tbsp grated fresh ginger 2 cups of shredded cooked chicken (or 100g of firm tofu) 2 bundles of soba noodles 1 cup greens: eg spinach, bok choy, silverbeet, or broccoli 1/3 cup coriander

WITH CHICKEN, PER SERVE: CALORIES 780 kJ (186 kcal) | PROTEIN 19g | FAT 3.3g (SAT FAT 1.1g) | CARBS 20.2g (SUGAR 2.1g) | FIBRE 1.9g | SODIUM 760mg WITH TOFU, PER SERVE: CALORIES 531 kJ (127 kcal) | PROTEIN 6.6g | FAT 2.4g (SAT FAT 0.6g) | CARBS 19.5g (SUGAR 1.4g) | FIBRE 2.1g | SODIUM 656mg

ASIAN NOODLE SALAD SERVES 5

Rice noodles add some variety to your diet. However, due to their high carbohydrate content, they can also adversely affect your blood sugar if you eat too much. This recipe keeps the carbs down – we bulk out the vermicelli noodles with lots of crunchy veg. The salad is brought to life with a tangy rice vinegar and lime dressing. The roasted peanut topping adds a satisfying nutty crunch.

100g dried vermicelli rice noodles 400g cooked, shredded chicken 2 carrots, cut into thin sticks I telegraph cucumber, cut into thin sticks 1 cup thinly sliced cabbage 1 small red onion, cut in half, then into thin slices 1 red pepper, sliced thinly 200g mung bean sprouts 1 cup chopped coriander 1–2 chilli, chopped finely 1/4 cup peanuts, roasted and chopped

DRESSING 2 tbsp reduced sodium soy sauce 2 tbsp rice wine vinegar Juice of 1 lime 2 tsp maple syrup 2 tbsp grapeseed oil 1 clove garlic Soften the vermicelli noodles in a large bowl by covering with boiling water and soaking for 3–4 minutes or until they soften. (I usually bite-test them at this stage – you don’t want a chewy noodle!)

Rinse under cold water, drain, and add to a large bowl. Add the carrots, cucumber, cabbage, bean sprouts, and chopped coriander to the noodles.

Add dressing ingredients to a jar and shake well to mix.

Just before serving, pour dressing over your salad ingredients and combine everything well.

Garnish with roasted, chopped peanuts and a few sprigs of coriander.

PER SERVE: CALORIES 1468kJ (351 kcal) | PROTEIN 26.4g | FAT 14.3g (SAT FAT 2.8g) | CARBS 26.5g (SUGAR 8.4g) | FIBRE 5g | SODIUM 330mg

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DIABETES WELLNESS | Spring 2024

SIX AND A HALF MINUTE NOODLES SERVES 1

Frozen veg is an affordable and convenient alternative to fresh vegetables. Because vegetables are usually frozen immediately after harvesting, they generally retain many of their nutrients. Check out the many different brands available in the supermarket and pick an array. There are selections that mix broccoli, cauliflower, carrots, green beans, kale, butter beans, capsicum, onions, and spinach. ½ cup frozen mixed vegetables 1 95g can tuna in spring water 1 cake of instant noodles (unflavoured) ½ cup of water 1 tsp onion flakes ½ tsp reduced sodium soy sauce 1 pinch chili flakes Break the noodles into a microwave-safe bowl.

Add ½ cup of water to the bowl.

Sprinkle onion flakes over the noodles.

Put the frozen mixed vegetables on top.

Microwave on high for 2 minutes.

Stir everything together.

Microwave on high for another 2 minutes.

Add the drained tin of fish and mix it in.

Microwave for 1 more minute.

Sprinkle with reduced sodium soy sauce and a pinch of chili flakes.

Vegetarian Option: Replace the fish with 2 poached eggs.

Tip: If you are used to the salty flavour of instant noodles, try reducing the amount of the flavour sachet you add. Start by halving the amount you add before cooking, then reduce it by half again within a month.

WITH FISH, PER SERVE: CALORIES 1382 kJ (330 kcal) | PROTEIN 32g | FAT 8g (SAT FAT 2.7g) | CARBS 28.6g (SUGAR 5.3g) | FIBRE 0.7g | SODIUM 492mg WITH EGGS, PER SERVE: CALORIES 1632 kJ (390 kcal) | PROTEIN 23.3g | FAT 18.4g (SAT FAT 5.7g) | CARBS 29.3g (SUGAR 6g) | FIBRE 0.7g | SODIUM 326mg

Make a difference today

A diabetes diagnosis can be scary, overwhelming, and confusing. It’s a steep learning curve whatever kind of diabetes you have. Your donation will help someone just starting their diabetes journey and ensure they can access the resources, support and advice they need to live well. Your donation will remind them they are not alone.

Donate today at www.diabetes.org.nz/donate or call 0800 342 238.

Thank you.

DIABETES WELLNESS | Spring 2024

21

Advocate

AMANDA DEANS:

ALL ABOUT THE PEOPLE We continue our journey around the motu, meeting each region’s Youth and Type 1 Coordinator. In this issue, we meet Whakatū Nelson local, Amanda Deans.

Amanda Deans with her husband Jonathan and children, Tate and Lucia.

I

t’s not unusual for a region’s Youth and Type 1 Coordinator to also be a parent of a child with type 1, and Amanda Deans is no exception.

After her son’s diagnosis, Amanda says she jumped right on board with getting involved with the then-Nelson branch, joining in with all the activities and support on offer. After a year of involvement, and becoming well-known around the branch, she says she was approached by the volunteer team to see if she’d like to take on the newly vacated role of area coordinator. ‘I jumped at the chance’, she says.

Before Amanda had anything to do with diabetes, she worked as a food safety microbiologist, doing a number of food safety tasks, including testing food before it was released to the public, or for export, to microbiological safety standards.

When children came along Amanda’s work/life balance needed to change. ‘It wasn’t an easy job to have with young children.’

Asked what she most enjoys about her job as Youth and Type 1 Coordinator, she quickly replies, ‘The people. It’s all about the people, not just the children with diabetes but their entire families.’

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DIABETES WELLNESS | Spring 2024

She says she and the volunteers have great relationships with the wider whānau. ‘We are expanding our reach to adults with type 1 diabetes in the community as well, forming some really great relationships there.’

Amanda has been Youth and Type 1 Coordinator for Whakatū for nearly four years, her region covering the Nelson Tasman district and beyond. ‘We’ve recently expanded to Marlborough, and people from the West Coast are invited to our events. Technically, they fall under Canterbury, but some will choose to come to the Nelson camp, some will choose to go to the Canterbury Camp. We’re

here if they need us.’ Growing up in Westport gives Amanda her passion for making sure isolated communities don’t miss out on support.

INTRODUCTION TO DIABETES

Amanda understands what it’s like to be faced with having your child suddenly diagnosed with type 1 diabetes. ‘It was such a shock.

We had our suspicions but never expected them to be confirmed.

‘Tate had really classic symptoms. He got thirsty and he started using the toilet more, and while we didn’t notice him get thinner we did notice he didn’t gain any weight. But the

diverse group of people with a diverse range of ages of children as well, so it’s a great sounding board for different activity options that might suit different children.

We’re trying to encompass the needs of as many as possible.’

WAKA AMA

At camp, Amanda briefs the big kids before they head out to lead an activity with the little ones.

extremeness of the thirst was just so fast. We really noticed the change over just a week.’

Five years on, Amanda says that now life just goes on. ‘We check everything, we still count carbohydrates, still dose for all food. We’ve changed our technology to manage diabetes multiple times over five years.

But from then on, you don’t have any choices. You just have to do it. Once you know diabetes is there, there’s no option to wait for treatment. You begin, you jump in, that’s it – your life has changed.

Some days, we still feel like one of the new families, depending on who we’re talking to. And other days, we feel like we’re the old hands who have it all under control.’

FORGING CONNECTIONS

Part of learning how to deal with your child’s diagnosis can be connecting with others who are in the same boat, and Amanda is keen to offer opportunities.

‘It’s important for us to provide events and activities for the whole family to get together. So not just for the children with diabetes, but their siblings and their parents and caregivers too. As parents ourselves, we know what

difference it makes to us to be able to speak to other parents and even for our daughter who doesn’t have diabetes herself to get together with other siblings.’

Nelson recently had a family outing to a gaming arcade in Blenheim, their first since including Marlborough in their catchment. ‘We had over 30 people register to come, which was a great response for our first activity day.

I’d never actually been, but my kids had and they loved it.’

Teen interests are covered as well, with a number of activities a year specifically set aside for rangatahi. Amanda says this time gives them the chance to be independent in their diabetes management. There they can talk about things they wouldn’t necessarily talk about with their parents around. It's also important for them to have downtime fun, be in each other’s company, and build peer-to-peer relationships.

Amanda may be the only one on the payroll, but she says she wouldn’t be able to do her job without the support of her volunteer base. She credits them with coming up with the ideas for activities, as well as the hours invested in fundraising. ‘Our volunteers are great. We’re a

Amanda is especially pleased with an activity from last summer. ‘One of my biggest highlights in terms of events would be our waka ama regatta last year in November. We joined up with a local club, Maitahi Outrigger Canoe Club, and they came and met us at the beach with their waka.’ The club played games and took everyone out on the water for races.

‘It was a lot of fun. I’m pleased I got out there in the end. I wasn’t sure about getting into a waka myself, but I loved it. It was a real highlight for Nelson Youth and a great way to incorporate managing diabetes, the heat, the water, and an activity that is out of the ordinary.’

ULTIMATE BOWLING CHAMPIONS – NORTH VS SOUTH

Diabetes NZ Nelson Youth went head to head with Diabetes NZ Bay of Plenty/Lakes Youth, battling it out for the top spot. In an excruciating finish, Nelson won 111 to 110.

DIABETES WELLNESS | Spring 2024

23

Advocate

We meet with Ruana Taito, fresh from the success of running our inaugural diabetes self-management education programme in Sāmoan.

MA'I SUKA R

uana Taito is the Diabetes Community Coordinator for Porirua, in Te Whanganui-a-Tara. One of her many tasks is to run the sixweek Diabetes: Your Life, Your Journey programme (also known as Diabetes Self-Management Education programmes – or DSME). This course, designed for people with type 2 diabetes, is where attendees get to learn everything there is to know about ma'i suka (diabetes), ask all their questions, and connect with diabetes nurses, dietitians, and pharmacists.

The programme has always been delivered in English here. Until now that is, and Ruana is thrilled with how well it went. ‘Honestly, from all the self-management programmes that I’ve run, this is my best. Because it’s actually delivered in my language.’

Ruana says she understands that the health system is hard to navigate at the best of times and that getting a diagnosis can often be overwhelming. She says that clinical language can be too complicated to fully understand, so she is committed to making all information accessible.

SOWING THE SEED

It was an invitation to an event in a local church last December that sowed the seed. Ruana found herself talking to church leaders about the work she does within Diabetes NZ. ‘Because we are Pasifika and Māori, we are a highrisk population’, she explains. She then broached an idea with the organiser of the event.

‘I asked if I could potentially come and have contact with the pastor of the church about the DSME because ideally we want to bring it to churches as that is where our Pasifika community

Ruana (centre) facilitating a Diabetes Self-Management Programme at a church in Porirua with help from diabetes clinicians.

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DIABETES WELLNESS | Spring 2024

Attendees in Porirua who completed the Diabetes: Your Life, Your Journey six-week programme proudly holding up their certificates.

is at.’ Contact was made where she shared some research about a programme that was trialled in the community and succeeded in delivering education to Pasifika in churches.

The pastor was very keen to receive the programme, being fully aware that, for successful uptake, this form of education must be interpreted or translated so it can be better understood.

Ruana explained to him that she, a non-clinical person, would facilitate it. ‘My role was translating from English to Sāmoan and Sāmoan to English. So a question would be raised, then I would translate it to English. The clinician would explain it, and I would translate it back.’

FIELDING QUERIES

Ruana says that, over the six-week course, she fielded many questions from the group. ‘I felt like people were coming out of their shell to talk about their experiences. They explained how they struggle with diabetes. They asked questions about any confusion and things that they did not understand, “I'm doing this, but why this?” They opened up and then received answers.’

A member of the group asked about sleep, which turned into

a discussion about sleep apnoea, which in turn required education on why sleep is important to self-management.

Gaps in understanding were also patiently filled by the clinicians via translation from Ruana. Someone didn’t understand what hypertension was, as this is one of many words that doesn’t have a Sāmoan equivalent. So Ruana asked the clinicians to describe what it was, then translated theoani Saili se fesoas explanation back to the group.

‘When I translate, people are like “aaah, ok”. They get it now.’

‘It was such a beautiful, more detailed way for our people to understand because it was now translated in our language.’

Pleased with how it went, Ruana is keen to repeat the model. ‘It was actually fun, and even the clinicians were talking about it. They really loved the community engagement from the participants. And the participants were actually engaging. So, honestly, I want to do more of this.’

Ruana shares that she feels she has learnt a lot as well, both from the experience of running the new model and in understanding more about diabetes from the clinicians.

Faaitiitia le mamafa

Gaioi mo le 30 minute pe sili atu foi i le tele o aso o le vaiaso

Tausami meaai paleni

Taga’i i la matou tusi kuka Eat Well Live Well mo meaai manana ia, taugofie ma paleni

‘Ausia ma tausia tulaga maualug a lelei o le toto ma le ga'o

Taga’i i le Take Control Toolkit i la matou upegatafailagi mo nisi auala e tausia ai le soifua malōlōina

Fai i tausaga uma siaki mo le fatu ma le ma'i suka mai lau foma’i

Saili i tagata e maua ai le fesoasoa ni ma feso’ota’i ma ‘aiga ma uo mo se suiga lelei

O le maua o le fesoasoani, e mafai ai ona faaitiitia ma tuai ai ona lamatia oe i le ituaiga no.2 o le ma'i suka, ma maua ai le soifua lelei a’o feagai ai male gasegase

‘I'm grateful to work alongside them. They gave their best for our community to receive, and I want to run as many as I can.’

She says she has another church lined up to run the programme in the future, and she is in the process of connecting with more churches.

Fa'afetai tele to Ruana and the wonderful clinicians.

Ma'i Suka

O mea e tatau ona e iloa

E mafai ona maua le fesoasoa ni mai uo ma aiga, e faigofie ai ona e filifili meaai e fetaui ma oe ma maua ai faamalositino e lelei. E fesoasoani foi le fesootai ma isi ua maua i le ma'i suka, e fautua ma faamalo si ai le tasi i le isi.

Diabetes – what you need to know is available on our website in Samoan and other languages.

O le Diabetes NZ o se faalapot opotoga faameaalofa e ‘avea ma fesoasoa ni e lagolagoina ai tagata ua maua i le gasegase.

E mafai ona matou fesoasoani ia te oe e saili faamatalaga ma lagolago ina ai taumafaiga auā lou soifua maloloin a ma le soifua manuia.

Iulai 2023 © Diabetes New

Zealand

Taga’i i le www.diabetes.org.nz e maua ai nisi faamatalaga ma feso’ota’i @DiabetesNZ

@Diabetes NZ

• Ia iloa ou a’afiaga • Ia iloa āuga • Ia iloa le eseesega • Ia iloa nofoaga e maua ai Diabetes - What you need

le fesoasoani

to know (Samoan)

Diabetes NZ stocks a range of pamphlets and resources with information to help people understand diabetes and to support people with diabetes throughout New Zealand.

DIABETES WELLNESS | Spring 2024

25

Life with T2

The Rotorua Marathon has been an annual event for the last 60 years, and Wayne Hart has consecutively walked exactly half of them.

WAYNE: MARATHON WALKER W

hen Diabetes Wellness speaks with Wayne Hart, he has returned from his (mostly) daily walk wearing his blue fundraiser ‘Every Step for Diabetes’ t-shirt. Full of smiles, he reports, ‘I’ve just done a walk today, so I’m using this as a good walking tool.’

Wayne has a couple of different circuits that he does. One he calls ‘just around the block’, which is a seven kilometre walk into the township and back home. The other is up on the hills. Wayne lives in Wainuiomata, near Wellington, and has access to some excellent walkways and quality hills, with awesome views over the harbour. ‘You get to a halfway point, and there’s a seat that looks over the harbour. It’s just stunning.’

Readers might already be familiar with Wayne’s walking history. Earlier this year, as well as celebrating his 50th birthday, he started a Givealittle page to raise money in the name of diabetes, calling himself ‘Type 2 Marathon Walker’. Then he walked his 30th marathon.

Wayne’s dream is that, out of the hundreds of stories about people with diabetes out there, someone reads something like this and thinks, ‘If he can do it, then I can probably do it.’

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DIABETES WELLNESS | Spring 2024

Photo: Alisha Lovrich / Rotorua Marathon

‘The atmosphere is great. There’s locals playing music for you. You come round the corner, and you hear music that lifts you. You might be having a bit of flat spot, but they’re cheering for you. Cars are going past and kids are waving out, and it gives you a burst. You get that grin back again. They've got hooters going, and you’re already halfway round the course. It puts that little smile on your face and keeps you going to the next flat spot.’

RON, THE RUNNER

Wayne’s link to the Rotorua Marathon is through his father, Ron, a sub-three-hour marathon runner. Wayne remembers him regularly coming home from work and going out for a run, and in the weekends he’d be gone for three to four hours at a time. The family would then go and watch Ron when he competed in marathons, acting as his support crew.

But a few years on, Ron succumbed to a knee injury and his doctor’s advice was to give up running. That, of course, only made him determined to find another way to continue his passion. That’s when he decided that, if he couldn’t run another marathon, then he could definitely walk one.

The then 19-year-old Wayne was keen to join in.

Father and son decided to walk the Hawke’s Bay Marathon as part of training, a course starting in Hastings, winding alongside the Tukituki river and ending up at the now closed Happy Tav Bar. ‘We turned up and enrolled at the pub and asked how many other walkers are there? The guy looked at us and said, “You, plus four others.”’

The six walkers started at 6am, two hours before the runners.

Noticing that the other four were competitive walkers, Ron was keen to keep up with them on his first walk, and Wayne says before long he was abandoned. ‘Within minutes, I can’t see anyone.

Everyone else has taken off. Then the runners come through. Then no-one. So I finished it by myself. I loved it though.’

One marathon turned into two, and father and son ended up doing about five together.

Then Ron took on the role of support crew. ‘They close the road at the 19k section, and Mum would drop in there and Dad would walk over the hill with me.’ Ron provided support but with attitude, as Wayne recounts. ‘I’ve walked half a marathon already, and I’m sore and I’m tired, having gone over bloody big hills. And he’s saying, “Come on, come on, get going.” He’s just got out of the car, he’s happy, he’s fit, and he’s everything. Sometimes, it was like, “Shut up for five mins.” I’d be there, hands on hips, breathing, and he’s going “come on, come on!’”

However, Ron’s tough stance was born out of experience and proved useful. With all that encouragement, Wayne says he’d

DIABETES WELLNESS | Spring 2024

27

Wayne shares his medal with his biggest supporter – his mum.

‘I look at some people around me, and when you say you’ve done 30, they say, “I could never do not even one.” You can. As long as you can get up, get out of bed, and walk. I believe most people spend all day at work. Unless they’re sitting on an office chair all day, they’re on their feet. Most of them are doing a lot of Ks, steps. I can reassure you, mostly you should be able to get around. Don’t sell yourself short.’ end up going past people who were starting to break down. Ron said that on the hills ‘you could tell the men from the boys’, being able to identify the ones who had put time into training and the ones who hadn’t.

Wayne says that, even though it was hard on the day, he was grateful his father’s urging got him over that point. Both parents spent many years following their son in this way and being noticed by envious others. ‘Everyone around me would say you’ve got the best support crew.’

30 DOWN, 20 MORE TO MATCH

So, what’s behind wanting to do 50 marathons? Wayne says he was inspired by the late Colin Smythe, one of the originators of the Rotorua Marathon. Starting in 1965, Colin ran or walked each and every marathon over the following

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DIABETES WELLNESS | Spring 2024

50 years until he passed away nine years ago.

‘I used to joke with him every year that he needs to stop because it makes it harder for me to catch him. It’s a massive goal.’ Wayne reckons doing 30 marathons without missing a year is even more of a challenge nowadays.

Race requirements change, family have their own timetables, and sickness and fitness obviously play a huge part. And then Covid – when regional lockdowns disallowed Aucklanders to race in 2020.

Wayne agrees he is blessed.

‘There’s so many things that could go wrong and stop you on a winning break. I’ve just been lucky. Healthwise, I’ve been good. Just 20 more years to go.

Although I’m not sure if my support crew are happy with 20 more years to go…’

‘GOOD NEWS’

Wayne was diagnosed with type 2 about 15 years ago, when he was working for Fonterra. The test was part of their wellbeing plan for all employees, and Wayne is pleased that it was identified then, even though the news he received was scary. Some years later, he was told by hospital doctors to start taking insulin but also that at his age he could do a lot more to try stop negative things happening to his body, such as neuropathy (nerve damage). This was when Wayne started walking with his health in mind.

He jokes about how he was recently called into his GP’s surgery to hear about his latest blood tests. ‘I had some good news!

I was feeling some chest pains and ended up in hospital. I got the allclear and went back to work. But prior to that, I’d done blood tests

for my next check-up. The doctor asked to see me about my results, and I assumed it wasn’t good news.

But he actually wanted to tell me I had the lowest result in seven years! So now we’re trialling no insulin for a few months.’

‘It’s so easy nowadays to make a bad call, like getting takeaways, although I still love my takeaways. If only it was that easy to make a call on going for a walk. You’ll see a massive change in everything.

How you feel, and you’ll feel a damn sight better after a walk.

Just set that goal.’

Wayne doesn’t put it all down to the walking. ‘It’s a bit of everything,’ he says. ‘The diet, the walking. I love facts and figures, so just the motivation of that makes me want to do even more. It kind of shows that you can do it. Like I said, I knew I was going into the doctor’s, and he’s probably going to tell me that it’s high and you can do better. But when I got that news, I definitely felt more motivated to try and push myself more.’

‘IF YOU’VE GOT IT, USE IT’

Wayne is full of wisdom and lived experience when asked to share his advice on completing one or more marathons walking.

He says, ‘People always come up with an excuse why you can’t do something. “It’s raining, it’s cold, my shoes aren’t the best.”

Then you turn up on marathon morning, and you look around.’

Wayne gives the example of a 100 year old who has done the five or 10km leg, as well as 20-odd full marathons. ‘He can’t quite do marathons anymore, but he still wants to be there on the day. So when you sit there complaining that it’s too wet or too cold, go look at some other people. If they can do it, there’s no excuse.’

He adds, ‘You sometimes see people turn up, and they’re wearing t-shirts saying, “I’m doing this for Mum” or “I’m doing this for Dad.” It’s like, isn’t it funny that you had to have something go wrong to get that motivation? Whereas, if you went and asked them, do you have kids? And they say, “That’s my kids standing there,” and you ask the kid, “Who should Dad being doing it for?”, they’ll say, “He should be doing it for himself.”’

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DIABETES WELLNESS | Spring 2024

29

Life with T2

SPREADING

THE WORD A fortuitous meeting on an airplane of Joshua McCarthy, who works for Fonterra, and a Diabetes NZ staffer has opened doors in his workplace for diabetes education.

J

oshua McCarthy was en route from Hamilton to Balclutha, on the first leg of the journey, when he found himself in conversation with a passenger in the next seat. Both of them would usually keep to themselves on a flight, but the pair started up a conversation and it wasn’t long before they found they had something in common.

Josh says, ‘We got talking. I never talk on the plane, and she said she never talks. She was friendly. She told me what she did as a job, and I started opening up to her about my journey.’

He found he was talking to Cara Thomas, Diabetes NZ’s Head of Community Services.

Eleven years before starting at Fonterra, Joshua felt something wasn’t right with his health.

Due to drinking a lot of water, he was getting up a lot in the night and the broken sleep was making him very tired. Then one morning he woke to find he had blurry vision. ‘I Dr Googled myself, which said I’m either going to die, or I need to check my blood glucose levels.’

Joshua had the advantage of

30

DIABETES WELLNESS | Spring 2024

‘I know what to do. It’s just very difficult to put it into practice. I need to do subtle changes in order for it to be my new lifestyle as opposed to change my lifestyle. I have a 16-year-old daughter and a loving wife as well, so it’s not just me in the picture.’

having a medical centre within his prior workplace, so the nurse there gave him the finger prick.

It took two tests to get a reading because the first one didn’t register. (Little did he know that he was off the scale.) Thinking it was an error, they waited half an hour until testing again. ‘It came up bang on 30,’ says Josh. The nurse called an ambulance, and off he went to the hospital.

‘That was my first introduction to what was going to be my next journey.’

STEP CHANGE

There was a lot happening in Joshua’s life when he got diagnosed, with moving towns being one of them. ‘I signed up to the medical centre here, and that’s where I met my very growly nurse who I absolutely love.

Shelley Milne was my diabetes nurse, and she sat me down in the chair and told me exactly what I needed to hear.’

“You’ve got no option now.

You follow this, or it’s going to shorten your life.”

These words made Joshua prick up his ears, jump on treadmill, start losing some weight, and begin changing his diet. ‘When I first got diagnosed, I went on this big rampage of exercising every day and eating rabbit food.

I lost 28kg in two months.’ But this change was too dramatic and unsustainable. Joshua and his family were also living out of a hotel for a length of time while their house was being built.

This meant no proper access to a kitchen, so his hard work fell over. He regained the lost weight.

Eleven years later, Josh has gradually brought changes into his lifestyle, ones that will be more permanent than his treadmill and rabbit food days.

‘I’ve been doing a bit more, eating a bit better,’ he shares but also freely admits that he is no

poster child. ‘I don’t look after myself as well as I should.’

But, looking after oneself requires some predictability on the work front as well as at home.

Joshua’s role with Fonterra involves a busy work schedule where he’s frequently away from home. His job requires him to regularly visit the five sites in the South Island. ‘It’s a pretty busy lifestyle, travelling all over New Zealand within Fonterra, helping out in the maintenance area. Not the best environment for eating.’

But of course, due to Josh’s career and his need to travel, a connection was made, which opened doors to conversations that wouldn’t have otherwise happened.

Following the interaction with Joshua, Cara Thomas accompanied Otago-based staff member Noeline Wedlock to the Fonterra site in Gore. Josh started the session by bravely sharing his own story to the audience of around 80 South Island site leaders. With a personal connection made, the Diabetes NZ team then delivered diabetes workplace education to Josh’s colleagues. The energy and interest was evident, with engagement on the day and questions forthcoming.

Josh says support from his work has been amazing. ‘I’ve had some amazing interactions with people coming up to me and thanking me for sharing the story. It’s something they weren’t really familiar with, but some have since gone and got a diabetes check-up for their HbA1c. Some have been diagnosed with prediabetes, so they’ve caught it early. So they’re going through that kind of journey themselves now, changing their diet and behaviour.’

WALKING TO WORK

A year ago, Joshua changed roles and locations within Fonterra and is now based in an office in the town centre. He now has the opportunity to walk to work. ‘I use the stairs. I don’t use cars. I don’t jump in a car first thing in the morning, then sit at my desk for the whole eight hours and go home again. I can actually walk everywhere around town, so I’ve kind of changed that kind of behaviour.’

This change in lifestyle has brought his HbA1c down to 66, from the 127 it was when first diagnosed. ‘The doctor still has it on his wall as a graph. He couldn’t believe I was still walking around, functioning.’

Joshua hopes to keep spreading the word at work. ‘It’s one of those diseases that’s not really talked about. It’s almost frowned upon because type 2 is almost perceived as self-afflicted. “You did it to yourself because you didn’t look after yourself, and you didn’t exercise, and you ate all the wrong foods,” and I get that, I really do. Now, I would love to be that educating person to change someone’s health status, and catch them at prediabetes so they don’t have to do what I have to do.

‘My pancreas is dead-dead.

When it reached 127, it probably was never going to come back.

Insulin is me forever and I’ve come to grips with that now.’

WORKPLACE EDUCATION

BY DIABETES NZ

Diabetes NZ offers workplace education and HbA1c testing.

If you or your workplace are interested in more information, please visit www.diabetes. org.nz/workplace-wellnessprogramme?rq=workplace%20 education or email info@ diabetes.org.nz.

DIABETES WELLNESS | Spring 2024

31

Care

‘I’m like the ice breaker. I get people’s attention and help them understand why it’s important for them to be tested.’

32

DIABETES WELLNESS | Spring 2024

YOU HELP ONE PERSON

AND YOU SEE THE IMPACT

Susan Moala’eua is out and about in the mobile van being the icebreaker, educator, translator, and fierce healthcare advocate.

S

usan Moala’eua spends most of her working week on the road, reaching into busy communities. When she’s not in the van, she books in van visits, fits in admin and finds time to share what she does with Diabetes Wellness.

Over the week, Susan and nurse Bandana Halka travel around the wider Tāmaki Makaurau region in the Diabetes NZ van.

Together, they visit workplaces, churches, places of education, supermarkets, and more to test and educate the general public on diabetes, primarily type 2. Easily noticed, their sandwich board and banners invite folk to come over and chat about diabetes and find out what’s true and what is a misconception.

‘Everyone’s got a different understanding of what type 2 is.

So many people just believe, “My family has it, I’m going to have it, so there’s no need to make changes.”’ Refusing to accept false inevitability as an excuse, Susan says that is the time when she starts talking, letting the public know that it doesn’t need to be that way. That there are

things that people can change about their health.

Susan has noticed over the past year that she has been meeting a lot more members of the public with an array of health issues. This is due, in part, to the difficulties in making an appointment to see a GP. Reasons vary, with some folk not being able to find the time, not having the money, or not being able to get time off work. Susan explains, ‘They come and express their concerns to us. So this is kind of like a point of service for them, even though it may not be about diabetes. But for them it’s really just a relief because they are meeting a health provider who can help.’ She helps with what she can by first listening then directing them into the van to get their measurements taken.

GETTING THAT HBA1C

The mobile van is fully set up for Bandana to take a finger-prick of blood and weight, height, and blood pressure measurements.

Once the drop of blood has gone through the test, that’s when Susan can move in with education and answer any questions someone may have.

‘The test is the HbA1c, which is the average blood sugar levels over the last three months.

'We have a chart where they can see what the measurements indicate. So if their levels fall between 40 and below, it’s in the normal range – 41 to 49 is prediabetes, 50 and above is diabetes.’

Susan says that, when she meets people in the community, they sometimes say to her, ‘No, I

Susan has been able to use her skills in education to help her own aiga/whānau/family.

Diabetes runs in her family, with her grandmother, mother, and brother having had their own journey with the condition.

DIABETES WELLNESS | Spring 2024

33

don’t think I have diabetes. The doctors haven’t told me anything.’

But Bandana is able to access electronic medical records on Health Link, so with their consent she can review any results people may have with their HbA1c.

Finding out what the numbers are gives people some medical literacy. Susan says that, with this education, people can understand not only their own numbers but that of family members.

‘It’s amazing when you have someone who doesn’t want anything to do with getting health checks to the point where they are looking at their own lab tests and understanding what’s happening.’

CHALLENGES

Some people aren’t pleased with needles, but Susan and Bandana always take time to explain the process to them and that it isn’t like the needle used in a full blood test. ‘It’s just tiny, you can’t see it, and you hardly feel it. We just pop

it on, press the button, it does its work, and then it’s disposed of.’

Winter can prove a challenge sometimes, especially when testing people who work outdoors.

‘We’re in there trying to warm up their hands, then milking their fingers to try and get the blood out, but some people just have very cold hands.’

At a recent Fieldays, they welcomed farm workers to go through the testing process. Susan says this rural crew had very thick skin. ‘We couldn’t get through the layers of skin. But our lancet has different levels, so we can increase the level when needed.’

SEEING, TALKING TO PEOPLE, AND EDUCATING

Susan’s connection to diabetes has come from many directions. As a new graduate in Health Sciences, she took on an internship with Diabetes NZ 11 years ago. Susan had just come from working for a Trust where she had created a

successful community package in women’s health. She was asked to adjust it to work for those with type 1 diabetes.

‘And that’s how my passion started for diabetes – seeing, talking to people, and educating.’

But it’s not just people new to diabetes who Susan talks to. She often meets people who have been diagnosed but haven’t fully understood their condition and what they need to do to manage it.

‘We have that discussion. And then, if the results are abnormal (prediabetes or diabetes), I take them through education, portion size, physical activity, ensuring they’re taking their medication on time, understanding what the labelling on the bottles is, and more.’

To find out where the mobile van is going to be, check out the events calendar on our website: www.diabetes.org.nz/eventscalendar

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