Diabetes Wellness Autumn 2023 by Diabetes New Zealand

wellness DIABETES

AUTUMN 2023 $8.00 INC. GST

DIABETES NEW ZEALAND | DIABETES.ORG.NZ

RILEY THE RIPPED • WEAVING CARE INTO INVERCARGILL • CONNOR NONSTOP SPROUTS ALIVE • JACK’S FLYING HIGH • LAURA IN LISBON • CGMS & WINZ

OUT OF THE BLUE PILOT JACK KOFOED LIVING HIS BEST LIFE

DAM 2022 IT‘S A WRAP!

Contents AUTUMN 2023 VOLUME 35 | NO 1

4 EDITORIAL

5 UPFRONT: Diabetes Action Month Wrap 8 LIFE WITH LADA: Jack Kofoed – Out of the blue 12 MY IDENTITY: Connor Allnut's 24-hour fundraiser

14 LIFE WITH T1: Riley Powell pumping iron

30 YOUR DNZ: Introducing three new trustees 32 CARE: Theresa Cherry, Southland hauora kaimahi 34 DIABETES YOUTH: Young leader Laura Snowden at the YLD training summit

36 YOUR DNZ: Our team at the IDF General Assembly 38 LAST WORD: Share your story

18 ADVOCATE: CGMs and WINZ 20 NOURISH: Sprouts alive! 24 YOUR DNZ: Fundraising roundup

28 ADVOCATE: Celebrating 100 years of insulin

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Editorial

ēnā koutou katoa. The importance of human connection has been highlighted in recent years, whether it be through whānau, friends, or neighbours. In the 13 years since the first of two diabetes diagnoses in our house, having the chance to talk with, message, email, and listen to others within the diabetes community has been an integral part of our ability to manage and sometimes just cope! We’ve met complete strangers in cafes because our then eight-year-old would leap out of his seat when he saw another child taking their insulin. We’ve met wise and well-informed specialists, and we’ve learnt tips and tricks from groups that were willing to share. Living well with diabetes takes a village, and although each individual’s pathway is unique the common thread is the importance of a community of people who support each other whenever they can. Each November, Diabetes Action Month puts the spotlight on our diabetes communities. In 2022, we reached new audiences, with our stories, experiences, and information, through television, radio, print, and online media. Sneaker Friday continues to grow awareness (not to mention fundraising) through the simplicity of wearing comfortable shoes for the day. Special thanks go out to the fabulous band of influencers and celebrities who joined our community to advocate and educate for 2022! As members of the Advisory Council, fair access to lifeimproving technologies remains a priority for us. I look forward to the day when Diabetes Action Month is a Show us your funded Flash or Continuous Glucose Meter while you wear it month! We can each help our community by continuing to have conversations about the long-term health benefits of accessible technology with anyone who will listen. The Advisory Council welcomes any input from our diabetes community, so do add us to your network of connections and supporters. In this issue of Diabetes Wellness, we bring you the inspiring story of a pilot who regained his licence two years after being diagnosed with LADA (Latent Autoimmune Diabetes in Adults). We feature a winning body builder, and we share what’s involved in getting Work and Income NZ to fund your Flash Glucose Meter. As usual, you will find pages of delicious recipes, this time centred around the simplicity of a sprouted seed. I wish you all the best for 2023. Let’s continue to look after ourselves and each other. Ngā mihi LYNDAL LUDLOW

Advisory Chair, Diabetes NZ

DIABETES WELLNESS | Autumn 2023

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 provide support for all New Zealanders with diabetes, or at high risk of developing type 2 diabetes, to live full and active lives. We have a network of branches across the country that offer diabetes information and support in their local communities. 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 Business Development Manager 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.

Upfront

DIABETES ACTION MONTH WRAP Diabetes Action Month 2022 was a hugely successful awareness and education campaign to support all people living with diabetes in New Zealand. We report back from the month of action. The theme for Diabetes Action Month 2022 was Diabetes Matters. More than 290,000 New Zealanders are now living with diabetes, and that number is predicted to rise exponentially over the next 20 years. Diabetes matters now more than ever. For the first time, Diabetes Action Month 2022 was split into four subthemes: Language Matters, Nutrition Matters, Movement Matters, and Prevention Matters. Each week, we focused on a different area that matters to people living with diabetes.

DIABETES MATTERS PODCAST For Diabetes Action Month 2022, we introduced a brandnew podcast series featuring a number of high-profile guests. The podcast series highlighted helpful information for everyone, including people living with diabetes, those at risk, and friends and family who provide vital support. Each week, we released a new episode based on one of our key subthemes. The podcasts featured tips on what to eat, steps you can take to avoid diabetes complications, tools for supporting people living with diabetes, and staying active when you have diabetes. If you missed out on the podcast series during Diabetes Action Month, you can check it out now on YouTube, Spotify, iHeartRADIO, Google Podcasts, iTunes, and Omny.

SNEAKER FRIDAY Sneaker Friday was a great success in 2022, raising more than $19,000 to support people living with diabetes. With the number of New Zealanders living with diabetes rising to 290,000 this year, these funds are more crucial than ever before. Kiwis across the country rocked their kicks on 18 November. Among them were some familiar faces, including radio and TV presenter Toni Street, and ZM host Clint Roberts. Thank you to everyone who got involved and donated. We are especially grateful for your support in what was a challenging year, and we look forward to bringing you Sneaker Friday 2023!

The team at National Office laced up their favourite kicks for Sneaker Friday.

DIABETES WELLNESS | Autumn 2023

Upfront

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This Diabetes Action Month, we wanted to change the kōrero and shine a light on the words we use to talk about diabetes. We know that words are powerful. The words we choose to talk to or about people with diabetes are important, especially when they’re our friends or whānau. Our words can be the difference between someone feeling empowered and motivated about their diabetes, and them feeling misunderstood or excluded. Similarly, the words people living with diabetes use to talk about themselves can have a huge impact. So, as part of Diabetes Action Month 2022, we developed a new resource to help Kiwis talk about diabetes in a way that is supportive and inclusive. To learn more, visit www.diabetesactionmonth.org.nz.

HEALTHY FOOD GUIDE E-BOOK

This year, Diabetes NZ teamed up with Healthy Food Guide to create a special e-book, all about Diabetes Matters.

Diabetes matters

BROUGHT

TO YOU BY…

PREVENTIO N SUPPORT NUTRITION EXERCISE RECIPES

The e-book features information on language, movement, nutrition, and prevention, as well as information to help Kiwis understand diabetes. This wonderful resource was included in the November issue of Healthy Food Guide and is also featured as an e-book on the Diabetes Action Month website.

#CHANGEMAKERS During Diabetes Action Month, we were thrilled to be supported by a special group of #changemakers for diabetes – inspirational New Zealanders who are fighting to make change and improve the lives of Kiwis living with diabetes. This included well-known New Zealanders, medical experts, researchers, and amazing people from our diabetes community. Top: Dr Bryan Betty, Dave Letele, Eddie Writes Bottom: Sir Prof Jim Mann, Meghan Whelan, Vince Harder and Abby Lee Harder

Diabetes Action Month 2022 was proudly sponsored by

DIABETES WELLNESS | Autumn 2023

LOCAL EVENTS A number of wonderful events took place across the country during Diabetes Action Month. Thanks for coming along, sharing your photos, and helping us raise awareness of why Diabetes Matters. Check out some of the highlights. 1

MY DIABETES JOURNEY… A FRIEND IN YOUR POCKET!

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.

Take care with • Foodconditions diary health 1. Connor Allnutt fundraiser in Timaru (see story on page 12). 2. Whānau Days were held in Auckland, with live entertainment, food, and fun. 3. Do Blue Days were held at many schools around Aotearoa, including Tahuna School, Waikato. 4. Reuben O'Neill and Dave Letele on the Movement Matters podcast. 5. Fun at Whānau Day in Otahuhu.

Ko to mate huka te mea nui | diabetes matters for everyone.

NGĀ MIHI NUI

Diabetes NZ is grateful to everyone who helped make Diabetes Action Month 2022 a success, raising both funds and awareness to support Kiwis with diabetes to live well. Together with our partners, supporters, and diabetes whānau, Diabetes NZ has shown Aotearoa that diabetes matters to everyone.

• have Space to record and track If you asthma, a heart condition, or Raynaud's disease, movement goals and be sure toemotional stay safe. Check with your wellbeing healthcare professional about what Diabetes resources extra• precautions you should take when • exercising Recipes in winter. • Nutrition tips DOWNLOAD IT TODAY

Life with LADA

When Jack Kofoed spent a few of his school years in London, each lunchtime he’d watch the Concorde as it flew over. Years later, his dream of becoming a pilot eventuated and he was well on his way to working for an airline. That is until some unruly blood tests were returned.

Out of the

BLUE

our years ago, Jack was living a successful and comfortable life on the Gold Coast, running a new car dealership as well as racing cars. One part of his career had him looking after a luxury dealership that was located just past Gold Coast Airport. Driving past it every day revved up his desire to fly, so he packed up his life and returned to Auckland to study aviation fulltime. Jack condensed the two-year course into 12 months. His prior experience of working in higher management, six days a week, had created a concentrated and well-practised work ethic. When he wasn’t in class, Jack says he would camp at the airport from 8 to 6 each day, keen to grasp opportunities. ‘Whenever someone didn’t show up for a plane, I’d manage to grab it. I

don’t think it’s a hard thing to do if you love it and you’re in a position where you can do it. I think it’s pretty amazing, so why wouldn’t you be there all the time?’ Then the time came to renew his medical certificates. Blood tests were taken, including HbA1c. Blood pressure and eyes were checked, including scanning of the retinas. All seemed straightforward until Jack noticed the doctor asking questions about his sleep, how often he felt thirst and dehydration, and whether there was diabetes in the family. Then a finger prick test showed a higher than normal blood sugar. Within an hour of walking in for the test, Jack’s medical was gone and he was grounded. Suddenly, there were GP and specialist appointments to go to. The doctors thought it was

odd for Jack to have diabetes as there weren’t any markers in his family history and he was fit and healthy. Four months later, a specialist ordered a different blood test, one that the GP hadn’t looked for. The GAD (Glutamic Acid Decarboxylase) blood test had found the presence of autoantibodies. These indicate an immune system attack, which can point to LADA or T1 diabetes. Jack says he had no idea. ‘The true definition of “out of the blue”.’ But being a glass half-full person, Jack says, if ever there was a good time to be diagnosed, this had to be it. It was during the early months of 2020 and right at the beginning of the Covid-19 pandemic. Much of the world was in lockdown, and many commercial airline pilots were losing their jobs.

Latent Autoimmune Diabetes in Adults is a slow-progressing form of diabetes. Sometimes known as Type 1.5, LADA is a slow-onset form of type 1 that can be misdiagnosed as type 2.

DIABETES WELLNESS | Autumn 2023

From diagnosis to diploma, what does Jack see in the future? ‘Ideally, having a white shirt on most days of the week. And sore shoulders from some stripes on them!’

NEW DIAGNOSIS

Like many, Jack had heard that diabetes rules you out of flying. This belief was echoed back to him by his family and in-laws, as well as his GP. He says that, while that information was disheartening, what hurt more was that he had given up his successful life in Australia. He had sold up and moved back to Auckland with his partner to chase his dream and at that one medical renewal, it had all slipped out from under him. Jack looked at how he could improve his health in the hope that one day he could get his licence reinstated. EXAMINING FOOD

Jack looked at what he was feeding his body. A friend put him onto an alternative health practitioner who offered DNA tests that highlight which foods your body is receptive to and intolerant of. They also offer an insight into which foods help with insulin sensitivity. He discovered that, even though kumara has a high sugar content, due to his particular DNA, it didn’t have nearly as much an effect on his blood sugar as potatoes did. A similar issue was discovered with pasta. Jack found that, if he ate

DIABETES WELLNESS | Autumn 2023

a bowl of normal pasta, it would send him high, whereas glutenfree pasta, with the same amount of carbs, did almost nothing to his blood sugar. The alternative health practitioner had found Jack carried a celiac gene that indicated he could be sensitive to gluten. EXERCISE

Each and every day, Jack likes to do some form of exercise. ‘Riding bikes, squash, tennis, anything endurance based, with a high heart rate, I’m all about it. Exercise, to me, is probably my foundation, next to diet, and mental health as well. Those three things make diabetes so easy, as long as they’re in check.’ Gym sessions help with his mental health as well. ‘The weights don’t have an effect on diabetes, but I’m single now, and I’m not the biggest bloke, so I kind of need to have something there so I don’t go on a date and get blown over by a gust of wind.’ GETTING THAT LICENCE BACK

While learning what he could about his diabetes, Jack went searching for a precedent – pilots who had been able to retain their licences after being diagnosed.

In 2002, Canada became the first country to allow insulintreated people to fly with a Class 1 (commercial) certificate. This was done on a case-by-case basis, under close supervision, and employed a protocol of twice-hourly blood glucose monitoring. The UK followed, a decade later, but it has only been in the last few years that New Zealand, has allowed it, via individual assessments. Currently, there is less than a handful of pilots living, and flying, with diabetes in New Zealand Aotearoa. This success is entirely due to CGMs (Continual Glucose Monitors). Worldwide, aviation has adopted the technology and created frameworks around it, and it was this technology that has saved Jack’s dream. ‘The whole basis of getting a medical in NZ is having a CGM. I can set the alerts where Civil Aviation wants them to be. Say, it goes from 5 to 6, and it did it in fewer than five mins, then my phone will go off, prompting me to take action.’ Civil Aviation has established all the settings they want Jack to use. He uses a CGM that has an app, so he can read his levels in real time. When flying, Jack’s phone

is Bluetoothed to his headset so he can immediately take action. ‘I can’t imagine managing this on insulin without having that situational awareness that a CGM gives. It’s an investment I can’t really ignore. It allows me to do what I do.’ ONWARDS AND UPWARDS

‘Once Civil Aviation was happy with the CGM data, then it was just a matter of having my retinas scanned, photographed, new blood tests (not just one but consistent trends), HbA1c, cholesterol, cardiovascular risks, liver function and kidney function. They looked at fitness and then personal management, and your mental state, because it does take quite a toll on it.’ Jack says Civil Aviation is quite a pedantic beast when it comes to how they evaluate everybody and who they have up in the air. But he is amazed at how encouraging they were. ‘They were on the phone to me, encouraging me to go for Class 1, once they started to see the data and see how they could control it and mitigate the risks themselves.’ Every three months, Jack must send Civil Aviation a 90-page report, generated from the CGM app. The report shows his blood sugar activity and the time it’s taken to return to normal. Also noted are all the alerts his phone has given off in that time frame. They get to see the time stamp, trends, and percentage of time in certain areas. He also logs his flights – when he started the engine, took off, landed, and turned off the engine, so they can see exactly where his levels were during the entire flight. This close monitoring has helped Jack stay on track with his food intake and exercise. ‘It’s like having a little angel on your shoulder, but it’s Civil Aviation. It holds you accountable. Full Big

Brother, but it’s a good thing. It’s data for them to make decisions on.’ He can’t change the parameters that Civil Aviation has set, so if it starts going low in the early hours, his phone alarm will go off. ‘Sometimes, I get woken up by my phone at 3am, thinking a bomb has gone off. It’s not good if you’re having a nice dream.’ PASTA

Jack stayed off insulin for a year and half after his diagnosis. ‘I was super strict with diet, and the exercise I do is for insulin sensitivity, which really helped me. It just got to a point when it was so hard for me to control, so I gave in.’ He is on a small dose of long-acting insulin. If he’s doing a lot of cardio, he takes a smaller dose. ‘I see people on social media where they take pride with being able to eat as much sugar or carbs as they want because, for their mental health, they just want to feel like the diabetes isn’t in their way. I respect that. But for me it is so much easier to not be chasing it. I enjoy a forced healthy life. ‘You only need a CGM for a month to see what foods work for you and what you like. Your diet doesn’t have to be that strict. I love pasta, and I thought that was a thing of the past.’

WHAT IS LADA? This type of diabetes has been referred to as type 1.5, or slow onset diabetes, because it is a form of type 1 diabetes but at early diagnosis often gets confused with type 2 diabetes. LADA, or Latent Autoimmune Diabetes in Adults, is diagnosed during adulthood like most cases of type 2 diabetes. However, LADA is an autoimmune disease, like type 1 diabetes, and sooner or later the insulinproducing beta cells in the pancreas will be destroyed. Eventually, insulin is needed for survival, usually within a few months to years of type 2 diagnosis, if it has not been diagnosed properly with GAD antibody tests. Some features of LADA may include: • being slim or at least not overweight • a history of autoimmune problems • no ketoacidosis at diagnosis • a positive GAD antibody test (blood test). The patient may need insulin relatively soon after initial diagnosis – usually within months to years.

THE FUTURE

‘Study never stops. I’ve just got my commercial licence now, so I’ve ticked that box.’ There’s a couple more ratings for Jack to get, and he needs to double his flight hours, which he estimates will be achieved within the year. He says only once that is accomplished will Air New Zealand look at his CV. ‘Whether or not they give me a call is a different story. Ideally, they’ve read Diabetes Wellness and they’ve seen me and their name in there and go, “We’ll call him up early!” ’

If you think you may have LADA, talk to your GP or diabetes provider. There are blood tests available to confirm this type of diabetes.

DIABETES WELLNESS | Autumn 2023

My Identity

At midnight on Saturday, 19 November last year, most of us were fast asleep or partying. Not so for Connor Allnut. The 26-year-old electrician from Timaru was exactly halfway through his 24-hour fundraiser for Sneaker Friday.

24-HOUR MOVER

or Diabetes Action Month, Connor Allnut, ran, cycled, long-boarded, scootered and walked his way around Christchurch’s Hagley Park, over 24 hours. In that time, he raised just over $7000 through both his Givealittle page and in-person donations. The funds raised will go towards the 2023 Family Camp, ensuring it is affordable for all our families to attend. ‘It felt like a good way to raise money and to get kids out on their bikes and scooters or whatever they wanted to do. The main thing was to show kids with diabetes that they can still go out and do everything that their mates do.’ What kind of person decides to spend all that time relentlessly moving around a very large city park, all in the name of fundraising? The very same kind of person who volunteers as a teen mentor for Diabetes Canterbury Youth. Also the same kind of person who raised about $800 for Diabetes New Zealand though a Big Splash event in Timaru a few years earlier. Connor says the volunteering first came about when he felt there were a lot of diagnosed kids who would benefit from talking to someone who’s not a doctor or a dietitian. ‘Someone who has a good sense of what it’s like to live with type 1 diabetes.’ Connor was diagnosed with type 1 when he was 16. He remembers sitting outside the dairy with a huge chocolate milk, finishing it, being amazed at still feeling thirsty, then going back in to buy a

DIABETES WELLNESS | Autumn 2023

juice. When he got home, he kept drinking. Luckily, this mum was a nurse and cottoned on. The next day, she told a doctor at the hospital she was working at, and he told her to bring Connor to the hospital immediately or they would call an ambulance to his school. PLANNING

Concentrated planning for the event started halfway through the year. He collated his thoughts and ideas on how the event should run and submitted it to Diabetes NZ, who of course thought it was a brilliant idea. Being a keen rugby, futsal, soccer, and AFL player, Connor was already super fit. He also goes to the gym a couple of times a week, so he says he didn’t feel he needed to do any extra training for the event. THE DAY

Connor originally had a set path planned, but some of the footpaths in the park were being resurfaced, so his laps was shortened for a number of reasons. Hagley Park covers a huge 165 hectares, and a loop is roughly seven kilometres, meaning it would take Connor an hour to complete. This would mean if he needed a snack or a drink, or if a supporter came to see him, they could be waiting a long time before he made it back to the gazebo HQ. The Christchurch spring provided some challenging weather. ‘There was very heavy rain, on and off, for the first 14 hours. It would stop for half an hour and we’d go, “sweet!” This is at one in the morning. Then it would start pissing down again.’

Connor came up with idea at the beginning of 2022. He says it felt like a good way to raise money, and he wanted to do something that kids could be part of, hence the bikes, boards and scooters.

My Identity

is proud to create

Connor wore a jacket and waterproof pants for a while, but the water soaked through. His friends were getting drenched as well, but the mood was light and he says they all just laughed about it and kept going. The weather saw him work through three changes of socks, one pair of gumboots, metres of strapping for his feet, and a pair of running shoes. SUPPORT

While Connor was prepared to be moving around the park a few hours on his own, he says time definitely went quicker when friends joined in. His partner had secretly organised a pit crew, so every hour a new set of friends would appear, with many accompanying him on his laps. He was joined by a couple of runners who were planning on doing a similar fundraising event in a month, so they used it as a training session for an hour or two. After 24 hours of almost constant movement and no sleep, Connor thought it would be a good idea to run the last lap. ‘There were people there, friends, family, and they were all clapping, which was really nice. I’m very grateful for their support. It was just as nice to stop and sit down and know I didn’t have carry on too.’ But ever the helper, Connor helped pack up the gazebo and all the gear to take home.

COUCH TIME

A burst of energy hit Connor once he’d finished, so after a shower, he went to the pub for lunch with friends. Then he says he just slept and laid around on the couch for two days as he couldn’t do anything. ‘That was probably the worst I’d ever felt. The recovery was definitely worse than doing it. ‘I couldn’t think or do anything. I’d try to eat and drink but couldn’t do it. Even to get up from the couch was such a big task at the time.’ Luckily, his partner was off work to support his recovery. By the time Wednesday rolled around, Connor was able to go back to his work as an electrician, but he told his boss that he couldn’t be left alone to do jobs. ‘Basically, I was just his apprentice for the rest of the week as I couldn’t think straight. And I was limping for a few days. ‘I didn’t realise how long it would take to recover. I went to the gym a week later and only got through three different exercises, and that was too much. It took four days to be able to walk properly as I had sore feet and blisters.’ His boss was supportive, backing him on the day and making a large donation. Would Connor do this again? He says he would, definitely. ‘Something similar but different. Maybe something longer.’

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Life with T1

When the first Covid-19 lockdown ended, Riley Powell had cabin fever, so she went straight to her local gym and joined up. She never thought that, two years later, she would be up on stage, wearing three layers of spray tan, and winning her first body building competition.

PUMPING IRON IN KATIKATI

DIABETES WELLNESS | Autumn 2023

Life with T1

n mid-2020, like much of the country, Riley was keen to get out of her home. After eight weeks of lockdown, both her physical and mental health had taken a toll. She was depressed and was suffering with anxiety and PTSD. ‘During lockdown, I realised I wanted something different. Where I was at was not a good place. My diabetes was up the wazoo. My weight was absolutely horrible, and I just wasn’t happy.’ Riley says that, when she first started at the gym, it was not even about weight loss. It was just about helping her mental health. For the first three months, she would go in and walk on the treadmill with her headphones on, not talk to anyone, and just ignore the world. Riley now works at that same gym, in her home town of Katikati, where she is studying via an apprenticeship to be a personal trainer. The mother of two was diagnosed with type 1 at 14. She says she doesn’t have a lot of memory about it because it was traumatic and she almost died. ‘My mother took me to the doctor because, in 48 hours, I’d gone grey and opened up with sores all over my body. So sick. The doctor said, “Don’t even wait for an ambulance. Take her straight up to hospital.” ‘Because I was hallucinating and a complete mess, they thought I had overdosed on drugs of some sort. So they were treating me for a drug overdose first before treating it as diabetic ketoacidosis.’ Riley spent two and half weeks in ICU. ‘They said the blood gases in my blood were some of the highest they’d ever seen in a living person. My body pulled a real stunt.’ The months after being diagnosed brought about a lot of tears for the young teen. She had difficulty understanding why this had happened to her. ‘I had gone from

living a normal teenage life to having to check my blood sugar and stab myself with needles. To this day, I’m still scared of needles – I’ll vomit. But I’m ok injecting myself now. I have no issue with that.’ TRAINING

It was a trainer at the gym who suggested she get off the treadmill and try something new. That’s when Riley started picking up weights. And from there she says she fell in love. ‘It was a love of muscles. I wanted those muscles. I didn’t want to lose all the weight and be this skinny little thing. I wanted to be strong. I wanted to be proud.’ The owner of the gym suggested Riley join an existing group of body builders. ‘She said, “I think you’ll be good at this. Let’s do it.”’ Riley

didn’t think twice about accepting the offer. She likes to train a lot more than is required. ‘I enjoy it and have fun doing it. So as long as I’m not injuring myself then I’m happy to do as many hours as I can.’ Riley likes to train six days a week, and a two-hour workout is her average. Currently, she’s not doing any cardio as she’s in the ‘bulking phase’, leading up to next year’s competitions. As opposed to building strength, ‘hypertrophy training’ focuses on building the size of the muscles. ‘If I was doing a squat with a barbell, I’d start with doing 12 squats, at a very low weight, just to get warmed up. Then I’d work up to five sets of eight reps, increasing the weight with every go. That’s where the majority of the muscle growth happens.’

Riley, second from left, with training buddies Kristina Moore, Jenna McCready and Shereen Boyd.

DIABETES WELLNESS | Autumn 2023

The purpose of the lifting training is to increase muscle mass, but Riley’s strength is well and truly there as well. Many bodybuilders are tremendously strong, although not as strong as the best powerlifters. ‘My squats sit at about 80 kilos on by back and my body weight is 60 kilos, so I can lift about 40% over my body weight in squats. It’s amazing what you can do. There’s also a hip thrust where I can do 120kg. I’ve got a friend next to me who can do 150–160 kilos. It’s all technical movements. I can pick up lots, but everyday lifting, nah, don’t get me to help you shift house.’ With technical lifting, there are proper supports in place. This means that the lifter always has safety within their movements. They also have the skill and practice to know exactly how to hold their body to safely perform each movement. ‘With everyday lifting, you don’t know what the weight of it is. Then there’s the random shape of it which makes it unstable, so you’re not sure how to place your body.’ DAWN PHENOMENON

Riley gets up to train at 2.55am in the weekdays, and 4.30am in weekends. That timing might be unthinkable for most of us, but she finds it a perfect time of day. It gives her time to fit in her training and then be back at home to get her kids ready for their day. Another reason Riley likes to train so early is to make good use of her ‘dawn phenomenon’. Sometimes known as the ‘dawn effect’, it is a natural increase in blood sugar levels that takes place in the early morning, often between 2am and 8am. Instead of taking her normal insulin correction, Riley chooses instead to get up and do her cardio, which lowers her blood sugar. Riley wears a CGM and a pump. She only started using one when she was pregnant with her second

DIABETES WELLNESS | Autumn 2023

Riley and her whānau in 2020, just before starting her body building career.

child, seven years ago, when she discovered she had lost all hypo awareness. ‘I wouldn’t recommend finger pricking alone when body building. It’s not sustainable. Every 15 minutes, throughout the day, you would be testing to make sure you’re staying on track. This is because insulin, also being a growth hormone, works against you.’ COMPETITION

Months of work lead up to each body building competition. As well as the muscle training, there are also many hours of practice dedicated to learning and perfecting the poses. Riley says it is a very vain game as you stand in front of the mirror, looking for your best angles. Luckily, in her gym there is a wealth of current and retired body builders to learn from and practice with. Riley wasn’t sure how her diabetes would perform on the day of the competition, so she entered the Novice Shape category in last year’s National Amateur Body Building Association competition (NABBA). This category is about

having nice looking muscles but without big definition and striation. Riley says the mental strain of the game is hard on anyone, let alone someone living with diabetes. With the physical, you simply go to the gym and do your workout. But the mental part involves keeping an eye on the diabetes, wondering what the blood sugar is doing, and worrying, ‘what happens if something goes wrong?’ Riley had that happen on the day of her competition. ‘About 10 minutes before I was due on stage, my sugars spiked up from 6 to 17. Because of that, my body went into shaking mode and I was there on stage, shaking. But I made it through, and I didn’t fall on my face.’ In her first competition – and only two years after taking her first steps onto a treadmill – Riley was thrilled to come in at third place. She kept her CGM and pump kit on, wearing them with pride throughout the competition, as you can see in the photos. SUCCESS

After two or so years of hard work, Riley’s mental and physical health has done a complete turnaround. A full 18 years after being diagnosed, and with the help of the national lockdowns, she has grown to understand her body, her mind, and her diabetes. Riley’s future is looking positive as she continues to enter body building competitions. This year, she will become qualified in Personal Training, Exercise and Fitness through Te Mahi Ako and hopes to start her own personal training business. She says she will also continue working with the Graham Dingle Foundation as a mentor for Project K kids. As Riley says, ‘I joined the gym, thinking I probably wouldn’t stick to it and then met the most amazing bunch of people who would never let me leave.’

HELPING TO MANAGE YOUR DIABETES

FreeStyle Optium Blood Glucose and Blood Ketones Testing FreeStyle Libre Flash Glucose Monitoring System The FreeStyle Libre Flash Glucose Monitoring System is a glucose monitoring device indicated for detecting trends and tracking pattern in persons aged 4 and older with insulin dependent diabetes mellitus, without the use of lancets. Diabetes Care

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Advocate

Getting East Coast locals who live with diabetes what they need to manage their diabetes can be a smooth process. We chat with Lana Reed, a social worker at Pinnacle who serves the Tairāwhiti region.

CGMS AND WINZ

y chance, Lana Reed was waiting in line at the Gisborne Work and Income office with a client’s forms for the Disability Allowance when a staff member approached her. She turned out to be the manager of the service centre who recognised her name and said, ‘let’s meet’. The meeting was fruitful, and, to streamline the previously confusing process, a case manager was specifically assigned to handle all disability allowance applications from people living with diabetes. Lana has been in her current job as a social worker for two and a half years, and Kim Cameron, the local clinical nurse specialist in diabetes, started not long after her. That’s when Kim asked how they could get the Freestyle Libre Continuous Glucose Meter funded for those receiving a benefit. Together, and with the cooperation of WINZ, the pair invested a lot of time into creating an easy process. ‘Our WINZ service centre here’s really good. They’ve understood what needs to be done, and they’re able to do it.’ IDENTIFYING THOSE IN NEED

Lana’s work covers much of the East Coast, from Matawai, down to Gisborne and completing its circuit at Hicks Bay. Pinnacle also has a rural clinic in Te Karaka, which is 30 minutes outside Gisborne.

DIABETES WELLNESS | Autumn 2023

Kim will identify a patient from her case load who will qualify. She carries the WINZ forms with her and will go through them with each client. If the client is unable to fill out the forms themselves, then Lana will visit to help. ‘Some of our patients might’ve had a stroke and can’t write. I go through it all with them, explain it, and then I’m able to write the forms for them.’ Once they sign it, she can then deliver the paperwork to the WINZ service centre and follow up if need be.

‘We’ve worked really hard for this and to see the outcomes for our patients has been amazing. The fact that our small rural communities are all starting to know about it and are all wanting it and are seeing the benefits is amazing.’ ‘It means they’re not worrying about it. There’s somebody out there who knows what they’re doing. A lot of our patients feel a bit whakamā about going into WINZ or requesting support. They feel they won’t get it. So they have somebody who knows the system, who knows what to ask, and who makes sure that things are getting done properly.’

PAYMENTS

WINZ will pay up to a maximum of $70.04 a week for the Disability Allowance. This payment is not taxed. How much you get depends on the extra costs you have because of your disability. It can be used to pay for a Freestyle Libre subscription. Or it can be used to pay for a medical alarm, MedicAlert membership fees, medical fees, or counselling. It can even be used towards gardening and window cleaning if the client is unable to do these tasks themselves. According to the WINZ website, you do not have to be on a benefit to quality for a Disability Allowance. But WINZ will consider how much you and your partner earn, as well as your assets. You can also apply for the Child Disability Allowance if you are caring for a child with a chronic condition. CGM

The time it takes from lodging the forms with WINZ to having the Freestyle Libre arrive in your letterbox takes is, on average, about four to six weeks. Firstly, MediRay sets up an account for a patient, and that is where WINZ will redirect the Disability Allowance payment to. ‘What WINZ and MediRay do is a lump sum at the beginning, so they’re always in credit. And they’re coming before the patient needs it. So if the road closes for

a few days, our patients aren’t without.’ The next thing people need to do is to contact their diabetes nurse to show them how to put it on. FEEDBACK

Lana is thrilled to see the difference the disability allowance has made in people’s lives, including the wider whānau. ‘They have control over their health and their life. They can monitor themselves when they want to. We have a lot of whānau caring for patients and they go, “I don’t have to finger prick anymore. I felt like I was hurting my mum, or my dad.” But now they don’t have to prick.’ Lana says that patients enjoy learning what effects different foods have on their bodies as well. For example, when someone has an orange juice, they will see their levels go up. They can see in real time what’s going on with their blood sugar. ‘I did a visit with a patient, and she had her two sisters over. Now we’ve got all three sisters, and they’re all having competitions on who gets what numbers. They all go to the doctor together and get it put on together. It’s great. It’s made a massive difference. We’ve got patients on their second year of funding now, and they don’t want to stop.’

WHAT YOU NEED TO GET A FUNDED FREESTYLE LIBRE • A support letter from your GP or Diabetes Nurse Specialist, stating that the device is not funded and how having it would support the patient’s health and well-being. They should add the reason why general finger pricking is not suitable for the patient – for example, the patient is elderly, has suffered a stroke, or has low vision. • A copy of the last 12 months of GP visits. • A 12-month pharmacy invoice, broken down into fortnightly payments. • An invoice from MediRay, stating costs for a year’s worth of sensors and 12 months’ worth of freight. Every 12 months you will need to reapply for this allowance. Sometimes, freight costs can change. If this happens, get a copy of this invoice with the updated costs, ask your doctor to sign the form again, and return it to WINZ.

WHO CAN GET THE DISABILITY ALLOWANCE You may get the allowance if you: • have a disability that is likely to last at least six months • have regular ongoing costs because of your disability that are not fully covered by another agency • are a New Zealand citizen or permanent resident • normally live in New Zealand and intend to stay here. It also depends on how much you and your partner earn. The income limits for Disability Allowance are: Your situation

Weekly income limits before tax

Single 16-17 years

$588.98

Single 18+ years

$733.72

Couple (with or without children)

$1,092.55

Sole parent 1 child

$821.43

Sole parent 2+ children

$865.46

Source: www.workandincome.govt.nz

DIABETES WELLNESS | Autumn 2023

Nourish

Sprouts are a great way to add flavour, crunch, and nutrients to your meals all year round. Rose Miller tells you how.

Sprouts alive!

prouts are easy and cheap to grow at home. It will take you just a few minutes, a few times each day, for rinsing and draining, then in a few days you’ll have a jar full of homegrown sprouts that pack a nutritional punch. WHAT YOU’LL NEED

The equipment you need is surprisingly basic: • a sieve for the initial rinse • a jar (preserving jars are ideal – either the small or large ones, depending on the size seed you want to sprout) • cheesecloth or fresh Chux cloth, and a rubber band (or use an Agee preserving band) or • a specially made mesh lid for around $5–$10 from a health food store – these will fit many standard jars, including preserving jars. You can also buy some pretty fancy sprouting equipment, but really all you need is a jar and a sieve! WHAT CAN I SPROUT?

You can sprout almost any legume, seed, or nut, but some are easier than others. I’d recommend starting with something easy. For a starter, try chickpeas, lentils, alfalfa, mung beans, peas (my favourite is a New Zealand-grown whero pea), radish, adzuki, or broccoli. There are some really great sprouting mixes available that use seeds that sprout within the same time frame and are also great flavour combinations. Buy your seeds directly from a sprouting supplier. You can feel safe in purchasing from a sprouting

DIABETES WELLNESS | Autumn 2023

supplier – your seeds will be clean and free from mould and pathogens. Seeds, grains, and legumes from the supermarket are generally okay, but sometimes imported products have been irradiated, which can cause them to become sterile and not able to sprout. Never use seeds from the garden store – seeds for growing in the garden are often coated with chemicals to help them grow and are not safe to eat. Try these sprout supplier stores: www.wrightsprouts.co.nz www.mrfothergills.co.nz WHAT NOT TO SPROUT

• Chia seeds, flax seeds, and other mucilaginous seeds (the ones that go gooey when you add water) are tricky to sprout properly. It can be done, but I generally avoid them because there are so many other seeds that are easier to sprout. • Split peas or red lentils – they won't sprout. • Avoid sprouting kidney beans. They contain a toxin that causes nausea, vomiting, and diarrhea. • Quinoa contains a high concentration of saponins, which can cause a strong allergic reaction.

3. Avoid standing water

Besides the initial soaking period, it is important to keep sprouts moist, but avoid standing water in the sprouting container. Drain your sprouts well, and, if possible, leave your jar upside down, but inclined, so there is airflow. 4. Rinse frequently

It's important to rinse sprouts thoroughly at least every 12 hours. If using beans that will not be cooked, rinsing every six hours, especially during warmer temperatures, is recommended. 5. Take extra care when the weather is warm and humid

Both humidity and warmth can breed bacteria, but so long as seeds are rinsed frequently and proper airflow is available humidity should not be a problem. 6. Keep your final sprouts as dry as possible

It is best not to wash sprouts just before storing in the fridge. Instead, wait until sprouts are nearly ready for another rinse before putting them into the refrigerator. 7. Eat your sprouts as soon as you can

Here are some tips to make sure you are only growing sprouts and not any problematic bacteria:

Eat your sprouts within 2–5 days. Plan on sprouting small batches of seeds, so that only a small amount will be stored at one time. If you can, plan it so that fresh sprouts are enjoyed straight away.

1. Be clean

8. Cook your sprouts

SPROUTING SAFELY

Always wash your hands. Use clean, sterlised equipment. 2. Use clean water

Besides the seed, a sprout's only other ingredient is water. If you can, use clean, filtered water.

If you have any concerns about eating raw sprouts, you can use them in cooked food, which will kill any possible harmful bacteria, while still enjoying the nutritional benefits.

The benefits

How to sprout

Step 1 Rinse your grains, legumes, or seeds in a sieve under running water. Add your seeds to your clean, sterilised jar. Add water – make sure the water is at least double the amount of the seeds being soaked. Cover with a clean teatowel or screw on a mesh lid and leave at room temperature away from direct sunlight. Refer to table below for soaking times. Step 2 Using a mesh lid, or a sieve over the mouth of your jar, drain the liquid, then rinse and fill back up with fresh water. Drain the liquid slowly at an angle to create a humid environment. Your goal is to keep the kernels moist until they sprout a bud. They do this by being exposed to light and moisture. Step 3 Repeat Step 2 every few hours or at least twice daily. Keep your jar out of direct sunlight. Step 4 In 1–4 days, your sprouted grains, legumes, or seeds should be ready to eat. Refer to the table below for specific sprouting times. Step 5 Store sprouts in a clean, dry container in the fridge. Consume within 2–5 days. If you see any signs of mould, discard your sprouts.

WHEN TO HARVEST

This largely depends on personal preference – some people like to eat their sprouts as soon as they start to germinate, others like a bit higher plant-to-seed ratio. However, the larger the seed, the less growth you would usually want. This is mainly because the large seeded varieties, such as peas or chickpeas, start to grow fairly large roots very quickly and often the roots can be the least appetising part of the plant.

Equipment

Soak

Drain & rinse

Easier digestion. One of the claims about sprouted grains is that they are easier to digest (at least, for some people) than regular grains. There may be some truth to this. A young plant that is still growing is more easily able to ‘digest’ the endosperm, thanks to enzymes. So, not surprisingly, sprouted grains may be a little easier on the stomach than regular grains — this means less stomach upset and less bloating. More nutrients. Sprouted grains contain more of certain nutrients than regular grains. For example, they’re higher in B vitamins, vitamin C, folate, fibre, and essential amino acids (the building blocks of protein). Sprouting also makes it easier for the body to absorb nutrients, such as calcium and iron, in the digestive tract. Less carbohydrate, more protein. Sprouted grains aren’t carbfree, but because sprouting decreases the amount of starch in grains they contain less carb. And the proportion of protein is a bit higher. This, in turn, can make sprouted grains a good choice for people who have diabetes. More fibre. Sprouted grains contain more soluble fibre than regular grains. Soluble fibre is a type of fibre that absorbs fluids in the digestive tract, helping you feel more full. This kind of fibre can also help lower cholesterol and blood sugar levels.

Store

Source: diabetesselfmanagement.com

SOAKING AND SPROUTING TIMES

HOW TO USE YOUR SPROUTS

Adzuki beans 8 hours

3-5 days

Your sprouts can be used in many ways. Here are a few ideas:

Alfalfa

8 hours

1-3 days

Buckwheat

30 minutes 1-2 days

Chickpeas

12 hours

12-24 hours

Lentils

8 hours

12-24 hours

Millet

8 hours

2-3 days

Mung beans

24 hours

2-4 days

Peas

24 hours

3-5 days

• Add to salads • Add to stir fries • Pop into a smoothie for a nutrient and protein boost • Add to soups and stews • Add sprouted grains to breads • Add sprouted grains such as buckwheat and millet to porridge • Try one of our recipes overleaf!

DIABETES WELLNESS | Autumn 2023

Hu mmus

Bolognese

Burgers

SPROUTED CHICKPEA HUMMUS This recipe makes a fresh tasty hummus. Sprouting the chickpeas increases the nutrient value. There’s no need to cook them first. Just make sure you follow all our safety rules for sprouting. 8 SERVINGS

¾ cup of dried chickpeas 1⁄3 cup tahini ¼ cup lemon juice 3 tbsp extra virgin olive oil 2 tbsp apple cider vinegar 2 cloves garlic, chopped ½ tsp salt 1 tsp ground cumin ¼ tsp smoked paprika (optional) water (if necessary) Sprout chickpeas using our sprouting guide. Sprout for 3 to 5 days, depending on how big you want your sprouts.

Give your chickpeas a rinse, drain well, and add to the bowl of your food processor along with the tahini, lemon juice, olive oil, apple cider vinegar, garlic, salt, ground cumin, and smoked paprika. Blend to a smooth, thick puree. You may have to stop the processor and push the ingredients down a few times, scraping the mixture down from the sides. If your hummus is too thick for your liking, you can add some water, a little at a time, until you reach your desired

SPROUTED LENTIL BOLOGNESE Sprouted lentils reduce the cooking time by half – this easy Bolognese sauce takes only 30 minutes to cook. It’s budget-friendly and nutritious. The wine is optional but will add to the depth of flavour. I recommend serving the Bolognese with wholemeal spaghetti.

consistency. The hummus will firm up a little when it chills in the fridge. You can serve straight away with fresh batons of cucumber, carrots, and florets of lightly steamed broccoli. Or use hummus in pita bread, sandwiches, or wraps. Keep in the fridge in an airtight container for up to five days. PER SERVING: ENERGY 625kJ (149kcal) | PROTEIN 4g | FAT 12.2g (SATURATED FAT 1.6g) | CARBOHYDRATE 4.7g (SUGARS 0.7g) | SODIUM 170mg

DIETITIAN TIP: We get used to salt in our food. Add salt last after you have tasted your food without salt – you may be able to do without.

SERVES 4

250g sprouted lentils 3 tbsp olive oil 1 small onion, diced 4 cloves garlic, minced ½ tsp dried oregano ½ tsp dried basil ½ tsp dried thyme ½ tsp chilli flakes (optional) ½ cup red wine 2 x 410g of chopped tomatoes in juice with no added salt 1 ½ cups veggie stock 1 tbsp tomato paste (no added salt) 1 bay leaf ½ tsp salt

DIABETES WELLNESS | Autumn 2023

In a large, heavy pan over medium heat, add 3 tbsp of olive oil. Add onion and sauté for 4-5 minutes until soft. Add in the garlic, oregano, thyme, dried basil, red pepper flakes (if using), and pepper. Stir and sauté for an additional minute until the garlic is fragrant. Add in the wine, scraping any browned bits with your wooden spoon.

Once boiling, add in your sprouted lentils and stir to combine. Lower the heat to simmer and cover. (Now is a good time to get your pasta on!)

Once the liquid has been reduced by about half, add the chopped tinned tomatoes, stock, and tomato paste. Stir to combine then add in the bay leaf. Bring the sauce to a gentle boil.

Serve the lentil Bolognese over pasta. Taste before serving and add salt if needed.

Allow the lentils to simmer for 15 minutes. Uncover and stir. Lentils should be tender and cooked through. If your sauce has too much liquid, simmer a little longer.

PER SERVING: ENERGY 1620kJ (387kcal) | PROTEIN 11.4g | FAT 25.7g (SATURATED FAT 2.2g) | CARBOHYDRATE 24.7g (SUGARS 1.7g) | SODIUM 190mg

SPROUTED LENTIL BURGERS Typically, lentils need to be cooked first to be easily digested. Sprouting breaks down phytic acid. This makes the nutrients in the lentils more available to you. Use these tasty patties in burgers. We recommend wholegrain buns and plenty of salad. SERVES 4

1½ cups sprouted green or brown lentils (follow our sprouting instructions) 1 cup cooked brown rice (or quinoa) 1 cup walnuts – lightly toasted (or sunflower seeds) 1 tbsp miso paste 1 tbsp olive oil 2 tsp whole-grain mustard 1 clove garlic, finely chopped or minced 1 tsp cumin ½ tsp ground coriander ½ tsp salt ½ tsp ground pepper 2 tbsp fresh chopped herbs (chives, coriander, parsley, basil, etc) 2 tbsp toasted sesame seeds

Use barely sprouted lentils for this recipe – sprout until the first little sprout is showing. One to two days after soaking is all that’s needed. Place your raw sprouted lentils (drained well or your burgers will be soggy!), cooked rice, toasted walnuts, miso, oil, mustard, garlic, spices, and pepper into a large bowl. Mix well to combine, ensuring the miso paste is well distributed and broken up. Now place in the food processor and repeatedly pulse until the mixture is combined well and becomes a coarse, sturdy dough. DO NOT OVER-PROCESS! You want a coarse texture, not smooth, or you’ll end up with a pasty patty. Place a piece of baking paper on a baking tray pan or large plate. Sprinkle the paper with the toasted sesame seeds. With slightly wet hands, divide the dough into four balls and form four burger patties. Place on the baking paper, coating both sides with sesame seeds. Place in the fridge for 15 minutes to firm up. Your patties can be pan-fried or oven baked. Use spray oil to limit fats. You can also pan-sear these and then finish in a hot oven. Patties can be wrapped before cooking and frozen. PER SERVING: ENERGY 889kJ (212kcal) | PROTEIN 7.5g | FAT 11.5g (SATURATED FAT 1.8g) | CARBOHYDRATE 15.7g (SUGARS 9.5g) | SODIUM 112mg

Now there’s a rice that is NEW to NZ from SunRice, our Low GI Rice is a perfect choice for people with diabetes looking for a carb that is lower on the glycemic index (GI). Foods with a Low GI are more slowly digested and produce a more gradual rise in blood glucose levels. This allows for a more sustained and measured release of energy throughout the body. Choose from SunRice Low GI White Rice or Low GI Brown Rice for sustained energy. Both officially recognised and approved by Diabetes NZ, and certified by the Glycemic Index Foundation. This nutritious product tastes and cooks just like regular rice and is a healthy choice. Now you can feel good about making a smarter carb choice.

Visit sunrice.com.au, and search “Low GI” for recipes and more product information.

LOOK OUT FOR OUR NEW PACKS!

Your DNZ

Biking and running Aotearoa Over spring and summer, many Kiwis were busy raising money in the name of diabetes. Here’s a round-up of the brilliant and sweaty work that some have done, from the tip to the toe of our beautiful country.

BIKE 2 BEAT DIABETES Palmerston North local Jude Fieldhouse got on her trusty steed and e-biked the entire length of Aotearoa New Zealand in just over a month. Her aim was to ‘Bike 2 Beat diabetes’. Last year, she was diagnosed with pre-diabetes. With that in mind, Jude jumped on the diagnosis, turning it into an opportunity to fundraise, raise awareness, and knock off a personal goal – to cycle the length of the country. ‘I decided if I was going to bike all that way – 2511km – I may as well use it to raise money for a charity.’ So, at the end of August, she pedalled away from the beautiful Cape Reinga and just over a month later cycled into Bluff. Averaging 70km a day, Jude only took two rest days over the extended month. Jude is no stranger to cycle touring. As well as most of the NZ Cycle Trails, she already had the Camino de Santiago and bike trails in Vietnam and the Netherlands under her belt. From north to south, Jude raised a whopping $9174.

DIABETES WELLNESS | Autumn 2023

AUCKLAND MARATHON

Diabetes Youth Auckland made their mark at the Barfoot and Thompson Auckland Marathon on the last Sunday of October. Raising money for children living with type 1, they blew their target of 5k by raising a total of $7726.50. Despite getting drenched in the continual Auckland rain, these fantastic people ran various distances, with one person completing the full marathon, several finishing the half, and the rest spread over the still-impressive 11 and 5km stretches. 3

1. Zoey & Richard Currie pose with batman. 2. Maria and daughter Lucy (T1) testing. 3. Shantelle Bliss with kids Larissa and Ashton. 4. Callum McCulloch. 5. Preston (T1) and Seron Stanley. 6. Katrina Collinson with kids Katie (T1) & Leo.

TAURANGA HALF MARATHON ’Twas the season to be running! Aucklander Ricky Dragland took up the challenge and ran the Tauranga Half Marathon in mid-September. He says he was diagnosed with pre-diabetes at the start of last year and was on his way to becoming type 2. ‘At first, I was in denial about it, then I decided to do something about it.’ He says he started off making small changes by walking his dog, then he set himself the challenge to run one kilometre continuously. That one kilometre turned into five, then 10, then Ricky found himself signing up to do the half marathon at 21.1km. Due to his lifestyle changes, Ricky lost 22kgs. ‘I have started on the journey to reversing my pre-diabetes.’ Well done, Ricky, and thank you for your $1000 fundraising effort.

DIABETES WELLNESS | Autumn 2023

Care

YOUR ANNUAL DIABETES REVIEW What does your diabetes annual review mean to you? Anita Parkinson is an Auckland Practice Nurse with many years’ experience specialising in diabetes care. She explains all the ins and outs of the yearly check-in, and what you will get out of the visit.

oming into a medical practice is, for some, a considerable undertaking. This is either because the visit has to fit around work or because poor health or complicated social circumstances make it difficult to get there. It is a common misconception that this appointment is a review of how poorly you are maintaining your health, almost akin to a visit to the headmaster’s office. This is not so. The annual diabetes review is all about how we, as health professionals, can help and enable you. We will do this without judgement or admonishment of perceived failures. You are a human being, not a machine. You are not expected to be perfect and, most of all, diabetes is not your fault. Please believe this fact. FINDING YOUR ‘NORMAL’

I ask patients, ‘How do you manage your diet?’ The usual answer is, ‘You know, just normal.’ Finding out what you perceive as normal is the first measure of where we are heading. I ask what you usually have for breakfast, lunch, and dinner. Sometimes, I hear some

DIABETES WELLNESS | Autumn 2023

shame that bad foods have been eaten. The thing to remember is there is no such thing as ‘bad’ food. It is all about balance – eating particular foods occasionally and in small quantities. But others should be eaten most days, as staple foods. That familiar line about diet and exercise ‘Eat your greens and go for a walk’ has probably made your ears close because you’ve heard it so many times before. I acknowledge that change is really hard, particularly if you have a family to fit in with. It is always worth giving it a try to improve your eating. Help is out there, including the Diabetes Self-Management Education programme (DSME), which is run by each region’s community coordinator. There you will meet experienced dietitians and gentle health coaches. We are all here for you, and programmes are funded. ‘YES, BUT…’

We often have barriers to doing exercise, but regular movement goes hand in hand with healthy eating. Have you heard yourself say, ‘I could do that, but my life

is too busy’? All these ‘buts’ are self-imposed barriers. They are not your friend nor protector, and they inhibit you being able to move forward. In the review, I might suggest setting a small goal, such as getting out of the chair and walking around the house three times per day. Then slowly add to it. Trying is so important. Please remember, your efforts are always worthwhile. SELF ESTEEM

Low self-esteem can be a huge barrier to making healthy choices. It is not uncommon to find talking about one’s self-esteem a challenge in itself. I usually start by asking where patients place their selfesteem and well-being in their lives. Often, we deflect our own needs in favour of those around us. Those of us with busy lives tend to leave our health hidden and uncared for, and I often have to deflect a few ‘yes, buts’ at this stage as well. But the truth is people often don’t consider their own needs as important as those around them. Sometimes, I invite a patient to

imagine they are about to fly off on an amazing holiday. However, as the pilot introduces herself, she admits that her blood sugar is a bit high and she feels a bit off, but she’s sure she will be okay to fly a plane full of people. Would you stay on the plane? I wouldn’t. But would you drive your car? I use this analogy to reinforce that the patient is as important as the people they care for. Then I ask them to unpack their own needs from the ‘box under the bench’. I urge them to be the ‘pilot’ of their family and to realise their importance to the people they care for. Examining your self-worth can be very challenging, and I encourage people to say to themselves, ‘Yes, I am important, my needs are valid, and it isn’t vanity to put those needs on my daily to-do list.’ TAKING YOUR MEDS

In the review, we discuss a patient’s medications. I ask how they are coping with their medications, and do they ever miss doses? Sometimes, the burden of medication is an

issue, so we look at alternative regimens. We discuss what might be improved for them and what they want going forward. Some people prefer more medication because making lifestyle changes is too difficult at that time. Whichever path a person chooses, if they are willing to optimise control, we should be able to support them. FINALLY, THE FOOT CHECK

Let’s be honest, feet are gnarly and very often ignored. They can be too far down to reach easily. Sometimes, they can’t be seen over a belly, making them out of sight, out of mind. But feet are important and need love, just like the rest of the body, so bringing some love to the extremities is always an ambition. Even fabulously hairy hobbit feet. Smooth, hairless feet on a hairy body is a red flag that something could be awry. All patients should be encouraged to maintain a good level of foot hygiene. You can help this happen by wearing well-fitted shoes and reporting any skin

conditions early. If signs are ignored, catastrophic outcomes later down the line are a real possibility. A health professional will examine the feeling in your feet to check for loss of sensation or numbness, then check all the pulses to make sure the circulation is healthy, and lastly the foot structure to check if loss of foot shape is causing problems. If any issues are identified, we can refer you for funded podiatry. Prevention is always better than a cure, so engaging with professionals in self-care is paramount to good and lasting outcomes ‘Fate’ genetics and modern living conditions all play a part in diabetes. As health professionals, we must ensure we are doing our job, encompassing all the health needs you are likely to face as a person living with diabetes. That is what you are, a person living with diabetes. Not a ‘diabetic’ or a ‘statistic’ and especially not a failure. You are a human being, not a machine, flawed and beautiful. You are not expected to be perfect.

DIABETES WELLNESS | Autumn 2023

Advocate

TRANSFORMING LIVES: 100 YEARS OF INSULIN Last year, on 24 November, the Edgar Diabetes and Obesity Research Centre, Healthier Lives National Science Challenge, Lions International, and Diabetes NZ collaborated on hosting a symposium at Parliament.

arliament’s Grand Hall welcomed nurses, doctors, researchers, advocates, and more. They all gathered to listen to diabetes experts from around New Zealand and Australia, facilitated by Professor Jeremy Krebs and Dr Rosemary Hall. The theme of the symposium was to celebrate 100 years of insulin. The scene was set by Professor Sir Jim Mann, who took the audience back 100 years, to imagine what it was like to be diagnosed with diabetes in a very different time. He said that this was a time of glass syringes and steel needles that needed sharpening when they became blunt. Blood glucose tests had to be sent off to a laboratory. But despite New Zealand being more isolated back then, the first Kiwi to be treated with insulin received it the very same year as the first person in the world, a Canadian. Ashburton farmer Mr Neil Stockdill shared his experiences, saying that in April of this year he will have been living with diabetes for 70 years. Diagnosed at 12, he spoke about having to test his urine in a test tube, over a Bunsen burner, in the corner of his bedroom. ‘If it turned blue, then it was good. If it turned orange, it was not bad. And if it turned red, then it was time to consider how much insulin to take.’ These methods of testing were clumsy and unreliable. Neil spoke of the relief and safety of now having a CGM and pump.

DIABETES WELLNESS | Autumn 2023

1. At the symposium: Catherine Taylor, Heather Verry, Pam Fiveash, Wendy Goodwin, Alice McDonald, and Jim Mann. 2. Sianne Chapman receives her Silver Medal Award for successfully managing diabetes with insulin for more than 25 years. 3. David Town receives the Sir Charles Burns Memorial Award for successfully managing diabetes with insulin for at least 50 years. 4. Winner of the Diabetes NZ Award Ruby McGill joining Catherine Taylor at the podium. 5. Catherine Taylor takes the mic to ask a question at the symposium.

Associate Professor Ben Wheeler shared studies of two young adults, one with frequent hospitalisations who was at extremely high risk for early complications and death. Ben estimated this young man’s HbA1c to be one of the worst in the world, at three times the average. Six months after trialling a CGM, his HbA1c dropped more than 100 points. The main topic each speaker returned to was technology, namely CGMs, and the need for fair and easy access to them. Endocrinologist Dr Ryan Paul outlined the inequities that type 2 diabetes creates in Aotearoa New Zealand, within Māori and, more so, Pasifika. He reported that this isn’t ethnicity related but driven around access to care. His plea was to the government for better funding and to Pharmac for access to the latest medicines.

‘I hope the words here diffuse out from these walls, to get the change we need.’ Other speakers included Dr Damian Wiseman, cycling coach for Paralympics NZ, and Professor Jenny Couper, Head of the Discipline of Paediatrics, University of Adelaide, who spoke about the origins of type 1 among children. Renza Scibilia, an advocate from Australia, provided background on the ‘slow burn’ activism needed to get CGMs fully funded in her homeland. Brianna Veale, who describes herself as a ‘16-year-old type 1 diabetic warrior’, shared her and her brother’s journeys navigating diabetes. She echoed others’ experiences of having their lives changed by technology. ‘CGMs are my key to the light at the end of the tunnel.’

AWARD WINNERS

The symposium concluded with the presentation of three DNZ Awards by Catherine Taylor, chair of the DNZ Board: • Sianne Chapman – Silver Medal Award for successfully managing diabetes with insulin for more than 25 years. • David Town – Sir Charles Burns Memorial Award for successfully managing diabetes with insulin for at least 50 years. • Ruby McGill – Diabetes NZ Award for making a significant contribution to support those with diabetes in Aotearoa New Zealand.

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DIABETES

Diabetes Wellness magazine is the flagship publication of Diabetes New Zealand

Your DNZ

Three new trustees Diabetes NZ is delighted to advise the appointment of three new trustees to the Board.

he new members joined the Board at the start of the year, and each brings a background in diabetes, as well as Māori and Pasifika health and community needs. These three new trustees will aid in guiding Diabetes NZ to ensure we embrace all New Zealanders and respect all cultures and values. These new appointments will help Diabetes NZ continue its focus on acheiving more equitable outcomes for people with diabetes in Aotearoa New Zealand. We welcome:

TIO TAIAKI

(Te Ātiawa ki Whakarongotai, Ngāti Tūwharetoa, Āti Hau Nui-ā-Pāpārangi)

Tio works for Deloitte as an Associate Director in Māori Health and Equity. Fluent in te reo Māori, he has experience in governance roles on health and school boards, and is an active member of his iwi and local community. Living in Paraparaumu, Tio has type 2 diabetes and is from a whānau that has been affected by the condition.

DIABETES WELLNESS | Autumn 2023

BEV GIBSON

(Te Atiawa, Ngaruahine, Te Arawa)

Bev is a health auditor for Te Whatu Ora HealthShare and a fellow of the Institute of Directors. She is also Chair of several community trusts, such as Wild for Taranaki, Mahia Mai A Whai Tara Kaumātua service, and Ngāti Tawhirikura Hapū. Bev has expertise in governance and management in a range of corporate and notfor-profit organisations. These include health, agribusiness, education, business development, environment, biodiversity, Māori land ownership, iwi, and hapū. Bev lives in New Plymouth, and diabetes is also present in her whānau.

EROLIA ROONEY Erolia is a Board trustee and community representative on the WellSouth Primary Health Network board and the Otago Youth Wellness Trust board. She is also the Supervising Scientist at the Dunedin Blood Bank. Living in Dunedin, Erolia is passionate about her Pasifika community, striving to ensure access of care and equality of support for all.

ADVERTISING FEATURE

Keeping the sugar balance Clinicians Naturopath Jane Cronin explains how to support your sugar balance.

Sugar, or rather glucose as it appears in the body, provides the fuel for our cells to make energy. But like all good things, it is best in moderation. Excess sugar can result from consuming more food than we need for energy, eating the wrong sorts

Choose complex carbohydrates

Food combining

Carbohydrates are important for energy, but some types are better than others. Whole grains and fruit and vegetables are rich in fibre, antioxidants, vitamins and minerals. They metabolise more slowly than refined carbohydrates like white bread, baked goods, pasta and sweet treats, which burn up fast then cause a drop in energy. Slower-burning carbohydrates help to avoid high levels of glucose being dumped quickly into the blood.

As well as choosing better forms of carbohydrates, you can also combine them with other kinds of foods so that they metabolise more slowly. When you combine carbohydrates with some good fats or protein they will be used for energy at a slower more consistent rate. For example, if you have a breakfast of white bread and jam, it will burn up quickly and leave you feeling hungry for more carbohydrates. If you chose wholegrain toast and egg or avocado, it would sustain your energy better through the morning.

Soluble fibre Whole grains, fruit, vegetables, legumes and nuts are also good for you because they contain fibre. This can help fill you up and keep your bowels regular. However, soluble fibre also helps to support healthy sugar and cholesterol levels. This type of fibre is high in food like oats, apples, psyllium, legumes (beans, lentils), kumara and broccoli.

When to eat Eating main meals around the same time means that you keep your energy levels constant. Try not to wait until you are over-hungry as you are likely to overeat and may get hangry (hungry and angry).

Drinks Water should be the main drink of the day, but green tea can also be helpful as it is strongly antioxidant, but also helps with blood sugar balance. Alcohol, carbonated drinks and fruit juices should be in moderation as they are loaded with sugar.

of food or if our cells are struggling to take up glucose. Imbalances with sugar occur gradually over time, but can be turned around with lifestyle changes. Here are some helpful tips for a healthy diet and sugar balance.

Clinicians for sugar support Clinicians Hi-Dose Chromium can help support sugar and carbohydrate cravings in people who are making dietary changes. It supports healthy blood sugar levels. Being a high dose only one capsule daily is required with food.

Supportive minerals Two minerals play an important part in supporting healthy blood sugar, zinc and chromium. They both support the healthy uptake of sugar into our cells. Zinc is an important antioxidant and chromium can be very helpful when it comes to sugar cravings. Zinc can be found in foods such as fish, shellfish, nuts, seeds and legumes. Chromium can be found in whole grains, lean meat, eggs and apples.

Herbs and spices There are several herbs and spices that can help support healthy blood sugar. Cinnamon is tasty but also helps to support a healthy sugar balance. Try sprinkling some cinnamon powder in porridge or add it to stewed fruit. Turmeric and fenugreek are also helpful and can be added to cooking, especially curries.

Always read the label. Use as directed. If symptoms persist see your healthcare professional. Dietary supplements are not a replacement for a balanced diet. Douglas Pharmaceuticals, Auckland. TAPS MR8754

Care

Hauora Kaimahi

IN THE DEEP SOUTH

W We continue our travels around Aotearoa New Zealand, meeting each region’s diabetes community coordinator. In this issue, we meet Theresa Cherry, our hauora kaimahi for the Southland region.

DIABETES WELLNESS | Autumn 2023

hen we spoke with Theresa Cherry, she had just come in the door and was taking off her lab coat. When not working for Diabetes NZ, she works part-time as a laboratory technician at Southland Hospital. ‘Having two roles, it’s all go, go, go, but that’s ok. It’s just nice to sit down for five minutes.’ When Theresa joined Diabetes NZ, Te Whatu Ora Southern allowed her to drop her hours so that she could work between the two. Theresa started in her role in April 2022. ‘I really enjoy coming from the hospital side of things to now being out in the community.’ A bonus of working in both jobs is being able to meet people on the wards who require follow-on care in the community. ‘I can meet and chat with them, establish a relationship, and move it forward into my other role.’ Two of Theresa’s workmates made her aware of the job vacancy

as they reckoned it had her name all over it. It was advertised as needing an understanding of both Māori and Pasifika frameworks, so having spent the last four years completing her diploma in Te Reo Māori through Te Wānanga O Aotearoa, her interest was sparked. Before starting her te reo journey, Theresa and her husband regularly wove wahakura (in-bed bassinettes) and were contracted by Te Whatu Ora. Her partner, Jason (Ngāti Kahungunu ki Wairoa), wanted to become a weaving tutor but realised he needed more reo, so they both took on the challenge four years ago, engaging themselves in te ao Māori. ‘We made amazing friendships and relationships over the years. The next step is full immersion, but that will require a lot of focus and I’m a bit too busy for that at the moment.’ Theresa also has a new mokopuna in the whānau to spend time with.

Theresa and Jason are supported by their kids Braedon, Kayson, Macaela and Jordan at their parents' Diploma in Te Reo graduation.

ENGAGEMENT WITH THE COMMUNITY

Theresa’s work as hauora kaimahi covers the broad Southland region. The majority of people she visits are in Invercargill, but she also visits people rurally, including where she grew up, in Te Anau. ‘Because I’m working between two roles, it’s almost a break. It’s a change of scenery all the time. I get the best of both worlds and don’t have a chance to get bored.’ She says that, for a number of reasons, some people aren’t always up to seeing her in person, so she will make it work for them by phoning, texting, or Zoom-calling. For Theresa, an average day will have her checking her emails for referrals, contacting existing cases, then spending the rest of the time out in the community, engaging with patients. ‘I’ve taken people to the gym and even out for a walk, as some need more one-on-one support than others.’ She will also help patients make plans around what they want to work on with their diabetes. ‘The other day, a man needed meal ideas, so we did some cooking together and I showed him a couple of quick and easy meals.’ Theresa enjoys building the relationships in a comfortable environment, saying that people then open up and that

allows her to dig a little deeper. ‘I can take people to their appointments, and because of my background I’m able to provide blood testing at home, which is a wee bit of an added extra.’ Not everyone has transport, and she sometimes meets people with anxiety, so being able to come into someone’s home helps put them at ease. DIABETES ACTION MONTH

Theresa had a busy few weeks in November as Diabetes Action Month was launched throughout the country. There were a number of local pop-up events outside supermarkets and shopping centres where people could get their blood glucose tested. There were also community walks hosted in the beautiful Queen’s Park in central Invercargill. This was an excellent way to introduce herself to the community. IN THE NEW YEAR

This year, Theresa will be facilitating the Diabetes SelfManagement Education programme (DSME). Held nationwide, it is a free, six-week programme where people living with type 2 can learn more about their diabetes, as well as build relationships with others in a

group. ‘Hopefully, we will be able to start up walking and coffee groups, and I’ll pop in from time to time.’ These DSMEs are run alongside clinicians. ‘In nutrition week, there will be a dietitian who can answer all the nitty gritty questions.’ Theresa says she already has a collection of people wanting to do this course. She just needs to figure out what time of day suits the various participants. AND ONWARD

Going forward, Theresa says it would be amazing to get more support for people with diabetes in the community, because there is such a growing need. ‘My role is only 20 hours, so there is a need for more hours or even another one of me, because Southland is such a huge area to cover.’ She hopes for more awareness of diabetes in the general community as well. ‘I would like to see the word spread and more education available, because diabetes is everywhere.’ Theresa says the desire for education goes for her too, as her learning curve since starting her job this year has been steep. ‘I’m soaking it up and enjoying the new knowledge.’

DIABETES WELLNESS | Autumn 2023

Diabetes Youth

OUR YOUNG LEADER, LAURA Lately, Laura Snowden has been a regular on these pages. As Aotearoa New Zealand’s youth representative, she reports back from her time in Lisbon as a ‘YLD’.

DIABETES WELLNESS | Autumn 2023

ast December, New Zealander Laura Snowden travelled to Lisbon, Portugal, to attend the Young Leaders in Diabetes programme (YLD). This international programme provides young people with education, guidance, and support throughout a two-year period to empower and help them become efficient advocates for themselves and others living with diabetes. Currently, the network is comprised of 95 young leader trainees and a number of mentors. These mentors are graduated trainees who choose to continue working within the programme. When Laura graduates from the programme in two years’ time, she says she would like to become a mentor. The group was asked to do a project online and submit it. Sixty were successful and invited to the biennial training summit. Laura found out last September that she

was successful and would be flying to the Portugal capital, thanks to the help of Diabetes NZ. LISBON

Before she had even set foot on the plane, Laura had already connected with many of the other ‘YLDs’ from around the world, through their WhatsApp group a few months earlier. This made getting to know each other easy. She says it was an intense week, working alongside a large number of equally passionate people. The days were full, with everyone attending seminars on a wide range of matters. Just a few of the topics covered were the use of social media for advocacy, effective communication, and using inclusive language. Training in advocacy featured highly. This included guidance on how to use data for advocacy and an introduction to the Type 1Diabetes Index: an expansive gathering

of worldwide data. One session featured successful stories of advocacy, such as Australia’s #cgmforall campaign. Laura says she went into the training summit thinking there was no way she could advocate enough as one single human. She believed she was limited in the ‘noise’ she could make as an individual, even in our small country. ‘I thought, I’m only one person and there’s no way I can advocate to make any change.’ But on her final day, she was energised. ‘I thought, this is it. I’m going to go back, and I’m going to write to the PM. I’m going to say we need these things funded.’ Laura says she feels so much more empowered now, believing she has the tools and voice to help make things happen. The busy week ended with the YLD regional elections at which Laura was elected the Western Pacific representative. As well as

Aotearoa New Zealand, her area now covers Australia, Thailand, Papua New Guinea, South Korea, Malaysia, Singapore, Taiwan, Fiji, Cambodia, and Hong Kong.

Clockwise, from top left: YLD attendees in front of the world flag wall; having an evening out at the Winter Wonderland Lisboa with other YLDs; YLD Regional Representatives voted for 2022–2024.

THE PROJECT

with her DNZ mentors as she drives through the project. The YLD training summit taught her that, to find inspiration and advice, it is encouraged to reach out to industry and organisations around the world who work with diabetes. That reach begins in her home town, where she is under the wing of Diabetes NZ Auckland Youth. In order to stay in the programme, Laura has to submit quarterly updates. But she does have until 2024, when the next YLD summit happens, to complete her project. The YLD always runs alongside the International Diabetes Federation Congress (IDF), and you can read about our team’s time at the IDF on the next page.

Laura says it’s still early days, but that her project is leaning towards developing a programme to train leaders who will then go on to become mentors for young Kiwis living with diabetes. This will happen through camps and online training for the emerging leaders. As members of Diabetes New Zealand’s Youth Forum, Laura and her working group conducted two surveys to gauge the interest in such a programme. The responses were overwhelmingly positive, with some surprising results highlighting a demand for a buddy from some older adults as well. Laura will be working closely

DIABETES WELLNESS | Autumn 2023

Your DNZ

OUR TEAM VISITS LISBON Last December, DNZ CEO, Heather Verry, and DNZ Service Development Manager, Liz Dutton, travelled to the 26th International Diabetes Federation General Assembly in Lisbon, Portugal.

he International Diabetes Federation General Assembly hosted 229 delegates and was followed by the IDF World Diabetes Congress which attracted over 5600 onsite and online participants from 175 countries. Our team attended as delegates. The International Diabetes Federation (IDF) is an umbrella organisation of more than 230 national diabetes associations in 170 countries and territories. It represents the interests of the growing number of people with diabetes and those at risk. The Federation has been leading the global diabetes community since 1950.

The General Assembly is IDF's general guiding body. It normally meets every two years, at the same time as the World Diabetes Congress. At last year’s Assembly, President Boulton provided his report, which covered two years. This was due to Covid-19 requiring the extension of the mandate of the Board by a year. Over this time, the Board reviewed the Strategic Plan which covered a 10-year period from 2011 to 2021. Professor Hussain (President Elect from Norway) gave an overview of the IDF Strategic Plan, covering the period 2023–2026: The 2022–2021 plan operated under the Vision established for the organisation in the mid-2000s. The Vision, ‘Living in a world without diabetes’ was aspirational but has, at least over the last 15 years, felt unachievable and, subsequently, less than inspirational. The data from our Atlas reports attest to a flooding tide of diabetes that, regretfully, shows no sign of ebbing any time soon. Over the past 15 years, advances in therapy, the organisation of care and, in particular, the introduction of new technologies in monitoring and delivery, suggest to some that we are closer to gaining control over diabetes than we have ever been in the century since the discovery of insulin. Some may feel that science is bringing us ever closer to a cure, at least for type 1 diabetes. However, from the global perspective, the better the care for those fortunate to afford it, or otherwise living under a healthcare Liz Dutton, Laura Snowden and Heather Verry.

DIABETES WELLNESS | Autumn 2023

regime that provides sufficient health coverage, the wider the gap between the haves and the less fortunate have-nots. The battle lines are now drawn around issues of access and availability. IDF must play its part in promoting the adoption of universal health coverage and improving access to care worldwide. For this reason, we have proposed a change in our vision to: ‘Access to affordable, quality diabetes care and education worldwide’. The Delegates were also asked to vote on a change to the previous mission – ‘Promoting diabetes care, prevention and a cure worldwide’ – as it no longer reflected the reality of what IDF wished to achieve. The new Mission statement was passed – ‘Improve the lives of people living with diabetes and prevent diabetes in those at risk’. The incoming President outlined three strategic aims to support the new Vision and Mission: to promote action to prevent diabetes, to improve diabetes outcomes, and to advocate to support the interests of people living with diabetes. A three-day Congress followed, where full days were spent in symposia, teaching lectures, panel discussions, and debates. The IDF Congress is a core activity of the IDF, offering a global platform to discuss a broad range of diabetes issues, from latest scientific advances to cutting-edge information on education, diabetes care, advocacy, and awareness. Some of the topics covered were genetics of type 2 diabetes, updates on kidney disease, the prevention and remission of diabetes, treating eating disorders, diabetes and mental health, teaching tools and models for managing type 1 and 2, Patient Reported Outcome Methods (PROMS), and sports and diabetes. We will report more on some of the lectures and discussion that our team went to in the next issue. Source: https://www.idf.org/who-we-are/about-idf/structure/generalassembly.html

We need your help to help them A diabetes diagnosis can be scary, overwhelming, and confusing. It’s a steep learning curve whatever kind of diabetes you have. We want Kiwis to know they are not alone. We are here to help them live well with diabetes and support their journey every step of the way. Your generous gift will improve the day-to-day lives of people living with diabetes and help us spread the prevention message far and wide. As a charity, every dollar we raise is crucial – please support our work today: Give securely at www.diabetes.org.nz or call 0800 342 238. Donate via Westpac 03 0584 0197985 09 – use your full name as reference.

Last word

Do you have a story to share? We are gathering individual views and experiences and would love to hear from you! We are looking for people with diabetes to join our consumer network. Diabetes NZ is working with the Health Quality Safety Commission (HQSC) Consumer Forum to facilitate input from consumers into the planning and delivery of diabetes care and services. The level of engagement is up to you – there are opportunities for consumer representatives at a local and regional level. As our new health system starts to evolve, this is your opportunity to have input into the future of diabetes care in Aotearoa New Zealand. For more information on being a Diabetes NZ Consumer Representative, please contact Karen Reed at karen@diabetes.org.nz

Farewell and thank you We would like to acknowledge the departure of our last editor of Diabetes Wellness, Johanna Knox (pictured). She was the editor of the magazine for three years, seeing us through all the lockdowns and bringing bright and informative content to our readers. Before coming to Diabetes Wellness, Johanna already had an extensive background as an editor and writer. In 2021, she published A Forager’s Treasury (Allen and Unwin), from which valuable information about finding free food in the outdoors was shared in last year’s autumn issue. Thank you for your time and expertise, Johanna. Our new editor is Rowena Fry. We are always looking for interesting stories, so if have a noteworthy story to share about your, or another’s, journey with diabetes, then please contact us at editor@diabetes.co.nz.

This summer, make a healthy choice

EAT WELL LIVE WELL

Eat Well Live Well is chock-full of diabetes-friendly recipes from well-known Kiwi chefs. Each dish is quick and easy to prepare and great for your whole family. Head to www.diabetes.org.nz for your copy – $33.00 including delivery – or purchase it directly from your local Diabetes NZ branch, Whitcoulls, PaperPlus, and The Warehouse. All profits go towards supporting Diabetes NZ’s work.

DIABETES WELLNESS | Autumn 2023

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The FreeStyle Libre Flash Glucose Monitoring System and the FreeStyle Libre 2 Flash Glucose Monitoring system is indicated for measuring interstitial fluid glucose levels in people (aged 4 and older) with insulin-dependent diabetes. The indication for children (age 4 – 17) is limited to those who are supervised by a caregiver who is at least 18 years of age. Always read the instructions for use. The system must not be used with automated insulin dosing (AID) systems, including closed-loop and insulin suspend systems. The sensor must be removed prior to Magnetic Resonance Imaging (MRI). *Data based on the number of users worldwide for FreeStyle Libre family of personal CGMs compared to the number of users for other leading personal CGM brands and based on CGM sales dollars compared to other leading personal CGM brands. ^The FreeStyle LibreLink app is only compatible with certain mobile devices and operating systems. Please check the website for more information about device compatibility before using the app. Use of FreeStyle LibreLink requires registration with LibreView. †Finger pricks are required if glucose readings and alarms do not match symptoms or expectations. #Notifications will only be received when alarms are turned on and the sensor is within 6 meters of the reading device. §The LibreLinkUp app is only compatible with certain mobile device and operating systems. Please check www.librelinkup. com for more information about device compatibility before using the app. Use of LibreLinkUp and FreeStyle LibreLink requires registration with LibreView. The LibreLinkUp mobile app is not intended to be a primary glucose monitor: home users must consult their primary device(s) and consult a healthcare professional before making any medical interpretation and therapy adjustments from the information provided by the app. 1. Varughese, B. et al. Diabetes Stoffw Herz 2021; 30: 231-242 2. Haak T. et al. Diabetes Ther 2017; 8(1): 55-73. DOI: 10.1007/s13300-016-0223-6 3. Alva S. et al. J Diabetes Sci Technol 2022;16(1): 70–77. (ePub 2020). DOI: 10.1177/1932296820958754 FreeStyle, Libre, and related brand marks are marks of Abbott. Information contained herein is for distribution outside of the USA only. Mediray New Zealand, 53-55 Paul Matthews Road, Albany, Auckland 0632. www.mediray.co.nz. NZBN 9429041039915. ADC-68475 V1.0

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Diabetes Wellness Autumn 2023

Articles inside

The Last Word

IDF General Assembly

Diabetes Youth

Diabetes Care

New Trustees

Diabetes Symposium

Diabetes Care

Fundraising Roundup

Nourish – DW recipes

Fundraising

CGMs and WINZ

Riley Powell

Out of the blue

DAM 2023

DW Autumn 2023 Editorial