Diabetes Wellness Spring 2019 by Diabetes New Zealand

wellness DIABETES

SPRING 2019 $8.00 INC. GST

DIABETES NEW ZEALAND | DIABETES.ORG.NZ

IS THAT FOOD LABEL RIGHT? • BEAT “SITTING DISEASE” • SPEAK OUT FOR HEALTH • RADIO DJ LEE WEIR ARCHER JILL GILLETTE • RESEARCH ROUNDUP • YOUR 28-DAY WINTER KICKSTART

PERFECT PLATTERS Nourishing spreads for every occasion

FITBIT CHALLENGE CELEBRITIES GET MOVING

measures spoon-for-spoon like sugar Apple Pie Preparation 20 minutes

Instructions

Nutritional Information

Cooking 50 minutes

1. Preheat oven to 200˚C

Average Quantity Per Serve:  Calories: 290  Protein: 2g  Carbohydrates: 45g  Fat: 13g  Cholesterol: 6mg  Sodium: 331mg

Serves 8

Ingredients Pastry for double-crust 20 cm pie tin 3 Tbsp cornflour 1 cup EQUAL Spoonful ¾ tsp ground cinnamon ¼ tsp ground nutmeg ¼ tsp salt 8 granny smith apples, peeled, cored, sliced.

2. On a floured surface, roll half the pastry into a circle larger than the pie tin. Ease pastry into the pie tin. 3. Combine cornflour, EQUAL Spoonful, cinnamon, nutmeg and salt. Sprinkle over apples in large bowl and toss to coat. Arrange apples on pastry in pie tin. 4. Roll remaining pastry into circle large enough to fit top of pie. Place over apples. Seal edges, trim and flute. Cut a few slits in top of pastry to allow steam to escape. Bake in oven for 40-50 minutes or until crust is golden and apples are tender. 5. Cool on wire rack. Serve warm or at room temperature.

The Essential Ingredient Equal Spoonful has almost no calories and measures spoon-for-spoon like sugar. Perfect for your recipes cereals and drinks. Find more delicious recipes at club

.co.nz

Contents

SPRING 2019 VOLUME 31 | NO 3

4 EDITORIAL

22 NOURISH: Helen Gibbs discusses Medical Nutrition Therapy

5 UPFRONT: Beyond Type 1 Kiwi Takeover 6 UPFRONT: Nelson Diabetes Youth rises above disaster 8 COVER: Jay and Sarah share their passion for honest, healthy kai

12 COMMUNITY: Healthy tips from movers and shakers 15 COMMUNITY: Taranaki brothers follow their dreams 16 LIFE WITH T2: Radio DJ Lee Weir shares his T2 challenges 18 ADVOCATE: Niamh O’Sullivan on standing up for healthy food options 20 LIFE WITH T1: Jill Gillette – champion bowhunter

25 TECHNOLOGY: George Bongiovanni – celebrating 50 years in medical technology 26 MOVE: Roslyn Eason reaches for a chance at life-saving surgery 28 GROW: Spring is the time to start your edible garden 30 ADVOCATE: Can we trust food labels? Helen Gibbs answers this frequently asked question

36 RESEARCH: Calls for participants – can you help? 37 RESEARCH: Latest findings from round the world 38 COMMUNITY: Diabetes and dyslexia: friends join forces to prove themselves

32 MOVE: Craig Wise on how to fight “sitting disease” 34 NOURISH: Dietitian Niamh O’Sullivan – living with diabetes and coeliac disease

Want to receive your own copy of Diabetes WELLNESS magazine? Subscribe today at www.diabetes.org.nz

SHOP

DONATE

JOIN

Shop online at diabetesauckland. org.nz/shop/ – members receive 10% discount

We'd love to hear your personal stories about living with diabetes – contact editor@ diabetes.org.nz

Join us on Facebook, Instagram and Twitter for the latest news and events

Want to find out more info about how to live well with diabetes? Go to our website diabetes.org.nz

Help make a difference to those living with diabetes – donate now at diabetes.org.nz

Get access to this mag, regular e-news and support from your local branch – join online at diabetes.org.nz

THANK YOU TO OUR CHAMPION SPONSORS FOR THEIR ONGOING SUPPORT AND PARTNERSHIP

DIABETES WELLNESS | Spring 2019

Editorial

e have had a really busy year at Diabetes NZ. As an organisation, we have been working together to establish and position ourselves as a Charitable Trust, as was mandated at our AGM last year. I would like to thank everyone for their input. I would especially like to thank the branches for their valuable feedback. This has allowed us the foresight to enable us to become a stronger, unified organisation. We are still working on updating our website with more toolkits and information about type 1, type 2 and gestational diabetes, as well as pre-diabetes. We would welcome any suggestions as to what else you would like to see on the website. I would like to also thank Heather Verry and her team at Head Office for the work they have completed in a very short period of time to get us where we are now on our journey. Our vision as an organisation is to be recognised as the leading support agency providing up to date and relevant information for everyone who has or is affected by diabetes. The Diabetes NZ Advisory Council is currently reviewing all the Diabetes NZ policies and updating them; looking at what campaigns and promotions Diabetes NZ will support; and, in conjunction with Head Office, we are working on developing a Distress Beyond the Body pamphlet. It will discuss mental health issues that can affect people with diabetes, including burnout, depression, and anxiety, and it will offer advice about getting help. In this issue of Diabetes Wellness, we take a look at some of the ways that all of us can advocate for healthier eating choices in our community. See the articles on pages 18 and 30. You’ll also find plenty of fitness inspiration in this issue: Hear some tips from influencers and leaders on page 12, and read about Roslyn Eason’s uplifting fitness journey on page 26. Our resident fitness consultant Craig Wise is also back with information and advice about “sitting disease” – what it is and how to avoid it. In our cover story, MKR fan favourites Jay Wanakore and Sarah Chase let us in on their secrets for creating spectacular and delicious grazing platters – a time-effective way to put on an impressive spread for whānau or friends whatever the occasion! And, as ever, we feature the personal experiences of some wise and inspiring Kiwis who live with type 1 and type 2 diabetes. We think you’ll find plenty here to inform and inspire. We welcome all feedback. PETER SLEEMAN

President, Diabetes New Zealand

DIABETES WELLNESS | Spring 2019

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 today at www.diabetes.org.nz

DIABETES NEW ZEALAND Patron Sir Eion Edgar President Peter Sleeman Chief Executive Heather Verry Diabetes New Zealand Inc. National Office Level 7, 15 Murphy Street Thorndon, Wellington 6011 Postal address PO Box 12 441, Wellington 6144 Telephone 04 499 7145 Freephone 0800 342 238 Email admin@diabetes.org.nz Web diabetes.org.nz Facebook facebook.com/diabetesnz Twitter twitter.com/diabetes_nz

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

ADVERTISING & SPONSORSHIP Business Development Coordinator Jo Chapman jo@diabetes.org.nz or +64 21 852 054 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

BEYOND TYPE 1

– AND NOW BEYOND TYPE 2

iabetes New Zealand has forged a strong relationship with international non-profit organisation Beyond Type 1 – the largest online diabetes organisation in the world. Beyond Type 1 was founded in 2015 and its programmes, resources and forums now help provide solutions to people living with type 1 globally. In 2017, Diabetes NZ first partnered with Beyond Type 1 to take over their social media

channels for several days and show the world how New Zealanders with type 1 diabetes ‘live beyond’ the condition. We called it the Kiwi Takeover. This August we’re doing it again, and there’s more. In March 2019, Beyond Type 1 launched a new programme: Beyond Type 2, where people with type 2 diabetes also share stories, connect to community, and find resources. This year’s Kiwi Takeover reflects this inclusiveness. From 5 to 10 August we’ll be sharing our local stories of living with type 1 and type 2 diabetes with the world. Beyond Type 1 has over a million followers on Facebook and is read in over 170 countries in multiple languages. Look out for the Kiwi Takeover here: instagram.com/beyondtype1 instagram.com/beyondtype2

Claire Mataira and Murray Dear staff the Diabetes New Zealand stall at this year’s Fieldays.

FIELDAYS A SUCCESS In June, Diabetes New Zealand’s Waikato branch staff and volunteers supported Business Development Manager Jo Chapman at the 2019 New Zealand Agricultural Fieldays in Mystery Creek. Murray Dear says, “At the Diabetes New Zealand stand in the Health and Wellbeing Hub we undertook diabetes risk assessments, sold Eat Well Live Well cookbooks and handed out magazines and other information to the 25,000 people who passed through. There was much interest from the rural community and it was a good opportunity to engage in conversations about risk factors for type 2 diabetes.”

EAT WELL LIVE WELL

Diabetes-friendly meals everyone will love Eat Well Live Well is chock-full of recipes from well-known Kiwi chefs. Each dish is family-friendly, quick to prepare, and suitable for people with all kinds of diabetes. Get your copy from www.diabetes.org.nz for $33.00 including postage and delivery, or purchase it directly from your local diabetes branch, Whitcoulls, PaperPlus and The Warehouse. All profits go towards supporting Diabetes NZ’s work.

DIABETES WELLNESS | Spring 2019

Upfront

DIABETES NELSON YOUTH RISES ABOVE DISASTER This year, members of Diabetes NZ Nelson Youth Branch worried that their treasured camp might not go ahead.

arrived they found the pond was dry. That meant no waterslide or kayaking. Fortunately, Heather and the other organisers had plenty of other activity ideas up their sleeves!

PRIZES AND CELEBRATION

or members of Diabetes Nelson Youth, camps are a highlight of the year and a great way for local kids with type 1 and their families to get to know each other. But co-ordinator Heather Bates says that because of the fires and droughts that were striking Nelson earlier this year, summer camp plans looked uncertain. Villages near Bridge Valley Adventure Centre, the camp venue, were closed off, and water restrictions from the drought looked like another spanner in the works. The camp went ahead in the end.Â Unfortunately, when they

Camp was full of announcements. Scholarships of $500 each were awarded to members Lily Barton and Lexi Pottinger to help them work towards goals in tapdancing and rowing respectively. (See our article about Lexi on page 38, and look out for an article on Lily in the next issue.) Meanwhile, committee member Caroline Wightlim had organised a design competition in the lead up to the camp: Youth members designed tee shirts expressing what camp meant to them. The winning design was chosen and the tee shirts were professionally (and secretly!) screen printed before camp.

The winner was announced at camp and tee shirts given out to everyone. Theyâ&#x20AC;&#x2122;ve been popular attire ever since. Anna Koldau was thrilled to discover her design had won. The news was especially welcome as she and her family (together with 16 sheep and 3 chickens) had been enduring a long, tough evacuation from their home because of the fires. Diabetes Nelson Youth has other regular activities throughout the year, including Wear Blue for Diabetes days at local schools where some of their members attend. The Wear Blue days fundraise for the branch (everyone who wears blue brings a gold coin) as well as raise awareness about diabetes. Contact Diabetes Nelson Youth: dnznelsonyouth@gmail.com

Anna Koldau

Lily (right) and her friend Bella

DIABETES WELLNESS | Spring 2019

Catherine Taylor presents Lily with her scholarship

Exciting changes at Diabetes New Zealand Diabetes New Zealand has moved from being an incorporated society to a registered charitable trust. This means we can support New Zealanders affected by diabetes much more effectively.

The Diabetes NZ Board of Trustees (left to right): Maurice Trapp, David Shearer, Catherine Taylor, Peter Sleeman, Heather Verry, and Alastair McKenzie.

iabetes New Zealand no longer has a paid membership structure, but you are still able to subscribe to Diabetes Wellness magazine. Diabetes Wellness remains the only magazine in New Zealand that is dedicated to providing an extensive range of up-to-the-minute news, information, advice and support to people who live with type 1, type 2, and pre-diabetes – as well as to their families, friends and medical professionals. Meanwhile, as a registered trust, Diabetes New Zealand will be able to be become a stronger, more inclusive authority for diabetes nationwide, with an ability to respond to issues much more quickly, and to advocate for the changes that people living with diabetes need. Diabetes NZ is thrilled with the years of loyal support that we’ve received from our thousands of members, and we hope you, and many others, will come along with us for the next part of our journey as we work for the benefit of everyone in the country whose lives are affected by type 1, type 2, or pre-diabetes.

INVEST IN YOUR HEALTH Subscribe for just $28 a year* Diabetes Wellness magazine is the flagship publication of Diabetes New Zealand

* Four issues delivered to your door – $7 per issue, including P&P. RRP is $32.00 To subscribe for this special price visit www.diabetes.org.nz and click ‘Magazine Subscription’

DIABETES WELLNESS | Spring 2019

Cover

Ever since their My Kitchen Rules debut in 2015, Jay Wanakore and Sarah Chase have been sharing their passion for honest, healthy food with the nation.

A fresh, versatile approach to food

ay (Waikato, Ngāti Maniapoto) and Sarah (Ngāti Tūwharetoa, Te Tai Rāwhiti) grew up understanding the importance of cooking. “With us both being from big whānau, kai has always been the centre of attention at hui, birthdays, tangi, weddings and celebrations,” says Jay. “As kids, we were expected to help out in the kitchen, which was the best training ground.” The pair have developed a strong commitment to fresh, unprocessed food. “In this day and age, there are so many hidden additives, preservatives and flavourings in kai that are detrimental to our

DIABETES WELLNESS | Spring 2019

health. Choosing fresh kai gives us peace of mind. We know that it hasn’t been tainted with all these extra ingredients in the processing stages. “In saying that, a lot of brands are being sneaky and trying to market foods as ‘healthy’ when they’re not. Always read the fine print, whānau!” Jay and Sarah are known for their spectacular grazing tables and platters. “They’re our go-to for events and occasions because they're so easy to prep and always look appealing. “They’re versatile enough for any occasion and group size, from a small family movie night to a

grand event. Home, beach, events, work ... You can set up a platter or grazing table pretty much anywhere with a clean, flat surface. Seeing the yummy final layout is always satisfying.” Their biggest-ever grazing table was 4 metres long. “It fed 50-plus people with an amazing array of fresh, moreish food. That took about four hours all up to shop, prep, cut, and present.” One of their favourite spreads has been a tropical-themed grazing table they created for their son’s fourth birthday. “It had lots of flavoursome finger foods that all the kids liked, and it was colourful and appealing to the eye.”

SECRETS OF THE SPREAD Here are Jay and Sarah’s pro-tips for putting together a grazing platter or table with the wow factor. CHOOSING FOODS

1. Get foods with different textures. For example, you want some crunchy things like nuts, seeds and crackers, as well as breads, fresh fruits and veges, sauces, dips, and yoghurts. 2. Get foods in different shapes and sizes. You want people’s eyes to constantly scan the table, excited with all these surprise pockets of yummy goodness. 3. Get foods in a range of colours. Most foods are plain coloured, so fill the table with pops of colour. Use bright fruits and veges. Also, bring in more colours through the bowls and plates you use. 4. Have one or more herostatement dishes, foods, or props: Even something like a big styled watermelon, coconut, or pineapple adds height and drama to a table. It’s also cool to have a bright flower bouquet, plants, candles or even ornaments. LAYOUT

1. Plan your table or platter in sections of three. 2. Place your bigger food or bowls first, then work outwards from there. Your smallest things can be gap fillers. 3. Place foods at different heights using bowls, jars, crates or boxes. 4. Look at your platter or grazing table from all angles to ensure it looks appealing from all sides. Alternatively, push your platter or table against a wall so you only have to worry about one main side looking good!

JAY AND SARAH’S ROAST VEGGIE HUMMUS AS PART OF A LIGHT MEAL, SERVES 6 (AS A SNACK, SERVES 12)

This delicious hummus is a great way to use up leftover roast veges. 400g can of chickpeas (rinsed) 1 cup chopped roasted beetroot and/or carrot ¼ cup extra-virgin olive oil (leave aside 1 tbsp for drizzling on top when serving) 2 tbsp of tahini 3 tbsp lemon juice (fresh if possible) 2 cloves of garlic, crushed 2 tbsp water ½ teaspoon of paprika ½ cup chopped coriander or parsley leaves

Drain chickpeas, rinse in cold water, then place in food processor. Add tahini, crushed garlic, water, salt and lemon juice. Start the food processor, and slowly pour in the oil while it runs. When the mixture is fully combined and smooth, tip into a serving dish. Sprinkle with paprika and coriander or parsley for colour. Drizzle remaining olive oil on top. Variation: Try using other roast veges like kumara and pumpkin.

NUTRITION PER SERVE: ENERGY 777kJ (186kcal) | PROTEIN 4.4g | FAT 13.3g (SAT FAT 1.9g) | CARBOHYDRATE 9.8g (SUGAR: 3.9g) | SODIUM 127mg

SUPERBEET WRAP CHIPS AS PART OF A LIGHT MEAL, SERVES 6 (AS A SNACK, SERVES 12)

Jay and Sarah love to serve these with their hummus plus more fresh veges. 6 Farrah’s superbeet wraps (one pack) Olive oil spray Preheat oven to 180°C. Spray one side of each wrap with oil. Cut the wraps into shapes using a sharp knife. Lay the shapes on baking trays with the olive oil side facing down. Bake at 180°c for 6–8 minutes or until slightly crunchy. Remove from oven and allow to cool before serving with your favourite dips and extra veggies. NUTRITION PER SERVE: ENERGY 714kJ (170kcal) | PROTEIN 2.8g | FAT 9.8g (SAT FAT 2.4g) | CARBOHYDRATE 17.6g (SUGAR: 1.5g) | SODIUM 181mg

Jay and Sarah love theming their platters and tables. Featuring corn on the cob and pōhutukawa as hero statements, this one was a celebration of summer.

For more food tips and tricks, plus recipe inspiration, follow @jayandsarahnz on Instagram and Facebook or head to their website: www.jayandsarah.nz

DIABETES WELLNESS | Spring 2019

NO A DDED SUGAR & RED UCED F AT * ICE CREAM

$5 OFF CHOCOLATE

•

at your local supermarket. Full creamy taste, gluten free & reduced fat! *

SUMMER BERRIES

•

VANILLA BEAN

*Zilch Vanilla Bean contains 53% less fat than Vanilla Ice Cream [USDA National Nutrient Database for Standard Reference, Release 28, Report 19095].

www.zilch.co.nz To the Consumer: This Voucher is non-assignable and is only valid on the following products: Zilch Chocolate, Zilch Vanilla Bean & Zilch Summer Berries. Only one Voucher can be used per product purchased. This Voucher cannot be used or exchanged for any other products, nor redeemed for cash. Copies are not valid, originals only will be accepted and can only be used once. This Voucher must be redeemed by 31/05/2020. This Voucher may not be used in conjunction with any other discount or special offer. This Voucher is issued by Emerald Foods Ltd, please present at your nearest supermarket ranging Zilch™ Ice Cream within New Zealand. To the Retailer: Provided this Voucher is redeemed in accordance with the customer offer above, it will be credited in full, plus the normal handling fee by sending to; The Coupon Company Ltd, PO Box 47-319, Ponsonby, Auckland 1144.

TCC 19959

Community

HEALTHY TIPS FROM MOVERS AND SHAKERS For two weeks in May, Fitbit-wearing leaders and celebrities competed to out-step each other in the Fitbit MoveMeant Challenge – run annually by Fitbit and Diabetes NZ. We asked competitors for their top tips on building exercise and healthy eating into a busy life.

CHALLENGE RESULTS

As part of the Fitbit MoveMeant Challenge, competitors publicly promote the benefits of exercise and raise money towards Diabetes NZ’s resources and projects. Our fantastic team raised over $120,000 this year, and their steps added up to 2,532 kilometres. If it was a relay they would have reached Australia. Our thanks go out to all of them: Sir Eion Edgar, Aimee Young, Aziz Al-Sa'afin, Hon Dr David Clark, Makaia Carr, Lee Weir, Mel Homer, Richard Chambers, Rachel Grunwell, Rod Slater, Jax Hamilton, Hamish Walker, Kerre McIvor, Michael Barnett and Rhys Jolly. 1st Place: Richard Chambers, with the mammoth step count of 433,016 1st Runner up: Rod Slater 2nd Runner up: Michael Barnett See page 16 to learn about competitor Lee Weir’s Type 2 diabetes journey, and stand by for an article about our inspirational patron Sir Eion Edgar in the next issue of Diabetes Wellness.

Richard Chambers – Winner Assistant Commissioner, Serious & Organised Crime, NZ Police “A close family member lives with diabetes. The Fitbit Challenge was also an opportunity to demonstrate that despite a demanding career and family commitments, I could find time to step up my exercise routine to a new level. I entered the Challenge last year and came second. I wanted to improve on last year’s placing, so that left only one option!”

DIABETES WELLNESS | Spring 2019

TOP TIPS

FAVOURITE QUICK EATS

• Don’t find excuses. Winter can be a challenge for those of us that like to exercise outdoors. Don’t let the cold be an excuse. Put something warm on and get out there. And if it’s raining, you’ll only get wet! • Owning and wearing a Fitbit is a fantastic way to motivate daily activity and stay focused on personal goals. You can store data on the Fitbit App, which allows you to monitor progress over time and compare your progress to others. It can become addictive, but in the context of daily movement that’s not a bad thing!

I love Weetbix and Sultana Bran. Throw in some yoghurt and a few berries and it’s an easy, healthy meal. I could have this (and do!) any time of the day or night. I also love omelettes if I’m looking for something easy but more filling.

Makaia Carr Author and speaker

Follow Makaia on Instagram: @makaiacarr

“Diabetes has been a major health concern in my mother’s family. It’s something that we’re all mindful of. I entered the Challenge because I wanted to support Diabetes NZ and also kickstart some regular exercise back into my daily routine. My goal of 10,000 steps per day was realistic, but still one that kept me more active than normal.”

TOP TIPS

FAVOURITE QUICK EATS

• One thing that’s been helping me mentally is trying to embrace the feeling that exercise or hitting a target gives me. It makes me feel satisfied, strong, confident and happy, and who doesn’t want to feel happy? • Something I’ve changed recently is not caring where I park my car. I use to drive around and around to find a car park close to my destination. These days I don’t care if I’m parked blocks away as I now enjoy the walk there.

Avocado and feta on Vogel’s bread; tuna on brown rice; Cobb salad loaded up with everything!

Rhys Jolly Personal trainer

Follow Rhys on Instagram: @coach.rhys

“My prime motivator for the Fitbit Challenge was showing people how planning your week of exercise and trying different ways to add exercise into your daily habits brings so much more to you than just a sweat!”

TOP TIPS

FAVOURITE QUICK EATS

• With exercise and healthy eating, I get clients to focus on the positive response you get from this. The more you focus on the positive response, the more you’ll want to do that thing, rather than see it as a chore. • When you first start, don’t go from zero to a hundred right away, as you’ll be more prone to injury because your body isn’t conditioned to sustain that. You’ll end up feeling it’s too hard, rather than focusing on that positive response. • Think outside the box. There are all sorts of ways to get your body moving more, from increasing the frequency of cleaning the house, to taking stairs, to having a small drink bottle at your desk rather than your big one so you have to walk to fill it more often. • Grab a friend to add enjoyment and accountability to exercise.

A can of tuna over mixed vegetables, or for something sweeter, here’s a great ice cream substitute: blend together frozen berries and half an avocado, then add crushed nuts on top for the crunch factor.

DIABETES WELLNESS | Spring 2019

Rod Slater – 1st Runner up CEO Beef & Lamb NZ “Sir Eion Edgar is a friend and also a great salesman. He issued the Fitbit Challenge to me in a way that was very hard to refuse. Once I’d made the commitment, my main motivation was a fear of not doing the Challenge justice. “I set myself a minimum target of 20,000 steps a day by walking to and from work. I was surprised to find myself in the top two after a few days. I realised then that to beat Richard Chambers was going to be difficult, but second place was a possibility! “On the final night I noticed that I was being caught by Michael Barnett. So, at 10.30pm, with an hour and a half to go, I took off and did 10,000 more steps, with Lesley my wife telling me I was crazy!

TOP TIPS

• We all feel resistant to exercise at times. We just need to remind ourselves of the immense satisfaction we get when we fight that resistance. • In my view, it’s important to make exercise a normal and consistent part of your day. I do think that’s where a Fitbit can play a significant role, challenging you and rewarding you with messages of support and congratulations.

“Until 1996, when I was diagnosed with type 2 diabetes, I thought I was bullet proof. It was more a blow to my ego than anything else. Once I got over that and came to terms with it, it was a case of getting on with life.”

Rachel Grunwell Author, journalist and coach

Rachel Grunwell and Diabetes NZ Patron Sir Eion Edgar walking together in Queenstown to increase their step count for the Fitbit MoveMeant Challenge.

Visit Rachel’s website at inspiredhealth.co.nz or follow Rachel on instagram @RachelGrunwell or Facebook @InspiredHealthNZ.

“I was an unfit mum and journalist seven years ago, and now I call myself a runner. I just gritted my teeth in the early days, tried hard to believe in myself and see where the run journey might take me. “I’ve worked alongside Fitbit and Diabetes NZ for a few years now to help raise awareness around the importance of movement to help with health management.”

DIABETES WELLNESS | Spring 2019

TOP TIPS

FAVOURITE QUICK EATS

• Starting can often be the hardest part. Be courageous, and just turn up to that fitness idea you want to try. Keep showing up until it becomes a habit, then a part of your lifestyle. • If you practise almost anything you get better at it, right? So hang onto that thought. • Find a community that wants to cheer you on. When you’re connected to a community, then you want to turn up. If you don’t, you’re not just letting yourself down, but others too. Social media is also wonderful for finding people to cheer you on.

For one of Rachel’s favourite recipes, and to find out more about her just-released book Balance: Food, Health + Happiness, see page 19.

Community

FOLLOWING Tama ‘the Tamanator’ Moeke (left) and Ngaru ‘the Diabetic Kid’ Moeke

Eleven months ago, Ngaru Moeke was diagnosed with type 1 diabetes. Now, along with his older brother Tama, he’s been selected to represent New Zealand at the Muaythai Youth World Championships.

he Taranaki-raised brothers will travel to Antalya, Turkey, at the end of September to represent New Zealand as part of the Junior Black Gloves – a team of 14 young martial artists from around the country. The Moeke family hopes to make a stop in Thailand as well, so the boys can train in the home of Muaythai. It’s something Tama and Ngaru have dreamed of since they were small. Their mother Laura Clarke says that when Ngaru was diagnosed

MUAYTHAI DREAMS

with type 1 in August 2018, the family worked to learn as much as possible about the condition. “Managing the timing of his insulin and training is crucial. We can finger prick every half hour, depending on intensity of training. Eating good food helps, and plenty of sleep.” The boys train at Pitbull Siam gym in New Plymouth, coached by their father Shannon Moeke. They also help out in the Muaythai youth classes he teaches there. Laura says Pitbull Siam is very family orientated. “We’ve found acceptance, respect, brotherhood, and sisterhood. The aroha given towards the kids is heartwarming.” The Moeke brothers’ kura is proud of them too: Te Pi’ipi’inga Kakano Mai I Rangiatea Kura Kaupapa Māori school. Laura says everyone is understanding when they have to be away for training or competitions, and

“teachers and friends come out to support the boys in home fights and help with fundraising.” There are raffles, car washes, sausage sizzles, and now a givealittle page to help cover flights, registration fees and accommodation for the World Championships. The boys are classed as elite athletes. “One thing we’ve noticed is funding is limited for elite athletes under the age of 15. Most funding is for schools and or groups.” When it comes to type 1, the family follows a philosophy of “listening to Ngaru’s body to find what works best for him. And on the week or day of a competition, if something does happen that’s type-1 related we don’t let it get us down. We take it in our stride, assess it and deal with it the best we can.” GIVEALITTLE givealittle.co.nz/ cause/help-get-tama-and-ngaruto-the-youth-kickboxing

WIN A SKINNYFIZZ 12-PACK SkinnyFizz are giving away 12-packs to 25 lucky Diabetes Wellness readers. SkinnyFizz is sparkling water with a splash of NZ fruit, and that’s it. It’s a great alternative to traditional sugary or sweetened soft drinks, with a refreshingly real taste. To enter the draw, put SkinnyFizz in the subject line and email your name, phone number and postal address to draw@diabetes.org.nz. Or post to: Freepost Diabetes NZ, PO Box 12-441, Wellington 6144. Competition closes 30 September 2019. Order SkinnyFizz online at SkinnyFizz.co.nz DIABETES WELLNESS | Spring 2019

Life with T2

In May last year, Radio DJ Lee Weir went to a new doctor, who was surprised he’d never had routine blood tests.

A LIFE CHANGED IN THREE MONTHS

“M

y doctor sent me off for a complete set of bloods: liver, kidneys, HbA1c, everything,” says Lee. “I got a call on a Friday afternoon from the nurse. She said the doctor wanted a chat, and could I come in on Monday. I asked if everything was okay. She said, ‘Everything's fine. Just looks like you've got diabetes, love.’ “So that was great news to head into the weekend with. “I was completely ignorant of the disease, so I spent most of the weekend researching. I always thought type 2 diabetes meant you’d had too much sugar. That was my wealth of knowledge on the subject! I thought, I don’t have a sweet tooth at all, so what’s this about? “The more research I did, the more I realised that not being very active and making bad diet choices had

Lee, his wife Nikita, and their children Lucy and Albie

DIABETES WELLNESS | Spring 2019

finally caught up with me. A lot of it for me was the portions side.” He’d always enjoyed large, carbrich meals, and had been brought up never to waste food. He cleaned up his plate, and if his kids left food, he cleaned that up too. Then there was erratic, late-night eating. “In the year leading up to my diagnosis, I did a lot of night work on the radio. I worked about 180 night shifts, which is almost half the year.” He says the diagnosis of type 2 diabetes made him feel “deflated, like I’d let myself down”. His doctor was encouraging, though. “He said, ‘Lee this isn't the worst thing in the world. A change in your diet, and some daily exercise should see you turn this around.’ “I told myself, I've got these two beautiful children that need a dad,

and if I don't do better, they won’t have that. “I stopped snacking, I stopped eating after 6 o’clock in the evening. I’d take my dog for a walk every day, whereas before I’d left that to the rest of the family.” He made sure every walk involved some hills. “I knew the first month would suck, because I needed to train my body to eat less. So I chewed gum. I drank water. Those hunger pains do go away. I made my own trail mix for snacks, like a scroggin, but because I don’t have a sweet tooth it was sunflower seeds, pumpkin seeds, and diced up bacon.” He replaced a lot of carbs with greens and other nutrient-dense vegetables. “My wife Nikita was incredibly supportive.” After a few weeks, he began to enjoy the change in habits. “I was

amazed at how much more energy I had.” For one thing, he could keep up with his kids at the park. When Lee checked back in with the doctor three months later, his HbA1c had dropped from 82 to 43. “That was a good day. I got really emotional on the call. The doctor said, ‘Have you been starving yourself?’ I said, ‘No, I’ve just been doing what you told me to do. Eating healthier and exercising every day.’

Lee and son Albie

He reflects that in the early days of his diagnosis he was angry at himself. ‘But I think for me, it was one of those things where I needed to be beating myself up a bit. It was a kind of motivation for me. I needed to push myself. That's how I got through.” It might not work for everyone, but, “I think that if I hadn’t have been so tough on myself I wouldn’t have seen such a substantial drop.” He’s continued to increase his exercise and lose weight: “Nikita can get her arms all the way around me now, which is nice.” He owns a Fitbit, and says, “It's amazing where you can find steps. You know, carrying the shopping inside in more than one go, even though that goes against every man code known.” Nikita also wears a Fitbit, and that’s another motivator. “I’m not going to let her get a higher step count than me! She’s an early childhood teacher, so she's always on her feet. We have little battles. They're pointless because no one wins anything, except bragging rights. But bragging rights are huge in a marriage. It’s good fun.”

WORKING WITH MY IDENTITY Lee enjoyed working with Hayley from My Identity to create the medical bracelet on the right. He says, “Medical bracelets should look cool, not be big chunky, ghastly pieces of jewelry. This one, it’s quite sleek. I could wear this without someone saying, ‘Bro, what the hell are you wearing.’ I think the beauty is in the simplicity. And the red star almost looks like the Red Hot Chilli peppers symbol, which is cool because I’m a big rock and roll enthusiast. But anyone who knows what they're looking for will identify that it's a medical bracelet.”

Lee works as a marriage celebrant as well as a DJ: www.facebook.com/LeeWeirWeddings He holds the world record for the most tattoos of the same cartoon character. (He has 41 tattoos of Homer Simpson).

$59

Available in a limited number

FASHIONABLE MEDICAL ID JEWELLERY Lee Weir, radio DJ for The Rock, marriage celebrant, husband, dad to two, world-record holder and living life well with type 2 diabetes since May .

Shop now for a beautiful piece of jewellery and support our community

www. myidentity.co. nz

Advocate

STAND UP FOR HEALTHY FOOD OPTIONS Taranaki dietitian and Diabetes NZ volunteer Niamh O’Sullivan says we need to focus on prevention if we’re to have any hope of slowing the tide of type 2 diabetes. She says there are ways we can all help.

s a society, we’re more sedentary then previous generations, and we’re surrounded by easy-to-grab processed and packaged food, loaded with sugar to hook you in and make you buy more. Our bodies evolved in a time when we couldn’t always get enough food. Now, we can’t stop the food overload, but we have the same genes from our ancestors that want to store food. We all need to take a harder look at our environment: • sugar as rewards from teachers and even healthcare staff • sugar and packaged food after sports and trainings

DIABETES WELLNESS | Spring 2019

• advertising giving us visual cues to eat high fat and sugary foods • takeaways and dairies right across from our children’s schools and play areas • chippies and chocolate at the end of every supermarket aisle. How can we expect people to make the healthy choice when our environment is setting it up as the hard choice? Our environment is everybody’s problem. WHAT CAN WE DO?

We need to lobby for places that everyone goes, like supermarkets, to make it easier for consumers to choose the healthy options. For example, make fruit and vegetables cheaper instead of tacking deals and discounts onto packaged foods. Recently one supermarket started a “Lunchbox” section, containing 100% packaged food items, such as crackers, chips, snack bars, fruit vines, and so on. It’s confusing for shoppers and harder to make a healthy choice when the supermarket is literally directing them to all the packaged items to add to their children’s lunch boxes.

In cases like these, the more of us who can stand up and actually say something to the manager about this, the more traction we’re going to get. Similarly, with sporting events where sports drinks, fizzy drinks and lollies are given out, the more parents who stand up and say, “This is not OK,” the more things will change. Sport Taranaki recently started an initiative called the “Good Sport of the Day Award” whereby instead of takeaway vouchers or lolly packets they give out free pool passes to the Sportsperson of the Day. There is strength in numbers, so if there are groups or individuals in your community already trying to pave the way for this work, add your support. And if you see something that needs to change that no one’s speaking up about yet, consider getting the ball rolling yourself. TELL US YOUR HEALTHY FOOD ADVOCACY STORIES

Is there an organisation in your area that’s helping to make healthy eating easier? Or have you spoken up for change yourself? Diabetes Wellness would like to hear your stories. Email us at editor@diabetes.org.nz

RACHEL’S SPINACH SMOOTHIE Rachel Grunwell, author of Balance: Food, Health + Happiness, shares a green smoothie recipe from her book.

PHOTOGRAPH: AIMEE FINLAY-MAGNE

pinach grows like a weed in my garden for most of the year. I hack it back regularly when I make salads or smoothies. This smoothie boasts lots of antioxidants and nutrients, and spinach is known for containing iron. I get my kids on board with loving greens by telling them that Popeye ate them to get super-power strength. Actually, they love this smoothie without the bribery because of the sweetness of the pear. I hope you love it too and get a kick out of its “super-powers”.

THE ONLY INSULIN PUMP THAT IS FULLY FUNDED AND WATERPROOF*

MINIMEDTM 640G INSULIN PUMP

POPEYE’S GREENS IN A CUP SERVES ONE

250ml coconut water 4 medium spinach leaves ½ chopped pear (remove pips) ½ avocado 4 cubes ice 1 tbsp coriander 2 mint leaves Wash the greens. Place the leaves and the rest of the ingredients into a blender and mix. Pour into a glass and savour.

* Waterproof at time of manufacture up to 3.6 meters for up to 24 hours at a time. See MiniMed TM 640G User Guide for a complete description of the waterproof capabilities and proper instructions.

NUTRITION PER SERVE: ENERGY 974kJ (233kcal) | PROTEIN 2.8g | FAT 12.9g (SAT FAT 3.1g) | CARBOHYDRATE 23.9g (SUGAR: 23.7g) | SODIUM 24mg

Rachel’s book Balance: Food, Health + Happiness contains 30 recipes and interviews with 30 global experts sharing their science-backed wisdom on living healthier and happier. Purchase the $40 book via Rachel’s website inspiredhealth.co.nz or from Paperplus and Whitcoulls stores. (You can request it in if it’s not on shelves).

InterMed Medical Limited Free Phone 0800 333 444 www.intermed.co.nz 71 Apollo Drive, Albany, Auckland 0632 PO Box 33268, Takapuna, Auckland 0740 The MiniMedTM 640G Insulin Pump is fully funded in NZ for eligible patients by Special Authority. TAPS PP4216

Life with T1

NZFAA National Bow Hunter Champion Jill Gillette discovered her passion for the sport in her early 30s, and was determined that type 1 diabetes wouldn’t get in the way.

STRAIGHT SHOOTER J

ill remembers, around 18 years ago, wandering round a sports expo in Auckland, where the New Zealand Bow Hunter Society had an area set up. She’d been fascinated with bows and arrows as a child, and had a go. “The guy said to me, wow, you’re a natural. And I thought, you know, I really enjoyed that.” Her excitement was quashed when she realised she couldn’t justify spending money on a new hobby, especially as she and her soon-to-be husband were saving for a house. Two years later, they had the house, and were married with a nine-month old daughter, when Jill’s husband suddenly passed away. Jill was devastated. It wasn’t until many months later that she started thinking, “I need to get out. I need to join a club. I need to do something. Then it just hit me: have a look at archery.” She bought a bow and found her local archery club: The Franklin County Archers. “I got in with a really good bunch of people who mentored me, and I’m still really close with them. They got me into competition, bow hunting, introduced me to my coach ... Once I picked up that bow, it was: this is right.” Jill had been diagnosed with type 1 diabetes in 1985 at the age of 12. She’d been getting thinner and sicker for four years. Her mother had taken her to the doctor constantly, but “he’d said

DIABETES WELLNESS | Spring 2019

she’s fine, she’s just a bit thirsty, she’s just a bit run down, oh, she’s got worms.” Finally, a locum took what was happening seriously, and when Jill’s mother suggested they test her for type 1 diabetes, he agreed. Jill was close to death when she was finally diagnosed. From then on, her parents did everything they could to educate themselves on the condition, as well as make sure that Jill was fully educated. To this day, Jill is grateful. She says education is the key to managing diabetes. As a field archer, managing her diabetes tightly is vital. Field archery is different from target archery. “Field archers walk an eight- or nine-kilometre long course through a bush setting. Usually there are around about 28 targets, and you can shoot anything from one to four arrows at each target.” The complex relationship between adrenaline levels and blood sugars is one of the toughest challenges for Jill. “When I get onto the archery course, I need to test my blood sugar every second target. Because we’re hiking up and down hills and there’s a lot of adrenaline every time you take a shot, it can be difficult managing diabetes on the course. But if you have high blood sugars you can’t concentrate and your arrows don’t go where you want them to. If you are hypoglycaemic you can’t concentrate either.” Before a big competition, nerves play even greater havoc. “I can be 6.3 leaving the house in the morning. By the time I get to the range I’ve wound myself up and I’ll be sitting on 17. It’s unbelievable what the emotional side can do to you, and that adrenaline.” Jill has also found a passion for hunting and fishing. She hunts for food, processes all her own meat and makes bacon and sausages. Adrenaline plays a big role in

her diabetes management while hunting, too. “You look at your sugars and go, okay, I’m on 7, that’s awesome. Then you go and find the animal. By then, the adrenaline that’s holding your blood sugars up has stopped and you do another blood test: Bugger. 2.8.”

“It’s unbelievable what that emotional side can do to you, and the adrenaline.” She’s always thinking about the other people around her. “My biggest fear is becoming an issue to them.” When she’s on a competitive course it’s about making sure no one else’s times are affected by worrying about her, and when she’s away hunting it’s simply about looking after friends. “We fly into the Kaimanawa Ranges and we’re in there for a week. You don’t have cellphones, you can’t ring an ambulance, so I have to make sure that I’m spot on, or I’m a problem to my hunting companions.” Last year, her partner Mike bought her a Freestyle Libre scanner for her 45th birthday. She says, for someone like her who has to test frequently, it’s lifechanging. STRESS STRATEGIES

Jill has a massive amount of support from friends and family, including her daughter Jorja, her parents, and Mike. Sometimes she has to remind herself, “I do archery for myself. When you get a lot of people behind you before going into competition, you suddenly think, oh my god, I’m going to let them down. If I don’t pull it off today, what’s going to happen? That can undo you. So I

look at it in the sense of – these people will love and support me no matter how I do.” Her coach Trevor Irvine understands her well. “He says, ‘slow down and breathe. Get back into enjoying it rather than being worried about the result.’ My shot process involves a sequence of breathing. He and I have developed my breathing technique so I’m not holding my breath. I’m allowing the body to work through the process of drawing the bow, aligning the bow, and then aiming. If you breathe through the shot, you have a better shot sequence and your arrow travels better.” Breathing is also a big part of calming down when she’s off the field. “And the other thing I use is two words, which I pull out whenever I need to: ‘For now’. For now I’m working. For now I’m practising. For now I’m collecting the mail. For now I’m in this house. I use those words a lot in my head, whenever I’m getting anxious planning ahead.” Field archery doesn’t receive any government sports funding, and despite being in New Zealand’s national Field Archery team, the Black Arrows are self-funded and struggle to get sponsorship. Jill works from home as a hairdresser, and fits this work around her training. Right now she’s getting ready for the 2019 IFAA World Bowhunter Championships in Yankton USA, which will take place in early September. And what of the future? She doesn’t even hesitate before answering. “For now I’m working at home. For now I’ve got a bow. For now I’m doing my archery.” Follow Jill’s progress on Instagram: @jillibeangillette

DIABETES WELLNESS | Spring 2019

Nourish

Nutrition therapy and you If you have type 1 or type 2 diabetes – or pre-diabetes – you should have access to up-to-the-minute dietary advice and support from your GP or a dietitian. Helen Gibbs looks at exactly what care you should be getting.

any people with a new diagnosis of type 1 or type 2 are uncertain how they should be eating, and even more confused when they start googling all the competing views, theories and research papers. That’s why we recommend you have access to professional Medical Nutrition Therapy (MNT). In April 2019, The American Diabetes Association released an important report: Nutrition Therapy for Adults with Diabetes or Pre-diabetes: a consensus report. In it they reviewed recent research (up to the end of February 2018), and distilled it into key messages. Any MNT needs to aim to achieve or maintain good blood glucose control, while also managing or improving heart-disease risk factors, such as cholesterol or high blood pressure. However, MNT should be individualised to fit the patient’s culture, lifestyle and values.

Helen Gibbs is a New Zealand registered dietitian and accredited DESMOND educator working for WellSouth PHN. She also runs her own private practice seeing clients, writing about nutrition and advising the food industry while maintaining a social media presence focused on food and nutrition.

DIABETES WELLNESS | Spring 2019

MNT FOR DIABETES Nutrition Therapy for Adults with Diabetes or Pre-diabetes: a consensus report has reached consensus on these things: Consistent, individualised care

According to the report, adults living with type 1 or type 2 diabetes should receive “individualized, diabetes-focused MNT at diagnosis and as needed throughout the life span and during times of changing health status to achieve treatment goals.” What this means is: if you live with diabetes, you should, from the start, be seeing the dietitian regularly, and when you need them. For those with Type 1, carbohydrate counting and insulin adjustment training should be offered as part of education in ways you can engage with. Education

Adults with type 1 and type 2 diabetes should be referred to “comprehensive diabetes self-management education and support (DSMES) services”. This means that within a year of your diagnosis, you should have received education either in groups or 1:1 that will help you manage your own condition. Qualified specialists

The report stressed that diabetes-focused MNT should be provided by “a registered dietitian, preferably one who has comprehensive knowledge and experience in diabetes care.” Intervention for pre-diabetes

The report found that people with pre-diabetes or a high risk of diabetes should be referred to “an intensive lifestyle intervention program that includes individualized goal-setting components, such as the Diabetes Prevention Program (DPP) and/or to individualized MNT.” This means that if you are pre-diabetic or at risk of diabetes, you should have access to services that will help you to be more active and improve the quality of your diet. Groups are an efficient way to see people who want to make lifestyle changes, but they need to have an element of individual care, i.e. they should encourage individual goal setting.

WHAT IS MEDICAL NUTRITION THERAPY (MNT)? This is a term that’s now used to describe the treatment of a condition through specialised advice on diet or eating, usually from a doctor or registered dietitian. It can involve support, counselling, advice, diet planning and ongoing monitoring.

REFRESHINGLY REAL Sparkling water & a splash of NZ fruit. That’s it! FREE SHIPPING* with code: DIABETESNZ @SkinnyFizzNZ on

www.SKINNYFIZZ.co.nz

™

*Terms & conditions apply.

DIABETES WELLNESS | Spring 2019

DIETARY RECOMMENDATIONS TO EXPECT Research shows that no one diet will meet everyone’s needs. Some people do best following a plantbased diet, others may do better on a healthy omnivorous diet, and others on a reduced or low carb diet. Your optimum diet should be worked out based on your response to it: changes in HbA1c values, blood pressure and cholesterol values. The diet should also be appropriate to your lifestyle and culture. If you have either type of diabetes there are some specific areas that you should receive advice on: Dietary fibre

Every adult should aim to have at least 25g of fibre per day, preferably from food (vegetables, legumes, fruit and wholegrains), or else through fibre supplements. This improves blood glucose control. If there are reasons to limit fibre, this should be under the supervision of the same dietitian providing your diabetes care. Types of fat

Although the direct roles of saturated and unsaturated fats in diabetes are uncertain, there is clear evidence that replacing saturated fat in the diet with unsaturated fat lessens cardiovascular risk. Reducing saturated fat remains one of the goals of nutrition therapy, but the impact of this intervention should be assessed through a regular review of the patient’s cardiovascular risk.

Sweeteners

The report stressed that sugar substitutes don’t turn an unhealthy choice into a healthy one; they simply make the choice less unhealthy. This supports the position of Diabetes NZ that sweeteners should be used as transitional products to reduce sugar intake. Advice to individuals needs to encourage reduction of added (free) sugars to 10% or less of total energy (kJ/kcal). Alcohol

Drinking alcohol alters liver function and increases the risk of low blood glucose during the hours after alcohol is consumed (delayed hypoglycaemia). Moderation and consumption of food with alcohol is important for people with diabetes. The advice to stick to safer alcohol limits and have at least two alcohol free days each week applies to everyone. Salt

Almost everyone in New Zealand should be aiming to reduce their salt consumption. Most New Zealanders consume well over the recommended daily intake. The maximum amount of salt recommended for an adult New Zealander is 5–6 grams (around one teaspoon) from all food sources. This translates as 2,300 mg sodium. Less is better, especially for those with high blood pressure. We used to rely on iodised salt to get enough iodine. Nowadays, if you eat bread produced by commercial bakers here, you’ll receive enough

iodine from this source. If you don’t eat commercial bread, just 1g of iodised salt per day should meet your intake need for iodine. Supplements and herbal medications

No herbal studies have been of sufficient scientific standard to recommend any herbal preparation specifically for diabetes. And for people with either type of diabetes, as with the general population, there is no evidence that vitamin and mineral supplements offer any benefit when there is no deficiency. However, people with type 2 diabetes who are on metformin for long periods are at greater risk of B12 deficiency. Screening for this should be considered after five years on metformin or if there is any indication of low Vitamin B12 levels. Weight loss

In those who are overweight, even relatively small weight losses (5%) help with blood glucose control, cholesterol levels and blood pressure management. In addition, type 2 diabetes can be either delayed or, in some cases, reversed with a weight loss of around 15kg. However, medical professionals need to recognise that there is a substantial level of disordered eating in the population who struggles with their weight. Therefore, disordered eating patterns must be screened for and managed appropriately, before and during any weight loss attempt.

TELL US YOUR EXPERIENCES

Do you feel you have access to the dietary advice and MNT you need? We’d like to hear your great experiences as well as those where you felt your care was inadequate. How is New Zealand doing on the MNT front? Email us at editor@diabetes.org.nz

DIABETES WELLNESS | Spring 2019

Technology

HALF A CENTURY IN MEDICAL TECH Diabetes New Zealand would like to congratulate MediRay founder George Bongiovanni on 50 years in the medical technology profession – 36 of those directly involved with diabetes management.

eorge Bongiovanni has taken a special interest in diabetes since he first arrived in this country in 1985. He was a regular attendee at Diabetes NZ conferences, and served on the National Executive and Diabetes Auckland Executive in his early days. In 2017, Diabetes NZ presented him with an award for

Services to People with Diabetes. George says, “In my decades of direct involvement with diabetes, there have been many changes in the technology of diabetes management.” MediRay were the first to introduce the new sensor test strip with the Medisense blood glucose meter. They then introduced the Disetronic insulin pump from Switzerland in the early 1990s, making pumps accessible and affordable. By the mid to late 1990s they were working with Medtronic insulin pumps and continuous glucose monitors. “The release of the Abbott FreeStyle Libre has been the biggest technological advancement in diabetes management that I’ve been involved with,” says George. “This was recognised recently with the Libre being a finalist in the Medical Technology Association of

“We are very close to the artificial pancreas” – GEORGE BONGIOVANNI

New Zealand Innovation Award.” When it comes to his hopes for the future of diabetes treatment, he says, “The DIY ‘closed loop’ network is making big strides forward, and together with commercial proprietary instrumentation, we are very close to the artificial pancreas.”

SIMPLE, NUTRITIOUS MEAL SOLUTIONS The Healthy Slow Cooker By Ross Dobson Allen & Unwin RRP: $39.99 Reviewed by Johanna Knox If you’re a slow-cooker fan, this book will be a welcome addition to your shelves. If you’re not already, it may convert you. (And with a chapter on slow-cooking basics, it’s all you need to get started.)

The Healthy Slow Cooker contains over 100 recipes, about half of them vegetarian or vegan. There are soups, curries and hotpots. The ingredient lists specify healthy olive oil, and are full of vegetables and legumes. Most recipes are low sugar, low fat and very low salt. Instead, they rely on fruits, vegetables and spices for rich flavours. There are a small number that use pre-made stock, so if you’re watching your salt intake you’ll want to check

the nutritional info on the stock packet and adjust accordingly. Ross Dobson shows that the “prep, set, and forget” nature of slow cooking makes it easier than we might think for busy folks to cook and eat healthily. Vegetarians and meat-eaters alike will find meals to love here. The book may be most valuable of all for those who are seeking to up their vegetable intake and eat less meat.

READER COMPETITION Allen & Unwin are giving away three copies of The Healthy Slow Cooker to Diabetes Wellness readers. To go in the draw, put SLOWCOOKER in the subject line and email your name, phone number, and postal address to draw@diabetes.org.nz Or post to: Freepost Diabetes NZ, PO Box 12-441, Wellington 6144 Competition closes 30 September 2019.

Move

A LIFE-SAVING ORGAN TRANSPLANT WITHIN REACH Nearly 12 months ago, 38-year-old Roslyn Eason from Christchurch was facing an uncertain future. She needed a kidney and pancreas transplant. Without it, she faced a lifetime of 15–20 hours of dialysis a week, an ordeal she says is “gruelling”.

oslyn says, “I was diagnosed with type 1 diabetes when I was 10 years old, and on top of that about 10 years ago I was diagnosed with kidney failure. I’ve been on dialysis for the past two years.” However, Roslyn’s doctor told her she couldn’t be placed on the waiting list for a kidney and pancreas transplant, as she needed to lose weight in order to be in a healthy BMI range and reduce the risks associated with this major surgery. Roslyn, a preschool teacher, decided to take charge. “For the last few years I’ve felt like I’ve had no energy whatsoever, and I just wanted to not feel like that anymore.” In August last year, she enlisted the help of personal coach Anna Green and joined her local gym, Anytime Fitness Shirley, in Christchurch. Roslyn needed to lose around five kgs, but her fluctuating blood sugar, blood pressure, fluid intake and energy levels meant weight loss didn’t come easily. Nonetheless, through twice-weekly personal coaching sessions, additional walking and cardiovascular exercise and a change in diet, she has now reached her target weight and is on the double surgery transplant waitlist.

DIABETES WELLNESS | Spring 2019

“I’m honestly amazed at how I feel now. I have so much more energy and I feel like the mental fog I used to carry around has lifted a lot. I still have bad days, like anyone else, but I’m able to manage them better and if I don’t feel like a workout I just remind myself how great I’ll feel afterwards.” Roslyn says her newfound fitness will help her recover from surgery. “Double surgery recovery is long and I’ll need a lot of rest, so I’ll probably lose a bit of the fitness I’ve gained – but when I’m ready to get back into it I won’t be starting from scratch, I’ll still have a good strength base to work from.” She says the support of coach Anna has been invaluable. “I’ve been to lots of gyms before, and they’ve usually just told me to hop on the treadmill and left me to my own devices, so I’d give up and not go back. But Anna really invested in me. She took the time to learn about my illness and create new exercises for me based on what I can do, and it keeps progressing as I build up my strength and fitness.” Roslyn says while her results may seem small to some, she’s proud of how far she’s come. “A couple of months ago I could only do squats and lunges assisted with a Swiss ball, and now I can do them completely unassisted. I’m rapt.”

Anytime Fitness trainer Anna (left) coaches Roslyn during weight training.

Anna says she’s incredibly proud. “Because Roslyn’s condition is quite complex, there was a lot she couldn’t do in the early stages and we had to work out a lot of modifications so she could start getting her fitness on track. “Some days she comes in and you can tell she’s had a hard night on dialysis or she’s really tired, but she always puts in the effort and has such a determination to achieve her goals. I’ve honestly been moved to tears by how far she’s come. I think she’s amazing.”

Roslyn (left) and Anna.

Winter Kick-Start Programme encourages Kiwis to get active for a good cause Anytime Fitness NZ and Diabetes NZ have joined forces to help Kiwis get active through winter and beyond, at the same time as raise money to combat diabetes. Anytime Fitness NZ’s 28-Day Winter Kick-Start Programme eBook is a 28day gym-based workout programme, which can be used on an electronic device in any gym. It contains safe, easy-to-follow instructions, with photos and videos to guide you through the workout. It’s also packed with nutrition, lifestyle and motivation tips to help you develop the habit of enjoyable, regular exercise. The book is priced at $19 and contains the kind of instruction and advice that would normally cost hundreds from a personal trainer. There are three levels of workout to choose from, so the programme can be tailored to any fitness level. All proceeds from the sale of the 28-Day Winter Kick-Start Programme eBook go to Diabetes NZ. Diabetes NZ Chief Executive Heather Verry says by joining this programme, New Zealanders can support the work of the charitable trust and advocate for the 250,000 adults and children currently living with diabetes across New Zealand. “Diabetes is the largest and fastest-growing health issue facing New Zealanders. We know that following a healthy diet and exercise plan is one of the key ways to help manage diabetes – and that’s why our partnership with Anytime Fitness NZ makes sense. “This campaign is not just about raising money. It’s also about challenging the stigma around diabetes and dispelling some of the myths surrounding the condition. “By getting in behind this initiative New Zealanders can help us deliver support and encouragement to those managing diabetes, and educate those at risk about the warning signs of Type 2 diabetes and things they can do to prevent it. “We are grateful to Anytime Fitness NZ for their generosity and for supporting us in helping all New Zealanders reach a healthier place.”

The 28-Day Winter Kick-Start Programme is available now and can be purchased online for $19 by visiting www.anytimefitness.co.nz/ kickstart

Grow

Spring is the perfect time to start a garden – but keeping it manageable is key. Rachel Knight offers her top five tips for planning a garden.

Starting your edible garden Growing food is satisfying and richly rewarding. It gets us outside in all weathers, and away from distraction. The results are nourishing and healthy. We don’t have to strive for full selfsufficiency to get these rewards.

Start small and close

Choose somewhere sunny

Improve the soil

We want our gardens to feel welcoming, not overwhelming. The secret is scale and proximity. Get in the habit of some small-scale successful sowing, planting, watering, weeding and harvesting before you dig up your whole lawn. Maybe some pots or containers are enough initially. Maybe it’s a kitset raised bed or two. Make it as close as possible to your kitchen door or somewhere you pass at least twice a day. Even better if it’s also accessible in your slippers. You could add some solar lights so you can harvest after dark.

Sunshine makes for sweeter crops and faster growth. Summer crops are most prolific in sunny positions. In winter, the sun brings warmth and dries out the damp. Leafy salad crops will welcome some shade in summer, though. This can come from other taller crops or by planting them in a position that’s shady after midday.

Gardeners can never have too much compost!

DIABETES WELLNESS | Spring 2019

Compost, compost, compost. If you haven’t got enough of your own (yet), you can buy in compost to spread on existing beds or fill new raised beds. Your kitchen and garden produces compost materials each week, so by using them to feed your own soil, you reduce the amount of waste you need to dispose of elsewhere. Try a small compost bin, a worm farm or a bokashi bin.

5 TOP CROPS

Everyone has their personal favourites. Grow what you love. Here are my top five for ease of growing, versatility in the kitchen and the benefits of having them available fresh.

Zucchini

Leafy Herbs – chives, parsley, basil, mint, coriander

Cucumber

Spring onions

Salad – lettuce in summer and rocket in winter

Get protection

Plants may need our help to defend themselves. Portable shade and shelter is useful, and comes in lots of forms. The threats change with the seasons: white butterflies and cricket balls in summer; pigeons and frost in winter. It may be worth building or growing a windbreak around the whole garden to get things started in a windy spot.

Water wisely

Plants will thrive with adequate water and be more resistant to pests and diseases. A simple tip for overcoming any mental block you may have about watering is, each time you’re in the garden, fill up your watering can again before you go back indoors, so that it’s ready to go straight away, next time. Useful purchases: Using a good quality spray nozzle on a handheld hose means you can apply water in a gentle mist or shower which plants prefer to a forceful drenching. Collecting water in a barrel from the roof means resilience during water restrictions.

A gift of a lifetime Every day, an average of 40 New Zealanders are diagnosed with diabetes. A gift in your will is a powerful legacy to ensure your desire to help and support people with diabetes lives on. No matter how big or small, your bequest will make a world of difference in helping Diabetes New Zealand to support the 250,000 New Zealanders with diabetes to live full and active lives.

For a confidential discussion, please contact Nicky Steel admin@diabetes.org.nz or 04 499 7145

Advocate

ARE FOOD LABELS TRUE? Our consultant dietitian Helen Gibbs explores a frequently asked question.

he most common question I get about food labels after “how do I read them?” is “are labels true?” Few people know about the large amount of legislation behind the words and numbers on food labels. Since 2003, New Zealand has had a joint food standards code with Australia. Food Standards Australia New Zealand (FSANZ) develops and oversees the code. This code covers food-related issues. It includes the legal definitions of particular foods (e.g. what is “milk”?), and the requirements for labels on food. The code also outlines the evidence needed for a health claim. For example, what evidence is needed to put a Glycaemic Index (GI) value on a food product? Enforcement of the code in New Zealand falls to the Ministry for Primary Industries (MPI) and to local councils. MPI and councils ensure that food manufacturing premises have appropriate methods for creating labels. However, they don’t have the time or capacity to check every label, and this is where your power as a consumer comes in.

DIABETES WELLNESS | Spring 2019

A RECENT EXPERIENCE

A couple of months ago, a client who has high blood pressure contacted me. She knew she needed to keep track of how much salt she was consuming, and she pointed out that a curry spices product she’d bought had salt listed in the ingredients, but didn’t have a nutritional information panel to say exactly how much salt (or anything) it contained. She wanted to know why not. I contacted MPI to request feedback on whether I was interpreting the food standards code correctly: Spices are exempt from nutrition panels. However, if a spice mix contains salt (or sugar), it is required to have a nutrition panel. MPI confirmed this was the correct interpretation, and put me in touch with the council where the curry spices business was registered to make a complaint. Within a week of contacting the council I had a response. The company has been served with a notice to make the labels of their products compliant within 28 days or face enforcement.

WHAT YOU CAN DO

There are many little companies moving into selling food in ways that require them to have food labels. Labels can be done inhouse, but it’s useful for these companies to seek some expert advice. This is especially important if they are about to make a health claim. As consumers, we have a responsibility to ask questions of people who manufacture our foods. This ensures they are safe and fit for consumption. If you suspect a label may be inaccurate or misleading, take a photo of it, and email the photo, with a description of your concerns, to the Ministry for Primary Industries (MPI) at info@mpi.govt.nz. Alternatively, call MPI on 0800 00 83 33. Once you have ascertained from MPI that there is definitely a problem with the label, find out where the business is located, and contact the local council. (All food labels must have an address on them.) The council will issue the company with a compliance notice.

FREE TO BE A KID WITHOUT LANCETS*

Introducing the FreeStyle Libre flash glucose monitoring system. Why prick, when you can scan?‡ • Convenient — A small sensor automatically measures and stores glucose readings day and night†† • Discreet — Glucose readings with a 1 second scan even through clothing lothing

• User Friendly — With every scan you get your current glucose reading, ading, the last 8 hours of glucose data and an arrow showing g the direction directio on n your glucose is heading.

0800 106 100 mediray.co.nz

Ask your healthcare professional how a FreeStyle glucose meter may assist you. Always read the label and use only as directed. *Scanning the sensor does not require lancets. ‡A finger prick test using a blood glucose meter is required during times of rapidly changing glucose levels when interstitial fluid glucose levels may not accurately reflect blood glucose levels or if hypoglycaemia or impending hypoglycaemia is reported by the System or when symptoms do not match the System readings. ††For a complete glycemic picture, scan once every 8 hours. The FreeStyle Libre software, designed to be used in conjunction with FreeStyle Libre reader and sensor, provides a snapshot of glucose patterns and variability; for more information, see the Software page. §The reader can capture data from the sensor when it is within 1 cm to 4 cm of the sensor. †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. The caregiver is responsible for managing or assisting the child to manage the FreeStyle Libre Flash Glucose Monitoring System and also for interpreting or assisting the child to interpret FreeStyle Libre readings. For more information call Customer Service on 0800 106 100. FreeStyle and related brand marks are trademarks of Abbott Diabetes Care Inc. in various jurisdictions. Information contained herein is for distribution outside of the USA only. Medi’Ray New Zealand, 53-55 Paul Mathews Road, Albany, Auckland 0632 www.mediray.co.nz NZBN 9429041039915 ADC-07478 TAPS No: NA 9883

POLY 12117

Now available for purchase for ages 4 and up.† Order yours today at FreeStyleLibre.co.nz

Move

Our fitness consultant Craig Wise looks at the rise of “Sitting Disease” – and how to avoid it.

STAND UP FOR YOUR HEALTH

s a young boy I often watched my grandad stand up from his chair with a groan, hand on hip. He’d mutter something about shrapnel from an old war wound and how he’d been sitting down for too long. Recently, I was waiting for my children and I saw another parent – younger than me – stand up, hand on hip, with a similar groan. For a few weeks after that, I became fascinated watching the people around me. I started noticing that many of our generation groan as they stand up. I never heard one of those people mention shrapnel from a grenade; instead I was watching the slow creep of what is becoming known as “sitting disease”. WHAT IS SITTING DISEASE?

This is a label that’s becoming popular to describe the effects of sitting for extended periods. In fact, some researchers are now saying that sitting for as little as 30–40 minutes without a break to stand or move can trigger a chain of events throughout the body which includes poor circulation and inflammation. This can

DIABETES WELLNESS | Spring 2019

translate into more serious issues in the long run – cardio vascular disease, weight gain and all the fun issues that come with those. It’s not hard to see how our modern lifestyles expose us to more sedentary behaviour. In 2008, Vanderbilt University published a study in the American Journal of Epidemiology estimating that the average American spends 55% of their waking time (about 7.7 hours) in sedentary behaviours (sitting in front of the TV, sitting at their desk, driving their car, and so on). HOW DO WE FIGHT IT?

There are a number of things we can do as an individuals. First, we can recognise things in our environment and routine which could be letting us slip into a trap of extended inactivity. If you have a desk job then you may be at higher risk, so evaluate your work station and methods. Here are some of my tips for avoiding becoming part of the seating: • Stand and stretch your legs at least every 20 minutes, especially if you’re at your

desk. Go and put some paper in the rubbish bin (not the one under your desk) or fill up that drink bottle you’ve been sipping to keep yourself well hydrated. Set a timer on your phone, computer, watch or fitness tracker. • Take a walk right around your office when you can, if not every 20 minutes, then at least try to squeeze it in once an hour. • Look at the opportunity to have walking meetings. • Make phone calls on your feet. Chances are, if you’re on the phone to me then I’m walking backwards and forwards. An added bonus: there are many studies about how different people act and are reacted to on the phone if they’re standing rather than seated. For example, apparently salespeople increase their sales volume if they stand up! • Investigate standing desks. An IPSOS market research study of US office workers found that 66% wished that their employers would offer them the opportunity to have standing desks or adjustable desks so that they could either sit or stand.

JUST STAND! TOO MUCH TV A study in Europe found that the people who watched the least amount of TV (relative to their sedentary time) walked at a faster pace than those who watched more TV. It appears that sitting around for longer periods is a vicious cycle â&#x20AC;&#x201C; slowing us down and making us more prone to sedentary behaviours.

AFTER WORK ...

After a hard day of sitting at your desk, followed by sitting in the car, the lure of more time sitting on the couch is strong! However, try not to plant yourself there, unmoving, until bedtime. Get up and move during the adverts, or have some fun creating games. I have one client who is rugby mad, but watching is an active pastime involving the whole family, as they compete to see who can do the most squats (or press ups or whatever other activity they choose) between the scoring of the try and the kicking of the conversion. Look for opportunities like this and the battle against becoming a couch potato is half won. Remember, standing for just a little more each day can help tone muscles, improve posture, increase metabolism and circulation as well as burn a few extra calories. And just so you know: I stood up and walked the room three times while typing this article.

In the UK, a campaign called Get Britain Standing aims to grow awareness of the dangers of a sedentary working lifestyle. Theyâ&#x20AC;&#x2122;ve created resources for people to calculate the amount of time they spend sitting down and how that can correlate to various risks. These are useful to us here in New Zealand as well. See: www.juststand.org

Nourish

KNOWLEDGE, DETERMINATION AND LUCK

Niamh O’Sullivan reveals what it’s like for a dietitian to be diagnosed with type 1 diabetes and coeliac herself.

rish-born Niamh O’Sullivan was in her third year of Nutritional Sciences at University College Cork in Ireland when she was diagnosed with type 1 diabetes. She says, “It turned my world upside down.” With her final exams just weeks away, she was hospitalised for several days and then, after discharge, had to deal with all the life changes that follow diagnosis. She vividly remembers the way blood-sugar highs and lows played havoc with her brain as she tried to study. But she persevered and, to her amazement, passed. Until then, she hadn’t been sure what she wanted to do with her nutrition degree. ‘Now I thought I could turn a negative into a positive by combining my insight into diabetes with nutritional knowledge.”

DIABETES WELLNESS | Spring 2019

She applied for a scholarship to study a Masters in Dietetics at King’s College in London. “I doubted I’d even get through to the interview stage, but in my application I wrote about my diagnosis and how it had made me a stronger person who was more focused and determined than ever. “The day I opened the email and read those words telling me I’d been accepted, I broke down in tears. It was the defining moment in my life that showed me things would be OK.” After qualifying as a dietitian, Niamh worked in the UK, then followed her partner across the world to New Plymouth. “I’m so fortunate to have moved to a community that’s given me a home, great friends and lots of opportunities.” She works for Sport Taranaki’s Future Champions programme and on the healthy lifestyle programme Whānau Pakari. She also volunteers tirelessly, especially for Diabetes Youth. “I want to pay my good fortune forward and give back into the community that’s supported me.” A NEW SURPRISE: COELIAC

Niamh says, “Coeliac disease came into my life two years ago, and it was all down to my professional knowledge that I got diagnosed. “I used to take an outpatient clinic in London where I saw a lot of coeliac patients. I learned that sometimes coeliac disease can present as mere fatigue; you won’t always have all the gut symptoms. I knew that the risk of getting another autoimmune condition is higher if you have one already, so when I started noticing how tired I was, I went to the doctor and begged for coeliac tests. Had I not been a dietitian there’s no way I would have gone unless I had physical symptoms, so I might not

have been diagnosed for years. “After my positive results came back. I told my whole family they should be tested, as it has family links. Sure enough, my sister – who thought she had IBS for years – has coeliac disease too.” There’s a silver lining: “It makes family events a lot more enjoyable not being the only one with coeliac. My husband’s sister also has coeliac disease, so I’ve plenty of people to be swapping recipes with!” Niamh says, “Dealing with a gluten free diet and carbohydrate counting can get overwhelming. I really feel for people getting diagnosed with coeliac disease who don’t have an interest in nutrition beforehand ... If you have cooking skills and can prepare most food at home yourself, going gluten free gets a lot easier over time.” But she stresses, “Being a dietitian doesn’t in any way make me immune to slipups. I try hard, but occasionally I let something creep into my diet that contains gluten, such as a recent nut bar debacle! I pay the price with fatigue and stomach aches. “There’s also the ‘third party influence’ that none of us can control – chefs and friends that think they’ve made an item gluten free but accidentally added soy sauce or stock and don’t let you know. We need to trust in the training that chefs are getting and maybe try to help our friends at dinner parties by looking through their recipes in advance. We’re all human, and if we can try to limit these experiences, then that’s the best we can do.” For two of Niamh’s favourite diabetes- and coeliac-friendly recipes, see opposite.

CHOCOLATE CHIA SEED PUDDING SERVES 8

All of Niamh’s family can enjoy this treat. ¼ cup unsweetened cocoa powder 1 tbsp maple syrup 2 tsp ground cinnamon 1 tbsp peanut butter 1 tsp vanilla extract 1½ cups unsweetened almond milk or light coconut milk ½ cup chia seeds ¼ cup natural low-fat yoghurt ½ cup berries or other fruit 1 banana ½ cup chopped walnuts or peanuts

Grind up chia seeds in a blender. Add cocoa powder, maple syrup, cinnamon, peanut butter, vanilla and almond/coconut milk, and blend to combine into pudding. Leave pudding in fridge to firm up for 30 minutes. Slice banana and other fruit. In a jar, glass or bowl, layer the chia pudding, yoghurt, fruit and nuts. Leftover chia pudding will keep covered in the fridge for 3–4 days, though it’s always yummier when fresh!

NUTRITION PER SERVE: ENERGY 1020kJ (245kcal) | PROTEIN 7g | FAT 16.6g (SAT FAT 1.6g) | CARBOHYDRATE 13g (SUGAR: 6.8g) | SODIUM 21mg

BALSAMIC STEAK SALAD SERVES 4

This is a tasty, nutritious lunch or dinner for people with diabetes, coeliac disease or both. 8 large handfuls of leafy greens 1 head broccoli, chopped into little florets 4 handfuls green beans (fresh or frozen), chopped into thirds 2 large carrots, grated 2 large red onions, roughly diced 2 large tomatoes, diced 1 large avocado, sliced 400g steak (top sirloin is best but optional) 4 eggs ¼ cup pumpkin seeds DRESSING ¼ cup olive oil ⅓ cup balsamic vinegar 1 tsp honey 2 tsp lemon juice

Prepare veges according to the ingredients list.

beans into it. Allow them to steam for 3–4 minutes, then take them off.

In a non-stick pan (or using a little olive oil spray if you don’t have one), sauté the red onions for 3–4 minutes until browned and soft. Take the onions out and leave to the side.

Let the eggs cook for another 3–4 minutes, then turn off the heat, drain and refill the pot with cold water to cool the eggs down.

In the same pan, cook the steak for a couple of minutes, turning halfway, until brown on the outside but still pink in the middle. If you prefer the steak not pink, then cook for a minute or two longer. Let the steak rest. Pour hot water into a saucepan and gently put in eggs. Bring to the boil. Place a steamer on top of boiling eggs and put broccoli and green

Prepare dressing by adding ingredients to a small container, closing lid and shaking well. Peel eggs and cut into halves. Slice steak into strips. Arrange spinach, green beans, broccoli, tomato, red onions, carrots, and avocado on plate. Place egg halves and steak slices on top. Sprinkle with pumpkin seeds. Drizzle with dressing. Enjoy!

NUTRITION PER SERVE: ENERGY 2430kJ (581kcal) | PROTEIN 41.2g | FAT 38g (SAT FAT 8.4g) | CARBOHYDRATE 12.1g (SUGAR: 10.3g) | SODIUM 186mg

DIABETES WELLNESS | Spring 2019

Research

CALLS FOR PARTICIPANTS A range of important studies are being undertaken in universities round the country, and researchers are looking for people who’d like to be involved. Can you help?

SIBLINGS OF PEOPLE WHO LIVE WITH TYPE 1 DIABETES

A new Massey University survey aims to identify the unmet needs of siblings of children with a serious chronic illness. Researchers hope this will be valuable for developing services which protect the wellbeing of siblings in this situation. The researchers would like to hear from you if: • you’re 16 years old or over • you have a sibling (or someone who was like a sibling to you) who was diagnosed with type 1 diabetes, cystic fibrosis, or cancer a year or more ago • you were living at home with your family/whānau when they were diagnosed. The survey is online, and should take 10–15 minutes. To find out more and take the survey visit massey.au1.qualtrics.com/jfe/ preview/SV_0ICOLf3OXt4XIY5 or contact Katie Armstrong at siblingneedsresearch@gmail. com

DIABETES WELLNESS | Spring 2019

PARENTS OF CHILDREN WITH TYPE 1 DIABETES WHO USE MIAOMIAO CGM

Researchers at the University of Otago are conducting a qualitative study exploring parent/caregiver experiences of using MiaoMiao for continuous glucose monitoring for children with type 1 diabetes. The researchers are interviewing existing or previous users of MiaoMiao in order to understand the experience of families using it. If you’re a parent or caregiver of a child under 16 who has been diagnosed with type 1 diabetes, and has been using MiaoMiao continuous glucose monitoring (with FreeStyle Libre), then your family may qualify for the study. Participants will receive a small reimbursement for their time. If you might be interested in participating and would like more information, please email Mona at mona.elbalshy@ postgrad.otago.ac.nz

PEOPLE LIVING WITH TYPE 2 DIABETES WHO TAKE TABLETS BUT NOT INSULIN

This Auckland University study is investigating personalised medicine in patients with type 2 diabetes, to see whether it can be predicted who will respond most, in terms of glucose lowering, to the medications vildagliptin or pioglitazone, based on clinical characteristics, biochemistry, and genetics. You will be asked to take one additional diabetes tablet daily (vildagliptin or pioglitazone) for four months, then swap to the other medication for four months. The researchers will analyse routine medical information and blood markers including genetics, to study if they can predict your response to these diabetes medications. The researchers would like to hear from you if: • you have type 2 diabetes • you’re between 18 and 80 • you’re on either or both metformin or sulfonylurea (such as gliclazide) • you don’t use insulin, and haven’t in the past three months • your HbA1c is between 58 and 110 • you’ve never been on pioglitazone or vildagliptin. If you think you might be eligible for this study, or if you are considering starting vildagliptin as add-on therapy, please contact Dr Rinki Murphy, Dr Ryan Yeu and Dr Rebecca Brandon at T2Dmed@ auckland.ac.nz

Research

RESEARCH ROUNDUP We present some of the latest findings from round the world. ACTIVE LIFESTYLES MAY WARD OFF DIABETESRELATED DEMENTIA

A Swedish study has looked into the effects of leisure and social activity on diabetes-related dementia. The study looked at dementia-free adults over a period of 10 years, both with and without diabetes. It found that in those with active lifestyles (rich social networks and/or moderate to high levels of engagement in leisure activities), the increased risk of dementia associated with diabetes was significantly reduced compared to those without such networks and engagement. Source: care.diabetesjournals.org/ content/42/2/232

EFFECTIVENESS OF SGLT2 INHIBITORS FOR PEOPLE WITH TYPE 2 DIABETES AND KIDNEY DISEASE

A trial has been conducted researching the effectiveness of a new class of drugs known as sodium-glucose cotransporter-2 (SGLT2) inhibitors as treatment for

kidney disease in patients with type 2 diabetes. The trial split patients into two groups: one receiving canagliflozin – an oral SGLT2 inhibitor – and the other receiving a placebo. At a median follow-up of 2.62 years, the trial found that in patients with type 2 diabetes and kidney disease, canagliflozin lowered the risk of kidney failure and cardiovascular events. Source: researchgate.net/ publication/332422345_Canagliflozin_and_ Renal_Outcomes_in_Type_2_Diabetes_and_ Nephropathy

REDUCING CONSUMPTION OF SUGAR‐SWEETENED DRINKS – WHAT WORKS?

Frequent consumption of sugar‐ sweetened beverages (SSBs) has been linked to an increased risk for a number of adverse health outcomes. SSBs include non‐diet soft drinks, sports drinks, energy drinks, sweetened tea and coffee, and other drinks. Cochrane Library has published a systematic review of 58 studies on measures taken to reduce the

amount of SSBs people drink. It focused mainly on measures that change the environment in which people make beverage choices. The review found evidence that some environment-changing measures have helped reduce SSB consumption. These include: increasing the price of sugarsweetened drinks, limiting their availability in schools and on children’s menus, adding labels rating how healthy they are, and promoting healthier drinks in supermarkets. However, the review found that the existing evidence for these interventions needs to be strengthened, and suggests that the best course of action is to adopt environment-changing methods more widely while also strengthening the research being done on them – something government officials, business people, and health professionals will have to work with researchers to achieve. Source: cochranelibrary.com/cdsr/ doi/10.1002/14651858.CD012292.pub2/full

Community

Friends through highs and lows Cycling the Queen Charlotte Track allowed two 14-year old friends from Marlborough to prove themselves, as well as show how people with different conditions can support each other.

exi Pottinger has type 1 diabetes and Mya Gane has dyslexia. Lexi says it gives them a lot in common. “Diabetes and dyslexia present us with new challenges daily. We both know what it’s like to have our challenges overlooked, or to have to be treated differently sometimes. And we can see when each other needs support.” When Mya struggled to finish reading a complex text for a school essay, Lexi helped in practical ways, with finding audiobooks and abridged editions so Mya could pass the assessment. And Lexi says, “Mya supports me through every high and low and mental breakdown. She always knows how.” Both girls have extra anxieties when exams approach. Lexi focuses on keeping her sugars in check, and Mya has to sort out a readerwriter. Their personal experiences of reading also offer common ground. Lexi says although any reading troubles she has are temporary, “I relate to the frustration Mya goes through because it’s hard for me to read if I’m high or low.” And when that happens, “Mya understands more than anyone what it’s like when words just swim around the page.” For a recent school assignment Lexi and Mya had to make some change in the community. They decided to bike the Queen Charlotte Track by themselves to break stereotypes: Mya wanted to show

that academic struggles don’t limit what she can achieve outside of school, and Lexi that diabetes doesn’t hold her back from intense physical activity. The trip took plenty of planning and thinking. During the ride they stuck together. “Mya was awesome with checking in on me,” says Lexi. “I let my sugars run a little higher than normal and was fine. I was low by the end, which Mya could see, but it was nothing a cookie (made by Mya) couldn’t fix.” The friends are not short on goals. Mya is a talented and dedicated hockey player and Lexi got hooked on rowing last spring. She’s now training for the South Island Champs.

LEXI ON ROWING WITH DIABETES I’m the first diabetic rower my coaches have had, so we decided we’d try a season and see if it works out. It has! There have been moments when I wanted to cry because diabetes stopped me from rowing. I opt out if my sugars are too high or low. I’m always checking them, and my coaches always have a backup plan. I use the Freestyle Libre. For rowing, I have a waterproof pouch with the libre reader and dextrose in it. I give it to the cox to hold, or tie it onto the boat. I got a t:slim insulin pump halfway through the season, and I was anxious because they aren’t really made for rowing. I’ve had one panic: Sometimes I don’t row with the pump on, but this day I did because I was close to being high. My double scull partner and I were going round a riverbend when we tipped and I fell out. I swam to the coaches’ boat and pulled myself in, then realised my pump wasn’t on me. I started screaming. After much scrambling around the boat I realised I still had it. It had just unclipped from my shorts! I can proudly say we haven’t tipped since.

Mya (left) and Lexi on the Queen Charlotte Track

DIABETES WELLNESS | Spring 2019

HELPING TO MANAGE YOUR DIABETES

Diabete-Ezy Accessories

FreeStyle Optium Blood Glucose and Blood Ketones Testing • FreeStyle Optium Meter Kit • FreeStyle Optium Blood Glucose Test Strips 50’s • FreeStyle Optium Blood Ketones Test Strips 10’s

• • • • •

Frio Cooling Wallets

MedActive Carry Cases

• • • • •

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

Diabetes Care

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

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

medactiv transforming lives

Hypo-Fit Glucose Gel

Dexto Energy Glucose Tablets

• Two flavours – Orange and Tropical • 18gram sachets, 13.4grams Carbohydrates • Gluten-Free

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

HYPO-FIT D I R E C T- E N E R G Y

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

ION

EST GG

SU G

IN RV SE

.00 off

At your local supermarket

To the Customer: This coupon is non-assignable and is only valid upon purchase of the product(s) stated specifically on this coupon. Only one coupon can be used per Sanitarium™ Low GI Granola™ 370g purchased. This coupon cannot be used or exchanged for any other products, nor redeemed for cash. Copies are not valid, originals only will be accepted and can only be used once. This coupon is valid until 30th April 2020. This coupon is issued by Sanitarium™ Health Food Company, valid at your nearest Countdown, New World or PAK’nSAVE supermarket. To the Retailer: Provided this coupon is redeemed in accordance with the customer offer above, it will be credited in full, plus the normal handling fee by sending to: The Coupon Company Ltd, PO Box 47-319, Ponsonby, Auckland 1144.

Strawberry & Coconut

Expires 30th April 2020 TCC 20156

Golden Almond Crunch

9 918258 201562 >

*Glycaemic Index (GI) value = 53 (Strawberry & Coconut); 49 (Golden Almond Crunch). ^per 50g serve of Low GI Granola without milk.

Diabetes Wellness Spring 2019

Articles inside

Nutrition Therapy and You