Diabetes Wellness Summer 2024 by Diabetes New Zealand

wellness DIABETES

SUMMER 2024 $8.00 INC. GST

DIABETES NEW ZEALAND | DIABETES.ORG.NZ

PARKRUNNERS AROUND THE MOTU • LIVING WITH AND ALONGSIDE DIABETES ARTISTS WITH DIABETES • HOW TO GROW A CONSTANT SUPPLY OF GREENS • CELEBRATING CGM

PARKRUN

FREE FITNESS FOR EVERYONE

DIABETES ACTION MONTH

DON’T SUGAR COAT DIABETES

FreeStyle Libre CGM sensors funded by Pharmac for people with type 1 diabetes or other specific forms of diabetes From 1 October 2024

Learn more: FreeStyleLibre.co.nz/Funding

Pharmac CGM funding for people with type 1 diabetes or other specific forms of diabetes

FreeStyle Libre is the #1 Continuous Glucose Monitoring (CGM) system worldwide^

There are two FreeStyle Libre products funded through the Pharmac CGM funding scheme:

•

Monitor your glucose levels on the go, with zero finger pricks.* Simple, painless, easy.

•

The only CGM sensors in NZ that take a glucose reading every single minute,† so you can make informed decisions based on real-time data.

•

Clinically proven to lower HbA1c1± and reduce time in hypoglycaemia.2-5

FreeStyle Libre 2 sensor

FreeStyle Libre 3 Plus sensor

To learn more about FreeStyle Libre products and the Pharmac CGM funding scheme (including eligibility criteria), visit FreeStyleLibre.co.nz/Funding The FreeStyle Libre 2 CGM System is indicated for measuring interstitial fluid glucose levels in people (aged 4+) with insulin-dependent diabetes. Always read the instructions for use. The system must not be used with automated insulin dosing (AID) systems, including closed-loop and insulin suspend systems. The sensor must be removed prior to Magnetic Resonance Imaging (MRI). The FreeStyle Libre 3 Plus CGM System is indicated for measuring interstitial fluid glucose levels in people (aged 2+) with diabetes mellitus. Always read the instructions for use. The sensor must be removed prior to Magnetic Resonance Imaging (MRI). ^Data based on the number of users worldwide for FreeStyle Libre family of personal CGMs compared to the number of users for other leading personal CGM brands and based on CGM sales dollars compared to other leading personal CGM brands. *Finger pricks are required if glucose readings and alarms do not match symptoms or expectations. †Compared to other on-market CGMs in New Zealand. As of Sep 2024. ±At HbA1c ~7% or higher. 1. Evans M. et al. Diabetes Ther. 2022; 13(6): 1175-85. 2. Leelarathna L. et al. N Engl J Med. 2022; 387:1477-1487. 3. Franceschi R. et al. Front Endocrinol. 2022; 13:907517. 4. Haak T. et al. Diabetes Ther. 2017; 8(1): 55-73. 5. Bolinder J. et al. Lancet 2016; 388(10057):2254-2263. The sensor housing, FreeStyle, Libre, and related brand marks are marks of Abbott. Information contained herein is for distribution outside of the USA only. Mediray New Zealand, 53-55 Paul Matthews Road, Albany, Auckland 0632. NZBN 9429041039915. ADC-99658 V1.0

Contents

COVER: KLARE BRAYE WITH TAKURUA, RUTH VAUGHAN, AND LIZ NEILL AT WAITANGI PARK, WELLINGTON. PHOTO © MARK HUTCHINGS

SUMMER 2024 VOLUME 36 | NO 4

4 EDITORIAL 5 DIABETES ACTION MONTH: Don't sugar coat diabetes 8 COMMUNITY: Artists living with diabetes 14 MOVE: People coming together for parkrun

28 26

18 CARE: Takapuna dental hygienist Nova Edgcombe

14 20 NOURISH: Build the ultimate salad

32 ADVOCATE: CGM timeline

23 FAMILY: Living with (and alongside) diabetes

34 YOUR DNZ: Tauranga Diabetes Youth Coordinator Lena Fendley-Peach

26 DEXCOM WARRIOR: Ultra-marathon runner Dana Young 28 NOURISH: Healthier work shouts

36 GROW: Perpetual greens 38 YOUR DNZ: Award winners

30 ADVOCATE: Catherine Taylor looks back

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Editorial

ia ora koutou. This has been an exciting quarter for Diabetes New Zealand. After nearly seven years of advocacy, continuous glucose monitors (CGM), insulin pumps, and insulin consumables for people living with type 1 diabetes will be funded from 1 October. The Pharmac announcement was greeted with joy and relief by those who have been struggling to fund their devices and those who have not been able to afford them. Free access to these devices is not only life changing for thousands of New Zealanders living with type 1 diabetes but it is also lifesaving. This is more than just vital technology – it’s a lifeline for better health and greater freedom. Quite simply, it’s a game-changer. As we know, type 1 diabetes affects people in different ways, so it was great to see that Pharmac recognised this in providing a choice of funded devices, given there is no one CGM device or insulin pump technology that works for everyone. Despite these choices, some people will be disappointed that not all devices currently being used by the diabetes community will be funded. We acknowledge the power and support of the whole diabetes community in advocating for this funding over many years. We share this exciting news with everyone who works for and with the diabetes community – clinicians, educators, and health care professionals. We are indebted to the strong advocacy that’s also come from our diabetes community, who have shared their experiences and made a strong case for funding – we couldn’t have done it without them. Our focus over the last few months has been to support people living with type 1 to access diabetes technology. We have done this by providing resources and guidance as people transition to funded devices and make decisions on what tech is best or start using this tech for the first time. We applaud Pharmac for its commitment to supporting people with type 1 diabetes with this major funding announcement. However, our goal now is to ensure all New Zealanders living with diabetes who are on insulin, including those living with type 2 diabetes, have access to this technology. For now, it is wonderful to know the whole type 1 diabetes community will benefit from this technology. In Australia, it took years to have funded access for all type 1s. We have lagged behind the rest of the world in having equitable access to this critical technology, but we have now caught up! In this Summer issue of Diabetes Wellness, among other topics, we say farewell to our Board Chair, Catherine Taylor – who, after giving us eight years of outstanding service and personal commitment, is standing down. HEATHER VERRY

Chief Executive Officer, Diabetes NZ

DIABETES WELLNESS | Summer 2024

Diabetes New Zealand is a national charity that provides trusted leadership, information, advocacy, and support to people with diabetes, their families, and those at risk. Our mission is to ensure every person living in Aotearoa New Zealand with diabetes or at risk of diabetes has equitable access to affordable, quality diabetes care and education. Across the country, Diabetes NZ has staff and volunteers who help people live well with diabetes. Join us today at www.diabetes.org.nz

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

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

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

November is Diabetes Action Month, where we’re all about busting myths that surround diabetes so everyone can have a greater awareness and understanding of the condition.

nderstanding the facts about diabetes is important to diagnosing, managing, and living well. With so much misinformation circulating, it can be challenging to know what’s fact and what’s fiction. Heather Verry, CEO of Diabetes NZ, stresses the importance of education during this Diabetes Action Month. ‘By increasing awareness and providing accurate information about diabetes, we can build a more understanding and compassionate community towards people living with diabetes.’ The hope is that with better knowledge there will be less judgement and stigma of people with diabetes. This Diabetes Action Month, it’s time to: • Get the facts: Learn the truth about diabetes and dispel the myths. • Get tested: Know the symptoms of type 1 and type 2, find out your risk of developing type 2, and encourage others to get tested. • Show more aroha: Find out how to support friends and whānau living with diabetes to help reduce the stigma.

RAISING AWARENESS

Diabetes NZ will be launching various initiatives throughout November to raise awareness and funds to support those living with diabetes: • Know Your Risk quiz: An easy online quiz to help New Zealanders understand their risk of type 2 diabetes. • New videos, socials, and a podcast: Informative new content to educate the public about diabetes and reduce stigma. • Sneaker Friday: A fundraising campaign everyone can get involved in that encourages more support for people living with diabetes. Diabetes Action Month 2024 calls for action from all New Zealanders. By educating ourselves, getting tested, and showing more aroha to those living with diabetes, we can reduce stigma.

DIABETES WELLNESS | Summer 2024

1-30 November 2024

More than 320,000 Kiwis live with diabetes. Not only is it lifethreatening, but misinformation and stigma can make daily life even more challenging. This Diabetes Action Month, it’s time to:

• Get the facts Learn the truth about diabetes.

• Get tested Know the symptoms and take the Know Your Risk online quiz.

• Show more aroha KAUA E WHAKAREKA I TE MATEHUKA

Find out how to best support friends and whānau living with diabetes.

To find out more, scan the QR code or visit:

www.diabetesactionmonth.org.nz

Diabetes Action Month

WORLD DIABETES DAY World Diabetes Day on 14 November always coincides with Diabetes Action Month. The theme for World Diabetes Day 2024–26 is ‘Diabetes and Wellbeing’. Over the next three years, this global initiative will focus on: • Physical wellbeing: The importance of physical activity and a healthy diet to reduce the risk of type 2 diabetes and manage all types of diabetes and its related complications. • Societal wellbeing: Highlighting the barriers that restrict a person living with diabetes from living a healthy and fulfilling life. • Mental wellbeing: Raising awareness of the challenges, stress, and anxiety that living with a chronic condition like diabetes can bring. Highlighting the importance of addressing mental health as part of managing diabetes. For more information and resources about World Diabetes Day, visit worlddiabetesday.org.

MYTH-BUSTING How many times do you hear people make throwaway comments about diabetes knowing they just have it wrong. Comments like ‘Should you be eating that?,’ ‘You get diabetes from eating too much sugar,’ or ‘People with diabetes bring it on themselves’ are not just incorrect, they are hurtful too. When that misinformation is constantly heard or repeated, it can feel like fact when, of course, the opposite is true. This November, Diabetes NZ is highlighting common myths surrounding diabetes. We’ve taken the most common phrases and provided easy explanations of why they are untrue and how to respond more accurately and thoughtfully. By busting these myths during Diabetes Action Month and beyond, we hope to set the record straight and provide support for friends and whānau living with diabetes. Reducing the stigma associated with diabetes and making others more aware is the end goal.

NOVEMBER

FRIDAY

SNEAKER FRIDAY Get ready to lace up your sneakers for Sneaker Friday on 15 November. This annual fundraising campaign encourages everyone to wear their sneakers to work, school, or just out and about to show support for people living with diabetes. By joining in, you're helping Diabetes NZ in their mission to raise funds and support all New Zealanders to live well with diabetes. Visit our fundraising page so you and your friends and whānau can donate and support people living with diabetes: sneaker-friday-2024.raiselysite.com. To learn more about Sneaker Friday, visit www.diabetesactionmonth.org.nz. Don't forget to use the hashtag #SneakerFriday and tag @diabetesnz and @diabetes_nz on Facebook and Instagram to share your participation. We can't wait to see how you're getting involved!

For everything DAM-related, visit our Diabetes Action Month website www.diabetesactionmonth.org.nz DIABETES WELLNESS | Summer 2024

Community

FOCUSING ON THE HERE AND NOW Artists living with diabetes discuss how their art practice helps their diabetes. Drawing by Jinny Gibbons

DIABETES WELLNESS | Summer 2024

CARRIE EDGERTON: ‘MY SILENT SPACE’

‘Creating definitely makes me focus on the here and now, and clears my mind of the constant thoughts and decision-making that diabetes can sometimes flood my brain with. I find it my calm quiet space.’

tago photographer Carrie Edgerton says she enjoyed art at school but chose to channel her creativity towards socialising when she was a teen and battle her type 1 diagnosis instead. ‘I spent years in denial and hating being different. I just wanted to fit in like everyone else. But after a while, I needed to find a space of peace and focus. To find my love for creating again.’ Carrie has a background in painting, but six years ago she bought a camera and challenged herself to learn how to manually take photos. She completed two courses in Cromwell through Stagebox. ‘I learnt so much. I love how the camera and choice of light can alter how a simple item can be viewed and the different feelings that are felt through one image by multiple people.’ The courses certainly paid off last year when Carrie won three categories in the Arrowtown Autumn Festival photo competition. Living in Otago, Carrie is surrounded by natural beauty, and she enjoys spending as much time as she can among it with her camera. ‘Walking and hiking has hugely increased in my life the last 10 years, and I find it also helps with balancing out the creative side with the nature side. I’ve completed a number of great walks both on manual insulin and now on a pump. Again, this is now my silent space. ‘Art helps me re-focus and puts me in a brighter happier space to tackle any challenges diabetes can throw my way on any given day.’

DIABETES WELLNESS | Summer 2024

JINNY GIBBONS: ‘BEING TAKEN AWAY TO A DIFFERENT PLACE’

en years ago, Jinny Gibbons was in an abusive relationship and working long hours as a caregiver. Early starts, coupled with physically demanding work, resulted in a spinal injury, severe burn out, and pre-diabetes, likely ignited by her poor diet at the time. ‘I was getting very sick, so something had to change.’ First to go was the partner, closely followed by the unhealthy food that wasn’t helping her. Over time, she regained her strength, lost a third of her weight, and sent her pre-diabetes into remission. Like Carrie, Jinny had immersed herself in art when she was younger but hadn’t returned to creativity until she was adult. It wasn’t until she was recovering and receiving intensive healthcare that Jinny picked up her art again, at the suggestion of a doctor who admired her work so much that he ended up purchasing a piece. Jinny rediscovered her love of creating and hasn’t looked back. Jinny says the humble ballpoint pen is her favourite medium at the moment. From her selection of pens, she is able to create fine work, often on large pieces of paper and in many coloured inks. Animals and native birds have been taking the stage in the last couple of years and Jinny finds her references both online and from family. She has an agreement with Wellington nature photographer, Sally Eyre (Eyre’s Eyes) to use her beautiful captures of native birds for reference. Jinny’s brother and eldest sister also supply inspiring photos. Because Jinny’s work is intricate, layered, and detailed, she says it can take a long time before she’s happy to step back and say it’s finished. ‘Some of my art can take up to three months to complete.’

DIABETES WELLNESS | Summer 2024

But she’s happy to let her art guide the way as it helps her mental health. ‘I can spend six hours at one time on my work. It takes me out of myself and what’s going on at the moment. It helps me to destress, and I love trying new things.’

‘I’ve been studying different methods for the last couple of years. I’m self-taught, and I love it! I’ve tried different media, but I just love working in coloured biro pens.’

ANNA SHARPES: ‘A WAY OF LIFE’

here are many accomplishments to Anna Sharpes’ life. The Wellingtonian has run a sewing school, designed dancewear (including a line for pole dancers), and been the life-saving, last-minute dress alteration angel for brides-tobe and bridesmaids. She’s also featured as a finalist in the World of Wearable Art show (WOW). Anna’s first had a garment accepted into WOW in 2018, a year before she graduated with her Bachelor’s degree in fashion design from Massey University. Created for the Transformation section, Bloom is exactly that – a giant flower that the audience witnessed gradually opening. But, coming from someone living with type 1 diabetes, there are deeper undertones. ‘Bloom touches on depression. The petals both shield and protect, and the soft, delicate, and fragile interior suggests emotions.’ This year, Anna created Dia-beat-this (right), a garment made utilising insulin pump waste packaging from 500m of tubing and 300+ infusion sets. Unfortunately, it wasn’t selected as a finalist, but Anna says she is looking forward to planning next year’s submission as well

as the hundreds of hours' work that each garment demands. ‘It’s so time consuming. You’re looking at 700–800 hours at least, and that’s just in evenings and whenever you can cram it in. It’s a passion project, a way of life!’ Currently, Anna and her husband are living amid a major house renovation. ‘My lovely husband just puts up with the whole living room being taken up by something. I’ve got many projects on the go, but I like being busy.’

Top: Anna's entry, Dia-beat-this for WOW 2024 featured diabetes pump waste. Middle: Garments inspired by Vivaldi's The Four Seasons, baroque architecture, and dancewear. Bottom: Anna made her 1920s-style reception wedding dress from scratch using glass-beaded fabric. ‘I took this on while our house was missing walls. My fiancé couldn’t see the dress, so it was chaos.’

DIABETES WELLNESS | Summer 2024

BLOOM. PHOTO © WORLD OF WEARABLE ART LTD

Anna’s wearable art, Bloom, from 2018 WOW: ‘Bloom touches on the highly political topic of depression, which has become ever-so-present within the 21st century. The petals are seen to both shield and protect, demonstrating strength and power. The interior representing our emotions, soft, delicate, and fragile, similar to the nature of a flower in bloom. The variety of radiant, dazzling colours allows for one to take a breath and be immersed in the organic nature of Bloom.’ – Anna Sharpes

ing h t e m o s o d r kers o a e n s r u o y r a We to r e b m e v o N 5 y1 BLUE on Frida tes! e b a i d h t i w g n livi support Kiwis

NOVEMBER

FRIDAY

It’s easy to get involved! 1 Pick a date, then hold a sneaker or a blue event

2 Donate online to support Kiwis living with diabetes

3 Check out our website for events happening near you

Move

PĀKAOMA AOTEAROA PARKRUN NZ We meet some of the regulars who are getting up and out for pākaoma Aotearoa/parkrun NZ.

very Saturday morning in 52 locations around Aotearoa New Zealand, people come together for parkrun. An international organisation, parkrun is a community event where you can participate by walking, jogging, running, volunteering, or just plain spectating. Stretched over five kilometres, it takes place in local parklands, waterfronts, botanical gardens, or domains. parkrun is based on four simple principles: weekly, free, for everyone, forever. parkrun started in London in 2004 and was exported here by Lower Hutt man Richard McChesney, who was keen to bring the concept back with him when he returned in 2012. The simplicity

of meeting up with a group of people to go for a short run is probably the success of parkrun. Step one is to register online, which is when you’re sent a barcode. Then all you need to do is find your local parkrun and turn up at 8am on any Saturday. Everyone starts at the same time and follows a set course, getting from one end to another by walking, running, walking the dog, or running with a stroller. That barcode you were sent when you registered is then scanned at the end of the run/ walk. From there, you can choose to take note of your finishing time and better it next time or completely ignore it and just enjoy the experience. The average time for a runner is about half an hour. (Ed: Writers who interview while walking can take just over an hour!) Starting at the gentle end, Ellie Johnson has been regularly coming

THE LITTLE ‘P’ MENTALITY

The culture and ethos of parkrun is reserved and humble, reflecting the nature of its founder. parkrun is written as one word with a lowercase ‘p’, representing the simplicity and inclusivity of the organisation and the events.

DIABETES WELLNESS | Summer 2024

for a couple of years. parkrun is completely volunteer-led, and Ellie enjoys giving her time to the Wellington event at Waitangi Park. One of her roles has been as the ‘tail walker’. ‘You win by losing,’ she explains. ‘Your job is to come last.’ For this job, Ellie makes sure no one is lost, left behind, or injured. Currently doing her PhD on healthy homes, Ellie is loyal to the weekly outing. ‘It has all the things that work as a programme,’ she says. ‘It has such a strong sense of community. And from my public health perspective, I see how cool it is. I’ve never been a super-fit person, but this has got me into running and being a bit more active. As a personal intervention, I think it’s great.’ Below: Tail walker Ellie Johnson at Waitangi Park, Wellington, making sure nobody is left behind.

ROYCE PRISK – KIRIKIRIROA HAMILTON

‘parkrun gives me three benefits in one go: the social element, the physical element, and the mental element’ – Royce Prisk

PHOTO © MIKE BAIN/PARKRUN

A few years ago, Hamilton local Royce Prisk wasn’t a runner, but, after his type 1 diagnosis, he decided to improve his base fitness level and began walking, slowly at first. Two kilometres was a struggle, but before long he built up to five kilometres a day. That’s when Royce turned to parkrun, as he thought that would be a good way to vary his walks. Then the 52-year-old changed things up. ‘Whilst walking, I was thinking “Can I actually run?” I’d give it a go every now and then, and found it difficult. But one day I saw a chap who was even older than me, and he was just shuffling along. And I thought to myself, if he can do it, so can I. And from there I just started running for longer and longer amounts of time in parkrun and also during the week, until I could run the full 5k.’ Royce says he enjoys many things with parkrun: ‘It’s a social event for me. Although I’m not a particularly social person, I’m still running with a group of people and might have a quick chitchat with someone. And that’s enough for me. Also, it helps maintain my mental health. ‘And not only has it improved my physical health in terms of my baseline physical fitness but it’s also increased my insulin sensitivity and makes managing my diabetes easier.’

By the time this issue of Diabetes Wellness arrives in letterboxes, Royce Prisk would have earned the infamous parkrun ‘100’ t-shirt, meaning he’s made it through one hundred parkruns. That’s a couple of year’s work. Alongside the branded 25, 50, 250, and 500 shirts, these tops are milestones – badges of honour revered among the international parkrun community. The attendees gradually work towards attaining, and then proudly sporting, their shirts to celebrate their persistence and consistency in knocking off runs. Ellie Johnson says: ‘Having a milestone shirt makes it about celebrating participating, rather than have it be like “I came first” or “I came second.” It’s more about “I came and I showed up, and that’s cool, and I’ve got the t-shirt that I’m really proud of, and it’s really early on a Saturday.”’

DIABETES WELLNESS | Summer 2024

Top left: Martin with sons James and Trent. A young parkrunner in England was doing parkour jumping between buildings, fell, and unfortunately was killed. His father sent out the image internationally and asked if people would wear the image to raise awareness and in remembrance for the boy. James and Trent were keen to show their support. Bottom left: James in action (aged 15), carrying his diabetes medication in his backpack. Right: James at a recent Queenstown event.

JAMES O'SULLIVAN – ŌTAUTAHI CHRISTCHURCH

Twenty-one-year-old art student James O’Sullivan has been doing parkrun since he was 10, which is around the same time that he was diagnosed with type 1. His dad, Martin, was already a runner, so it was inevitable that James and his older brother Trent would join in. James earned his 250 t-shirt last year and has since hit the 300 mark, as well as setting the current record as the only Kiwi to complete every

DIABETES WELLNESS | Summer 2024

course in the country. The O’Sullivan whānau has steadily worked their way around the country, seeking out parkruns most weekends. To date, James has been to 49 different courses around the country and another two in Australia. James’ dad, Martin, is his biggest fan, and he is quick to rave about what his son has achieved. ‘James is an example of what parkrun is all about. A young person who struggled at school as he has autism as well

as type 1 diabetes and epilepsy.’ James enjoys travelling and trying each area’s courses. ‘Some are easy, some are hard. My favourite one is Scarborough Park (Christchurch), and Waitangi Park (Wellington).’ Asked if he’s ever found any not fun, he describes the course he did for his 250th: ‘One I didn’t enjoy was Queenstown. It looks really great, but it was more challenging. It was the hardest one I’ve faced.’

YULIYA BOZHKO – TE WHANGANUI-A-TARA WELLINGTON

Yuliya Bozhko is Event Director for Wellington – a course that starts at Waitangi Park and winds around the waterfront. She is also mum to fouryear-old Sam, who has type 1 diabetes. Her son's diagnosis at 18 months made her family pause getting parkrun up and moving in the capital. ‘His type 1 diagnosis came as a shock, and we put the idea of parkrun on hold for nearly a year trying to adjust to our new reality. I quit my job as a software developer to look after Sam full-time.’ It wasn’t until a year later that Yuliya felt she finally had more mental space than just being a ‘full-time pancreas for a toddler’. She explains, ‘I started getting back into my old projects, and Wellington parkrun was one of those projects. Although Sam was too young to participate, I believe that early exposure to exercise and healthy activities is very important to someone with his condition. Plus, the parkrun community is so welcoming and inclusive, I wanted him to grow up as a part of it.’

Make a difference today

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

Yuliya, her husband Graham, and four-year-old son Sam at Waitangi Park.

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

Care

A DENTAL HYGIENIST’S PERSPECTIVE Takapuna dental hygienist Nova Edgcombe explains the link between the health of your mouth and the management of diabetes.

hen you have diabetes, your body struggles to fight infection due to high blood glucose weakening your immune system. In the mouth, this vulnerability makes it easy for bacteria to cause gum disease. Gum disease starts with gingivitis, the medical term for swollen and bleeding gums. With proper care, gingivitis is reversible. However, if left untreated, it can worsen into periodontitis, a more serious gum infection that damages not only the gums but the bone around your teeth and, if left untreated, can lead to the loss of teeth. The ensuing inflammation of the gums also raises blood glucose levels, pulling you into a vicious cycle. On top of this, as well as impacting diabetes, periodontitis is also a risk factor for heart and lung diseases, likely due to the chronic inflammation it causes. Understanding the link between diabetes and gum disease can help you manage both conditions more effectively. By following these tips, you can protect your oral health and make diabetes easier to control.

DIABETES WELLNESS | Summer 2024

SIMPLE TIPS TO PROTECT YOUR ORAL HEALTH CONTROL blood glucose levels: Keeping levels in check is key to preventing gum disease. PRIORITISE oral hygiene as it is essential to a healthy, pain-free mouth. BRUSH twice a day using a fluoride toothpaste and a soft-bristle toothbrush. To make brushing more enjoyable, put on your favourite song and brush for the entire duration – this will help you reach the recommended two minutes. Practice mindfulness while brushing by staying present and focusing on cleaning each surface, rather than letting your mind wander. FLOSS daily: If flossing is challenging, try using interdental brushes instead—they’re excellent for cleaning between teeth. This step is essential because it removes the 40% of plaque that your toothbrush can’t reach. USE specialised gels and mouthwash: Some diabetes medications can cause dry mouth, which heightens the risk of cavities

and gum disease. Ask your doctor, dentist, or dental hygienist about gels that can help maintain moisture in your mouth. Dry mouth is a result of reduced saliva flow, and this flow plays a key role in washing away food particles and neutralising acids that cause cavities, bad breath, and gum disease. VISIT your dental hygienist regularly. You don’t have to wait a whole year between visits. As a dental hygienist, my primary role is to prevent dental issues before they start, catching potential problems in their early stages and reducing the risk of painful treatments due to inflamed tissues. Consider scheduling cleanings every six to eight months, as this makes it easier to remove deposits early. AVOID smoking: Smoking worsens gum disease and makes diabetes harder to manage. If you smoke, consider talking to your doctor about quitting – it will greatly improve your health.

The relationship between diabetes and gum disease is a powerful reminder that oral health is an integral part of your overall well-being.

A REAL-LIFE EXAMPLE

EAT: A healthy balanced diet helps both your mouth and your diabetes. Fibre-rich fruits and vegetables require more chewing, and this action cleans the surface of your teeth. Veges also stimulate the flow of saliva, which helps to scrub away food particles and bacteria. If you crave sugary snacks, try to follow them with fresh veggies like celery or carrots to clean your teeth naturally. DRINK: Stay hydrated. Water is the best as it helps produce saliva, which keeps your mouth clean, moist, and healthy. MANAGE: Stress can raise your blood sugar and affect your gums. It can also easily lead to the neglecting of oral hygiene routines, as well as other healthy habits, which can worsen gum disease. Practice some relaxation techniques such as deep breathing, yoga, moving around outside, or getting involved in hobbies you enjoy.

I see patients with all types of diabetes every day. One of my patients had both diabetes and severe gum disease. Chewing was painful for them, and they felt embarrassed to speak because of bad breath. Their treatment required multiple cleaning sessions to remove the hard deposits and bacteria from under the gums, which couldn’t be taken care of at home. We also used advanced equipment such as ultrasonic scalers, air powder polishers, and a laser to promote healing and reduce harmful bacteria. After staining was removed, we coached them on personalised brushing and interdental cleaning techniques. As they improved their diabetes management, they were able to chew comfortably again, their breath improved, and it became easier to manage their blood sugar.

As a dental hygienist with over 20 years’ experience, Nova has witnessed firsthand how maintaining good oral hygiene can have a significant impact on controlling diabetes.

Nova Edgcombe, BSc RDH With over 20 years of experience, Nova Edgcombe is the founder of Mint Dental Hygiene, a direct access dental hygiene clinic in Takapuna. She has collaborated with leading cosmetic dentists, periodontists, and holistic dental clinics in both New Zealand and the UK. Nova integrates advanced treatments – such as nonsurgical periodontal care, implant maintenance, and diode laser therapy – with a holistic approach that highlights the connection between oral and overall health.

DIABETES WELLNESS | Summer 2024

Nourish

BUILD THE ULTIM Love salads but need inspiration of what else goes in a salad besides the usual lettuce, cucumber, and tomatoes? We've created a pull-out guide so you can create the tastiest and most nutritious salads of the summer. Choose one item from each of the salad categories and discover some fabulous combinations. Each salad combo serves one person.

GREEN BASE 1 cup

TIP: Weekend meal prep makes these an excellent weekday lunch. Take your dressing in a tiny container to avoid a soggy salad!

GRAINS AND LEGUMES 1/4 cup

CRUNCHY RAW VEG 1/4 cup

DIABETES WELLNESS | Summer 2024

Shredded chicken, 100g

One boiled egg

Brown rice, cooked and cooled

Quinoa, cooked

Carrot/beetroot grated or peeled into ‘noodles’

Capsicum, sliced

Grilled zuchinni strips

Roasted pumpkin chunks

Walnuts

Toasted seed mix*

Cherry tomatoes, handful

Spring onions, sliced, 1 tbsp

Green goddess dressing*

Simple vinagrette

COOKED VEG 1/4 cup

CRUNCHY TOPPERS 2 tbsp

FLAVOUR BOMBS

DRESSINGS up to 1 tbsp

Rocket

PROTEIN

Layer them or toss them – it's up to you! *Check the next page for recipes.

Baby spinach

MATE SALAD Mixed greens

Kale

Coleslaw mix

Cos lettuce

Tuna or salmon, 95g can

Beef strips, 100g

Tempeh strips, 1/4 pack

Cheese – feta, goats cheese, mozzarella – 50g

Four bean mix

Cooked and cooled noodles/pasta

Cooked lentils

Chickpeas

Cucumber, sliced or cubed

Sprouts

Celery, sliced

Sugarsnap peas

Eggplant, grilled

Roasted kumara chunks

Corn kernels

Green beans, steamed and cooled

Pickled radish*

Pomegranate seeds

Toasted pinenuts

Croutons

Red onion, sliced, 1 tbsp

Fresh chopped herbs, 1-2 tbsp

Olives, 1–2 tbsp

Dukkah,* 1 tbsp

Low-fat mayo

Lemon tahini dressing*

Citrus vinaigrette*

Store-bought low calorie ranch dressing

DIABETES WELLNESS | Summer 2024

Dukkah

Dukkah is an Egyptian nut, seed, and spice blend. It lends an irresistibly nutty, subtly spiced flavour to everything it touches. An authentic recipe will use whole coriander and cumin seeds, but we've opted for a quick and easy recipe with ready ground spices. There are many variations on dukkah, but you'll always find sesame seeds and spices included. ½ cup hazelnuts 3 tbsp almonds 4 tbsp white sesame seeds 3 tbsp shelled pistachios 1 tbsp fennel seeds 1 tsp ground cumin 1 tsp ground coriander ½ tsp cayenne pepper ½ tsp fine sea salt Place the hazelnuts and almonds in a dry cast iron pan (do not add oil). Toast briefly over mediumhigh heat, tossing regularly, until the nuts start to turn golden brown. Transfer to a side dish for now. Place the sesame seeds in the same pan and return to the heat. Toast over medium heat, tossing regularly, until the sesame seeds turn golden brown (this will be fairly quick, so watch carefully). Add the toasted nuts and sesame seeds to the bowl of a small food processor fitted with a blade. Add the pistachios, fennel seeds, spices, and salt. Pulse for a few seconds until you reach a nice coarse mixture. (Do not overprocess the dukkah. The mixture should not be too fine. See photos and video for exact texture.) Use straight away, or store in a tight-lid jar for up to 2 weeks to use as a topping for salad, soup, chicken, meats, or roasted vegetables.

DIABETES WELLNESS | Summer 2024

Toasted seed mix

Add a crunch to your salads with this toasted tamari seed salad topper. Doubles as a tasty snack! 30g (1/4 cup) pumpkin seeds 30g (1/4 cup) sunflower seeds 40g (1/4 cup) sesame seeds 20ml (1 tbsp) tamari Mix your seeds, then place in a medium frypan on a gentle heat. Fry the seeds for about 3 minutes, stirring often. The seeds will begin to pop and puff up as they cook. When the seeds are a golden brown, add the tamari to the pan. Continue to stir until the seeds are dry, making sure they don't catch and burn. Tip the seeds onto a plate or tray and allow to cool. When cool, store in an airtight container in the fridge.

Pickled radishes 1 bunch radishes ¾ cup white wine vinegar or apple cider vinegar ¾ cup water 2 tbsp honey or maple syrup 2 tsp salt ½ tsp whole mustard seeds (optional) Optional add-ins: garlic cloves, black peppercorns, fennel seeds, coriander seeds, pinch of red pepper flakes Slice tops and bottoms off the radishes, then slice into thin rounds. Pack into a jar. Top with mustard seeds and any optional extras. In a small saucepan, combine vinegar, water, honey or maple syrup, and salt. Bring just to the boil, stirring occasionally, then pour the mixture over the radishes. Cool to room temperature. You can serve the pickles immediately or pop a lid on and refrigerate for later. The pickles will keep well in the fridge for several weeks but are at their crunchy best for about five days after pickling.

Dressings

Green goddess dressing

Ready in just 5 minutes, this dressing is completely plant-based and oil-free. 2 cloves garlic, minced 1 large avocado, peeled and sliced ¼ cup chopped spring onion ¼ cup fresh lemon juice 1 tbsp apple cider vinegar ½ cup water 2 cups chopped fresh parsley ¼ cup fresh basil Salt and pepper to taste Blend all the ingredients until smooth and creamy. (A stick blender is great for this.) Taste and season. Serve immediately or store in the fridge in an airtight container for up to 5 days.

Lemon tahini dressing

This dressing is great as a dip, but if you want to thin it for a salad dressing just add another tablespoon of water and stir until pourable again. This should last up to a week in the fridge. 1/2 cup raw tahini 1/4 cup water (plus more to thin) 6 tbsp fresh lemon juice (about 4 lemons) 3 cloves garlic, minced 1/2 tsp onion powder 1/2 tsp sea salt freshly ground black pepper Combine all of the ingredients in a bowl and whisk well to combine. Add extra water one tablespoon at a time until the dressing is as thin as you'd like it to be. Season to taste.

Citrus vinaigrette 31/2 tablespoons apple cider vinegar 11/2 teaspoons orange zest 2 tbsp fresh squeezed orange juice 21/2 teaspoons Dijon mustard 2 tablespoons pure maple syrup 2/3 cup light olive oil Salt and freshly ground black pepper to taste Place all ingredients in an air-tight container and shake well, or whisk ingredients in a bowl with a wire whisk.

Family

LIVING WITH (AND ALONGSIDE) DIABETES We meet folks who aren’t the only ones in their household dealing with diabetes. A COUPLE

When people find out that Erin and Cam Jefferies both have diabetes, they get asked some interesting questions. The couple’s favourite one is always directed to Erin: ‘Did you catch it from Cam?’ Then it’s quickly followed by ‘Do your children have it?’ And sometimes they get the chronologically incorrect: ‘Did you both meet at the kids camps?’ The Tauranga beekeepers have been together 24 years, and their diagnoses were 31 years apart. Cam was diagnosed with type 1 when he was four. ‘My granddad had it. It skipped the next generation, and then I picked it up.’ Erin, on the other hand, was diagnosed just three weeks before the couple was due to be married. Since she was 16, Erin had also had Graves’ disease – an autoimmune condition that affects the thyroid gland. With the arrival of coeliac disease, yet another autoimmune surprise, she has received a hat trick of health issues. The 31 years’ gap between diagnoses created friction in the relationship at the beginning. Whereas Cam had had a few decades' practice in treating highs and lows under his belt, Erin was new to it all. ‘It was interesting

Beekeepers Erin and Cam overlooking Lyttelton Harbour. The couple’s business has created honey in a squeezy bottle, which Cam has had to employ a few times. ‘I open it up and squeeze it into my mouth. That avoids dodging excited bees on the spoon and trying to get it back. They get excited about it, which isn’t great for me.’

when you haven’t been the one with diabetes and then suddenly you are,’ she says. ‘You go from being on one side of the fence to being in the paddock.’ She says her new husband wasn’t gushing sympathy. He’d had type 1 most of his life and told her, plainly, ‘You’ve got diabetes, so get on with it.’ Erin, having lived most of her without it, found it a big shock. Making the move to CGMs and pumps has made life significantly easier for the couple. As

beekeeping is hard yakka, Cam found that, as soon as he started work, his long-acting insulin would work faster and release into his bloodstream all at once. This resulted in him having hypos and feeling awful. Once he started using short-acting insulin within the pump, it covered what he had recently eaten, making an enormous difference to his overall health and wellbeing. To answer the earlier question about their children and whether they have diabetes as well: their 13-, 16-, and 20-year-old children are tested every five years, and the last test came back negative for all three. Erin explains, ‘Cam raises their risk because his is purely genetic. Whereas mine, they don’t know. Obviously, they know I’ve got thyroid and coeliac, but they don’t know if my diabetes is that late onset diabetes or not. I’m the only one ever in my family as far as you can go back in my family tree who has it.’ Being a beekeeper definitely has its perks for someone with diabetes. Because Cam spends a lot of time working alone, he says he is always prepared for a low. ‘If it gets bad, I’ve either got my honey or a sugar feeder on the back of the ute with 550 litres of liquid sugar in it, which I have sucked out of on a couple of occasions. Or you can dive into a beehive or something if you really want. You don’t have to be caught short.’ https://jbeeshoney.nz

DIABETES WELLNESS | Summer 2024

From left: Charlie, Mark, Sharon, Lily, and Jack. And their old labrador, Bruno.

Lily is able to empathise with families coming through the ward. Having been through the same situation, she can offer reassurance. ‘There’s a lot of information to learn quite quickly. Depending on the patient, I’ll tell them I’m a type 1 too. And that you’ll turn out fine, you’ve just got to learn the stuff.’ A SIBLING

Lily Warrior is part of a whānau very well versed in the ins and outs of diabetes. First came her dad, then each of the kids. And then to top it all off, Bruno the dog. The three Warrior kids’ diagnoses were spread out over a few years, with Lily kicking things off when she was eight. While the stress on the family at the time must have been palpable, she says by the time her youngest brother Jack was diagnosed the family was well into the swing of things. Ironically, it was dropping off Lily and brother Charlie to a Diabetes Youth summer kids camp that prompted Jack’s diagnosis. He had been constantly thirsty, frequently heading off to the bathroom, and was very tired – all the classic symptoms of type 1. They tested Jack’s blood glucose then spoke to one of the doctors, who advised them to take him to hospital.

DIABETES WELLNESS | Summer 2024

‘By then, we knew the drill. The signs were clear,’ Lily says. The following year, all three Warriors attended the summer camp together. It was Jack’s first, but by that time Lily and Charlie were seasoned pros. ‘In a roundabout way, it almost makes it feel nicer if you’re not the only kid who has it in your family. You’ve got a sibling you can go along with.’ A decade after that memorable camp drop-off, much has happened. Jack is at college, and Charlie is studying product design at Canterbury. He was recently selected from his class to give a presentation to a panel about his new diabetes invention – a patch that attaches to pump sites that detects if insulin is leaking or if the site isn't working. And Lily is now a paediatric nurse. When she was in her final year of college, she was reflecting on different parts of her life and what sorts of people had made an

impression on her. She quickly came to the realisation that her diabetes nurses really stuck out, so she applied to study nursing at Massey University. ‘I knew even before I started that I wanted to work with children and diabetes, and the placements only confirmed this. I realised surgical is not for me. I like the medical side of things and along with that comes the new diagnosis of diabetes in children.’ Lily now works with the new type 1 diagnoses and welcomes the families into the diabetes community. ‘I have been able to become the diabetes champion for the ward, which means I now have input into new policies and forms used by people with diabetes whilst they are inpatient.’ Lily’s hope for the future is to eventually become a Diabetes Nurse Specialist, with the end goal becoming a Nurse Practitioner and running her own diabetes clinics for kids.

The Blennerhassett family, from left: Campbell, Macsen (standing), Keegan (T1), Noel (T1), Emma, Valerie (T1), and Rachel.

A FAMILY

Rachel Blennerhassett says she knew nothing about diabetes until she was dating her soon-to-be husband. ‘My first exposure to diabetes was visiting his parents and seeing his mum taking her blood sugars on the glucometer. And then seeing her inject with a syringe.’ This was in 1991, and Rachel’s eyes continued to open a few years later when her husband, Noel, was diagnosed with type 1 diabetes. He had been constantly sick with colds and flu and chest infections, and seemed to no sooner get over one ailment when he was sick with another. ‘It was massively life changing because suddenly I'd gone from just getting a glimpse of it with the in-laws to actually living it with my husband.’ Fast forward another decade or so and the couple’s five-and-ahalf-year-old son Keegan was also diagnosed. Rachel explains, ‘The transition of partial caring for my husband to full-on caring and being a living pancreas for my son was hard. I felt like his life was in my hands, literally. There was lots of learning, like how to read his

Rachel’s husband Noel and his mother Valerie receiving their Diabetes NZ Awards for managing type 1 for 25+ years and 40+ years respectively.

high or low symptoms.’ Rachel’s advice to anyone living in a similar situation is plain and simple – positivity. ‘Our children learn off us, so if we can (or at least to them look like we can) roll with this challenge and face and conquer the hurdles as they arise, our children will learn that tenacity and that resilience and just keep going.’ Over 10 years ago, wanting to reach out to parents new to this challenge, Rachel started the Facebook page Diabetes Parents Unite. ‘I thought, okay, I'm learning all this stuff, how can I help others?’ Her belief behind starting the social media page was that parents’ learnt and lived experiences could help and empower others. The action of helping others has a roll-on effect, she says. ‘It also helps and empowers ourselves and builds up our own confidence. Like, “I've helped this person get over this hurdle because I remember what it was like.”’ Eighteen years later, and Keegan is living independently, dairy farming, and managing himself beautifully, Rachel says. ‘My

opinion is biased because he's my son, but he's amazing. He has this “shrug it off and get on with life” attitude, which just blows me away really.’

‘When Keegan was little and people would refer to him as ‘the diabetic boy’, I would say to them, “He is a boy who happens to have diabetes just like that kid over there that happens to be asthmatic or happens to have an allergy to peanuts or whatever. He is not “the diabetic”, he is a child who has diabetes.’ DIABETES WELLNESS | Summer 2024

Dexcom Warrior

Dana Young shares how becoming an ultra-marathon runner started with a run with the buggy.

NOT JUST AN AVERAGE MARATHON

eing active has always been a significant part of my life. I was deeply involved in rowing during my school years, a very competitive sport that many Kiwis will be familiar with. I remember our training to be rigorous, involving crosscountry skiing and running. After giving birth to my first child, I decided that I wanted to focus on my running. So it all started with me simply running with him in a buggy and then

DIABETES WELLNESS | Summer 2024

participating in 10K events. After the birth of my second child, I ran a full marathon, and following my third I ventured into ultramarathons. This year, I completed a 105K ultra. It’s been a challenging yet rewarding journey, juggling my passion for running with my role as a mother. DIAGNOSIS

I was diagnosed with type 1 diabetes over 30 years ago, when I was seven years old. At such a

young age, I vividly remember the shock of my diagnosis. I had the classic symptoms, from being really thirsty, not being able to eat, to losing a lot of weight. My mum actually had to restrict my water intake as I was constantly waking up at night to go to the toilet. After realising that something may be wrong with me, I was eventually hospitalised for about a week. This is where the reality of lifelong diabetes management

began, with learning how to inject myself with insulin. Initially, it was a challenge; my parents had to chase me around the house just to administer my insulin. Back when I was first diagnosed, diabetes management was different. You’d go to your doctor, they’d tell you how much insulin to give yourself, the amount of food you need to be eating, and you’d follow this routine every day until your next appointment ,when they’d reassess things and then provide further modifications to your routine. At the beginning, my attitude towards my diabetes was quite negative. As a child, my blood sugar levels were often high, and my doctor back then would tell me and my parents about potential blindness and limb loss. Of course, this left us overwhelmed and fearful. As I grew older, this fear led me to disassociate from my condition, and for about 15 years I largely ignored the recommended diabetes care plan. DISCOVERING TECH

But everything changed when I became pregnant with my first child. Suddenly, it wasn’t just about me anymore – I had to take care of my health for the sake of my child. This was when I started going back to my appointments. During one of my pregnancies, I started using an insulin pump, which I found to be more manageable and less intrusive than multiple daily injections. As I continued to challenge myself with my running journey, advancing to longer distances, it became clear to me that the frequent injections were not effective in managing my blood sugar. I began to

research for other options and decided on an insulin pump, which I now use with my Dexcom G6. Using continuous glucose monitoring (CGM) technology has made a significant difference in managing my diabetes. With finger prick tests, you typically only get a snapshot of your blood sugar at one point in time. Then if you check again five minutes later, you might see it rising or falling again, and this is not a very accurate reading. CGM has changed all of that. I love how it tracks my glucose levels in real time, and on my phone I can see the arrows going up and down. Ultimately, it gives me a sense of assurance and control, especially when I’m going out for a run. Without it, you might get out of the door, then 1km later, your sugar drops. But with a CGM, you can see and predict these changes from the start, which is incredibly empowering. PUBLIC AWARENESS

I think there needs to be education around the difference between type 1 and type 2 diabetes. There can be a stigma associated around type 2 diabetes, and it can be misunderstood as a lifestyle disease. People also often don’t

When I was first diagnosed, it was daunting to hear about going blind or losing limbs. But look at me today, none of that has happened and I’ve been able to accomplish some pretty incredible things in my life.

understand that type 1 is an autoimmune disease and not caused by eating a lot of sugar. I find people can get confused about why I need to eat sugar if my blood sugar reading is low. The advice I’d give someone recently diagnosed with diabetes is simple – just keep living your life. Continue doing what you love, as it’s very important to maintain your passions and activities. When I was first diagnosed, it was daunting to hear about going blind or losing limbs. But look at me today, none of that has happened, and I’ve been able to accomplish some pretty incredible things in my life. If there is something I want to do, I never think I can’t do that because of my diabetes. Instead, I plan and figure out how to manage my diabetes around it. I don’t want my diabetes to define or limit my life.

DIABETES WELLNESS | Summer 2024

Nourish

It’s edging towards that time of year when many of us find ourselves requested to ‘bring a plate’. Here’s some diabetes-friendly, and downright delicious, ideas to take to your next work or social ‘do’.

HEALTHIER WORK SHOUTS

call-out on social media for the most loved morning tea spreads came back with sausage rolls as the overwhelming winner. One person offered asparagus rolls, saying no one likes them anymore so they were the ones that got to eat them all. And many said

that sweet things were always overrepresented, so it was always nice to see savoury. So, instead of picking foods like sausage rolls, which often have high levels of salt, fat, and carbs, try cutting the carbs and lifting the nutrients with some equally delicious alternatives.

Instead of spring rolls, swap rice paper wraps for silverbeet leaves. Silverbeet leaves are pretty strong and will hold either cooked and cooled rice or vermicelli noodles and a protein. (Check out our resource in the centre of this issue for some ideas for fillings.)

Instead of sausage rolls, go for the traditional club sandwich. They can be made plentifully and cheaply with wholemeal supermarket bread and filled with an array of ingredients. Something as simple as thinly sliced cucumber and finely chopped mint is deliciously fresh going into summer.

Instead of pastry, consider using supermarket wholemeal bread. Just pop it into a muffin tin and top with an eggy mix of a protein and vegetables to make savoury bread nests.

©ANNA WWW.JUSTAMUMNZ.COM

DIABETES WELLNESS | Summer 2024

Instead of a creamy or cheesy dip, find or make dips from legumes such as hummus or root vegetables such as kumara and pumpkin. Roast veges and some fresh herbs are a delicious addition to hummus.

MY DIABETES JOURNEY… A FRIEND IN YOUR POCKET!

Ditch store-bought crackers, with their frequently high levels of salt and fat, and try making your own seeded crackers.

Scattering some fresh fruit, especially summer fruit and berries, around your plate of goodies will make your spread more colourful and inviting.

Another use for sliced bread is as cool and dry toast. It can be used in place of high fat/high salt crackers and can hold delicious toppings such as chopped fresh tomatoes and herbs, guacamole, or seasoned and roasted ribbons of kumara.

We know that managing diabetes is a journey and we all need a little extra support sometimes. With helpful tips, information, and inspiration, the new My Diabetes Journey app truly is like a friend in your pocket! It’s totally free, so download it today. • Food diary • Space to record and track movement goals and emotional wellbeing • Diabetes resources • Recipes • Nutrition tips DOWNLOAD IT TODAY

It’s not just vegans who appreciate meatless meals. Vegetarian/ vegan snacks typically involve utilising more plant-based ingredients and that’s never a bad thing.

Advocate

Catherine Taylor has served Diabetes NZ as a Board member for eight years. She shares some highlights achieved during her time with us.

‘If something needs to get done, I’ll push for it’

hen Catherine Taylor first got involved with Diabetes NZ (DNZ), she recounts that some people believed DNZ was irrelevant. ‘Why would you want to be involved with that organisation? It does nothing for people with diabetes,’ they’d tell her. ‘But it was true. It was at the stage where it had no purpose, had no sense of direction, and didn’t know where it was heading,’ says Catherine. ‘So I thought that was the best challenge a mother could ever get.’ Catherine’s daughter was diagnosed with type 1 diabetes in 1982 when she was only 14 months old, and Catherine

acknowledges the significant support she received at the time. ‘It was a big shock to me personally because diabetes was not in my family, although it was in my husband's family. The hours that I spent talking to people about what this might mean and how I might approach supporting my daughter through her diabetes journey proved important. That's really why I got involved in the first place.’ Having been on the diabetes journey herself, Catherine says she understands the need for DNZ to focus on supporting people at time of diagnosis. ‘Supporting them to understand that it is a long-term condition that can be managed, recognising that at times

management of diabetes can be very challenging and demanding. People can manage it themselves with appropriate support.’ ‘A GROWING ORGANISATION WITH A BROAD MANDATE’

Catherine’s focus during her time as a Trustee (and before that as an Independent Director) has been on ensuring DNZ has the right tools and the right people to enable it to grow and develop. In Catherine’s time, DNZ has moved from an Incorporated Society to a Charitable Trust, with a skillsbased Board of Trustees supporting the growth and development of the organisation. ‘So whilst it might sound deadly dull and boring, unless you have

‘My vision has always been that we needed to raise our profile. We are now regarded as the diabetes consumer organisation that government and other central agencies like Pharmac go to.’

DIABETES WELLNESS | Summer 2024

My Identity

is proud to nominate

the focus and the strategy right at the top, the ability of the organisation to grow and develop is somewhat hindered.’ Catherine is proud to have helped guide DNZ forward from 2016. With the support of her fellow Trustees, and the senior leadership team, DNZ has grown from having 12 staff to nearly 40. ‘And we have a much wider presence across the country and in those communities that need our support – namely, the Māori, Pacific Island peoples, and South Asian populations. ‘We've just had two days with the staff and Trustees in Waikanae. It was uplifting for me to see that at least two thirds of our staff are either of Māori, Pacific Island, or Indian ethnicity. For me, I think that's the greatest achievement that the organisation has made. We, as an organisation, reflect the diversity of the people that we serve, and, with recent appointments, our Board of Trustees also

reflects that. I think that's really important.’ There is much that Catherine is proud of during her time with Diabetes NZ. ‘The work we did on the #CGMForAll campaign is something the team can be immensely proud of,’ she says. ‘The work we’re doing with Diabetes Community Coordinators is really important, as is the focus that we've had on our website – making sure that the information we have is accessible and useful to all people with diabetes.’ In this issue, Catherine has nominated her ancestor Amelia for the MyID bracelet. She was the first Pākehā woman born in Pōrangahau, central Hawke’s Bay. The strength of whānau lies in its ability to unite diverse perspectives and strengths, fostering an environment where everyone can thrive. This collective strength not only nurtures individual growth but also enriches the community, highlighting the vital role of family in shaping our lives and values.

A WEALTH OF EXPERIENCE Catherine started as a chartered accountant, then as she moved among organisations held senior management roles, eventually becoming the Director and Chief Executive of Maritime New Zealand. She was in that position when the ill-fated Rena grounded on Ōtāiti, Bay of Plenty, back in 2011. Catherine led the initial response, fronting three or four public meetings a day, letting people know what actions Maritime NZ was undertaking to respond to the disaster. She later returned to the Bay of Plenty and worked with iwi coordinators to support the environmental recovery programme that followed. Catherine has also given 20 years of her time and expertise as a Trustee of Wellington’s Life Flight Trust. She has been involved in the aviation industry working for Wellington airport and serving on the Boards of Nelson and Dunedin Airports. She is currently on the Board of the New Zealand Transport Agency – Waka Kotahi. ‘The breadth of what I’ve done is what has kept me interested in all sorts of things. I’m intellectually curious. I’ll always ask questions. If I want to do something or think something needs to be done, I don't let go. I’ll push for it. So I’m a pusher.’

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Your DNZ

CGM TIMELINE 2019 November 2019: Diabetes NZ presented a petition to Parliament, asking: ‘That the House of Representatives urge Pharmac to fund Continuous Glucose Monitors (CGM), GLP1 agonists including Bydureon, Byetta, Lyxumia, and Victoza, SGLT2 inhibitors including Forxiga and Jardiance, and DPP-4 inhibitors including Januvia, Onglyza, and Trajenta.’ The petition had gained close to 28,000 signatures. Diabetes NZ also produced a template letter for people to write directly to their local MP.

2020 December 2020: In response to feedback from Diabetes NZ and others, Te Pātaka Whaioranga – Pharmac made the decision to fund two new medicines for New Zealanders who are at high risk of heart and kidney complications from type 2 diabetes. The first of these medicines became available, fully funded, from 1 February 2021.

2021 January 2021: Diabetes NZ submitted background information to the Health Select Committee on the matters outlined in the 2019 petition. June 2021: Diabetes NZ argued the case for funded CGMs in front of the Health Committee. Te Pataka Whaioranga – Pharmac responded a week later. August 2021: The Health Committee presented its report on the Petition to the House. (A copy of the report is available on the Parliament website.)

In 2022 and 2023, Diabetes NZ asked people to share their diabetes stories using the hashtag #CGMFORALL

August 2021: Musicians Vince Harder and Abby Lee released the song ‘Overwhelmed’ after their daughter was diagnosed with type 1 diabetes. The song helped to raise awareness about type 1 diabetes, and how life-changing continuous glucose monitors can be for those living with type 1 and their families, and how unfair it is that many can’t afford them.

DIABETES WELLNESS | Summer 2024

2022

2023

2024

February/March 2022: Continuing on the momentum built by the 2019 petition and the Health Select Committee hearing of the petition in June 2021, Diabetes NZ took to social media to gather support and visibility for their campaign for CGMs to be publicly funded for everyone in Aotearoa.

February 2023: PHARMAC signaled the first step in funding continuous glucose monitors in Aotearoa New Zealand. After many years of advocating, Diabetes NZ are hopeful that this is a decision for all people with diabetes who are insulin dependent.

April 2024: Te Pātaka Whaioranga – Pharmac announced their proposal to provide fully funded access to CGMs, insulin pumps, and insulin pump consumables for all people living with type 1 diabetes. This was an historic milestone for the diabetes community and for all those living with type 1 diabetes.

As part of the campaign, Diabetes NZ called on people with diabetes to flood Facebook and Instagram with images and posts illustrating the burden of diabetes and the life-saving impact of CGM technology using the hashtag #CGMforall. The campaign generated the highest engagement on social media out of any activity during the year.

June 2023: Diabetes NZ kicked off the next stage with a new campaign We Won’t Stop with the message ‘We Won’t Stop until all New Zealanders living with diabetes who are using insulin have access to the global standard of care, including access to funded CGMs to manage their diabetes and avoid complications.’ September 2023: Diabetes NZ held the Diabetes Matters forum in the lead-up to the election with support from New Zealand Society for the Study of Diabetes, Edgar Diabetes & Obesity Research Centre and Healthier Lives – He Oranga Hauora National Science Challenge. The forum included representatives from the National, Labour and Green Parties (all of whom supported the funding of CGMs) and National followed up this support by adding CGM funding into their Health Policy.

May 2024: Pharmac announced a delay in their proposals around the funding of CGMs, insulin pumps and insulin consumables. Diabetes NZ remained committed to working with Pharmac while representing the diabetes community. 29 August 2024: Te Pātaka Whaioranga – Pharmac announced they would be funding CGMs, insulin pumps, and insulin pump consumables for people with type 1 diabetes. 1 October 2024: Funding is available for people with type 1 diabetes in Aotearoa New Zealand. About 12,000 people with type 1 diabetes are expected to receive CGMs in the first year of funding, rising to more than 18,000 after five years. About 4,800 people are currently using insulin pumps and Pharmac expects this number to increase to nearly 10,000 over five years. Diabetes NZ will not stop until CGMs are funded for all, so the advocacy will continue.

DIABETES WELLNESS | Summer 2024

Your DNZ

We continue our travels around the motu where we meet each region’s Diabetes Youth Coordinator. In this issue, we meet Lena Fendley-Peach in Tauranga.

LEAN ON ME L

ena Fendley-Peach recounts those first few weeks of her son’s diagnosis with type 1 diabetes. ‘We were in that head spinning/not knowing what you’re doing/worried about the future place.’ The one positive thing about this stressful period for Lena and her son Ezra was the timing. ‘We got to go to the family camp three weeks after diagnosis, which was amazing. So to be able to go to camp and talk to people that had been dealing with type 1 for a long time was great. Knowing he was going to be ok and live a normal life was what we got out of that time, watching these other kids just doing normal, everyday stuff.’ Back home, Lena and her then eight-year-old son enjoyed the help they started receiving from their newly discovered community. The awesome support they found blossomed into friendships, Lena says, with two mums in particular who were in similar positions to herself.

GIVING BACK

Once her head had ceased spinning, Lena threw herself into as much volunteering within her local diabetes community and helping at camps and events as her job as a home-based carer would allow. But the time came when she didn’t have as many kids coming to her, and that’s when she decided to go to Toi Ohomai Polytech in Tauranga and embark on a Bachelor’s degree in

DIABETES WELLNESS | Summer 2024

Community Health. ‘My goal was to work in a paid role, supporting families who had a child with type 1 diabetes,’ she says. ‘I wanted to give the same type of support I received when my son was diagnosed.’ Her first work experience placement was with the local diabetes group, which at that time was called Diabetes Help Tauranga. ‘A few weeks into my placement, the manager resigned and I took on her job, while still finishing off my degree. We needed to make a few changes to the services we provided because she was a diabetes nurse. So a couple of months later the committee merged Diabetes Help Tauranga with Diabetes NZ, and I have been working in this role since 2019.’ Similar to a few other Youth and Diabetes Community Coordinators around the country, Lena has a split role, and her workdays reflect that. She spreads herself between working with type 1 and youth across the Bay of Plenty, Rotorua, and Taupō but is also part of a community service team that works with type 2 and adults across the wider Tauranga area.

DAY TO DAY

On an average week, Lena helps ‘walk-ins’ find whatever information or support they are seeking, whether they be type 1, type 2, kids, teens, adults, or family members. She also runs support groups for people with type 1 and type 2 diabetes and attends diabetes educational groups run by the Western Bay of Plenty PHO to promote Diabetes NZ services. Another job in Lena’s busy schedule is attending community and kaumātua groups to educate the participants about living well with diabetes. Finally, she also gets referrals from Tauranga Hospital of families who have just had a child diagnosed with type 1. A lot of Lena’s time is spent organising events for local families, which includes the annual Diabetes NZ Youth family camps. With grant funding becoming more difficult to secure, Lena says organising and finding sponsors takes up a lot of time. Lena praises the fundraising team, saying they do an excellent job in securing grants that cover about half

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the cost of the camp. Lena’s dedication in this area has paid off, and she notes that in the last few years she has developed a good relationship with the local Lions clubs, which makes the job easier. ‘I am thankful to the businesses who are connected to some of the type 1 families and that donate for these events,’ she says. ‘This makes it easier to reach our goal.’ An event that is requiring a lot of Lena’s time lately is the upcoming CGM and pump rollout throughout the country. ‘I’ll be coordinating with reps from the different suppliers to organise training sessions. We’ll do that for all the areas we have a staff member, so we’re very, very busy.’ Asked what she would love to see happen in her area in the future, she’s quick to reply: ‘More camps! I would love to see a teen camp in our area. Diabetes NZ Waikato (which is run by volunteers) has a kids’ camp that some Tauranga families get to go to. Here in the Bay of Plenty, we run a family camp, but we don’t have a dedicated teens camp and I’d love to see that.’

Grow

It’s that time of year again – the perfect season to sow a few seeds and get some edible greenery going to see you through the summer.

PERPETUAL GREENS T

hese vitamin-packed veges are known as perpetual greens due to their ability to keep producing even while leaves have been picked from them. Non-hearting, these plants continue growing, sucking up moisture and nutrients from the soil. Perpetual greens can be grown in containers or even on a patch of weeded and tilled ground. They don’t require any special attention and can grow for many months, depending on the season.

PERPETUAL SPINACH

Harvesting Cavalo Nero kale

DIABETES WELLNESS | Summer 2024

This spinach is reportedly easier to grow than standard spinach. It’s the one you can buy as ‘baby spinach’ at the supermarket. Technically, it is a type of chard, like silverbeet, however it’s named a spinach due to its similar flavour to true spinach. As with most plants, it does best in fertile soil and full sun. However, you can also plant it in shady areas where soil is poor, as it is very forgiving. Growing: Sprinkle a few seeds in a pot or straight into your garden and then sprinkle soil lightly over. Water lightly.

Picking: Allow a few leaves to get the plant started, then you can begin harvesting the outer leaves. Never completely strip a plant. Eating: Sandwiches, salads, stir fries, smoothies, and fry ups, with poached eggs. KŌKIHI NEW ZEALAND SPINACH

Native to eastern Asia, Australia, and Aotearoa, this plant has been growing wild on our coastlines for centuries. Kōkihi is a low-growing, leafy plant that can spread to half a metre. It is another one that isn’t a true spinach but tastes very similar and can be eaten raw or cooked just like the real stuff. It does beautifully in sunny, hot, dry conditions, and you might’ve even seen it growing on stony beaches. Kōkihi is jampacked with goodness, being a source of calcium, vitamin A, vitamin E, vitamin K, iron, manganese, folic acid, B vitamins, phosphorus, riboflavin, and vitamin C. Growing: Just press a couple of seeds slightly into the soil, cover lightly with soil, then water. Picking: Pick the youngest leaves, which will encourage the plant to grow more voluminously. Eating: It is best suited for lightly cooked preparations. Before adding to recipes, it is recommended to soak the greens in cold water for half an hour or blanch them to reduce the oxalates in the leaves. Warning: Oxalates are organic compounds produced by many plants, including rhubarb. The general consensus seems to be that oxalates are fine for most people in moderate amounts. However, if you have gout, kidney trouble, rheumatoid arthritis, or some other condition that makes oxalates dangerous for you, then you should avoid foods that contain them. If you are worried, check with your doctor. (Taken from The Forager’s Treasury by Johanna Knox.)

Perpetual spinach

Kōkihi New Zealand spinach

Oakleaf lettuce

These varieties are referred to as ‘cut and come again' – just harvest a few of the outer leaves of these perpetual greens, allowing the younger ones to develop. OAKLEAF LETTUCE

With tender leaves, the oakleaf lettuce has a mild sweet flavour. Its soft buttery leaf resembles an oak leaf, and these are formed in a loose rosette – perfect for taking as much or as little as you need. Oakleaf lettuces come in two different colours – green and ‘red’, which is a green/bronze variety. Growing: Start your seeds in a tray or six-pack pot. The seeds are tiny, so only top with a light dusting of potting mix/seed raising mix or soil. Water lightly every few days until the plants are large enough to transplant to a larger pot or garden. Picking: Wait until the plant has reached a good size, then start pulling off the outer leaves, ideally in the morning while still dewy. Eating: Use the oak leaf lettuce as you would any other lettuce in sandwiches and salads. KALE

There are many types of kales, some yummier than others. Curled, American, Italian, and Russian are the most common. Russian kale is slate green in colour, with dark purplish

stems and is cold-hardy. The Italian, Cavalo Nero, is tall with a dark green leaf and is delicious steamed. Kale contains fibre, antioxidants, calcium, vitamins C and K, iron, and a wide range of other nutrients. It also contains nutrients that can support eye health, weight management, heart health, and more. Growing: Either in seedling punnets or even straight into the soil, kale is a very forgiving plant and will put up with almost any conditions. Once the plants start to ‘bolt’ (grow too quickly, get leggy, and suddenly grow a seed head), you can allow it to scatter its seeds and will end up growing some babies. Kale is excellent for this. Picking: The younger leaves are soft enough to be eaten raw. The larger leaves benefit from being cooked into curries and stir fries, and the Russian type make excellent oven ‘chips’. Eating: Like spinach and chards, kale can go into almost any meal, cooked or raw. Baby leaf kale and Cavalo Nero are particularly delicious raw in salads.

DIABETES WELLNESS | Summer 2024

Your DNZ

2024 DIABETES NZ AWARD WINNERS Each year, we grant a number of awards to recognise determined and hardworking people in our diabetes community. DIABETES NEW ZEALAND AWARD

This honour recognises some of the inspiring members of our community. This year, we acknowledge Julie Russell from Waiuku, who has made an outstanding contribution to support people with diabetes. SIR CHARLES BURNS MEMORIAL AWARD

Diabetes NZ presents this award to anyone with diabetes who can demonstrate that they have managed their diabetes through insulin therapy for a continuous period of at least 50 years. This year, we are giving our new commemorative coins for this award. The recipients are: Geraldine Stayte, Auckland Tāmaki Makaurau Karyn Binns, Moutere Astrid Tudberry, Nelson Whakatū Michael Drury, Wanaka Ralphia Paynter, Papamoa

SILVER MEDAL AWARD

This award is for anyone who can demonstrate that they have managed their diabetes through insulin therapy for a continuous period of at least 25 years. This year, our recipients are: Simon Rickwood, Auckland Tāmaki Makaurau James Whitlock, Tauranga Alice (Ally) Avery, Marlborough Te Tauihu-o-tewaka Lee Savage, Nelson Whakatū Elizabeth (Liz) Hickey, Christchurch Ōtautahi Alistair Turnbull, Invercargill Waihōpai

JOHN MCLAREN YOUTH AWARDS

These awards offer a scholarship to young people living with diabetes who are aiming high in their chosen fields. Matthew Butterfield from Christchurch Ōtautahi is the winner in the Sporting category. He has made the initial NZ Volleyball Men’s Team, the Volleybacks, and plans to use the scholarship to help with costs associated with travel, accommodation, and food expenses for the training camps. Elijah Booth from Dunedin Ōtipoti is our winner in the Academic category. He has enrolled at Otago University for 2025 to study a Bachelor of Laws (LLB, First Year) and a Bachelor of Arts, majoring in Psychology. His scholarship money will go towards his course entry fees and courserelated costs. Finally, our Arts winner is DJ Mills from Waikato. DJ aspires to become a Formula 1 photographer, and his scholarship funds will go towards travel, accommodation, and photography equipment.

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DIABETES WELLNESS | Summer 2024

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Diabetes Wellness Summer 2024

Articles inside

2024 DIABETES NZ AWARD WINNERS

PERPETUAL GREENS

LEAN ON ME

CGM TIMELINE

‘If something needs to get done, I’ll push for it’

HEALTHIER WORK SHOUTS

Dana Young: Dexcom Warrior

LIVING WITH (AND ALONGSIDE) DIABETES

A DENTAL HYGIENIST’S PERSPECTIVE

PĀKAOMA AOTEAROA PARKRUN NZ

FOCUSING ON THE HERE AND NOW

Don't Sugar Coat Diabetes

Diabetes Wellness Summer 2024: Editorial