Diabetes Wellness Autumn 2024 by Diabetes New Zealand

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AUTUMN 2024 $8.00 INC. GST

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TATTOOS AS TOUCHSTONES • WALKING THE MIDNIGHT SUN HALF MARATHON ADVOCATES: WORKING HARD FOR THE COMMUNITY • COFFEE GROUPS • IN & OUT OF A PICKLE

JADEN HURA-WHITE FINDING MENTAL CLARITY

NOW IS PERFECT PICKLE TIME!

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To get started on Dexcom G7 or Control-IQ, visit our website today! 0800 500 226 diabetes@nzms.co.nz nzmsdiabetes.co.nz Always read the label and follow the directions for use. Read the warnings available on nzmsdiabetes.co.nz/resources before purchasing. Consult your healthcare professional to see which product is right for you. Tandem Insulin Pumps are medical devices which provide continuous delivery of insulin through subcutaneous self implanted infusion set. The Dexcom G7 Continuous Glucose Monitoring System (Dexcom G7 CGM System or G7) is a glucose monitoring system indicated for continuously measuring glucose in the interstitial fluid in persons ages two years and older. To ensure this product is right for you, always read and follow the user information. References: 1. Brown SA, et al. N Engl J Med. 2019;381(18):1707-171. © 2024 Tandem Diabetes Care, Inc. All rights reserved. Tandem Diabetes Care, Control-IQ, and t:slim X2 are registered trademarks or trademarks of Tandem Diabetes Care, Inc. Dexcom, Dexcom G7, and any related logos and design marks are either registered trademarks or trademarks of Dexcom, Inc. in the United States and/or other countries. NZMS is a Dexcom company. 2A Fisher Crescent, Mount Wellington, Auckland 1060. NZDI_TAN_124 February 2024

COVER: JADEN HURA-WHITE ENGAGES IN A HONGI TO NGĀPUHI WHAKAIRO/CARVING IN OPONONI, HOKIANGA. PHOTO © ERUERA WALKER.

Contents AUTUMN 2024 VOLUME 36 | NO 1

4 EDITORIAL

28 LIFE WITH T1: Jaden – Dexcom warrior

5 DIABETES ACTION MONTH: It's a wrap! 8 COMMUNITY: Choosing ink over bling

30 RESEARCH: Dr Esala Vakamacawai – sowing the seeds of health

12 YOUR DNZ: Shantelle Bliss – melding business and healthcare

33 LIVE BRAVE MANA ORA: Summer camps

37 YOUR DNZ: Annual Review 2023

16 ADVOCATE: Francella Tulilo – the Manurewa marvel 18 MY IDENTITY: Local coffee mornings a great support 20 NOURISH: Pickles 24 COMMUNITY: Susan Dickson – every step for Diabetes 27 LEGACY: Murray Dear on bequests

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Editorial

ia ora koutou. Happy New Year to everyone and fingers crossed that 2024 will be a memorable one for people with diabetes, with the funding of CGMs. Pharmac has now completed their due diligence, and we were pleased to be able to provide consumer input into the process. International experience has shown us that initial release of CGMs may well come with criteria that will not enable all people dependent on insulin to have free access. If this is the case, we will continue with our ‘CGMs for All’ campaign until such time as CGMs are fully funded – it has been five years of ongoing advocacy! Changes are all around us, particularly so with the health sector, which has meant Diabetes NZ has needed to re-evaluate our model of service. As we reflect over the last 60 years, when we started out as a health-focused organisation, we have now repositioned ourselves as a community-centric organisation, where we continue to acknowledge the intertwined aspects of both health promotion and community engagement. We have experienced enormous internal growth, much of which has been brought about through our partnerships with iwi, Māori, Pasifika, and primary health organisations. These partnerships enable us to increase our reach across New Zealand, and we value the engagement we have with the clinicians in the longterm conditions’ teams. The new government will be implementing even more change, so it will be interesting times for the NGO (NonGovernmental Organisation) sector. This is a time of year when our Youth Coordinators and Youth Committees are extremely busy running camps for our type 1 youth. For those newly diagnosed, it is an opportunity to meet other children with type 1 – and this also applies to the parents, who get to ‘compare notes’. We were delighted to recently welcome Wellington and Hawkes Bay Youth into Diabetes NZ, which means we are now well represented across New Zealand in eight areas from Auckland to Dunedin – a significant commitment to youth and type 1 by our organisation. In this Autumn edition of Diabetes Wellness, we begin a series checking in on each region’s hardworking Youth Services Coordinator. We get social, meeting members of a local coffee group who have been drawn together for a cuppa and then found they had type 2 in common. We find out why some folk choose diabetes tattoos over medical jewellery, and we continue our travels around the motu to meet South Auckland’s Diabetes Community Coordinator/Kaiāwhina Mate Huka. HEATHER VERRY

CEO, Diabetes NZ

DIABETES WELLNESS | Autumn 2024

Diabetes New Zealand is a national charity that provides trusted leadership, information, advocacy, and support to people with diabetes, their families, and those at risk. Our mission is to provide support for all New Zealanders with diabetes, or at high risk of developing type 2 diabetes, to live full and active lives. Across the country, Diabetes NZ has staff and volunteers who help people live well with diabetes. Join us today at www.diabetes.org.nz

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

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

ADVERTISING & SPONSORSHIP Head of Business Development Jo Chapman Email jo@diabetes.org.nz Telephone 021 852 054 Download the Diabetes Wellness media kit: http://bit.ly/2uOYJ3p Disclaimer: Every effort is made to ensure accuracy, but Diabetes NZ accepts no liability for errors of fact or opinion. Information in this publication is not intended to replace advice by your health professional. Editorial and advertising material do not necessarily reflect the views of the Editor or Diabetes NZ. Advertising in Diabetes Wellness does not constitute endorsement of any product. Diabetes NZ holds the copyright of all editorial. No article, in whole or in part, should be reprinted without permission of the Editor.

Diabetes Action Month

DIABETES ACTION MONTH WRAP Diabetes Action Month 2023 was another successful awareness, education, and advocacy campaign supporting all people living with diabetes in New Zealand. We report back from the month of action.

he theme for Diabetes Action Month 2023 was Eyes on Diabetes. Diabetes is the leading cause of preventable blindness in Aotearoa, and everyone living with diabetes is at risk of losing their vision. Vision loss can be very difficult to accept, and for those living with diabetes it can have a huge impact on their quality of life. Any loss of sight can indicate the progression of diabetes, and other complications can become more likely from that.

Together, with our partners, supporters and diabetes whānau, Diabetes NZ raised awareness of the importance of regular diabetes eye checks and supported people with diabetes to live well. We were able to spread the good news that, with early diagnosis and treatment, eye damage can be reduced or even prevented. Diabetes NZ is grateful to everyone who helped make Diabetes Action Month 2023 a success, raising both funds and awareness to support Kiwis with diabetes.

SNEAKER FRIDAY The third annual Sneaker Friday took place on Friday, 17 November, raising funds to support people living with diabetes. With the number of New Zealanders living with diabetes rising to 307,000, these funds are more crucial than ever before. On Sneaker Friday, Kiwis across the country rocked their kicks – among them some familiar faces, including Olympian Dame Valerie Adams. The What Now team featured tamariki from the local diabetes community showing off their awesome sneakers on their Sunday, 12 November show. In addition to holding local events around the country, we partnered with the Warriors Community Foundation to bring a fun fitness session to this lucky school, Rise Up Academy in Māngere. This is where former Warrior and Foundation ambassador Ruben Wiki got the kids up and moving, and Te Ao Māori News and Pacific Media Network covered the event. Thank you to everyone who got involved and donated. Left: Reuben Wiki at Rise Up Academy school in Māngere, Auckland.

DIABETES WELLNESS | Autumn 2024

HEALTH TV & MEDIBOARD

EYE HEALTH RESOURCES During Diabetes Action Month, we wanted to shine a light on diabetes eye health, and the importance of regular diabetes eye checks at least every two years. Much of the day-to-day management of diabetes relies on your eyesight to administer insulin, monitor glucose meds, and check for feet or skin issues. As part of Diabetes Action Month 2023, we developed a new resource to raise awareness of diabetes eye health, how diabetes affects eyes, how to delay or prevent eye damage, signs that should make people visit their doctor, and how to access a diabetes eye check. To learn more, visit www.diabetesactionmonth.org.nz.

We created a new video for 2023 based on the topic of eye health for those with diabetes. The video, shot in Specsavers St Luke’s with optometrist Sima Lal, walked through three important issues – why taking care of eye health is important, what eye conditions are associated with diabetes, and what is involved in a diabetes eye check. The video ran across more than 163 Health TV screens nationwide in general practices and was featured in Health TV’s monthly e-news. Health TV also ran a Sneaker Friday promotional video to promote our signature fundraising day. An Eyes on Diabetes poster was designed and distributed widely through Diabetes NZ local offices, partners, and supporters, as well as by Mediboard. A new eye health and diabetes brochure was also created and made available in Mediboard brochure racks from October to December.

HEALTHY FOOD GUIDE E-BOOK For the second time, Diabetes NZ teamed up with Healthy Food Guide to create a special e-book following the Eyes on Diabetes theme. Featuring information on diabetes and eye health, nutrition and diabetes, plus some recipes and sponsor content, the 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.

DIABETES WELLNESS | Autumn 2024

LOCAL EVENTS

SOCIAL MEDIA AND FACEBOOK LIVE We ran two Facebook Live sessions in 2023. Both were hosted by TV presenter Monique Bradley, who has a history of diabetes in her family and has had prediabetes herself. The first session on Tuesday, 7 November focused on the 2023 theme ‘Save our Sight’. Specsavers optometrist Philip Walsh, leading ophthalmologist Dr David Squirrell, and Liz Dutton, head of clinical services at Diabetes NZ, were our guests (pictured above). Taking a wider view on what diabetes self-care looks like, the second Live on Tuesday on 21 November featured Stefan Crooks from VIBE, Courtney Giddens from NZMS Diabetes, a Dexcom company, and Marianne Parker from Diabetes NZ. They discussed both high- and low-tech ways to manage diabetes, including CGM technology and how to implement self-care principles around nutrition, exercise, and mental wellbeing. If you missed those great sessions, they are still available to watch on the Diabetes Action Month microsite at diabetesactionmonth.org.nz.

Several wonderful events took place across the country during Diabetes Action Month. We thank you for coming along, sharing your photos, and helping us raise awareness of diabetes. Highlights included markets, mobile awareness van visits, picnics, fun youth activities (including bowling and laser tag), Do Blue Days held at schools around Aotearoa, and Lap the Map with various Lions Clubs. Below: Weston School in Oamaru celebrates Do Blue Day.

THANK YOU! Ngā mihi nui to everyone who helped us spread the word about diabetes eye health during Diabetes Action Month! To everyone who attended an event or Facebook Live, rocked their sneakers on Sneaker Friday, sent us a message or downloaded our new resources, we are so grateful for your support. Diabetes Action Month 2023 was proudly sponsored by

DIABETES WELLNESS | Autumn 2024

Community

CHOOSING INK OVER BLING Wings, a snake or two, syringes, mathematical symbols, flowers, NHI numbers, and even the molecular structure of insulin. These are just a few of the designs that some Kiwis have chosen to get tattooed on their bodies.

or many, a My Identity or Medic Alert pendant or bracelet is the perfect piece of medical jewellery. It’s easily recognised around the world and means, in the event of an emergency, critical medical information can be discovered and passed on to medics if the wearer is unable to communicate. For anyone experiencing a hypo, having this backup can be lifesaving. Some folks with diabetes find their occupation, lifestyle, or even time of life has made them veer away from traditional medical jewellery towards a permanent message – one that is etched into their skin. We speak to a nurse, a mechanic, an early childhood teacher, and a couple of parents who okayed their teen’s desire to get their health status tattooed and hear their reasons why they chose ink over jewellery.

DIABETES WELLNESS | Autumn 2024

ROD OF ASCLEPIUS

Thomas George, from Oamaru, has type 1 diabetes and works as a nurse. He says a tattoo is perfect for him, as working so closely with patients can result in jewellery of any form being pulled off him. He also notes the hygiene aspect, which is important when working in a medical setting. Thomas’s tattoo design (pictured below) borrows from ancient times. Asklepios/Asclepius, son of Apollo, was the Greco-Roman god of medicine. He is depicted holding a rod with a snake curled around it, but some sources suggest this image of a snake on a stick is from a different part of the world (when a stomachchurning condition called Guinea Worm disease used to be rife) and that the two have merged due to similar health-related meanings. Many international medical organisations employ this design, some adding in another iconic medical emblem – the Star of Life. The six-pointed ‘star’ represents emergency medical services. The blunt points represent six pathways or tasks executed by rescuers: detection, reporting, response, on-scene care, care in transit, and transfer to definitive care.

CADUCEUS

Easily mixed with our earlier snake on a stick is the Caduceus symbol – another staff but this time with two snakes coiled around it and sometimes topped with a set of wings. This design is based on Mercury/Hermes (Roman and Greek names for the same god who could fly), who attempted to stop a fight between two snakes by throwing his rod at them, and they twined themselves around the rod. Hayden Adams, from Wellington, chose to go with Caduceus, saying his tattoo (above left) represents his journey in life with diabetes. ‘I chose this because I work as an electrical lineman, and I’m still active in rugby.’ Fellow Wellingtonian Chrissy Fage says that, after having a few medical ID bracelets break and waiting a good two years to consider it properly, it was time to get something tattooed. Her son designed the piece for her (pictured above right), based on a number of examples she gave him. She says she was drawn to the angel wings but particularly wanted a design that she could read from her own point of view, not from other’s.

BLUE

Blue is a common key colour in diabetes tattoos. It is frequently used to colour the insulin within the often-depicted pre-1950s metal and glass syringe. There’s also the blue circle – the global symbol for diabetes – signifying the unity of the community in response to the rising number of people affected by the condition. Then there is the ribbon, seen in blue and grey or all blue, another signifier for all types of diabetes, as well as for mental health. Annabel Darcy Collett, from Christchurch, says she has a mixed opinion about supporters’ tattoos and so she chose to incorporate the global blue circle as a way to underline that she was the one with diabetes.

SWAPPING OUT THE ROD FOR A SYRINGE

Aucklander Rodney Knight has a number of tattoos that he chooses to hide under his business shirt, so he says it was a big call to get this one done in an easily seen area of his body. ‘It needs to be confronting to attract attention in an emergency.’ Rodney says he described the components he wanted to the tattoo artist, who then sketched a basic outline and completed the tattoo freehand. Rodney’s design mixes a number of elements. A rod of Asclepius is wrapped around a syringe of blue fluid and topped with wings, and, in case anyone misunderstands what it all means, he’s specified which type of diabetes he has.

Tony McKay, an 18-year-old Winton local, was diagnosed at 15 and had no interest in wearing medical jewellery. So his dad, Richard, told him he’d design and pay for a tattoo for his 16th birthday. ‘Since his diagnosis, nothing seems to faze him anymore. We tried to hassle him when he showed a little pain, but he didn’t waver at all, only stopping to check his bloods and to eat – only because he had to.’ Hamiltonian Joel Knight also sports the Caduceus symbol with a syringe. He says he found an image online and gave it to the tattoo artist to use. Joel works as an engineer, so jewellery is never safe to wear in his workspace, as he is around welding and machining, and works within confined spaces.

Lena Fendley-Peach, Diabetes Youth Coordinator in Tauranga, got a tattoo when her son Ezra was diagnosed with type 1. ‘It represents me wrapping my love around my son to give him the courage and strength he needs on his diabetes journey.’ She had an idea what she wanted, and once the design had had a bit of back and forth with the tattoo artist, Lena gave the OK.

Another part of the community is the supporters: the parents, the partners, the whānau of those with diabetes. Some of those have chosen to get a tattoo as a kind of touchstone, something that can remind them of the challenges their loved ones are going through. DIABETES WELLNESS | Autumn 2024

FLOWERS

Three years later, Ezra got his own tattoo (top left), designed by his step-brother, a tattoo artist whose trade name is Peachy Boy. Lena says Ezra had wanted to get the tattoo since he was about 14 but that her stepson recommended he wait until his growing slowed down. It was done a year ago, just before he turned 17, and completing the work took about an hour and a half. Aucklander Madison McCaughan chose her design of beautifully drawn flowers (bottom left) because she wanted something different to what others were doing. ‘It’s something I knew I would love and could incorporate with my sleeve later on down the track.’ She says she has received a lot of comments and compliments over the years for it being different. Abbie Davis’s tattoo (top right) is just a couple of years old. The Blenheim local says she still wears a medic alert bracelet but chose to get her tattoo since she works in early childhood where the children love to tug and pull on things, meaning the bracelet has broken a few times. ‘This tattoo means a lot because, when I got it, I decided to add bees too it and, when I was diagnosed, I was gifted a diabetic bumblebee toy as a reminder that things will be okay.’ A few people have chosen symbols that only those ‘in the know’ would understand: ‘I am greater than my highs and lows’. Masterton local Tayla Seville chose simple line work (bottom right) employing basic mathematical symbols to remind her that she is more than her diabetes. ‘While it is important to manage the condition, it is also important to live my life to the fullest. The flowers in the insulin vial represent the amazing and lucky life that insulin allows me to live.’

Blue as a new tattoo: Until 2006, there was no single symbol for diabetes. That year, the United Nations adopted the blue circle, symbolising Mother Earth, life, health, and the unbreakable unity of the global diabetes community.

DIABETES WELLNESS | Autumn 2024

C257H383N65O77S6

THE PARAMEDICS’ RESPONSES

If you’re wondering what this code is, it’s the molecular composition of insulin. Christine Pole, from Kaiapoi, chose it to celebrate her 21st year of living with type 1 diabetes. ‘It didn’t take me too long to decide on the design. I knew I wanted a tattoo signifying my diabetes – but I didn’t want it to say that I have diabetes. I also like science/nerdy stuff, so it was pretty easy to decide. The figure 8 is an infinity symbol, as I’ll forever be taking insulin!‘ Aucklander Ashleigh Kennedy says she kept losing her medical jewellery, possibly helped on by being allergic to a variety of the metals used, so getting a tattoo was the next option for her. Ashleigh knew exactly what she wanted when she went to the tattoo artist: the molecular geometries of insulin as a stem, leading to a peony bloom. Peonies were her grandfather’s favourite flower which makes it something unique and important to her.

The Wellington Free Ambulance reports that they have no specific guidelines around tattoos. They would ask the patient first, but that would rely on them being able to communicate. ‘Other clinical tests would be used to determine if the patient has diabetes specifically, but if a tattoo was noted as visible that would certainly be taken on board but not used as a definite answer to any health issues that the team was responding to.’ Hato Hone St John also has no formal policy on tattoos. They inform us that staff consider all available information when making treatment decisions for patients who are unable to communicate with them. This would include taking into account a tattoo containing medical information, if one was present and it was observed by their staff. ‘We do not recommend people get a tattoo containing medical information. This is because it is rare for the tattoo to contain enough detailed information to adequately guide ambulance staff, and the information may need to subsequently change after the tattoo has been completed.’

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Your DNZ

MELDING BUSINESS AND HEALTHCARE As we welcome in 2024, we travel around the motu meeting each region’s Youth Coordinator. In this issue, we meet Shantelle Bliss, coordinator for Tāmaki Makaurau.

DIABETES WELLNESS | Autumn 2024

hantelle Bliss is an extraordinarily busy woman. Having previously been a personal health and wellness trainer, sports masseuse, and business assistant across a diverse range of activities, she’s now concentrating both her business and healthcare skills to help run the Auckland Youth section of Diabetes NZ Youth. Her high school experience in national level triathlon and completing the NZ Ironman after her first child (and, later, marathons in Utah, Rotorua,

Dublin, and Galway) have taught Shantelle about tenacity and grit and she has plenty of both. She has been told on more than one occasion that she works too hard, and her response is, ‘But it’s got to be done. I’ve got to help. I do it because I love it.’ DNZ T-SHIRT

In early 2021, it was a fortuitous sighting of a Diabetes NZbranded t-shirt in a supermarket that helped urge Shantelle into applying for the position of Youth Coordinator. She was waiting to

bag up some carrots when she noticed a woman in front of her wearing the shirt. ‘Diabetes!’ Shantelle blurted out. And when the wearer turned around, they realised they had met before when Shantelle had volunteered as a sports masseuse in a previous Auckland marathon, raising money for diabetes. Her daughter had also been to a recent Auckland Youth event. It was there in the supermarket that Shantelle found out the Youth Coordinator position had been advertised twice before but no-one suitable had been found. After chatting about previous work and experience, she was urged to apply. Even though she was still recovering from a bad concussion and not looking for a job yet, she knew the youth needed support, so she started with just 10 hours a week and slowly built up to 20. Shantelle’s lived experience with and around diabetes has made her well qualified for the job. She is the mother of a teen with type 1, has had gestational diabetes, and has injected in her second and third pregnancies. Alongside this is her work experience and education – a Bachelor of Sport and Recreation, a Bachelor of Business, and a Masters of Health Science. CAMP

Planning the Live Brave Mana Ora Auckland summer camp, which is held each year in Whangaparāoa in the second week of January, keeps Shantelle extremely busy. There are volunteers to source and police vet when required, followed by doctors, nurses, night nurses, a psychologist, parent helpers, youth leaders, and dietitians. Then there’s budgeting, ticketing, food, and activity planning, and camper registrations to collate. Risk assessment forms and health profiles need to be assessed and grocery orders made, just to name a few of the necessary

Shantelle and family at Ross Castle, Co Kerry, Ireland.

tasks required to get a successful diabetes camp underway. Despite the massive undertaking, the benefit of camp makes it all worth it. This year there were a total of 51 personnel, not there at the same time, and 31 campers. Shantelle laughs. ‘It’s massive!’ FUNDRAISING

Before the immediate planning of the camp even starts, funds need to be raised, a challenging task in the current financial climate. Camp costs over $1000 per person to run, and that’s with most helpers volunteering their time. With grants, fundraising, and WINZ carer support combined, Diabetes NZ Auckland Youth were able to sell tickets to camp at heavily subsidised rates. With the impressive fundraising efforts of the Auckland Youth community in 2023, a few ‘financial support’ tickets were able to be offered, which meant some families could send their children to camp who wouldn’t otherwise have been able to attend. There have been other social events on the calendar for

Auckland’s youth that have only been made possible due to the amazing fundraising efforts received from the Auckland Youth community. One such example was a brilliant young man who organised a sausage sizzle at his high school and raised enough money for a teen 10-pin bowling event. Shantelle says, ‘We have several standard fundraisers that we do each year, but it only takes a little bit of creativity and passion to come up with your own little or big ideas.’ Last year, Shantelle helped raise over $21,000 for Auckland Youth, but she says the majority of it was due to the diabetes community that participated in the city’s marathon, raising over $13,000. Thre was also the Do Blue Day, held during Diabetes Action Month last November. The Z Energy ‘Good in the Hood’ was a success probably partly due to Shantelle’s relentless enthusiasm, having spent a few hours at each of the six Z Energy petrol stations meeting with people and educating them about what type 1 diabetes is and how it affects the children and

DIABETES WELLNESS | Autumn 2024

‘Camp is where kids get to see others that look like them. Seeing others with pumps and CGMs, and getting their fingers pricked helps them understand that they’re not the only going through it.'

In the Connemara National Park, Co Galway, Ireland, about to start the 42.2km Connemarathon.

families, and explaining what the Z Energy funds would contribute towards if they placed their token in the Auckland Youth box. Tough work considering there were four charities per station for people to choose from. She says she received some lovely feedback from members of the public who had been touched by diabetes one way or another. COMMUNITY AND CONNECTION

Shantelle says the various events and camps can be invaluable experiences for a child and their whānau after being newly diagnosed. With the shake-up that finding out your child has diabetes can bring, finding others to connect with is often a relief. ‘Kids get to see others that look like them. Seeing others with pumps, CGMs, and getting their fingers pricked helps them understand that they’re not the only ones going through it.’ Kids don’t just make friends, they meet peers, someone they can relate to so they don’t feel so different. Shantelle gives the example of a

DIABETES WELLNESS | Autumn 2024

zoo event where everyone walked around the zoo then met up for a picnic at the end. An hour after the event had officially finished, there were kids still playing with each other, parents planning playdates, and another had organised an older youth to be a babysitter. Events are created to cater for different age groups, some with just children or teens and others for the whole whānau, depending on the goals and impact that the event is trying to achieve. One of the most popular events last year was a sleepover at Kelly Tarlton’s Sealife that sold out within a day. Designed for kids too young to go to camp, after introductions, the children went with youth leaders to explore the aquarium’s glass tunnels and go behind the scenes to feed the fish. Meanwhile, Shantelle invited the parents into the education room, and one by one they went around in a circle, talking about when their child was diagnosed. Several teared up due to the relief of finally letting it out and being truly understood by parents in the same situation. Shared empathy and knowledge between those newly diagnosed and those further along the journey, was invaluable. ‘Every time I talk about it, I get the chills. It was so amazing,’ says Shantelle. After supper, the excited children slept under the sharks or next to the crayfish and seahorses. Over the whole event, families got to see others live like them; doing pre-meal carb counting, testing, and injecting or pumping. They also saw other parents up in the night checking sugars and

treating highs and lows, and heard CGMs beeping. After seeing the penguins in the morning everyone left weary but happy. BUILDING NEW LEADERS

One of the many projects Shantelle is working on is how to train and upskill youth leaders. Having a process to encourage young people’s individual leadership skills is inevitably a bonus that will help when running future events. When thrown the question of whether more volunteers are needed, Shantelle’s answer is simple. ‘Volunteers are important. It was definitely a struggle to find them for the Auckland marathon fundraising runners. My husband, dad, and younger daughter ended up working as crew for the day. My husband Richard said to me recently, “You know I will always help you with anything for diabetes because it is a worthwhile cause and it’s close to our hearts.” Donations and volunteers are always welcomed, no matter the amount and time offered. ‘I try to do the best I can, but there’s always more I want to do, that’s for sure.’

If you’d like to support Diabetes Youth with a donation, please visit www.diabetes.org.nz/donate. If you’d like to find out more how you can volunteer for Diabetes in your area. contact us at info@diabetes.org.nz.

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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). *Finger pricks are required if glucose readings and alarms do not match symptoms or expectations. Glucose readings are automatically displayed in the FreeStyle LibreLink app when the sensor has been started with the app, and the smartphone and sensor are connected and in range. Optional scan to backfill up to 8 hours of data following a period of lost sensor connection The FreeStyle LibreLink app is only compatible with certain mobile devices and operating systems. Please check www.freestylelibre.co.nz for more information about device compatibility before using the app. Use of FreeStyle LibreLink requires registration with LibreView.^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. ±At HbA1c ~7% or higher. 1. Evans M. et al. Diabetes Ther. 2022; 13(6): 1175-85. 2. Leelarathna L. et al. N Engl J Med. 2022; 387:1477-1487. 3. Franceschi R. et al. Front Endocrinol. 2022; 13:907517. 4. Haak T. et al. Diabetes Ther. 2017; 8(1): 55-73. 5. Bolinder J. et al. Lancet 2016; 388(10057):2254-2263. The sensor housing, 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-85740 V1.0

Advocate

THE MANUREWA

MARVEL

We continue our trek around Aotearoa, meeting each region’s Diabetes Community Coordinator. This issue, we meet the Kaiāwhina Mate Huka for south Tāmaki Makaurau, Francella Tulilo.

ven though Francella Tulilo is only 25 years old, she has an absolute wealth of life experience behind her. One of the reasons she chose to work in healthcare is due to her own understanding of having to overcome health challenges. This she took charge of when threatened with a diagnosis of pre-diabetes at only 19. ‘When you’re younger, you think you’re invincible and you’re not.’ ‘The doctor said, “You will go into pre-diabetes. Very close.” Having that conversation was shocking because I’d seen the effects of diabetes on my own family members. Gosh, I need to change. I can’t keep living like this.’ The other main driver that led her to do her degree in health science was her aiga (whānau/ family). Aotearoa-born, Francella says she was blessed to be raised by her mother’s parents for five years of her life, while her parents migrated from Samoa. Unfortunately, both her grandparents had already developed type 2 diabetes, as well as some co-morbidities. When she was 17, because her parents needed to be at work, Francella started accompanying her grandparents to their medical appointments and acting as translator for them. ‘Pacific people tend to have that behaviour

DIABETES WELLNESS | Autumn 2024

‘One thing that I tend to think about is that our first learning place is home. One of my biggest challenges is from my own family. I’m trying to help them with their diabetes, but at the same time it gives me the experience to take back and provide to the community as well.’

Francella (second from the left) celebrates at graduation ceremony for her Bachelor of Health Science degree from University of Auckland.

where it’s all ‘’Yes, yes, yes” to the clinician. But they have no idea what’s going on.’ Francella also mentions her cousin who lives with cerebral palsy. She watched the attention that her other cousins laid on him to make sure he was well cared for. ‘These were the two main drivers to me doing my degree.’ POPULATION HEALTH

When she first started university, Francella planned to do medicine and become a doctor. But during her journey she realised she was not as interested as much as she had first thought. ‘What interested me more was the side of population health. Why do some members of society have a different healthcare status? What are the main drivers, the main factors? And what are potential solutions to help these populations? So that’s what drew me away from medicine but still down the path of health science.’ When Francella finished her degree, she went straight into Youth Health, working for Village Collective, a Pasifikabased organisation, focused on equipping their youth and families with the skills to navigate life. From there, she moved into health coaching and was a Healthy Lifestyle advisor for the Green Prescription programme, based at Southseas Healthcare. This happened when Francella was having her own health issues. She had made changes to her diet, and added in exercise, so when she applied for the position she was ready with lived experience. ‘This is everything I’ve been through and have been applying to my life. I was so excited to get that job.’ Francella ran fitness classes and health literacy classes, which covered a multitude of things from nutrition, time management, sleep, and stress management. Many topics were covered with the aim

that the people she worked with could become empowered. JOINING DIABETES NEW ZEALAND

When Francella applied for the job of Diabetes Community Coordinator in March 2023, she says she found it quite emotional but thought she’d apply anyway and see how she went. Not long before, Francella had lost her beloved grandfather to complications of diabetes. Out of experiencing something so painful, Francella found she was able to identify with others on their diabetes journeys. ‘I’m just so grateful to be in this role, because not only am I helping people in the community but I’m also taking knowledge back home for my family, especially my nana, and my dad who has diabetes as well. It is a challenge.’

Francella has first-hand experience of understanding the benefits exercising can bring to the body. She has been going to a local weightlifting and cross fit gym for the last few years and has recently come to love weightlifting. OUT IN THE COMMUNITY

Francella often sees patients in their own homes or through community visits. She says that she will often join them for a walk around the block. Transport issues or the preference to walk near their homes gets turned into an opportunity for free exercise. Other days, she will get in the pool with patients and go aqua jogging with them. She uses these sessions as a way to catch up and see how they’re going and what they present with on the day. She says because some patients go through

such a rough time, they appreciate having someone to talk to, help them, and motivate them through their difficulties. When Francella sees patients in her office, she asks them the question – what is diabetes to you? ‘They commonly reply that it’s their sugar level, and that is what their doctor has said. I say that’s pretty much it. From there, I ask, with their permission, is it ok for me to share a little bit more?’ Francella then draws it all up as a graphic explanation for them. She covers what is happening in the body. Then explains what the doctors are trying to say in terms of ‘blood sugar levels’. ‘So many of them say, “The doctor says it’s my sugars. But l don’t really know what that means.” Having it all drawn out for them is like a lightbulb moment for them. It suddenly makes a lot of sense. So then I work with them to bring down their sugar levels.’ Alongside the check-ins and motivating, Francella liaises with different organisations, community centres, and local marae. One government department she has been connecting with is Work and Income NZ. Francella has not only been helping patients access the sickness benefit and the disability allowance, she has also been spending time educating the staff on diabetes. When not helping others, our Diabetes Community Coordinator has been constantly keeping herself up to date, upskilling by learning the art of motivational interviewing, as well as taking the advanced diabetes course run by Dr Ryan Paul. The continued education is paying off, and Francella has been accepted into a Te Whatu Ora working group on improving access to diabetes care. ‘It’s an interesting space to be in. And I’m the only one from the community. The rest are clinicians.’ DIABETES WELLNESS | Autumn 2024

My Identity

Coffee groups can act as support groups in disguise. We meet Mandy Sorasio, Vanita Gandhi, and Robyn Cotton, three recent retirees with type 2 who meet up a couple of times a month at a local coffee morning.

WE’LL MEET AGAIN.

And again. Y ou may remember Mandy Sorasio from the Spring issue of Diabetes Wellness. There she shared her journey of going from an HbA1c of 58 to 28, as well as losing almost half her bodyweight, in a year and a half. This was due to massive modifications to her diet but also a number of other lifestyle changes. Mandy started attending a couple of exercise classes – one in a gym and the other at her local community centre. Because she was regularly seeing the same people at each class, week after week, she got to hear about a local coffee group. This is when she began to spend down time getting

to know fellow type 2s, Vanita and Robyn, and met a whole bunch of new people. The bi-monthly coffee mornings run from February to November on Friday mornings at the Churton Park Community Centre and are largely attended by local retirees. After the Covid-19 lockdowns, the Centre’s coordinator was looking for groups to use the space. A coffee morning was suggested, and Vanita, a natural people-person, was nearby so was put in charge. Both Mandy and Robyn rave about Vanita’s ability to bring people together and make them feel at home. ‘Vanita’s an amazing facilitator,’ says Mandy. ‘She

organises people to come in to talk to us about nutrition and balance. We quite often talk about our health, such as diabetes, its impacts, and what you can do to try to avoid it.’ ACTIVE MIND/ACTIVE BODY

Each week, anywhere from three to 20 people turn up. Vanita says it is a very social group but there’s nothing laid back about the crew that comes along. ‘We don’t just sit there and have coffee and biscuits and chat. We try to do some sort of activity – dance, memory games, quizzes, sign language. It’s all very multicultural, so we try to learn about different cultures. We walk

From left: Vanita Gandhi, Mandy Sorasio, and Robyn Cotton

DIABETES WELLNESS | Autumn 2024

My Identity

is proud to create

‘MANDY INTRODUCED US TO CARROT STICKS AND CELERY’

Both Vanita and Robyn admit to having their eyes opened to healthier coffee morning snacks, thanks to Mandy’s influence. While there’s still baking and sometimes Indian food on offer, the group has started gradually moving towards bringing healthier snacks for the shared morning teas. ‘Everyone brings nuts now and fruit. Everyone’s turned a little bit healthy since then. It’s opened the eyes of quite a few people.’ out having learnt something new every time.’ They have group discussions too, often starting with one agenda and before you know it ending up on another. ‘This is what we do,’ says Mandy. ‘We go in with one topic and then get side-tracked.’ Having done an online dementia course, Vanita understands the value of keeping brains stimulated, saying the group aims to keep everyone’s minds active and working. Then there is friendship and connection among the community. ‘The main goal of the coffee mornings is that you get to know different people in the community or even outside

of it. So, if you see somebody in the supermarket, you can say, “I know you.” You can say hello to them.’ GROUPS FOR ALL

Like most community centres, the Churton Park one runs a range of classes and groups, including tai chi, Pilates, mahjong, and yoga. There’s a couple of crafters groups and plenty to keep younger folk busy, with STEM, kids’ coding, and a playgroup for pre-schoolers. Mandy, Vanita, and Robyn also attend the weekly Zumba Gold, a dance-inspired fitness class.

FIND A COFFEE GROUP IN YOUR AREA

If you want to find a support group or coffee morning in your area, ask at your local Citizen’s Advice (CAB) or community centre, or jump online and see what is available. There you will find groups specifically designed for retirees and even companies that offer home pick-ups and will drive you to a venue. Below is just a selection of what’s on offer. There are groups throughout the country that we promote: www.diabetes.org.nz/local-support-groups If you want to stay online, we offer online support groups, which are very active and where people can get instant peer support and advice: www.diabetes.org.nz/online-diabetes-support-groups Meetup – just type in your location and what social event you are looking for: www.meetup.com General support groups around the motu for those with diabetes: healthify.nz/support/d/diabetes-support/

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Nourish

If you are trying to keep your diet low in sugar and salt, then pickles, with their delicious crunch and mouth-watering zing, can help save your taste buds. They are also super quick, easy, and, best of all, cheap to make. Dietitian Helen Gibbs and editor Rowena Fry explain how.

THE CRUNCH OF A HOMEMADE PICKLE

Pickled foods can be sweet, sour, sweet and sour, or spicy. You can choose to make them piquant or pedestrian.

20 DIABETES WELLNESS | Autumn 2024

rying to lower salt and sugar intake can be challenging for some folk. A common complaint to dietitian Helen Gibbs is that there is no taste in lower salt and less sweet foods. Be assured, the taste is there, it just takes our taste buds a few weeks to adapt.

PICKLES/FERMENTED VEGETABLE & QUICK/SLOW – WHAT IS THE DIFFERENCE BETWEEN THEM ALL?

The method you choose dictates the flavour, health benefits, and shelf life. The faster process is true pickling, where vinegar, salt, and sugar all act to preserve the vegetables. Once quick pickles have cooled, they must go straight into the refrigerator, unless they’re heat processed, which involves heating the pickle jars to high enough temperatures to kill any microbes that could cause spoilage. The jars of pickles on grocery shelves are of this variety. Quick pickles will be ready in as little as an hour but must be used up within three weeks.

Slow pickles are the result of a long fermentation process powered by harmless bacteria that produce the acid responsible for the tart flavour. Kimchi and sauerkraut are all fermented rather than pickled and therefore offer the digestive health benefits of live, active cultures. Once they are open, store and use like quick pickles. Pickles contain vinegar, but fermented foods rely on a higher salt level to encourage the growth of acid-producing bacteria and avoid the growth of yeasts. If you are making your own fermented foods, note that there will be at least 1.5g salt (600mg) per 100g of vegetables and often much more. Fermented vegetables need to be occasional foods, due to this high salt content. Regardless of which pickles we use, these recipes aim to have salt and sugar within a reasonable range, lower than traditional ones. Helen has designed them to have sugar at less than 10g per 100g and sodium at around 400mg per 100g.

WHAT’S THE DIFFERENCE IN THE TASTE?

Quick pickles will give you tangy, crisp onions in a snap – ideal for those spontaneous culinary moments when you just can’t wait. Slow pickles allow flavours to develop and meld over a few days, resulting in a more nuanced flavour. SO HOW TO START?

First off, start by buying your fresh produce in season. Now is the perfect time to buy all the vegetables that are perfect for pickling. Onions, broccoli, cauliflower, garlic, capsicum, spring onion, button mushrooms, zucchini, cucumber, radish, beetroot, cabbage, carrots, and beans all make excellent pickles. Just about any vegetable that can be eaten raw can be pickled, so leave out potatoes, kumara or pumpkin – they always need cooking. Next step is washing your produce and cutting it into small bite-sized pieces: cauliflower and broccoli into florets, carrots into wheels or thin lengths, mushrooms quartered or left whole, and onions lengthwise or left whole if they’re not too large. Only use produce that is in its prime. Don’t use worn out vegetables – use those for soups or stock.

REUSE PICKLE JUICE Don’t tip it down the sink! You can reuse it for pickling if you boil it for a minute to reduce the likelihood of growing moulds.

DIABETES WELLNESS | Autumn 2024

SLOW PICKLED ONIONS Add pickled onions to sandwiches, tacos, burritos, or salads for a nice crunch and irresistible flavour, or serve them as a tasty side relish for cooked meats and soups. Ingredient

500g jar

3 kg (6 jars)

Per 100g

Onions with skins

290g

1.75kg

60g

Vinegar

162ml (2/3 cup)

35ml (2 tbsp + 1 tsp)

Sugar

55g (3 tbsp plus 2 tsp)

330g (1 1/3 cup)

12g sugar (1 tbsp minus ½ tsp)

Salt

4g (1 tsp)

2 tbsp

0.9g salt (½ tsp)

Pickling spices (such as: bay leaf, peppercorn)

1 tbsp

1/3 cup

½ tsp

In a large bowl, pour boiling water over the unpeeled onions. Let them cool until you can handle them. This makes them easier to peel. Cut the ends off. Find enough glass jars to pack the onions into. A 500ml jar will pack around 250g of vegetables. The jars must be clean and able to be sealed with new metal lids. Rinse the jars with clean water and put in an oven heated to 100°C. Put vinegar, sugar, and salt into a pan. Bring to the boil and let simmer for one minute. Take one to two jars out of the oven at a time. Place them on a cloth or

newspaper. Fill them using tongs and cloths as the jar will be hot. Make sure the onions are 1.5cm below the rim. Pour the hot pickling liquid over the onions to half a centimetre below the rim. Seal the lids. Keep in a cool, dark cupboard space for at least three weeks before using them. Date each jar and use within 18 months. Discard if there are moulds growing on the surface when opened. Once open, store in refrigerator and use within three weeks.

TOP TIP Do you have a few mushrooms to use up? A quarter of a head of broccoli that won’t get used up in time? Quick pickling is perfect for using up vege odds and ends. Place them together in one large jar for mixed pickles.

DIABETES WELLNESS | Autumn 2024

QUICK ASIAN CUCUMBER PICKLE This refreshing spicy salad serves well with rice and your favourite proteins. You can choose to peel and seed the cucumber or leave them intact, but remember the seeds and skin is where you will find the most fibre and magnesium. Ingredient

500g jar

Per 100g

Cucumber with skin, cut into slices or thin lengths

290g

60g

Vinegar

162 ml (2/3 cup)

35ml (2 tbsp + 1 tsp)

Sugar

55g (3 tbsp plus 2 tsp)

12g sugar (1 tbsp minus ½ tsp)

Soy sauce

1½ tbsp

1 tsp

Red chili cut fine

1 tbsp

½ tsp

Garlic crushed

1 tbsp

½ tsp

Ginger grated

1 tbsp

½ tsp

Pour boiling water in to a clean jar and leave standing. Put vinegar, sugar, soy sauce, chili, garlic, and ginger into a pan. Bring pickling liquid to the boil and let simmer for one minute. Empty the jar and fill with cucumber slices or lengths. Pour hot pickling liquid over the cucumber. Use a chopstick to release trapped bubbles, so the pickling liquid surrounds the cucumber. Allow to cool for half an hour and put in the fridge. Allow to stand for at least eight hours to develop its lovely flavour. Store in refrigerator and use within three weeks.

There’s a special vegetable that can often be found in people’s garden, even though many don’t particularly want it. Onion weed! (Allium triquetrum.) Make sure you can identify it properly before use. It smells like onion when you break it, and the blades – different from grass – have three edges to them. The whole plant can be successfully pickled, but the little white bulbs and stems are the most delicious.

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Community

Last June, Susan Dickson took Live Brave Mana Ora under her wing and set off for the Arctic Circle to go running in the middle of the night.

Susan and Bruce Dickson, stopping for a photo at 2.30am after running the Midnight Sun Half Marathon in Norway.

DIABETES WELLNESS | Autumn 2024

Every step for

DIABETES M

ethven locals Susan and Bruce Dickson went on a mission last year. Known locally for their community spirit, the busy pair upped their training and flew off to Tromsø, Norway, to compete in the Midnight Sun Half Marathon. June in Tromsø is mid-summer, when the sun never sets. So, when Susan, Bruce, and another 6000 runners from around the world started their run at 10.30pm and finished in the early hours of the following day, they did it all in bright sunshine. As the National President of the Catholic Women's League of Aotearoa New Zealand (CWLANZ), Susan was heading to Europe for a General Assembly of Catholic Women’s Organisations. ‘Over the past few years, Bruce and I have travelled around the world on trips built around running destinations. True to form, I looked for an event to enter. I found the Midnight Sun Marathon in Tromsø.’ As the name suggests, CWLANZ is an organisation of Catholic women. Although they have branches across much of NZ, it is a relatively small organisation. Every year, each branch is encouraged to hold fundraising and information or promotional activities. The aim of this is to raise around $10,000

each year and to lift the profile of each recipient organisation. Each year, the CWLANZ National Board chooses an organisation to be their ‘At Home Appeal’ recipients. The Board has an interest in organisations that foster the health and wellbeing of vulnerable people within New Zealand. The criteria included that the organisation be family – children/young people – or women-centred, that it rely on community funding rather than government funding, and that it is a good fit with the CWL core values. Nominations are put forward by members. RAISING AWARENESS, PROMOTION AND FUNDRAISING

In 2023, Diabetes New Zealand’s Youth’s programme – Live Brave Mana Ora – was thrilled to be the chosen recipient. Susan and Bruce both wore the ‘Every Step for Diabetes’ t-shirts when running around town while they were training. ‘I feel it did help people to identify with what I was doing and raised the profile along with my other activities. A couple of people stopped me to say they loved what I was doing as they had type 1.’ The t-shirts were also worn in Europe while the couple did a

road trip from Munich to Tromsø, covering Bavaria, the Czech Republic, Berlin, Copenhagen, Oslo, Bergen, the Fjords, and Stockholm. ‘I had a list of places and experiences we hoped to see and do, and we just made our own way. This is the pattern of our previous destination runs. We had not been to this part of Europe before.’ Their goal was $50 each for every kilometre of the half marathon, which would amount to $2,100. The final total was $2,500, which went into the CWL donation of $12,000. OTHER RUNS

The Midnight Sun Half Marathon was not Susan’s first fundraising run. In 2019, she and Bruce ran the Angkor Wat Charity Half Marathon (with another 10,000 people) . The sponsored charity was an Australian-based organisation that works primarily with victims of human trafficking and exploitation in Cambodia, Vietnam, and Afghanistan. Also last year, in a fundraiser for NZ Red Cross, Susan walked the same mileage as a refugee would on their journey from Afghanistan to Pakistan, held over two months. That’s a whopping 425km. ‘The CWLANZ throws our support behind the campaigns of other groups that align with

DIABETES WELLNESS | Autumn 2024

‘The CWLANZ throws our support behind the campaigns of other groups that align with our values. We raise awareness locally and nationally, we make submissions to government select committees, local MPs, and decision-making groups.’ SUSAN DICKSON

Kim Verry-Bester, Diabetes NZ Funding Manager (left), and Heather Verry, CEO Diabetes NZ (right), meeting with Susan and others from the CWLANZ National Board to receive the details of the fundraising for 2023.

our values. We raise awareness locally and nationally, we make submissions to government select committees, local MPs, and decision-making groups.’ Previous campaigns have been in support of quality social housing for all who need it and good health care for mothers and babies. Susan says she discovered running when she was 30 years old and has been going out regularly since, having completed more half

marathons than she can count and six full marathons. Not bad for someone who only ran her first marathon at 55 years of age. Susan says she mostly walks now as she has had fractures from osteoporosis in her spine and wants to remain strong and not do any more damage. She says that whenever she enters an event, she follows a standard training programme and walks every chance she can.

Leave a lasting legacy.

Leaving a gift in your Will is the most powerful way to leave a lasting positive impact on future generations affected by diabetes. Your gift will help to transform people’s lives by providing them with the help they need to live full and healthy lives.

Call today on 0800 342 238 or email us at legacy@diabetes.org.nz to find out how you can leave a gift in your will, or to request our legacy brochure.

The regular training keeps Susan fit and scanning the horizon for the next half marathon. This year’s CWL At Home Appeal is for Plunket Community programmes, so Susan and Bruce are off to complete the Victoria Falls marathon in July.

Legacy

A GIFT TO HELP FUTURE GENERATIONS A few years ago, Murray Dear thought about what legacy he would leave behind. He has found a kind and thoughtful way to be remembered when he’s no longer here.

hen Murray Dear was in his late thirties, he started to feel unwell. He had lost weight, he felt tired, and he noticed that his vision had blurred. He went to the doctor and had a blood test, and the results showed that Murray had developed late onset type 1 diabetes, also known as LADA (Latent Autoimmune Diabetes of Adults). ‘It was a complete shock. I went to the doctors without diabetes and walked out with diabetes.’ Feeling bewildered and looking for help, Murray’s wife encouraged him to attend a meeting at their local Diabetes NZ branch, in the Waikato. This was the start of a long association with Diabetes NZ and one that will still endure long after his lifetime. A CHARITABLE CAUSE CLOSE TO HIS HEART

Murray has decided to leave a gift in his will to Diabetes NZ as a lasting testament of his desire to see people get the help and support

they need to manage this complex health condition. ‘After my wife died, I decided I really needed to think about what my legacy was going to be. We don’t have children, so I have focused my giving to charitable causes close to my heart. I really want people who are affected by diabetes – whether that’s children, parents, older people, or partners – to have access to the best possible information so they can manage their health and get the very best out of life.’ Murray also wants to ensure that the advocacy work of Diabetes NZ continues after his lifetime. ‘I’ve seen so much inequity in how the health condition is managed. It isn’t right that people on low incomes can’t afford blood glucose monitors, which really is an effective tool to self-management. I want to see my legacy used to help advocate for more government funding for people who need the right tools to live better lives.’ For Murray, leaving a gift in his will is also a way to give back to young people who are just starting their lives and their journey with managing diabetes. ‘Diabetes can be all consuming, so I really want to ensure that young people have the information and the tools they need to manage their condition, so it only ever becomes just a small part of their lives.”

“For me, leaving a gift in my will is a way to leave something behind that makes a positive difference to people, and that’s how I want to be remembered.”

DIABETES WELLNESS | Autumn 2024

Life with T1

JADEN

DEXCOM WARRIOR The mental clarity he found after finally having his diabetes under control is what brought Jaden Hura-White back to te ao Māori.

28 DIABETES WELLNESS | Autumn 2024

Jaden believes that CGMs came into his life when he really needed them, allowing him the headspace to really immerse himself in his course. ‘I live in hope that the subsidy will come to fruition in Aotearoa New Zealand so other people living with diabetes can experience what CGMs can do for them – and to help prevent long-term issues.’ PHOTO © ERUERA WALKER.

aden says there was a point in his life when he became tired of being dictated to by his health status. Having felt the burden of living with type 1 diabetes throughout his teenage years, he had lived in denial and felt limited by what he could do, saying there was never a time when he felt like a ‘normal’ young person. ‘I didn’t want to be different and so it become harder to manage my diabetes when I wasn’t mentally clear. I also hated being in the spotlight when I had to test my blood sugars.’ As a result of this stress, Jaden says he stopped playing sports, resenting that diabetes had become the main plot line in his life. Life changed five years ago, just before Covid-19 hit, when Jaden decided to stop fighting and start educating himself on how to manage his condition. He immersed himself in reading all he could about insulin resistance. Then he followed it up with how to manage diabetes with diet and technology. Jaden came to the realisation that a change in his diet was key. Exit: his old way of eating. Enter: a plant-based and wholefood diet.

LOCKDOWN

During the first Covid-19 lockdown in 2020, Jaden heard about the one-month trial of the Dexcom CGM and jumped at the chance

to give it a go. Being a student, Jaden knew he wouldn’t be able to afford the ongoing expense but still wanted to give it a go. He says he immediately felt better and more in control. ‘It acted like a stock take of my body, and I knew exactly what to do before I hit the curve! My blood sugars were more consistent because I could easily check all the time, and I began to understand the correlation between what I ate and how my blood sugars would react.’ He says he became addicted to feeling good. Now Jaden had the challenge of finding a way to keep CGMs in his life, an expense not everyone can afford. ‘I spoke with my family, and in the end it became a shared cost between me, my mum, and my grandparents. Something I will forever be grateful for.’ THE RECLAMATION OF TŌKU REO MĀORI

The CGM allowed an ease of living, letting Jaden rediscover one of the most important parts of his life. ‘In 2021, I decided after I found the mental clarity and headspace that I would study te reo Māori.’ Despite not being brought up in te ao Māori as a child, Jaden says he has now found so many benefits in finding a deeper understanding of his culture.

‘It’s the mental and spiritual clarity that comes with rediscovering a part of you.’ This rediscovery has led Jaden down a path where he has become passionate about Māori and indigenous community development and finding ways to heal the multi-generation hurt that Māori have endured in the loss of their language. In his third and final year of study, Jaden says he is looking forward to what mahi will come next. ‘I recently read that every decision you make in your daily life requires the same amount of neurological power no matter what the decision is, and people living with type 1 diabetes are constantly making choices about what to do next. So I am forever grateful that the Dexcom CGM has taken some of those decisions away from me, meaning I can use that extra brain power as a force for good!’ Jaden believes that CGMs came into his life when he really needed them, allowing him the headspace to really immerse himself in his course. ‘I live in hope that the subsidy will come to fruition in Aotearoa New Zealand so other people living with diabetes can experience what CGMs can do for them – and to help prevent long-term issues.’

DIABETES WELLNESS | Autumn 2024

Research

Dr Esala Vakamacawai has witnessed too many diabetes-related amputations of iTaukai (indigenous Fijians) in his homeland. So he has come to Aotearoa New Zealand in the hope of finding some answers here.

SOWING THE

SEEDS OF HEALTH

hen we speak to Dr Esala Vakamacawai, he is not long back from collecting medical data from his homeland. The background photo, during our Zoom session, is of Esala’s home island, in the Kadavu Province – taking in beautiful, clear tropical waters and looking back to land. A big jump then for Esala and his family to move to Ōtautahi Christchurch in 2019 for his PhD study. Already a doctor of 12 years and a surgeon for seven, Esala has seen the heartbreaking end of diabetes complications in Fiji. When diabetes lowers the immune system, it exposes patients to infections. Add often-poor diabetes management, a strained health system, eating habits altered by colonisation, and poverty to this, and you have a recipe for limb loss. After Esala completed his Masters of Medicine in General Surgery, he published a paper on liver abscesses in the World Journal of Surgery. This was in 2020, and the paper is now used as a guide to managing liver abscesses across the Pacific. It was through this research that he saw the impact of research and data collection in publishing.

DIABETES WELLNESS | Autumn 2024

TALANOA TIME (MEETINGS AND DISCUSSIONS WITH THE COMMUNITY)

Esala believes much research is needed in hospitals and healthcare in Fiji, and this is what led him to the University of Canterbury Macmillan Brown Centre for Pacific Studies to start his PhD. His thesis focuses on ways to reduce the risk of type 2 diabetes in Fijians using cultural and traditional methods. He explains, ‘Instead of looking at type 2 diabetes from the tertiary end of healthcare, meaning hospital-based care, I think the key is primary health care. Looking at things from the ground level, the root cause of the problem. Looking at type 2 but more from the community and social side of things.’ With the help of funding sought by the Kadavu Province Canterbury Club Incorporated, Esala and his colleague, Dr Suliasi Vunibola, undertook talanoa, thanks to the University of Canterbury’s Community Urban Resilience (CURe) funding. Esala then continued to travel around the country, meeting with and listening to New Zealand’s many Fijian populations, and especially taking time to meet with any women’s groups, such as the Rotorua Women’s Methodist

group. ‘Our communities are very male dominated,’ he explains. An important part of the process was finding out what was culturally appropriate. An example being, if you go for a run in the villages, Esala says people will laugh at you because no one does that there. Although an effective form of exercise, it is a foreign idea and not culturally appropriate. There is the tropical climate making dedicated running uncomfortable, the roading, as well as the antisocial aspect. Esala adds, ‘Even the clothing can be a barrier as well.’ Through these talanoa, they identified that a project might encourage lifestyle modifications if it was collective, involved exercise, and offered access to affordable fresh vegetables.

Gardening is a practical method of improving health in Fijians and Pacific peoples, whether they be in Fiji or Aotearoa. Being a physical activity – which also produces food for the community – working the land actively reduces the risk of type 2 due to delivering both exercise and strengthening community. Gardening is practical, cultural, applicable to the people, and is realistic.

EVERY SEVEN HOURS

A HINT FROM HOME

‘In Fiji, there will be patients waiting in line, even if you go down to the Emergency Department, with patients on the floor awaiting a hospital bed. When the hospital is at full capacity, that’s what happens – no beds on the ward. To save a life, that’s the only logical thing to do, amputate. Healthcare sometimes comes down to that.’

When Esala was last in Fiji, he visited his cousin’s village. There he noticed 14 young men, at the end of the day, looking like they were returning from somewhere. He asked his cousin, who is also the spokesperson of the village, where they were coming

Before Covid-19, diabetes-related amputations in Fiji occurred once every seven and a half hours. Now colleagues tell Dr Esala it is even worse. The numbers are not helped by many people becoming hesitant to engage with hospital treatment by seeking traditional and religious healing, which is perhaps understandable when faced with hospitals often at capacity.

Frustratingly, some of the poor eating habits come from parents’ drive to help their children. Some non-farming folk sell their fresh produce. The money is then used to pay for their children’s education and what is left over is spent on lower grade food such as tinned fish and corned beef.

‘Everyone plants in the islands, and by doing that it brings back that feeling of being back in the islands. It’s a way of bringing our culture together in Aotearoa.’

DIABETES WELLNESS | Autumn 2024

What’s growing now? Esala reports that corn, silver beet, cabbages, celery, spring onions, and even taro is growing well in Christchurch. ‘And tomatoes. I’ve been comparing growing in a little plastic-made house and outside. It seems the ones inside are much bigger and greener compared to those growing outside. I’m just testing things out. I don’t know much about gardening here in a seasonal country, still learning, but it seems like a small makeshift plastic house is better than growing outside.’

One of Esala’s daughters, 13-year-old Vilimaina Qoroya, helps in the garden.

back from. He learned they were returning from a day’s gardening at a number of sites. Solesolevaki is the name of this cultural practice, where workers garden as a group. Going from one garden to the next, the group tends four to five gardens in a day, Monday to Friday. Esala explains, ‘Even though they are gardening, it’s a form of socialising as well. When someone is tired, they keep talking to each other, joking, and this takes their minds off the hard work, having to plough the land and carry heavy things. They’re talking and laughing and working at the same time.’ ‘A WAY OF CONNECTING BACK TO WHAT WE DO IN THE ISLANDS’

Putting theory into practice, Esala approached his children’s school, Te Maire St Francis of Assisi Catholic School. They had a garden-sized piece of land that

DIABETES WELLNESS | Autumn 2024

wasn’t being used. Some more funding was granted by Pegasus Heath, and before long Esala was bringing together the local Fijian population, kids and all, and a community garden was created. The garden at the school regularly donates an array of vegetables and delivers to the community for free. ‘We are living in a time in New Zealand when healthy food is very expensive, especially vegetables.’ Esala imagines this idea could be adopted by all families and start to improve health. It didn’t stop there. The project has established 20 backyard vegetable gardens for Ōtautahi Christchurch, with many more being created over the summer break. By bringing the community together, the gardens, established in backyards and planter boxes, are provided for those who rent houses with a ‘no-dig’ policy.

Some families have learned how to garden for the first time, while others learned to adapt their skills to local conditions. One gardener, Mosese Vilivilioyawa, built his own mini-greenhouse to extend the seasonal limits of growing vegetables in Christchurch. Esala built one too, discovering that taro will survive under cover. Beyond studying gardening as a tool to mitigate type 2, Esala hopes to improve health literacy among iTaukai, using the NZ Diabetes Risk Assessment tool. He cites Lilo et al., 2020, when sharing that Pacific peoples in New Zealand have low health literacy compared to others in the country. ‘Improving health literacy can motivate healthy behaviour change. I aim to improve health literacy using simple, realistic, and practical tools – for example – community gardening.’

Live Brave Mana Ora

Summer means Diabetes New Zealand Youth camps season. We hear back from our Youth Coordinators about all the fun had around the motu, where the camps bring kids and families together.

Happy little campers AUCKLAND

Shakespear Regional Park, on the Whangaparāoa peninsula, once again hosted 32 children for an experience of a lifetime. The activities focused on providing a real classic Kiwi outdoor adventure, with sunshine and fresh sea air within the wildlife sanctuary and all while our campers enjoyed orienteering, bush skills, kayaking, and more. New experiences abounded, with team challenges, raft building, low ropes, a climbing wall, archery, and UHF radio skills. The camp programme also included a psychologist-led mindfulness and sensory session to help kids cope with the daily demands of diabetes. Many campers arrived a little nervous but left with noticeable improvements in their personal development, including heightened self-esteem and a more positive outlook on their diabetes. In many cases, their diabetes management improved and milestones were met. Shantelle Bliss Diabetes NZ Auckland Youth Coordinator

Children always leave camp having made lifelong friendships.

DIABETES WELLNESS | Autumn 2024

WAIKATO

For our 20th year, it was great to return to Ngamuwahine Lodge in the Lower Kaimai Ranges. Luckily, the weather forecast was very wrong, and we welcomed our 35 campers, aged 7–12, from the Waikato and Bay of Plenty. Our theme this year was Safari Adventure, and a roaring great time was had by all. High ropes, ziplining, archery, axe throwing, mountain biking, and a climbing wall were no small feat to achieve – in fact, the seven year olds were braver than many of the adults! The Ngamuwahine river provided great opportunities for river swims, tubing, and kayaking. We also managed to fit in arts and crafts, a movie night, and the much-loved Burma trail – it was particularly dark this year, which made it even more scary! Team challenges included relays, a newspaper fashion show, as well as play dough sculpting and a quiz – all with a jungle safari theme! Our last night was definitely a highlight, with a dress up silent dinner when the wild animals came out to play. This year was full of milestones. Two of our committed staff – Sonya Fraser, dietitian (Te Whatu Ora – Waikato) and Dave Roigard from Karapiro Charters notched up their 20th camp, having done far more than what was expected over the years. Amber, one of our young adult volunteers, celebrated five years as a leader, having also attended as a camper five years previously. Another three ex-campers – Thomas, Hannah, and Lucy – all returned to ‘give back’, their ongoing enthusiasm so welcome. Four teenage youth leaders – Mars and Nico – returned for a second year and were joined by Lachlan and Willow, who also attended camp when they were younger. The rest of the staffing came from the Te Whatu Ora – Waikato, Hauora a Toi Bay of Plenty, Intermed, and Karapiro Charters. It really is only with this support that we can run our camps the way they do. For this camp, the Potters Masonic Trust provided the majority of our financial support, along with the camp fees and donations from individuals. Dr Jo McClintock Consultant Clinical Psychologist, Waikato Hospital Volunteer Camp-Coordinator

DIABETES WELLNESS | Autumn 2024

‘P had a best time!! She came home buzzing, with some independence, confidence, friendships, and ideas for the future.’

NELSON

CANTERBURY

Amanda Deans Nelson Youth Coordinator

Victoria Wynn Thomas Canterbury Youth Coordinator

Nelson Family Camp ran in February on the same weekend as the Midland crew. Teapot Valley Camp in Brightwater, Nelson, was the venue, and the kids enjoyed all the fun activities, such as abseiling, ziplining, and rock wall climbing. We also had education opportunities with a local diabetes nurse specialist. With a swimming pool, tennis court, and gym hall, there was plenty to keep people busy in the down time. Teapot Valley Camp’s sprawling grounds allowed ample space for family to opt to stay in cabins, or pitch their tents. It was a fun-filled full-on weekend of building support networks and relationships, and learning from peers. The biggest focus of our camps is always on making sure no-one in our community feels isolated with their type 1 diabetes diagnosis.

Diabetes NZ Canterbury Youth is about to hold their Family Camp at the Waipara Adventure Centre from 22 to 24 March. North of Christchurch, the camp is nestled among trees in a tranquil park setting, next to the Waipara River. The centre always offers the opportunity to kick back, relax, and enjoy the environment. Camp is a great opportunity for families to connect and for tamariki to make new friendships and renew old ones. Families will enjoy a weekend of fantastic outdoor activities, including archery, flying fox, water slide, the Flying Kiwi, and the Giant Swing. Registration: https://events.humanitix.com/ diabetes-nz-canterbury-youth-live-bravemana-ora-family-camp-2024

MIDLANDS

On the last weekend of February, we were back at Totara Springs Christian Centre in Matamata for our tenth wonderful year. Nested at the foot of the Kaimai Ranges, Totara Springs has 90 acres of native bush and park-like grounds. Families enjoyed kayaking, archery, rock climbing, abseiling, go-karts, slingshot paint ball, and all the water slides. The Flying Kiwi was a hit, where kids tried to shoot basketballs while up in the air, suspended in a harness. About 13 families from Tauranga, Rotorua, Eastern Bay of Plenty, and Taupō came together to enjoy a fun weekend, to make friendships, and to share experiences.

‘Thank you to all the volunteers and hard mahi for this incredible week and experience.’

Lena Fendley Youth Coordinator Midlands Region

DIABETES WELLNESS | Autumn 2024

OTAGO

‘We asked the campers what they liked about camp and their answers tell us a lot – making new friends, hanging out with others who have diabetes, archery, high ropes, beading, and chicken burgers!’ BUT WAIT, THERE’S MORE! Wellington, Monday 15–19 April

The Diabetes NZ Wellington Live Brave Mana Ora Youth Camp 2024 is for young people living with diabetes from the Wellington region aged 8–17. Diabetes NZ Wellington Youth is excited to offer your child the opportunity to attend the Live Brave Mana Ora Youth Camp for 2024 at El Rancho. Come along and enjoy the opportunity to try out the amazing activities on offer, including horse riding, kayaking, mini golf, and more, while meeting other youth with diabetes. Registrations are live now and close 15 March. Go to bit.ly/diabetescampwgtn.

DIABETES WELLNESS | Autumn 2024

In the middle of January, a total of 19 excited children descended on Berwick Forest for a four-day summer camp, 16 of whom had never been to a Diabetes NZ Otago camp before. The 8–12 year olds came from Ōamaru, Dunedin, Central Otago, and Southland to Berwick Lodge, 45 kilometres south-west of Dunedin. Located near the Sinclair Wetlands, the camp is set among exotic forest with native bush nearby. Diabetes Otago hired the services of Tim Bartholomew from Dunedin Adventures. He and his staff ran all the adventure-based activities at camp, including abseiling, tree climbing, kayaking, go-karting, flying fox, confidence, and initiation courses. And if kids needed more action at the end of the day, the activities included spotlight and bush walks. Our summer camp is for youth only, so there are no parents present. Instead, it is staffed by a full paediatric diabetes team gathered from Otago, Central, and Southland. Diabetes burnout is very real, so our camps are designed to give all the family members some much needed respite. Parents, siblings, and caregivers get the opportunity to have some downtime from the dayto-day care of a child with diabetes. To attend camp, families pay a small contribution fee, and most use four days of Carer Support available through WINZ to subsidise the rest. To date, our camps have not received any funding from community grants, and the cost to run camp is always rising, so we are increasingly reliant on local fundraising to keep the cost down for families. Paula Fryer Otago Youth Coordinator

Your DNZ

ANNUAL REVIEW

2023

We bring you a report from the Board Chair Catherine Taylor and Chief Executive Officer Heather Verry.

ontinuing to grow Diabetes New Zealand (DNZ) and expand our reach to support more people with diabetes has been a focus over the last 12 months. We are still a small charity and know we have a lot more to do to make a difference, but we are pushing hard to lift our game and be more relevant and supportive. The work we do is even more important now in the context of a health system that is being challenged with funding and resourcing issues right across the sector. Over the last 12 months, Diabetes Wellington Youth, Diabetes Canterbury Youth, Diabetes Marlborough, and Diabetes Hawkes Bay ceased to exist as separate organisations and joined DNZ, pooling their resources and allowing us to expand the network of areas we support. We welcome

these regions and groups knowing that, as we strengthen our numbers, we can increase our voice and provide better services. In other regions, various committees and groups also assist us to grow our reach and add more value. We are committed to continue to grow as funding allows, while at the same time ensuring prudent and careful management of our reserves. We are pleased to report on some of our achievements through the Statement of Service Performance that forms the basis of this Annual Review. However, there are achievements that cannot be measured year on year but should form part of this report. We strengthened our partnerships with: • the New Zealand Society for the Study of Diabetes (NZSSD) – the

clinical team supporting people with diabetes across the country. We are working more closely with clinicians to ensure we speak with one voice about diabetes. • the Diabetes New Zealand Research Foundation (DNZRF), which has now established a website with information about its objectives and the summer student grant programme it supported over the summer period last year. Check out the website at www.dnzrf.org.nz. While DNZRF is still in start-up mode, it has plans to grow its capital base to have more grant funding available for diabetes research relevant to New Zealand conditions and our context. • primary and community health providers, including iwi and pacific providers, to strengthen and grow our Diabetes

DIABETES WELLNESS | Autumn 2024

Community Coordinator roles. We now have a presence in nine regions of New Zealand working alongside primary health care workers to support people with diabetes to access health services and better manage their diabetes. Our coordinators have also delivered Diabetes Self-Management Programmes with the support of local health professionals. The Coordinators working in the different regions pivot their support to align with local needs. The majority of our Coordinators are either Māori or Pasifika peoples. • the Edgar National Centre for Diabetes and Obesity Research and He Oranga Ora National Science Challenge who supported Diabetes Action Month by holding a Symposium Transforming Lives – 100 years of Insulin, which was held at Parliament in November 2022. We strengthened our advocacy by: • developing a Position Statement on CGM Funding in partnership with NZSSD, the Edgar National Centre for Diabetes and Obesity Research, and He Oranga Ora National Science Challenge. We collectively urged the New Zealand Government to support Pharmac to fully fund Continuous Glucose Monitoring (CGM) technology for all New Zealanders living on insulin to improve health outcomes and promote equitable care for people with diabetes. – The announcement in July 2023 from Pharmac that they were to accept Requests for Proposals to secure the supply of, and fund, CGMs for people living with diabetes was welcomed. While it is not clear what this might mean

and who will benefit, it is a step in the right direction. Mindful of the experience in Australia where the introduction of CGMs for all was staged over a number of years, our ‘#CGMforall’ campaign will continue. • Diabetes Action Month was themed ‘Diabetes Matters,’ with four sub-themes for the month – Language Matters, Nutrition Matters, Movement Matters, and Prevention Matters. The legacy from this campaign was the development of Language Matters Resources, which are downloadable from the website. There were changes to our Board of Trustees over the year: • Andy Archer and John Denton resigned as trustees. They became trustees at the time we merged the Auckland branch committee with the Trust so we could build better working relationships and greater consistency in the delivery of services across the country. We thank them for their contribution during this period of transition and acknowledge Andy Archer’s contribution over

Catherine Taylor Chair

many years to ‘things diabetes’, such as his report advocating for a sugar tax to be levied in New Zealand. It is still used as a reference document when Diabetes New Zealand is asked to comment on healthy food choices. • Recognising that our trustees did not reflect the multicultural society in which we live, we appointed Bev Gibson (Te Atiawa, Ngaruahine, Te Arawa) and Erolia Rooney (Pacific peoples – Samoa) as trustees and Tio Taiaki (Te Ātiawa ki Whakarongotai, Ngāti Tūwharetoa, Āti Hau Nui-āPāpārangi) as a Special Advisor to the Trust. There is always more we could be doing, and we are only limited by the resources available to us, so we are incredibly grateful for the support we receive from our donors, grant funders, sponsors, and the contracts we have with Te Whatu Ora. We look forward to the year ahead and delivering on our purpose – to reduce the impact of type 1 diabetes and incidence of other types of diabetes in Aotearoa New Zealand.

Heather Verry Chief Executive

To read the complete Annual Review, including the Statement of Performance, go to www.diabetes.org.nz/our-story

DIABETES WELLNESS | Autumn 2024

HELPING TO MANAGE YOUR DIABETES

FreeStyle Libre 2 Glucose Monitoring System NOW WITH OPTIONAL ALARMS! 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

FreeStyle Optium Blood Glucose and Blood Ketones Testing

Not Just A Patch™

• FreeStyle Optium Neo Meter Kit • FreeStyle Optium Blood Glucose Test Strips 100’s • FreeStyle Optium Blood Ketones Test Strips 10’s

• Waterproof adhesive patches for your FreeStyle Libre sensor • Designed to suit activity, sport or fashion choice • Assorted colours available • Pack of 20

ESENTA™ Sting-Free Adhesive Remover Sprays and Wipes

Skin Glu™ Barrier Wipes • Barrier wipe used pre-CGM application • Gives the skin extra protection and helps your CGM stick better • Pack of 40

The new ESENTA Sting-Free Adhesive Remover is a fast, painless way to remove adhesive residue that is frequently left behind while changing an ostomy pouch.

™

Diabetes Care

™

Frio Cooling Wallets • Keeps Insulin cool and safe • Refrigeration not required • Simply activate with cold water • Reusable, light and compact • Available in five sizes and six colours

Hypo-Fit Glucose Gel • Two flavours – Orange and Tropical • 18gram sachets, 13.4grams Carbohydrates HYPO-FIT • Gluten-Free D I R E C T- E N E R G Y

MedActive Carry Cases Diabete-Ezy Accessories • Ezy-Fit Carry Case (Blue, Pink & Green) • Multi-Fit Carry Cases (Black & Red) • Test Wipes Starter Pack • Test Wipes Refills • Comfy Pump Belts

A selection of convenient carry cases for medical supplies. • Easy Bag Single • Easy Bag Classic • iCool Weekender • iCool Prestige transforming lives • iCool MediCube

medactiv

Dextro Energy Glucose Tablets • 24 sticks per carton (12 tablets per stick) • Available in four flavours Orange, Blackcurrent, Lemon, Tropical • All with added Vitamin C

Order Online: www.mediray.co.nz Freephone: 0800 106 100 Address for Correspondence: PO Box 303205, North Harbour, Auckland, New Zealand

Enjoy Good Vibes Refresh, rehydrate with great taste and zero sugar.