Diabetes Wellness Spring 2017 by Diabetes New Zealand

wellness

SPRING 2017

DIABETES

DIABETES NEW ZEALAND | DIABETES.ORG.NZ

GOOD MOOD FOOD • YOUTH ADVOCACY • VOTE DIABETES • FAMILY EXERCISE DOGGIE DIABETES • SPRING GARDEN • TECHNOLOGY TIME • MY T2 LIFE • GOING BEYOND

NO LIMITS

Young, T1D and living life to the max

FOOT & HEEL BALM

Suitable for diabetics. Bio-organics Glycemix Foot & Heel Balm hydrates and smoothes the cracked skin of heels, providing immediate relief with results within 24 hours. Always read the label. Use only as directed. If symptoms persist, consult your healthcare professional. Sanofi Consumer Healthcare, Auckland.

Bio-organics Glycemix™ Neuropad® Diabetic Foot Test Patch Easy to use 10 minute self test for early detection of diabetic foot syndrome. 2 patches – one for each foot. Always read the label. Use only as directed. This device may not be suitable for every person with diabetes, seek the advice of your healthcare professional. Use of Neuropad does not replace the need for patient vigilance for the early signs of diabetic foot neuropathy and regular consultation with their healthcare professional. A normal result does not preclude diabetic foot syndrome or foot neuropathy. Common signs of diabetic foot neuropathy include numbness, reduced pain, ability to sense temperature range, tingling or burning sensation, sharp pains or cramps, increased touch sensitivity, muscle weakness, loss of reflexes, loss of balance, ulcers or foot deformity. Consult your doctor if you experience any of these signs even in the event of a normal test result. Sanofi Consumer Healthcare, Auckland 0800 445 365. TAPS PP9144.

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CHCANZ.BORG.17.01.0070

Contents

COVER: SURF LIFESAVER BEN CROSS (IN WATER) TAKES PART IN RESCUE TRAINING EXERCISE. .© JAMIE TROUGHTON/DSCRIBE MEDIA

SPRING 2017

VOLUME 29 | NO 3

4 EDITORIAL

20 TECHNOLOGY: Launch of the ‘world first’ MiniMed system

5 COMMUNITY: World Diabetes Day

21 PETS: Spot the signs of diabetes in your dog or cat

6 UPFRONT: CGMs funding, Dress Diabolical, Diabetes NZ AGM/Conference 8 COVER: Ben Cross and Niamh O’Sullivan talk about their T1D journeys

12 GOING BEYOND: Eight amazing people who don’t let diabetes hold them back

22 GENERAL ELECTION: Health policies from our political parties 24 CARE: NZ’s new bowel cancer screening programme 25 LIFE: Grant Bason won a FitBit and turned his life around

14 DIABETES ON MY MIND: Rachel Kelly beats the blues by changing her diet

27 FAMILY: What would you have told your 18-yearold self about diabetes?

16 RECIPES: Good mood food

28 ADVOCACY: Young people helping unite the diabetes community

18 RESEARCH: Food is my medicine

30 DIG: Growing super foods – seven super crops

32 MEAL MAKEOVER: How to bake a healthy muffin 34 EAT: The importance of whole grains and why we should eat more of them 36 MOVE: Craig Wise gives us tips on exercising as a family 38 RUBY’S WORLD: Ruby McGill goes back to basics

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DIABETES WELLNESS | Spring 2017

Editorial

Kia ora koutou. What an exciting time to be part of Diabetes New Zealand. I joined the team in March 2017 as the Director of Youth and it’s certainly shaping up to be a busy, fast-paced year. In July, the new Diabetes Youth Advisory Committee (DYAC) was established to replace Diabetes Youth NZ, which has been wound up as a separate legal entity. Without a membership structure, its volunteer organisers were finding it increasingly challenging to maintain high levels of engagement and reach nationwide, while juggling the growing number of administrative and financial tasks required to operate smoothly. The good news is that members of the Diabetes Youth NZ executive committee have joined DYAC, which sits within Diabetes NZ’s influential Advisory Council. This administrative change does not affect Diabetes NZ’s branches or Diabetes Youth societies around New Zealand. They will continue to operate as they do now and you’ll still see the same familiar faces. This is a fantastic outcome that ensures Diabetes Youth NZ’s experience, expertise and passion are not lost. It also means there will always be a youth presence and youth voices at the Diabetes NZ Advisory Council ‘table’. In the future you’ll notice more youth initiatives delivered from a national level as the team focuses on helping young people living with diabetes thrive. Appropriately enough, the spring issue of Diabetes Wellness is dedicated to our incredible young members and supporters. It’s jam packed with stories about inspiring young people living with diabetes, who are achieving amazing things and not letting diabetes hold them back. Our new Diabetes Youth Advisory Committee is looking to recruit four regional representatives (two from the North Island and two from the South Island), two independent members and two youth representatives (aged 18-25). Are you interested, or do you know someone who might like to get involved and help advocate for young people with diabetes? Contact Diabetes Youth Committee member Stephanie Mills at contact@diabetesyouth.org.nz. We’d love to hear from you. Stay safe and well this spring. Ka kite ano. RUBY McGILL

Director of Youth, Diabetes New Zealand

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 Patrons Lady Beattie and Sir Eion Edgar President Deb Connor Chief executive Steve Crew Diabetes New Zealand Inc. National Office Level 7, 15 Murphy Street Thorndon, Wellington 6144 Postal address PO Box 12 441, Wellington 6144 Telephone 04 499 7145 Freephone 0800 342 238 Fax 04 499 7146 Email admin@diabetes.org.nz Web diabetes.org.nz Facebook facebook.com/diabetesnz Twitter twitter.com/diabetes_nz

DIABETES WELLNESS MAGAZINE Editor Caroline Wood editor@diabetes.org.nz Publisher Diabetes New Zealand Production & distribution Rose Miller, Kraftwork 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 1176-4406

ADVERTISING & SPONSORSHIP Director of Business Development Sue Brewster sue@diabetes.org.nz or 09 810 7047

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

DIABETES WELLNESS | Spring 2017

Community

PUTTING WOMEN FIRST A woman’s right to timely and affordable diabetes care is the focus of World Diabetes Day on 14 November.

irls and women with diabetes often experience barriers in accessing cost-effective diabetes prevention, early detection, diagnosis, treatment and care, particularly in developing countries, says the International Diabetes Federation (IDF). There are more than 199 million women living with diabetes in the world and this is projected to increase to 313 million by 2040. Diabetes is the ninth leading cause of death in women, with more than two million deaths each year. The IDF’s Our Right to a Healthy Future campaign will promote the importance of ensuring all women have affordable and equal access to essential diabetes medicines, technologies, selfmanagement education and information. The global initiative is being supported in New Zealand by Diabetes NZ, which is adopting the same Women and Diabetes focus as the theme for its Diabetes Action Month from 1-30 November 2017.

Sue Brewster, Director of Business Development for Diabetes NZ, said: “We will be working to raise awareness about the impact all kinds of diabetes have on women and their long-term health outcomes. “Two out of five women with diabetes are of reproductive age, which accounts for over 60 million women worldwide. Women with diabetes have more difficulty conceiving and may have poor pregnancy outcomes.” Diabetes NZ’s campaign will also include a focus on gestational diabetes. About one in seven births is affected by gestational diabetes and a significant number of women with gestational diabetes also go on to develop type 2 diabetes, resulting in further healthcare complications and costs. The IDF wants women worldwide to be offered equal access to resources and information that will strengthen their capacity to prevent or delay the onset of type 2 diabetes. This includes promoting the adoption of healthy lifestyles that will improve the health and wellbeing of their family and future generations.

OUR RIGHT TO A HEALTHY FUTURE

1 in 10 women

are living with diabetes. Many do not have access to education, treatment and care.

ACT TODAY TO CHANGE TOMORROW www.worlddiabetesday.org

WOMEN AND DIABETES

OUR RIGHT TO A HEALTHY FUTURE THE ISSUE

199 MILLION WOMEN WITH DIABETES 313 MILLION BY 2040 WHAT DOES THIS MEAN?

THE CHALLENGE ALL WOMEN WITH DIABETES REQUIRE AFFORDABLE AND EQUITABLE ACCESS TO CARE AND EDUCATION TO BETTER MANAGE THEIR DIABETES AND IMPROVE THEIR HEALTH OUTCOMES

DIABETES IS A LEADING CAUSE OF DEATH AMONG WOMEN

2 OUT OF 5 WOMEN

WITH DIABETES ARE IN REPRODUCTIVE AGE

WOMEN WITH TYPE 2 DIABETES ARE ALMOST TEN TIMES MORE LIKELY TO HAVE HEART DISEASE WOMEN WITH TYPE 1 DIABETES HAVE AN INCREASED RISK OF MISCARRIAGE OR HAVING A BABY WITH MALFORMATIONS

A SOLUTION ACCESS TO ESSENTIAL DIABETES MEDICINES AND TECHNOLOGIES, SELF-MANAGEMENT EDUCATION AND INFORMATION ARE KEY TO ACHIEVE OPTIMAL DIABETES OUTCOMES

ACT TODAY TO CHANGE TOMORROW www.worlddiabetesday.org

You can download these IDF posters and infographics at www.idf.org

If you want to get involved in DIABETES ACTION MONTH, or organise a local event in your community, please contact sue@diabetes.org.nz. If you have a story to share in our special women and diabetes issue, published 1 November, please contact editor@diabetes.org.nz

DIABETES WELLNESS | Spring 2017

Upfront

Time to fund CGMs Diabetes NZ received a huge response to a question posed in the last Connect e-newsletter: What diabetes-related support should the government be funding? The vast majority wanted to see insulin pumps and continuous glucose monitors (CGMs) subsidised or funded. One respondent said: “I have had T1 for 32 years and over these years have seen many changes to equipment and technology and I have been lucky enough to have an insulin pump funded which has made my life about as ‘normal’ as a T1 can get! My control is so much better and I have more freedom to actually live my life like a normal person, which means I am not getting ill and having to burden the already stretched health system by visiting doctors or having to be admitted into hospital for complications.” Another called for funding for CGMs: “As the mum of a baby girl diagnosed with type 1 at 11 months, I absolutely feel that a CGM should be funded. We are relatively new on our type 1 journey and it has been a devastating roller coaster. We have a CGM on loan from the

Steve Crew, CE Diabetes NZ

hospital and we can’t live without it. After doing some research I see it’s funded in Australia but not in New Zealand.” At the time of writing Diabetes NZ was still working through all the responses and will be using them to inform its decisionmaking and next steps regarding specific recommendations. Chief Executive Steve Crew said: “One of Diabetes New Zealand’s key stratetic goals is to advocate for people with diabetes to improve their health and wellbeing. This includes being aware of the latest advances in technology and devices that improve self-management and advocate for their introduction and funding. “We advocate for fully funded continuous glucose meters for all people with type 1 diabetes and for new diabetes medicines approved by the Pharmacology and Therapeutics Advisory Committee to be introduced and funded.”

GET B12 CHECKED One of our readers asked his diabetes nurse to check his vitamin B12 levels after reading our Autumn 2017 issue, which revealed how people with type 2 diabetes taking metformin are at higher risk of vitamin B12 deficiency. John found out his level was low, was treated, and already feels much better. His diabetes practice nurse requested a copy of the article and has implemented annual screening for all her patients. If you think you might have low vitamin B12, get checked – it could make a big difference to your life!

DIABETES NZ’S NEW WEBSITE DUE TO LAUNCH Our IT guru and volunteer Amar Raman is putting the finishing touches on Diabetes NZ’s new website. Keep an eye on www.diabetes.org.nz for the allnew design and content. There will be new blogs and diabetesrelated articles and some of the Diabetes WELLNESS articles will be reproduced online too. Diabetes NZ is enormously grateful to Amar, who has given many hours of his time to the new project.

DIABETES WELLNESS | Spring 2017

It’s scarily simple Dress Diabolical is a fund-raising, mufti-day event designed to increase the awareness and impact of diabetes. It is a joint venture between The Warehouse, Diabetes New Zealand and our local diabetes branches to help raise vital awareness. Diabetes NZ would love schools and workplaces across New Zealand to get involved in the “fun-raiser” on Friday 27 October, and raise money for a good cause. It’s easy to organise, all you do is encourage children and adults to dress up in appropriately scary outfits and donate a gold coin to diabetes. During last year’s inaugural event, The Warehouse Group sold appropriately outrageous wigs in all their stores and the head office teams dressed in their best diabolical outfits for the day. It donated a proportion

FRIDAY 27 OCTOBER Save the date for Dress Diabolical 2017 and help children and teenagers living with diabetes.

of the price of all wigs sold, raising $2,000 for Diabetes NZ. The Diabetes NZ Auckland branch joined in the action, along with a host of Auckland schools, with participants choosing to dress in a range of attire including their brightest clothes, superhero outfits or their favourite scare suits. We are delighted to announce The Warehouse Group is again partnering with Diabetes New Zealand to make Dress Diabolical

2017 a New Zealand-wide campaign with national and local branch fundraising opportunities, and all the proceeds will go towards youth type 1 projects. Grab your colleagues, family and friends and contact Jo Chapman at Diabetes NZ today. She can help you plan a fun-raising, aware-wolfraising day at home, your child’s kindy/school, or your workplace. It is scarily simple! Contact Jo on jo@diabetes.org.nz

There are still opportunities for our members to get involved in the review. Your feedback is crucial in determining what Diabetes NZ will look like going forward, so we encourage you to participate in this process. We encourage all branches to have representation at the workshops, which will also be open to all interested members. You are also invited to make written submissions. These will need to be received by 30 September 2017. More information and a submission template are

available on our website: www.diabetes.org.nz

WHERE TO NEXT? Destination Unity was the name given to the restructuring of Diabetes New Zealand when its independent local diabetes societies became incorporated into one national ‘unified’ organisation. A review of Destination Unity is now fully under way with a steering group established and an independent facilitator appointed. During July surveys were collected and these are now being reviewed and that data will inform regional workshops scheduled for August and September.

diabetes

Additional workshops to new zealand discuss the outcomes of the review are scheduled to take place at this year’s AGM/ Conference in Wellington at the end of October. The final report is due at the end of November. Queries regarding this review can be directed to Karen Reed at Diabetes NZ Rotorua Branch in the first instance. Email: karen@diabetesnzrotorua.org.nz

SAVE THE DATE: Diabetes New Zealand’s AGM/Conference 28-29 October 2017, Copthorne Hotel, Wellington ENHANCING, IMPROVING, CONNECTING: Guest speakers, workshops on youth, lifestyle and branch business and conference dinner. For details go to www.diabetes.org.nz, see you there!

DIABETES WELLNESS | Spring 2017

Cover

T1DEYS

NO LIMITS

Young people across New Zealand are pushing the boundaries, doing what they love and not letting diabetes hold them back. Here, Caroline Wood talks to surf lifesaver Ben Cross, while overleaf Niamh O’Sullivan reveals her T1D journey.

DIABETES WELLNESS | Spring 2017

en Cross lives for the ocean, having grown up next to the sea in Hawke’s Bay. He is a volunteer lifeguard at his local beach and has been competing in surf lifesaving competitions since he was 11 years old, winning medals nationally and internationally. The builder and carpenter qualified as a surf lifesaver at 14. Three years later he was diagnosed with type 1 diabetes but that hasn’t stopped him doing what he loves, which includes competing in the highly physical world of competitive surf lifesaving. Ben, 28, travels across the country in summer taking part in surf lifesaving competitions. When he’s not competing you will find him out on the water most weekends helping keep people safe at his Waimarama Beach home.

“Ben is a wonderful inspiration in a quiet way,” says his diabetes specialist Dr Janet Titchener, of GPSI Diabetes, Hawke’s Bay. “I’ve been helping Ben manage his diabetes for a number of years and what has always impressed me is how little he seems to have allowed the diabetes to interfere with his life. “Even to this day, I don’t imagine that any of his surf lifesaving team mates have any idea just how big a diagnosis Ben received when he was 17 – and clearly having diabetes hasn’t been detrimental to Ben’s ability to perform.” Ben competes for Waimarama Surf Lifesaving Club in two disciplines: the four-person surf canoe race, where a team of four heads out through the surf to a buoy and back. And the racing IRBs, when he and team mate

PHOTO: JAMIE TROUGHTON, DSCRIBE MEDIA

Ben Cross, left, with IRB team mate Michael Harman.

JOURN

Michael Harman start on the beach, run down to grab an IRB (inflatable rescue boat), get it in the water, race beyond the surf to pick up a patient and bring them back in. He has travelled to two world surf lifesaving championships, representing his club in IRB events. He won a silver medal in Egypt in 2010 for the tube rescue event and scooped silver in Adelaide in 2012, in the single rescue event. Ben also competes around New Zealand and recently medalled in the 2017 nationals. Bens says he’s hoping to go to Adelaide next year for the world champs. When I catch up with Ben, he is quietly spoken and modest about his achievements. He explains how he came to be diagnosed when he was a teenager after noticing he had a very dry mouth, was thirsty and going to the toilet all the time. He was on tour playing rugby at the time. A couple of days later he saw his GP, who ordered blood tests. Ben says the GP didn’t mention diabetes, and no-one else in the family has it, so everyone was shocked when, a few hours later, Ben received a call and was told he needed to get to the hospital straight away.

HEALTHY FOOD GUIDE – EXCLUSIVE MEMBER OFFER!

“I didn’t really accept it for a little while,” says Ben. “I found it difficult at the start, it took a while before I grasped everything. “My control is a bit up and down but I’ve had a lot of help from Janet [Dr Titchener] on how to adjust [insulin] for my sport, which involves short but intense periods of exercising.” Ben doesn’t have an insulin pump, he says it’s too hard to wear one with a wetsuit and while in the water. Ben loves competitive sports, surfing, and is about to start training in endurance waka. In the winter he trains for surf life saving and plays netball. “Sport is a big part of my life. If I couldn’t do that, it would be tough. Having other people supporting me really helped, especially my mum, dad and Janet.” When asked for his advice for other young people diagnosed in their teens he says: “It was definitely pretty hard at the start but you don’t have to change too much. You can still do what you love, you just need to keep on top of things and be a bit more careful.”

Diabetes New Zealand has teamed up with our friends at Healthy Food Guide to offer a special discounted rate to access their huge treasure trove of diabetesfriendly recipes and expert advice. The popular magazine’s digital platform www.healthyfood.co.nz has thousands of fast, fresh and healthy recipes, including a special diabetes friendly recipe section, plus lots of expert nutritional and healthrelated advice. This content is being constantly added to every week. Our members can take advantage of an exclusive offer to access all of this info, advice and recipes for just $15 per year instead of the usual $23.40 – that’s only $1.25 a month. The recipes are suitable for people with diabetes, prediabetes, or anyone wanting to make healthier food choices. The team at Healthy Food Guide will also donate a proportion of your subscription to Diabetes NZ to help with our vital work.

• Go to www.healthyfood.co.nz • Click on SUBSCRIBE in the top right • Select the Digital option – then tick the yearly option (showing as $23.40) • Fill in your details and enter DNZ17 when asked for your PROMOTION CODE (this code will change the price to $15)

Diabetes is not a barrier to me, see overleaf >>

Ben Cross (left) celebrates another win at the IRB nationals last year.

PHOTO: JAMIE NILSSON

This offer is only available to Diabetes NZ members. Not a member? Sign up today at www.diabetes.org.nz

Cover

T1DEYS

In August, paediatric dietitian Niamh O’Sullivan will take part in the Rose of Tralee International Festival, which is held in Ireland, where she will likely be the first person in the competition to wear an insulin pump!

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LIVING A BIGGER LIFE Earlier this year Diabetes NZ member Niamh O’Sullivan, 27, from New Plymouth scooped the New Zealand Rose of Tralee title. Here she explains her T1D journey.

DIABETES WELLNESS | Spring 2017

y name is Niamh and I’m not letting diabetes put a limit on what I can achieve with my life. I have lived in four different countries in the past six years, including Ireland where I’m from. I now call New Zealand home. My attitude towards living with diabetes is – if they tell me it will be hard or I can’t do it, I’ll prove to them that I can! Life can try its best to keep throwing me challenges to overcome, most recently my diagnosis of coeliac disease, but I refuse to make myself small to fit into the box of a “type 1 diabetic”. I intend on living a much bigger life. I’m from Cork in Ireland and was diagnosed with diabetes while studying nutritional science in Ireland just before my 21st birthday. I feel lucky because the whole experience focused me on my career, plus I could be my own

diabetes dietitian. Then I moved with my partner to New Zealand where he is from. I was paving my way to becoming a diabetes dietitian but that life goal has had a big setback. It’s very hard to find work as a dietitian in Taranaki, let alone as a specialist because there aren’t any diabetes dietitians in Taranaki, which is a real shame. I have had this discussion with numerous people and I’m hoping funding will be put towards a new diabetes post in the near future. MY DIAGNOSIS

When I was diagnosed it was a total shock to everyone, including myself, which it really shouldn’t have been as I was showing all the classic signs and symptoms. I really think the power of denial is so strong as I was literally sitting in lectures learning about diet, diabetes and symptoms and

While other girls will be asking: “Does my bum look big in this”, I’ll be worrying: “Does my pump look big in this?!” did not put any of mine together. I had a trip to Italy just before I was diagnosed and went to the Coliseum and barely saw much of the beautiful building but saw the bathrooms like three times! Thirsty, like I was stuck in the desert, and so much weight loss. I think I saw the diagnosis as a project, an interesting practical nutrition assignment but I soon learned it wasn’t just for Christmas.

where to go to get help or they are reluctant to change. I think it’s vital to reach this age group and offer them a helping hand to refocus on their own health in this period of flux in their life. Having someone who is your own age, who you can meet in a casual, relaxed setting, either as a group or one-on-one, is key to capturing this age group. I aspire to be this link in the Taranaki community.

FALLING THROUGH CRACKS

HELPING YOUNG T1s

After my diagnosis I was determined to sit my final exams which were a few weeks later, and then I moved to the other side of Ireland on my own to do work experience. After all the craziness died down and I found myself all alone in a new place I really started to feel all the “normal” feelings of loss of freedom, terror for the future and the feeling of drawing the short end of the straw in life. I shut down, stopped talking to most people and wallowed a lot. I’m not really sure what happened to get me out of that hole – possibly supportive friends, possibly time, but I turned things around and started to see life in a different way. It’s given me a thrill for life and a will to experience everything I can and to the fullest. For a lot of young diabetics, either newly diagnosed or living with diabetes since childhood, I feel that between the ages of 16 and 30 years, you can easily fall through the cracks. They decide to go to uni or go travelling or start a family and suddenly their diabetes takes a back seat to other important life events. Some people struggle on without any support as they feel they should know it all and are embarrassed to seek support, or they don’t know

I have had planning meetings with Diabetes Youth Taranaki, part of the Taranaki Diabetes Societies Network and the Diabetes NZ Taranaki Area Branch and they are supportive. I would like to start a 16 to 30 years group that would act as a social support network. A group that can support people whatever their needs may be – venting, getting help with education or medical support, being around other people who inject/have a pump – whatever it may be. Entering the Rose of Tralee, I hope to be an advocate for the type 1 diabetes community around the world. I will be (as far as I’m aware) the first woman to be involved in the 10-day festival wearing an insulin pump, something I’m very proud of. While other girls will be asking: “Does my bum look big in this”, I’ll be worrying: “Does my pump look big in this?!” By taking part in the Rose of Tralee, I hope to pave the way for other young women who are living day-today with the added pressure of managing blood sugars, pumps, blood meters and all the other fun stuff that is part of the package!

The Rose of Tralee International Festival takes place in August 2017 and is one of the largest events in Ireland. The young winner will be expected to be a global ambassador for Irish culture. The 64 international finalists also do a lot of promotional and charity work in their own countries. Going beyond type 1 >>

DIABETES WELLNESS | Spring 2017

Going beyond

T1DEYS

JOURN

HOW DO YOU LIVE

BEYOND TYPE 1?

These eight amazing men, women and children from across New Zealand share their stories of how they are going beyond T1 and living life to the full.

Emilia Lo Iacono, 1, Wellington My mum and dad think I am an absolute warrior princess, and I think they’re right! I have been through quite a lot in the last two months. One day when I was eleven months old, I woke up feeling absolutely rubbish. Luckily for me, mum and dad didn’t muck around, but when I was admitted to hospital, I was one very sick little girl, and it scared the living daylights out of my mum and dad. We have had some hairy moments but for the most part, I laugh, play, giggle. I have just started to walk so am feeling pretty proud of myself about that. Mum and dad tell me all the time that type 1 diabetes won’t hold me back.

DIABETES WELLNESS | Spring 2017

Ruby McGill, 32, Wellington When I was first diagnosed I thought I was the only child with diabetes in New Zealand. By connecting with other type 1s and their supporters I’ve realised we’re everywhere and we are smashing it! Two years ago, suffering from diabetes burnout I began blogging about my journey living with type 1 and joined the T1D online community. It’s incredible to be able to share when you’re having a tough diabetes day online, connect with type 1 warriors who are in the same boat and share tips and tricks to make living with diabetes a little bit easier.

Hoani Fuimaono, 51, Wellington After finding out I had type 1 diabetes, I was in denial, feeling sorry for myself, not listening to others. I was letting T1D control me. One day as I was holding my grandson I knew I wanted to watch him grow into a man. Now I walk, exercise, eat healthy, and enjoy every day as if it were a new day. Everything I do, I own with positivity and enjoyment. I enjoy my work more than ever, I exercise and thrive, with the eagerness and strong attitude to get out there and do it. I’m inspiring others to do the same. No excuses, No regrets. Join me in the journey, #Hikoi4Health. T1D is my fuel to live healthier, stronger and to never give up.

Samantha Northcott, 25, Napier By letting T1D aid my lifestyle rather then preventing it. Getting diagnosed has allowed me to fully understand my holistic nutrition studies by living with the illness and experiencing first hand how food affects our bodies. Diabetes has aided my nutritional studies by allowing me to help others with T1D and other health problems and be relatable to my clients. Having T1D has also allowed me to finally be happy and allow the true me to come out and shine.

Sascha Oldehaver, 8, Auckland By having fun no matter what! I can do anything just like anyone else – I have fun by playing with my friends, learning kenpo and playing netball at school. It’s a lot easier for me to be happy and have fun living with diabetes. I get to go and have sleepovers and play dates too. I even got a giant cookie for having diabetes for five years!

Bela McMillan, 11, Wellington I know that, even though I have diabetes, I can do anything I want to. I have big dreams for when I’m older, I want to become a famous movie director! I know that I can be a bit of a handful when I’m not in the mood, but it’s not easy having T1D, as you all know. I use hanging out with my friends, Harry Potter, and going on adventures to get through the struggles. My name is Bela (a.k.a. Ginny Granger) and this is how I live beyond.

Erin Caswell, 31, Otago Type 1 diabetes doesn’t stop me living my life and doing the things I love. I manage and control my diabetes, not the other way round. In doing so I am able to do my job as a large animal veterinarian, hike up mountains, travel the world and a year ago completed a dream of hiking the Inca trail in Peru to see Machu Picchu. My name is Erin and diabetes doesn’t stop me living my life beyond.

Ricky Winikerei, 37, Cambridge I grew up around sport and music. This was my norm. I was very active the majority of my life and sport and music went hand-in-hand. Making reps sides was the pinnacle of my sporting achievements. Growing up with family members in bands, playing instruments, singing and performing were in my blood, as was the risk of developing diabetes. Being diagnosed at a young age was scary and being told I had T1D was heart breaking. Initially my world was turned upside down. I thought my career as a musician was over. That lasted all of a week, I realised that my need to live, perform, sing and entertain was greater than the fear of living with my new best mate T1D.

Beyond Type 1 uses the power of social media to challenge popular misconceptions about what it means to live with type 1 diabetes. Diabetes NZ recently took over its global social media accounts, which have a following of over 890,000, to show the world how T1Ds in New Zealand live beyond their diagnosis.

CONNECT TODAY www.beyondtype1.org

DIABETES WELLNESS | Spring 2017

Diabetes on my mind

You can banish anxiety and depression by changing your diet, says Rachel Kelly, mental health ambassador and author of the Happy Kitchen.

Beating the

Blues Did you know your gut is responsible for producing about 90% of your serotonin, the chemical that makes you feel good?

Rachel (left) and Alison spent many hours testing recipes and researching the science behind the foods they chose.

DIABETES WELLNESS | Spring 2017

achel Kelly is in the middle of a whirlwind book tour of New Zealand and Australia when we talk. The former Times journalist has written several acclaimed books and is an official ambassador for the UK mental health charity SANE. She lives in West London, has a successful business, her own website, publicist and assistants. She is the epitome of success in a busy, fast-changing media world. But, as she is quick to point out, her life hasn’t always been like this. Rachel’s first depressive episode was in 1997 and it lasted for six months. She says she shut out well-meaning advice and didn’t want to know anything about depression or change anything in her life. She recovered only to hit rock bottom six years later in 2003. “I was really ill for two years. I didn’t do the school run for two years. That was the worst of it. The following 10 years were bumpy getting well again.” At first Rachel took the traditional route back to good mental health, anti-depressants and therapy sessions, and they helped. But after another bout of depression in 2011, Rachel began a journey that would lead her to discover what she believes is a third, more holistic, way to stay well. Rachel changed her diet and food became her happy medicine. “No-one I had ever spoken to had talked about nutrition before. One day I saw a doctor about

anxiety and she said ‘what about happy food?’ and suggested oily fish with omega-3. That was the start of it, coming from a GP it gave me permission to go and find out more.” Rachel consulted nutritionist and food doctor Alice Macintosh, who encouraged her to make some changes in her diet. She was amazed to find that even small steps worked and she started to have more energy, feel calmer and sleep better. Changing what she ate, choosing fresh, nutritious food and dumping low mood foods (see p18), helped her feel in control and she was surprised how quickly changing her diet made a difference. Determined to find out more Rachel read over 140 scientific studies about nutrition, gut health and mood. What she found out inspired her to write a book with Alice and together they developed and tested 70 evidence-based recipes that target particular symptoms of depression, from insomnia and mood swings to stress and exhaustion. When you are feeling fragile, it can be hard to overhaul your diet but, as Rachel has learned, even small steps can bring positive change. “Food can be your friend, it can be medicinal, and it can make a difference,” she says. “People can change their gut health in five to six days. It’s about giving people hope and allowing them to take back control. When

the book came out, people were saying ‘Wow I can’t believe there are very simple things that I can do, and they make a difference really quickly’. “Our message is something that’s very encouraging, we’re not demonising things. Psychologically, being able to be your own food ‘detective’, is a really positive message, it can bring hope that you can take charge, help heal yourself.” If people feel anxious or depressed, it can make it harder for them to exercise and more likely to eat sugary food, which depresses their mood and the cycle continues, says Rachel. She suggests trying to take small steps, even if you are feeling fragile. For example, try to increase the variety of foods you are eating and choose fresh, mood-boosting foods (see p16). Colour is also important because you also ‘eat’ with your eyes. Grey doesn’t lift the spirits in the same way. Never a big fan of cooking, Rachel recalls the thrill of making her first spelt and spinach crepes, which are pictured on this page and featured in The Happy Kitchen. Co-author Alice made the traditional pancake recipe healthier, adding iron-rich green spinach, spelt for energy, omegarich smoked salmon, avocado and slices of lemon. Rachel hopes her book will encourage people to change the way they look at food, to see it as a wonderful bounty that can be on their side, and not the enemy.

Check out recipes from The Happy Kitchen overleaf

The Happy Kitchen tells of Rachel’s personal struggle with depression and how she manages her illness through nutrition and diet. It is a beautiful book with a strong scientific premise. *The Happy Kitchen by Rachel Kelly is published by Simon & Schuster. Available from all good bookshops, RRP $39.99 DIABETES WELLNESS | Spring 2017

GOOD MOOD FOOD

BLISSFUL BERRY SMOOTHIE

DIETITIAN’S TIP

Make this smoothie serve 2 if trying to maintain or lose weight

I find this smoothie boosts my concentration, perhaps because it keeps me hydrated. Don’t be deterred by the brown colour – this is due to the mix of purple and green. Though not easy on the eye, this smoothie can do much to ease the mind. SERVES 1

½ banana Large handful of blueberries (can be frozen) Large handful of kale, thick stalks removed ½ avocado 6 almonds, or 1 teaspoon almond butter 200ml unsweetened almond milk (use less or more depending on desired consistency) 1 teaspoon goji berries Pop all the ingredients into a food processor and blend until smooth. This is best enjoyed right away, but it can be kept in the fridge for up to a day as an easy snack or breakfast.

DIABETES WELLNESS | Spring 2017

OMEGA-3 KEDGEREE This traditional Indian dish of fish and rice became popular in England in the Victorian era, when British colonials returned home and started having it for breakfast. Our version works at all times of day, and is filled with omega-3 fats, zinc and B vitamins. My mother said that this was one of the best kedgerees she’d ever had, and she’s eaten a good number. This kedgeree can be reheated a day later, and served for breakfast: those Victorians were on to something. It’s useful on those dark days when I don’t feel like eating or cooking first thing, but know it will help me feel more cheerful if I do. There’s something comforting about serving this DIETITIAN’S TIP dish in an individual bowl, which If watching your you can cradle. weight, cut the portion SERVES 4 size and add salad or vegetables.

4 eggs 100ml semi-skimmed milk 2 bay leaves 3 mackerel or salmon fillets 300g long-grain brown rice 2 tablespoons olive oil 1 large onion, finely diced 2 garlic cloves, finely sliced 1 teaspoon ground coriander 1 teaspoon ground cumin 1 teaspoon ground turmeric (or fresh if you can get it, peeled and chopped) 2 heaped tablespoons curry powder, or to taste 1 red chilli, deseeded and finely sliced 4 tomatoes, deseeded and chopped Juice of 1 lime 4 tablespoons Greek yoghurt Large handful of fresh coriander, chopped Large handful of fresh parsley, chopped

Boil the eggs for 10 minutes, then run them under cold water to stop them cooking. Leave them to one side. Put the milk, bay leaves and fish fillets in a pan and add enough water to cover the fish. Bring to the boil, and then reduce to a simmer for roughly 5 minutes. Remove the pan from the heat and leave it to one side. Cook the rice according to the packet instructions, drain it, rinse it in cold water, and then drain it again. Leave it in the fridge until it is needed. Meanwhile, heat the olive oil in a large pan and add the onion, garlic, coriander, cumin, turmeric, curry powder and chilli.

Leave the mixture to soften for about 10 minutes on a low heat, adding a little water to the pan to keep the temperature low. Stir occasionally to make sure it doesn’t burn. Then add the tomatoes and lime juice and simmer for 5 minutes. Flake the fish into the pan; quarter the eggs and add these and the rice, too, and gently heat everything through. Serve each portion with a dollop of Greek yoghurt, a generous sprinkle of coriander and parsley and freshly ground black pepper: this may help you absorb the curcumin, the bright yellow chemical in the turmeric.

Food is my medicine, see overleaf

Recipes extracted with permission from The Happy Kitchen by Rachel Kelly, Simon & Schuster, RRP $39.99

DIABETES WELLNESS | Spring 2017

Research

FOOD IS MY MEDICINE The notion of diet as treatment for mental illness is being examined around the world. Earlier this year, Melbourne’s Deakin University published a world-first trial, which showed that improving your diet could treat major depression. Director of Deakin’s Food and Mood Centre Professor Felice Jacka said the results of her team’s new study offered a possible new treatment approach to depression, one of the world’s most prevalent and costly medical disorders. “We’ve known for some time that there is a clear association between the quality of people’s diets and their risk for depression,” Professor Jacka said. “This is the case across countries, cultures and age groups, with healthy diets associated with reduced risk, and unhealthy diets associated with increased risk for depression. “However, this is the first randomised controlled trial to directly test whether improving diet quality can actually treat clinical depression.” In the study, adults with major depressive disorder were

recruited and randomly assigned to receive either social support, which is known to be helpful for people with depression, or support from a clinical dietitian, over a three-month period. The dietary group received information and assistance to improve the quality of their current diets, with a focus on increasing the consumption of vegetables, fruits, wholegrains, legumes, fish, lean red meats, olive oil and nuts, while reducing their consumption of unhealthy ‘extra’ foods, such as sweets, refined cereals, fried food, fast-food, processed meats and sugary drinks. The results of the study, published in the international journal BMC Medicine, showed that participants in the dietary intervention group had a much greater reduction in their depressive symptoms over the three-month period, compared to those in the social support group. At the end of the trial, a third of those in the dietary support group met criteria for remission of major depression, compared to 8% of those in the social support group.

To read more, see: http://bit.ly/2lPbGGg

DIABETES AND MOOD People with diabetes are at higher risk of developing depression than those without the condition. Rachel Kelly says a third of people who attend her workshops in London have diabetes. “Don’t be ashamed, the problem with depression is that you can’t see it so people somehow think it’s not real. There’s something going on in your head so go and get help because it’s treatable. You can recover and you have got a responsibility to yourself, your family and friends, to get the help.” You can get 24-hour help or talk to a trained counsellor at the Depression Helpline about how you are feeling or to ask a question, see depression.org.nz, call 0800 111 757 or text 4202.

DIABETES WELLNESS | Spring 2017

FAB MOOD FOODS Avocados • Blueberries • Camomile tea • Cavolo nero • Crab meat (brown and white) • Eggs • Flaxseed – in moderation • Goji berries • Green tea • Hempseed (in moderation) • Kale • Kefir • Kimchee • Mackerel • Marmite • Mushrooms • Natural organic yoghurt • Oatcakes • Oats • Pecans • Prawns • Pumpkin seeds – in moderation • Quinoa • Raw cacao powder • Rocket • Saffron • Salmon • Sauerkraut • Spinach • Sweet potato • Tuna • Turmeric • Walnuts (in moderation, i.e. a small handful) • Watercress

LOW MOOD FOODS Canned soups (some are fine but check ingredients carefully) • Cereal bars • Diet drinks • Energy drinks • Food colourings • Low-fat ‘diet’ snacks • Margarine • MSG (and other food additives) • Pasties and sausage rolls • Pastries, sweet baked goods (doughnuts, pains au chocolat, cookies) • Ready meals • Refined white sugar • Sweetened and processed breakfast cereals (Check the ingredients for added sugar and avoid anything processed, choosing whole grains where possible. Some less processed cereals are fine, often fortified and a source of iron and B vitamins) • Sweet fizzy drinks • Takeaways – be careful. There are now some pretty healthy ones, which take care to use fresh ingredients • Wafer-thin ham and similar processed meats Extracted with permission from The Happy Kitchen

The Fitbit family of trackers helps motivate you to get active which can help manage type 1 diabetes and prevent or delay type 2 diabetes. They also track every part of your day including activity, exercise, food, weight and sleep â&#x20AC;&#x201C; to help you find your fit and stay healthy.

fitbit.com

Technology

PHOTO SUPPLIED

MiniMed launch a “world first” The revolutionary new MiniMed

A ‘world first’ hybrid closed-loop system, which is like an artificial pancreas for people with type 1 diabetes, has been launched in the US.

edtronic’s MiniMed 670G system, which self-adjusts blood sugar levels and delivers basal insulin when needed, has been given the go ahead by the US Food and Drug Administration (FDA). Alejandro Galindo, president of the Intensive Insulin Management division within the Diabetes Group at Medtronic, said: “The response from the diabetes community has been tremendously positive and we are proud to be leading this remarkable period in diabetes history in partnership with the clinical and advocacy communities.” “We’ve essentially designed a smarter insulin pump that alleviates some of the burden associated with diabetes management, which can be unrelenting and exhausting.”

GRAPHIC SUPPLIED

HOW THE MINIMED WORKS

DIABETES WELLNESS | Spring 2017

The pioneering MiniMed 670G has been well tested. Research published in the Journal of American Medical Association (JAMA) last year showed the device led to less variation in blood sugar levels and fewer episodes of hypoglycemia and hyperglycemia in people with diabetes aged 14 or older. Dr Jennifer Lynn Sherr, assistant professor of endocrinology at the Yale School of Medicine, said: “The MiniMed 670G system has proven to be life-changing for many patients [...] and we are truly excited to be able to introduce it to many more who stand to benefit. “We’ve seen this system positively impact not only patients [...], but also their caregivers who are experiencing a new sense of security. The constant vigilance that this chronic medical condition imposes on both patients and their families is now relaxed and caregivers have a new level of independence and freedom.” Diabetes NZ welcomes the launch of MiniMed, which is being shipped to priority access customers during 2017, but cautions that it will be a while until the pioneering technology reaches New Zealand.

Freestyle Libre launches At the time of writing the highly anticipated FreeStyle Libre was released by Medi’Ray in New Zealand. The FreeStyle Libre provides ‘flash glucose monitoring’ with glucose readings provided by scanning a sensor rather than pricking your finger. Some people wanted one so much they imported them from Europe rather than wait for the New Zealand launch. Many clinicians and patients believe the Freestyle Libre is going to revolutionise the lives of many people with type 1 diabetes. If that’s the case, let’s hope Pharmac will consider subsidising the cost. You can read more about the Freestyle Libre on p12 in our winter 2016 issue.

Pets

DOES MY DOG HAVE DIABETES? Auckland vet Rachel Gebbie explains how to spots the signs of diabetes in your dog or cat.

iabetes is not unique to humans. Our four-legged furry friends also develop the big D. And because they can’t talk and tell us how they’re feeling, or if they were naughty and had a ruffle through the neighbour’s rubbish bin for scraps, there are a whole new set of challenges with management. Both type 1 and type 2 diabetes exist in cats and dogs in New Zealand and it’s reasonably common. With increasing life expectancy in our pets, and also changes to their lifestyles, we seem to be seeing more diabetes. Or perhaps we are just getting better at diagnosing it. A lot of people tend to think that cats and dogs are similar small animals and so they must have similar diseases, right? Wrong! Dogs traditionally get type 1 diabetes (also known as insulindependent diabetes). Type 2 diabetes is rare in dogs. Cats, however, are more likely to develop type 2 diabetes (around 80% of diabetic cats have T2) and type 1 diabetes is rare in our feline friends. Boy, oh boy, do I wish animals could talk sometimes! It would make things so much easier. “Now tell me how you’re feeling today Fluffy? Did you eat a dead rat you found by the bait station in the garage?” “Why yes doc I ate one yesterday, and now I feel mighty poorly.”

QUICK FACT It’s estimated that about 1% of the dog population has diabetes, while the figure for cats is about 1 in every 200 or half a percent.

Things would be so much simpler! But no… as pets can’t talk, veterinarians have to rely on owners to pick up on the warning signs of disease. Once you’re aware of what to look for, these signs shouldn’t be too hard to spot. Diabetes is, in essence, a disease of starvation: without sufficient insulin the tissues of the body are starving for energy, and the signs we see in pets reflect that. The four key things to look for in your pet are: • increased drinking • increased peeing • increased appetite • weight loss. Prompt diagnosis and initiation of insulin therapy are important in animals. If you suspect your pet may have diabetes, please contact your local vet as soon as possible so they can be urgently assessed. I cannot emphasise this strongly enough. Animals with diabetes can be really challenging to manage but they can also be some of the most rewarding. Success depends on many factors,

Kaka has diabetes

notably the dedication of the owners and implementation of a consistent routine of diet, insulin and exercise. Treating a diabetic pet isn’t always cheap, especially if they are difficult to stabilise, but with motivated owners we can get amazing results. Vets are already using the Freestyle Libre (blood glucose meter) in dogs! Dr Rachel Gebbie is the Veterinary Clinical Director of the Veterinary Hospital Group in Auckland and an elected member of the Veterinary Council of New Zealand. Rachel’s special interest areas are in small animal medicine and clinical pathology. Her husband is also a veterinarian and together they have a very pampered, much-loved cat called Indie.

This article is the first of a regular Pets with Diabetes blog that Rachel will be writing for Diabetes NZ’s new website, see www.diabetes.org.nz

DIABETES WELLNESS | Spring 2017

General Election 2017

VOTE DIABETES

With the General Election approaching on 23 September 2017, we approached each party’s health spokesperson with the same question: What specific policies do you have that will help adults and children living with diabetes? Here are their responses.

ACT DAVID SEYMOUR

Diabetes is one of New Zealand’s most pressing health issues. But the answer isn’t to waste money on trendy high profile national health promotion campaigns that don’t work, or pushing ineffective fat and sugar taxes that hurt low income earners and have failed overseas. Instead, ACT advocates spending money on real frontline healthcare professionals and services like pre-diabetes testing, targeted education and lifestyle intervention programmes, and greater treatment choices for patients.

DIABETES WELLNESS | Spring 2017

GREEN PARTY JULIE ANNE GENTER

The current Government’s reduction of diabetes and obesity prevention services has not helped the rising rates of type 2 diabetes. There should be ‘diabetes navigators’ in primary care to work alongside people to manage their diabetes and access the services needed. We would fund primary care services to provide free annual comprehensive checks for people with diabetes, extend Care Plus for more regular doctor’s visits, and Green Prescriptions. We would also properly fund hospitals to keep up with need, rather than having to manage the health cuts delivered by this Government. We specifically would increase provision for ophthalmology, dialysis, transplantation and bariatric surgery.

LABOUR DAVID CLARK

One issue a future Labour Government will confront is adequate funding of Pharmac so, where appropriate, modern diabetes medicines can become readily available. Labour believes in the affordable provision of high quality health care for New Zealanders living with diabetes. In our first 100 days we will plan more spending on health and gradually resolve the huge problem of people not being able to access primary care, including over half a million Kiwis not going to their GP because of cost. If the food industry doesn’t map out and follow a path to sugar reduction, Labour is not afraid to explore a regulatory system. However our priority commitment is to set reduction targets for additional sugars being put into everyday food.

MĀORI PARTY TE URUROA FLAVELL

The Māori Party policies to eliminate diabetes include better access to support, increased funding for bariatric surgery procedures, removing GST off fruit and veges, and investigating an introduction of tax on sugary drinks. The Māori Party also wants to address health inequities and inequalities in the broader health system and to ensure that both Pacific and Māori and low income whānau receive greater access to services that meet their needs as whānau.

NATIONAL JONATHAN COLEMAN

There’s much being done to support children and adults with diabetes: • The Living Well with Diabetes plan continues work already underway and seeks to improve outcomes for people with diabetes. • The Green Prescriptions programme has helped 400,000 people get active and change their diets. • The Government’s Before School Checks programme identifies at-risk children and refers them to health professionals for advice around nutrition, activity and lifestyle. • Our previous heart and diabetes target saw more than one million heart disease and diabetes risk assessments reported. Now our focus is on preventing those at risk from developing diabetes; enabling effective self-management; improving the quality of services; detecting diabetes early; providing integrated care and meeting the needs of children and adults with diabetes.

NEW ZEALAND FIRST RIA BOND

New Zealand First is committed to establishing and implementing a national strategy for addressing diabetes. We believe that early diagnosis and intervention are critical. We would support education programmes to encourage early diagnosis. Kiwis that have been diagnosed need to know that it is possible to live well with diabetes. Helping people manage their diabetes helps to reduce further complications such as cardiovascular disease, obesity, and loss of eyesight, amongst other preventable diseases. We would encourage programmes such as ‘Jumpstart’ – an exercise, nutrition and lifestyle education programme. We would sufficiently fund district health boards to ensure that diabetes care is optimal. To invest now in healthcare for those with diabetes benefits us all, prevents further negative health outcomes, and ultimately saves the health system money.

HAVE YOUR SAY This is what the key political parties have to say about diabetes. Do you think it’s good enough? Diabetes NZ is encouraging its members and their families to attend local hustings and ask candidates about their party’s diabetes policies. Together we can raise awareness and encourage lawmakers to do more for people living with diabetes and at risk of developing it.

THE OPPORTUNITIES PARTY GEOFF SIMMONS

The key to The Opportunities Party (TOP) health policy is prevention*. We know that on current projections one in three Kiwis are at risk of developing diabetes. We urgently need to ensure that this doesn’t happen, as our health system wouldn’t be able to cope with the demand. TOP’s health policy will include an evidence-based plan to improve our diet and prevent this outbreak of diabetes happening. Diet is also important for people already living with diabetes, but so is the rest of the health system. TOP wants to see a shift to greater investment in primary care, so that people can stay healthy in their own communities and avoid expensive trips to hospital. *At the time of writing TOP’s health policies had not been formally released.

UNITED FUTURE PETER DUNNE

UnitedFuture will establish a national register for type 1 diabetes, a diabetes research fund, and increase funding for type 2 diabetes testing. We will also improve access to medical services by encouraging the development of integrated electronic medical records and prescription systems to reduce medical errors, remind patients and physicians about preventative and follow-up care, and facilitate the sharing of integrated records and information across sites of care. We will strive make the lives of those living with diabetes easier, make visits to endocrinologists and other medical professionals as easy as possible and make it easier to get insulin and other important medication.

DIABETES WELLNESS | Spring 2017

Care

TAKE THE TEST

ew Zealand’s National Bowel Screening Programme was launched in July and will be phased in across the country over the next three years, starting with Hutt Valley and Wairarapa District Health Boards. New Zealand has one of the highest rates of colo-rectal (bowel) cancer in the world. It is linked with diet factors and obesity and people with type 2 diabetes have been found to have a higher chance of developing it. Bowel cancer is most commonly diagnosed in older people as the risks increase with age. About 80% of all cases are in the 60–74 years age group. Clinical Director of the National Bowel Screening Programme, Dr Susan Parry, said: “Every year, more than 3000 New Zealanders are diagnosed with bowel cancer and more than 1200 die from it. Regular bowel screening can help save lives by finding bowel cancer at an early stage, when it can often be successfully treated.

cells of the glands in the colon start to grow in an uncontrolled fashion, and tumours develop. If untreated, the cancer will grow into the muscle wall of the colon and can spread to neighbouring organs.

People with type 2 diabetes have a greater risk of developing bowel cancer

RISKS OF DEVELOPING OF BOWEL CANCER

“The roll-out of the National Bowel Screening Programme is a significant health milestone for New Zealand. We are now on the cusp of launching a programme which we know will save lives.” For further information on the National Bowel Screening Programme, including who is eligible and how to do the test, go to bowelscreening.health.govt.nz. WHAT IS BOWEL CANCER?

The colon is the large intestine which is the last part of the digestive system and ends at the rectum. Bowel cancer (also known as colon cancer) occurs when

The risk of developing bowel cancer is increased for people who: • have a related bowel condition such as Crohn’s disease or ulcerative colitis • have a close relative with bowel cancer • smoke • regularly eat processed meats • regularly drink alcohol • are overweight. BOWEL CANCER AND TYPE 2 DIABETES

People with type 2 diabetes have a greater risk of developing bowel cancer although the reasons why are not yet fully understood. A large-scale research study published in 2011 showed that people with type 2 diabetes had a 38% higher risk of developing bowel cancer than people without diabetes.

Order our free Diabetes NZ information pamphlets Go to www.diabetes.org.nz, download the order form and email it to pamphlets@diabetes.org.nz or call us on 0800 342 238 (a handling fee applies)

ALSO AVAILABLE FREE TO HEALTH PROFESSIONALS

DIABETES WELLNESS | Spring 2017

Life

A HISS AND A ROAR Grant Bason, 57, from the Bay of Plenty, tells his story.

couple of years ago I learned through my GP that I have type 2 diabetes. I was feeling listless and lacking in energy but it was a total surprise when the blood tests came back. With a hiss and a roar, as I usually do, I dieted, exercised and controlled my food intake and weight well. But then I had a minor operation that put me off work for four weeks. Over this period, I fell back into bad habits of little exercise and poor eating. I put the weight back on and my blood sugar levels were very high. Last August, I won a Fitbit Charge HR in a Diabetes NZ prize draw – what an awesome surprise! This piece of kit helped me to get back off the couch. Coincidentally, my wife and I had recently purchased a good quality exercycle to help us rehabilitate injuries and winning the Fitbit motivated me to become healthier. It has helped very much in my exercise planning, gives me a digital read out and diary via my iphone and desktop PC. I love seeing the running total over time. On the diet front, I’m trying to change and eat more healthily. There is a lot of information out there about eating healthy: carbs vs no carbs, protein vs no proteins. I have purchased The 8 Week Blood Sugar Diet book and researched recipes and menu

plans via the web. I have found the recipes and meal plans on the Diabetes NZ website to be the easiest to follow. They are less time consuming, more affordable and, considering the modern lifestyle, easier to manage.

Winning a Fitbit motivated me to become healthier. It has helped very much in my exercise planning, gives me a digital read out and diary via my iPhone and desktop PC. I love seeing the running total over time. My work is packing and processing orders in a warehouse, then we load these on to pallets and onto trucks for delivery to our customers. It’s very heavy work and I work the graveyard [night] shift. I wear the Fitbit all the time – it never leaves my wrist. Some days I will do 24,000 steps in a 24-hour period. My previous exercise routine has taken a hit as I now spend a lot of time during daytime hours sleeping. I try to get out on the weekends walking and I have taken up photography. I learned just recently, after annual testing, that my diabetes has progressed and I have had to up my metformin and am now using a blood pressure tablet

to try and limit some damage happening to my liver. We have once again revisited my diet and further restricted it to cut down sugars and carbohydrates, the problem being trying to find menu plans that involve locally available produce. I have just recently been using Te Atatu Toasted healthy muesli, which has been a boon. My diabetes nurse said to me: “If you want to get on top of this thing, you have got to get off the couch and change your diet.” I am trying my best to control my diet, lose weight, and get some more control over my diabetes. It’s a work in progress.

DIABETES WELLNESS | Spring 2017

DIABETES IS THE LEADING CAUSE OF BLINDNESS, AMPUTATION, KIDNEY DISEASE, BLAH, BLAH, BLAH. WEâ&#x20AC;&#x2122;VE HEARD THAT ENOUGH! THE TRUTH: DIABETES IS THE LEADING CAUSE OF COURAGE, SELF-AWARENESS, PERSISTENCE, MATURITY, EMPATHY, APPRECIATION, ENLIGHTENMENT, UNDERSTANDING, COMPASSION, BRAVERY, FORTITUDE, SUBSTANCE, PERSONALITY, DARING, GRIT AND GUTS. TAKE THAT AND FOLD IT UP AND PUT IT IN YOUR POCKET FOR A WHILE. ANON. / THEDIABETICJOURNEY.ORG

Family

We asked our lovely supporters to share some nuggets of wisdom – what did they wish they could have told their 18-year-old self about diabetes?

THINGS I WISH I’D KNOWN AT 18 s

Having high or low blood sugars doe not make you a ‘bad diabetic’.

Diabetes burnout is a thing! Make sure you look after yourself. Work out what you love doing, what picks you up when you’re feeling a bit flat and be sure to do this often . It might be catching up with friends, reading, dancing, playi ng sport, cooking, building things – do whatever floats your boat.

I would tell my 18–year-old self to not sweat the small stuff as you never know what the future will hold. Diabetes does not have to rule your life, be sensible, follow advice, find ways to make things work, remember it’s your life and you have only one chance.

sugar but keeping s that affect your blood ng thi ny ma so are There s so you can make ll help you notice trend wi s ult res ur yo of a record changes to your feel confident making n’t do u yo if T BU s. ge chan asking for their help betes team and keep dia ur yo to k ea sp , on medicati do feel confident. and advice, until you

IF I COULD – what would you have told your 18-year-old self about diabetes? Share your thoughts by email at editor@ diabetes.org.nz or go to Diabetes NZ’s Facebook page and share with us there. We’d love to hear from you!

Look after your stress levels because they will affect your sugars, trust your intuition… you know your body well.

Make your life your d listen to your body. an ff sta al dic me m ber there will be ups Take advice fro ur dream. Just remem yo ing low fol ll sti ile for extra help. responsibility wh t group or go on-line or pp su a n joi o als s, and down Thanks to Ruby McGill, Deb Connor, Joy-Stephen Porritt (via Facebook), Corrina Rayson (via Facebook) and Helen Roberts (via Facebook) for your contributions.

DIABETES WELLNESS | Spring 2017

Advocacy

What inspires young people to start incredible ventures and help others in the diabetes community do the same? Katie Doyle finds out.

NO BARRIERS

oung people all over New Zealand are making their mark on the diabetes community, from writing children’s books to setting up youth groups and pushing their physical limits in extreme sports. “Getting diagnosed with a chronic disease is hard to process,” says Samantha Northcott, founder of the Diabetes Support Group for Young Adults in Hawke’s Bay. “No one knows what it is like unless they have been through it themselves.” Samantha, 25, was diagnosed with type 1 diabetes last year. A sense of acceptance is what she and many others seek from the diabetes community. “Social media is an awesome way to start [getting involved] and there are amazing people on Instagram with type 1 diabetes who are in the same position and want to connect with other people with diabetes,” Samantha says. “Reaching out to others in the community is a great way to get support on those bad days when type 1 diabetes takes control, or when you have a problem that you can’t quite figure out. It’s also a great way to celebrate the achievements of having type 1 diabetes and the good days.” What, exactly, is the diabetes community? Ruby McGill, Diabetes New Zealand’s Director

DIABETES WELLNESS | Spring 2017

of Youth, offers the following definition: “The diabetes community is made up of anyone and everyone that either lives with diabetes, loves a diabetic, or supports diabetics in some way.” No matter how you choose to define it, choosing to get involved can ease the psychological strain of living with diabetes. Ruby, who has had type 1 since she was 14, marked her 18th “diaversary” this year. “I love being part of this tight community,” she says. “I am surrounded by diabetic warriors and their supporters that know exactly what I am going through and everyone is happy to share what works for them.” Maybe you’ve been thinking up an idea or project of your own – is something stopping you from following through with it? Carrie Hetherington, author of Little Lisette, The Diabetic Deep Sea Diver, has found creative ways to channel her passion for helping others. “I’ve written for the International Diabetes Federation (IDF) magazine, the Diabetes NZ magazine (rather a lot!) and I currently guest write for the Diabetes Daily Grind,” she says. Along with representing New Zealand at IDF programmes in Australia and Canada, Carrie was a leader on a few of the kids and teen camps for Diabetes Wellington. She has some words of wisdom for others who want to make a difference:

ONLY WE KNOW WHAT IT IS LIKE LIVING WITH T1D

CARRIE HETHERINGTON: THERE ARE ENDLESS OPPORTUNITIES

“There are endless opportunities so it can take up all your free time if you let it! Make sure you have serious passion if you’re prepared to go that far.” Don’t let your own big ideas deter you from starting out. “Never underestimate the significance of small things,” advises Emily Wilson, who also represented New Zealand

MAKING CONNECTIONS Check out these two websites that are connecting people in the diabetes community to create a world where diabetes is not a barrier to living a full life.

GUA

BEYONDTYPE1.ORG

This US-based not-for-profit shares stories of everyday people who “live beyond” type 1 diabetes with their vast social media network, including Instagram. The Beyond Type 1 app allows users to connect with anyone on a mobile device around the world. Helen Mepham, from Christchurch, is a member of Beyond Type 1’s Bike Beyond team – a group of people with type 1 diabetes who came together to bike across the United States. She says “I found out about Bike Beyond on the Beyond Type 1 Instagram. I love biking and loved using the BT1 community app. It was a such great combination!”

BETACHANGE.ORG STEPHANIE MCKENZIE: WE SHARE OUR STORY WHENEVER POSSIBLE

EMILY WILSON: NEVER UNDERESTIMATE THE SIGNIFICANCE OF SMALL THINGS

as a Young Leader in Diabetes with the International Diabetes Federation. Emily is an outdoor adventurer and sports instructor who lives in Wanaka. She paddled the circumference of Lake Wanaka to mark last year’s World Diabetes Day. “We all want to make a large impact and see progress fast but sometimes it’s the small,

GUP

The Beta Change mission aims to bring the diabetes community together through new channels like Beta Change minisodes and virtual roundtables: live broadcasts where people from all corners of the diabetes world discuss relevant issues and brainstorm ideas to make living with diabetes a little bit better. In addition to working with organisations like Diabetes NZ, this article’s writer Katie Doyle produces the live broadcasts and creates other content for Beta Change.

seemingly minor things we do for others that make a lasting impression”, she adds. Other advocates use sport as a channel to reach the diabetes community. New Zealand cyclist Stephanie McKenzie was diagnosed at age eight and is now a Team Novo Nordisk representative. “[Team Novo Nordisk] is a global all diabetes sports team with runners, triathletes, cyclists and spearheaded by the first all diabetes pro cycling team. We share our story whenever possible, and show those living with diabetes what may be possible.” No matter what, your voice matters! Decide how you want to engage with the diabetes community – in a way that’s right for you.

GET IN TOUCH Join Diabetes NZ to find out about local youth groups, camps and other support services designed for ages 1-30 years. Different membership options are listed on www.diabetes.org.nz

Contact your local Diabetes NZ branch and come along to its youth events being held around the country.

Like us! Follow Diabetes NZ on social media and be sure to share your thoughts and feedback. G facebook.com/diabetesnz U twitter.com/diabetes_nz

If you want to advocate for youth in your area or find out more about what Diabetes NZ is doing for young people with diabetes, contact Ruby McGill at ruby@diabetes.org.nz

DIABETES WELLNESS | Spring 2017

Dig

Growing super foods

‘S

Rachel Knight recommends some simply super crops to sow and plant this spring.

uperfood’ has no legal or medical definition. It’s a term often used by marketers to promote foods that have health benefits. Fortunately, we don’t have to spend a fortune or go very far to find health-promoting foods, you can grow many of them in your own garden and they will taste fresher and sweeter than shopbought veges and fruit. Spring is here and is a wonderful time to get out into the fresh air, and be active, while growing super foods on your own doorstep. The pleasure of popping out into the

garden to grab a few handfuls of spinach, fresh spring peas, and home-grown strawberries is good for the soul, as well as the wallet. Any plant-based food can be regarded as ‘super’ as they all contain antioxidants and other plant-based phytonutrients that reduce many health risks, including cancer, type 2 diabetes, heart attack and stroke. Choosing fruits and vegetables with a particularly high antioxidant content offers the greatest health benefits.

SEVEN SIMPLY SUPER CROPS Beans – make your own baked broad beans, include baby beans raw in a lunch box or freeze the glut of runner beans for winter. Home grown edamame (soy beans) anyone? Beetroot – not just round nor red. Mini beets for roasting, orange beets if you don’t want to turn everything red, cylindrical beetroot for even slicing. And you can use the leaves in a salad or a smoothie. Chives – year-round onion flavour from your garden or a pot on your windowsill. Add a snip of freshness to soups, sandwiches and salads. Pick the flowers for a purple garnish.

DIABETES WELLNESS | Spring 2017

Pak choi – smaller, easier and quicker to grow than its bigger brassica cousins like cabbage, broccoli and cauliflower, but just as healthy. Perfect for pots. Pumpkin – ugly or smooth on the outside but wearing its own grown-to-fit storage skin to keep all that golden goodness fresh through winter. Soups, stews, cakes or pies can all stand some orangey pumpkin sweetness. Spinach – dark leafy greens to eat raw or cooked. Sow somewhere shady in summer time.

A diet high in fruit, vegetables and wholegrains and low in meat will deliver a range of health benefits. Seeking out a single ‘superfood’ may turn out to be an expensive and ultimately unsuccessful strategy, whereas incorporating a range of local produce at every meal is an achievable, affordable and sustainable road to health. Strawberries – plant in spring and divide off ‘runners’ in autumn to expand your strawberry patch. Cover with mesh to keep off the birds, although humans can prove to be the biggest predators.

Including a wide variety of produce (fruits, roots, legumes, grains and leaves) maximises the nutritional content of our diet. And selecting a rainbow of colours (white through yellow, orange, red, purple, black and dark green) satisfies our palate and makes for a pretty plateful. Many of these foods are relatively simple to grow at home. It’s best to include them in every meal so having a plentiful, fresh supply, readily to hand makes this cheaper and easier. It’s worth growing just a few salad leaves and some herbs in a container close to your kitchen door so you don’t have to walk far to harvest them.

If you or your family aren’t keen on the taste or texture of vegetables, then pureeing them into food offers the same benefits without the drama! Try adding a layer of spinach in your lasagne, mashing pumpkin and potato together or grating beetroot into a chocolate brownie. Strawberries and other berries are packed full of nutrients and are easy to grow in a home garden. Fruits such as plums, pears and apples have some of the highest levels of antioxidants, as well as being inexpensive and readily available. Add a sprinkling of cinnamon and cloves and you can further enhance their effect.

SUPERFOOD PROMISES

People who eat a diet rich in fruits and vegetables with a full spectrum of healthprotective antioxidants and phytochemicals have a lower incidence of disease. Antioxidants are molecules found naturally in some foods that combat oxidation, help prevent damage to cells from free radicals and have beneficial health effects. Phytochemicals are natural chemicals derived from plants. Many have health-protective or disease-preventive characteristics.

The 2018 Organic Gardener’s Year calendar Organic Edible Garden has dug deep and is donating $2 from every purchase of their 2018 Organic Gardener’s Year calendar to Diabetes New Zealand. This beautiful calendar is packed full of gardening ideas along with seasonal advice and makes for the perfect gift or to take pride of place on your own wall at home. Purchase one for $20 today and know that you’re helping to make a difference in the lives of all people affected by diabetes.

http://organicediblegarden.co.nz/shop/calendar-2018

DIABETES WELLNESS | Spring 2017

Meal makeover

MAD ABOUT MUFFINS Many people who have just been diagnosed with diabetes wonder if they can still have sweet treats. Here nutrition expert Helen Gibbs gives the nation’s favourite muffin a makeover. My previous meal makeovers have focused on changes that make a recipe healthier for someone with diabetes, but today’s makeover has two parts. The first change is the most important – considering portion size when it comes to making and choosing sweet treats, which are often high in sugar and fat. In recent years, just about everything we eat has been served in larger portions. This includes sweet treats such as muffins, which are now served super-sized along with cakes, scones and slices. So reducing the portion size is a good option. For example, share a sweet treat with a friend in a cafe, or make more, smaller, muffins than the recipe recommends.

The second change I suggest is tweaking your favourite muffin recipes so they contain less saturated fat and sugar. I have done this in my healthier blueberry muffin recipe (right). While this makes them a better choice, a usual portion will still raise blood glucose. Even if served in small portions, these foods should still be considered “occasional” rather than daily snacks. If you are going to whip up a batch of muffins at home, you can make a half or even a quarter recipe if you are like me and struggle to stop eating the treats until they are gone! Muffins and other sweet treats also freeze well, so you don’t need to eat the lot in one go.

ENERGY

PROTEIN

FAT

SATURATED FAT

FIBRE

Typical blueberry muffin (large size)

1972kJ (472kcal)

8.8g

21.3g

12.7g

3.5g

Typical blueberry muffin (regular size)

986kJ (236kcal)

4.4g

10.7g

6.3g

1.7g

Healthier blueberry muffin (regular size)

665kJ (159kcal)

3.4g

7.0g

0.6g

1.7g

Calorie difference between typical and healthier muffin (both regular size)

321kJ (77kcal)

-1g

-2.3g

-5.7g

Do you have a favourite family recipe you would like to know how to make over? Email editor@diabetes.org.nz.

DIABETES WELLNESS | Spring 2017

HEALTHIER BLUEBERRY MUFFINS SERVES 4

25g skimmed milk powder 150ml water 75ml oil 1 egg 75g sugar 1 tsp vanilla 150g blueberries 100g plain flour 100g wholemeal flour 2 tsp baking powder Make up milk from skimmed milk powder and water. Mix oil, eggs, sugar and vanilla then add blueberries. Mix flour, wholemeal flour and baking powder. Very gently stir dry mix into wet mix, with 100ml of milk, then add a small amount of milk more if too dry. Flour should be just barely mixed through. Spoon into 12 regular-sized (105ml volume) muffin tins that have been sprayed with oil. Bake at 180 degrees until cooked – 10–15 minutes. These are best eaten on the day and any left over will freeze well.

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Eat

WHOLEY MOLY Helen Gibbs looks at the importance of whole grains and why we should be eating more of them.

DIABETES WELLNESS | Spring 2017

ou probably already know that you need to eat lots of veges and less fat, salt and sugar. Did you also know that whole grains are an important part of your diet? Most New Zealanders don’t realise this and, as a result, are not eating enough of them. Consuming 45–90g of whole grains per day is thought to have substantial health benefits because they are rich in fibre, vitamins and minerals. Some studies have shown that healthy diets, rich in wholegrain foods, can reduce the risk of heart disease, stroke, certain types of cancer, like bowel, and type 2 diabetes. It’s not fully understood why whole grains are so good for you. They play a part in

maintaining a healthy body weight as part of a healthy diet. The fibre in whole grains helps keep your gut healthy due to the compounds it contains called phytochemicals. Studies also suggest that wholegrain foods may be more filling than their refined counterparts, which may help reduce the urge for snacking between meals. If you have diabetes, eating wholegrain foods can help with managing blood glucose levels because they tend to have a lower glycaemic index (GI). This means they do not affect blood glucose levels as quickly as refined carbohydrate foods. But whole grains are carbohydrates and all carbs affect blood glucose levels, so be mindful of your portion sizes.

A whole grain is any grain, such as wheat, maize, corn, rye, barley, oats, rice or quinoa, either unprocessed or processed (rolled or milled) that contains the three parts of a grain in the same amounts as it came out of the field (see the diagram below). A good example of a 100% wholegrain food is porridge oats, as nothing is added or removed during the milling process. Other examples include wholegrain bread and cereals, brown rice, wholemeal pasta and noodles, and wholegrain couscous. A GRAIN OF WHEAT

83% endosperm – the central part of the grain which is a concentrated source starch that makes up white flour

10% bran – the fibre or roughage which contains phytochemicals and B vitamins

Achieving 45–90g per day might seem a challenge, but it can be done by selecting wholegrain rich foods as often as possible druing the day. Here are some great examples with their wholegrain content in brackets: • 45g oats (45g) • 2 Weetbix (36g) • 2 slices heavy grain bread (20g) • 4 wholegrain crackers (16.5g) • 35g brown rice (35g) • 70g wholegrain pasta (70g) Making the transition to a healthy wholegrain diet can be a bit of a challenge, but it is worth working on increasing your intake of wholegrain foods where possible. One low-cost way to achieve this would be to change your breakfast cereals to porridge and Weetbix, and using these nutritious foods for an after school or bedtime snack. Try using wholemeal flour for baking. Start by substituting half the white flour with wholemeal. Other ways to eat more whole grains include swapping white bread for whole grain, white pasta for wholemeal pasta, white rice for brown rice, and couscous for wholemeal couscous or bulgur wheat. ARE THERE GLUTEN-FREE WHOLEGRAINS?

7% germ – the nutrient store for the new plant once it sprouts. It contains a concentrated source of protein, healthy fats, B vitamins and vitamin E.

LOW

HOW MUCH?

Yes, there are plenty of gluten-free wholegrains that you can enjoy such as brown rice, quinoa, millet, sorghum, and buckwheat.

CALORIE SWEETENER Measures spoon-for- spoon like sugar Perfect to use in your favourite food or drink recipes. Add a delicious, sweet taste with fewer calories.

WHAT IS A WHOLEGRAIN?

WHAT’S THE DIFFERENCE BETWEEN WHOLEMEAL, WHOLEWHEAT AND WHOLEGRAIN BREAD?

These are different descriptions of the same thing and are all whole grain.

For delicious recipes, visit

club

.co.nz

Move

Craig Wise goes in search of ways to be active and have fun as a family.

FAMILY FITNESS

s a self-employed father and husband in an increasingly busy world, I know all too well how easy it is to slip into a habit of hanging out as a family in front of the television, the computer, or just sitting in separate rooms staring at our phones. Exercising as a family doesn’t have to mean running laps or lifting weights, which requires us to set aside blocks of time. If you think about it as leading an active lifestyle with your children, you may be surprised how much activity you can fit in an average week. As a bonus, exercise with family does double duty as quality time – all the more important as we try to squeeze work, family and social duties into our working weeks. As the weather begins to improve with sunny days on the horizon, try setting aside some time for family exercise. The simplest and cheapest activity is to get out into nature and go for a walk. Luckily it’s easy for us here in New Zealand with so many beautiful places to walk, most of which are easily accessible. Exercising outdoors can be done for free unlike costly family trips to the cinema. It gives you time to talk and find out what is going on in your children’s

DIABETES WELLNESS | Spring 2017

lives. If you don’t have time for a walk, then a trip to the local park or gardens can be just as good. The park also provides space for more vigorous activities, such as football, playing on play equipment (essential for building strength) or just running around. For something more structured try looking for family-friendly classes or sports, for example zumba (great fun as a family) or ballroom dancing (a skill you are never too old to learn). If the weather isn’t good, a trip to the local swimming pool or trampoline park will be popular with the kids. Local centres, such as the YMCA, have family programmes which are reasonably priced. There are always sports available, such as rugby, netball, basketball, volleyball or soccer, through your children’s school or local sports clubs. At primary and intermediate age these games are played for fun and to develop team skills. If you encourage your children to take up an activity when they’re young, they’re more likely to learn to love a sport or active hobby and continue that into their teenage and adult years – what a great gift of future health to give them. We are the biggest inspiration for our children and if we set a

good example they will follow. There is no need to be a star netballer or record-breaking marathon runner but just by being active we can encourage that desire in those we inspire. Our family recently went along to the local Brazilian ju-jitsu academy as they offered an hour introduction to let people have a look at what they teach. Martial arts are very popular for a number of reasons and can be taken by both children and adults of all ages (don’t feel shy!). While all the family may not necessarily be in the same class, it gives a common element outside of the home to bring the family closer together. Martial arts can also be good for encouraging selfdiscipline and self-confidence. You may not find the activity which your children enjoy first time. If they don’t like a certain activity, it’s not the end of the world. Don’t force your children into rugby or swimming just because it’s something which you like, instead take time to find an activity that they really enjoy. You’ll be setting a great example that will show them from a young age how important (and easy) it is to make fitness part of their daily routine. Plus you will be building memories and habits that will last a lifetime.

FIVE WAYS TO...

exercise as a family

VIDEO FUN. Have your family create their own exercise video where your children are the stars. Everyone will get fitter creating the videos, and at a future time, have fun exercising along with the video over and over again. There will be hours of guaranteed laughter to go with this activity.

FIND A WAY TO GIVE. There are a number of charity exerciserelated events on throughout the year, eg. fun runs or walks. These are a great way to be active, bond as a family and help a worthy cause. The challenge of training for the event can be fun too.

COMMERCIAL BREAKOUTS. Have a family boot camp during the day. For example, whenever a commercial break comes on the TV, exercise as a family. Try running in place, push-ups, or jumping jacks during each commercial to keep everyone up and moving. Or try the commercial break routine from our previous issue.

HAVE A WEEKLY DANCE NIGHT. Just dance! Turn on the radio or stream some fun songs on your phone or tablet and spend time grooving together as a family. Jump around, do a shimmy, shake your limbs and let the giggles come freely. With minimal effort, you can burn some calories and have a super-fun, spirit-lifting family time.

SHAKE IT UP. Take it in turn each week to decide on a physical activity for the family. This ensures that nobody gets bored with the activities and everyone gets an opportunity to do something they enjoy.

DIABETES WELLNESS | Spring 2017

Ruby’s world

Ruby McGill realises she needs to go back to basics as she juggles a new job with a growing family.

ROOKIE MISTAKES

ou’d think after 18 years of living with type 1 diabetes I’d have mastered it. I’m afraid not. I’ve been caught out a lot lately, forgetting some of the real basics and, if I’m truly honest, I should know better. We all make mistakes and most of the time there are no major consequences. However when the little mistakes are related to diabetes, and they’re frequent, the results can be disastrous. It all started when my diabetes team realised I wasn’t changing my insulin pump site every three days. I knew I should be changing the site frequently to prevent infection and ensure the insulin is fresh. I’d done this properly in the past but somehow I’d fallen into a bad habit of only changing my pump site when the insulin was almost empty. I’m not sure how I’d overlooked this one. During the school holidays I packed Miss 6 and our little man into the car and set off to the river for a walk, some sunshine and fresh air. As we pulled into the park my blood sugars plummeted. I’d spent all morning

getting everyone else ready, I’d forgotten to pack food to treat any hypos. Luckily I found the world’s smallest juice box at the bottom of my bag. Unfortunately this meant I had to cut our walk short. I couldn’t risk my blood sugars dropping further, with two children in tow and no way to treat a hypo. What an amateur. One of the benefits of using an insulin pump is the built-in alarms that keep things ticking along smoothly. Recently, late one evening, it alarmed and said the battery was low. No big deal, I normally replace the battery every three to four weeks so reached for my stash of batteries in my diabetes case. It was empty...you can imaging my reaction! The final straw was when I went to change my insulin pump site and discovered I only had 30 mls of insulin in the fridge. I would need at least 170 mls to fill the cartridge inside my pump. What an absolute rookie mistake. How had I missed this? It’s no surprise that after the arrival of baby No. 2 and recently returning to work, life is pretty

busy at the moment. Some might even say chaotic. Perhaps that explains why I was making such silly mistakes. Whatever the reason, I had to get focused and create a plan to make managing my diabetes a little easier. I started by restocking everything. I ordered more insulin, test strips, ketone strips and lancets. I bought juice boxes, jelly beans, dates and two AA Lithium batteries (they’re not cheap). I was off to a good start but to ensure I didn’t fall into bad habits, I had to put a few systems in place. I set a reminder on my phone to replace my insulin pump site every three days. When I use an item (batteries, insulin, test strips, juice boxes), I replace it! As the last line of defence at the end of the month I’ll do a quick stock-take of my supplies and order anything that is getting low. With a few minor tweaks and new processes I should never get caught out again! Well that’s how it should work in theory. It’s worth a try.

You can follow Ruby’s journey to master diabetes at www.masteringdiabatesnz.com

DIABETES WELLNESS | Spring 2017

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Introducing the FreeStyle Libre flash glucose monitoring system. A painless, 1-second scan tells you: • Your current glucose reading • Your 8-hour glucose history • If your glucose is going up, down or changing slowly The reader even scans through clothing.†

Why prick, when you can scan?‡

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Find out more at FreeStyleLibre.co.nz

*Scanning the sensor does not require lancets. †The reader can capture data from the sensor when it is within 1 cm to 4 cm of the sensor. ‡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. The FreeStyle Libre Flash Glucose Monitoring System is a glucose monitoring device indicated for detecting trends and tracking patterns in persons (aged 18 and older) with insulin dependent diabetes mellitus. Health care professionals and consumers should be aware about the limitations of available scientific evidence for use of this device in any other groups of patients who require diabetes management. Ask your healthcare professional how a FreeStyle glucose meter may assist you. Always read the label and use only as directed. 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 ABN 95 000 180 389 ADC05126 TAPS NA 9299