Diabetes Wellness Spring 2018 by Diabetes New Zealand

wellness

SPRING 2018

DIABETES

DIABETES NEW ZEALAND | DIABETES.ORG.NZ

BUSTING FOOD MYTHS • BEST DIET GUIDE • D-BULLYING • MY REASON TO RUN MEN’S HEALTH • MY DIABETES LIFE • ANATOMY OF WALKING • TECHNOLOGY TIME

THE FOOD ISSUE Should we be eating a plant-based diet?

FREE TO BE A KID WITHOUT LANCETS*

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Ask your healthcare professional how a FreeStyle glucose meter may assist you. Always read the label and use only as directed. *Scanning the sensor does not require lancets. ‡A finger prick test using a blood glucose meter is required during times of rapidly changing glucose levels when interstitial fluid glucose levels may not accurately reflect blood glucose levels or if hypoglycaemia or impending hypoglycaemia is reported by the System or when symptoms do not match the System readings. ††For a complete glycemic picture, scan once every 8 hours. The FreeStyle Libre software, designed to be used in conjunction with FreeStyle Libre reader and sensor, provides a snapshot of glucose patterns and variability; for more information, see the Software page. §The reader can capture data from the sensor when it is within 1 cm to 4 cm of the sensor. †The indication for children (age 4 - 17) is limited to those who are supervised by a caregiver who is at least 18 years of age. The caregiver is responsible for managing or assisting the child to manage the FreeStyle Libre Flash Glucose Monitoring System and also for interpreting or assisting the child to interpret FreeStyle Libre readings. For more information call Customer Service on 0800 106 100. FreeStyle and related brand marks are trademarks of Abbott Diabetes Care Inc. in various jurisdictions. Information contained herein is for distribution outside of the USA only. Medi’Ray New Zealand, 53-55 Paul Mathews Road, Albany, Auckland 0632 www.mediray.co.nz NZBN 9429041039915 ADC-07478 TAPS No: NA 9883

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Contents SPRING 2018

VOLUME 30 | NO 3

20 CARE: Brett Renall supports Men’s Health Week

4 EDITORIAL

5 WORLD DIABETES DAY: Whānau first

22 LIFE WITH T2: Christina cuts sugar

6 UPFRONT: Latest news and views from your society

24 EAT: Busting food myths with Helen Gibbs

8 COVER: Should we be eating a plant-based diet? 10 COVER: New diabetes cookbook launching soon

12 COVER: We put six popular diets through their paces

16 COMMUNITY: Anytime Fitness fundraiser

19 FAMILIES: Packs for the newly diagnosed

28 PROFILE: Kit Perera turns from cricketer to chef

30 MOVE: Anatomy of walking

14 LIFE WITH T1: Beyond Type 1 takeover

18 ADVOCATE: Lifting the lid on bullying

26 EAT: Addressing the low-carb question

32 DIG: Plant your strawberries for summer 34 BRANCH SPOTLIGHT: Celebrating with our Auckland branch 35 TECHNOLOGY: Turning tech dreams into reality

36 FAMILIES: We continue our sailing journey with T1 Braca 38 BRANCH DIRECTORY: Your guide to Diabetes NZ branches

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DIABETES WELLNESS | Spring 2018

Editorial

It has been a busy few months and as we head out of winter we are looking forward to the Advisory Council elections, AGM and conference, Diabetes Action Month, and World Diabetes Day. We have four very good candidates for two elected positions on Diabetes NZ’s Advisory Council, which supports the Board and Chief Executive. Their profiles and voting papers are included with your magazine. Every full member has a vote, please take the time to read the profiles and fill in the voting papers. These need to be posted to National Office by 24 August 2018. The two successful candidates will be announced at the AGM on 17 November, along with the President and Vice President positions. These roles were uncontested with one nomination received for each. We are currently organising our Diabetes NZ Conference on 17 November, which will feature a top line up of engaging and expert speakers. There will be time to discuss the changes recommended in our recent Destination Unity review and we will be presenting our annual awards, which recognise the achievements of some of our members. This is a day for all members, please do come and join us. The theme of November’s Diabetes Action Month is Act Now to Live Well, which will give us plenty of opportunity to encourage positive action locally and nationally. We will have a special focus on the importance of the family and diabetes, which is also the theme for World Diabetes Day. Our branches and members around the country play a vital role in promoting diabetes awareness throughout the year. I encourage as many of you as possible to get involved, in any way you can, to help make this our most successful Diabetes Action Month campaign yet. This issue of Diabetes Wellness also contains a tribute to Lady Beattie, who was a long-time Patron of Diabetes NZ and tireless advocate for people with diabetes. Lady Beattie was a regular attendee at conferences and AGMs and her astute advice and guidance could be relied upon. Lady Beattie led by example and used her personal experiences as the mother of a child with type 1, who in later life went on to develop type 2 diabetes herself, to inform and advocate. She will be sorely missed by her Diabetes NZ whānau. Finally, if you haven’t already, please read Diabetes NZ’s sugar tax submission to the tax working group, which is available on our website www.diabetes.org.nz. Many thanks to Andy Archer for his work in pulling this submission together. Stay warm and I look forward to seeing you in November!

Diabetes New Zealand is a national charity that provides trusted leadership, information, advocacy and support to people with diabetes, their families, and those at risk. Our mission is to provide support for all New Zealanders with diabetes, or at high risk of developing type 2 diabetes, to live full and active lives. We have a network of branches across the country that offer diabetes information and support in their local communities. Join today at www.diabetes.org.nz

DIABETES NEW ZEALAND Patron Sir Eion Edgar President Deb Connor Chief Executive Heather Verry 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 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 2537-7094 (Print) ISSN 2538-0885 (Online)

ADVERTISING & SPONSORSHIP Business Development Coordinator Jo Chapman jo@diabetes.org.nz or +64 21 852 054 Download the Diabetes Wellness media kit: http://bit.ly/2uOYJ3p

DEB CONNOR

President, Diabetes New Zealand

DIABETES WELLNESS | Spring 2018

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

Upfront The theme for this year’s Diabetes Action Month is Act Now to Live Well, while World Diabetes Day focuses on the important support role of the family.

Diabetes Action Month

ct Now to Live Well will be the theme for this year’s nationwide Diabetes Action Month, which takes place from 1-30 November and is organised by Diabetes NZ. Plans are being worked up for a series of events across the country that will raise awareness about the importance of families in many aspects of diabetes care and prevention. Diabetes NZ is also teaming up with the Lions Club for Diabetes Action Month with Lions volunteers across the country working in their local communities to raise awareness and much-needed funds to help people with diabetes live well at all stages of their lives. The theme for World Diabetes Day on 14 November is “Families and diabetes”, which reflects the important role the family plays in the diagnosis and ongoing support and care of people with diabetes. More than 425 million families worldwide are impacted by diabetes. The International Diabetes Federation (IDF) thinks families are so important they will be campaigning globally over the next two years to encourage governments to adopt family-friendly diabetes policies that can help reduce the tsunami of new cases, especially of T2D. “Please think about how you can mark Diabetes Action Month in your community,” says Heather Verry, Chief Executive of Diabetes NZ. “Perhaps you could join one of Diabetes NZ’s events, for example organise a diabetes fun day at your child’s school, raise awareness about diabetes in your workplace, or team up with your local Diabetes NZ branch and help fundraise for us. “November is a time for the whole community to come together to spread the word about what it’s like living with diabetes. We will be encouraging people to take action today for a healthier tomorrow. This might include making different food choices, being more active, getting a diabetes test, and taking control of their diabetes management.”

Fewer than one in four families worldwide have access to proper diabetes self-management education

Here are four reasons why families play a vital part of the global diabetes community, including in Aotearoa. have a key role in reducing the risk factors 1 Families for T2D. The government needs to make it easier for people to do regular physical activity, have a healthy diet, and achieve better access to healthy living environments. diagnosis and treatment are key to prevent 2 Early diabetes complications. All families are potentially affected by diabetes and raising awareness of the signs, symptoms and risk factors will help in the early detection of all kinds of diabetes. support has a substantial effect in improving 3 Family health outcomes for PWD. It is important that ongoing diabetes self-management education is accessible to all people with diabetes and their families to reduce the emotional impact of the disease. can be expensive for PWD and their families. 4 Diabetes In many countries, the cost of insulin injection and daily monitoring can consume half of a family’s average disposable income, and affordable access to essential diabetes medicines is out of reach for too many.

Keep up to date with Diabetes Action Month at www.diabetes.org.nz or if you want to help, email admin@diabetes.org.nz or call 0800 342 238. See www.idf.org for campaign messages, posters, and ideas for World Diabetes Day 2018-19.

DIABETES WELLNESS | Spring 2018

Upfront

The diabetes community has lost a true champion and friend in the passing of Lady Norma Beattie. By Caroline Wood

A tribute to Lady Beattie

ady Norma Beattie played a significant role at Diabetes New Zealand, serving as Patron for 30 years and being incredibly generous with her time and support. She was also responsible for one of this country’s most famous pictures, having given Prince William the Buzzy Bee toy he so memorably played with on the lawn at Government House in Auckland during the 1984 Royal Visit. Lady Beattie, a former nurse, came from a family of “strong” women and had seven children, 21 grandchildren, and eight great-grandchildren. Diabetes first touched her life when her youngest son Simon was diagnosed with type 1 diabetes at the age of 14. “It’s a tremendous shock for parents, when they discover their child has diabetes out of the blue,” she told me when I interviewed her in 2011. “But there’s good education out there and people pick it up very quickly and easily. There’s no reason why you can’t lead a better way of life with the knowledge you have. It’s not complicated when you understand what it’s all about.” Following Simon’s diagnosis, Lady Beattie became joint patron in 1988 with her husband Sir David Beattie, a judge and former Governor-General. The couple worked hard helping Diabetes New Zealand raise the profile of diabetes, trying to reduce the stigma and educate people about the condition. After Sir David died in 2001, and was given a state funeral, Lady Beattie continued as sole Patron of Diabetes New Zealand. “Lady Beattie played a significant role at Diabetes New Zealand and it was a great privilege for me to

DIABETES WELLNESS | Spring 2018

work with her for 10 years in her role as Patron,” says former Chief Executive Sarah Thomson. “I always knew I could talk things over with her and rely on her for sound advice. She was always available. She supported Diabetes NZ in so many ways and I particularly remember the role she played at Annual General Meetings and conferences when she cogently expressed views of members to elicit responses from Minsters of Health.” Lady Beattie developed type 2 diabetes when she was in her 70s. She took it in her stride and took immediate action. “I went out and got a dog and I go out walking every day. It keeps me fit and gives me the motivation to go out,” she said in 2011. “My advice when you are diagnosed is not to panic. You take a big breath and think how you can improve your lifestyle. “I tried to support people and encourage them to think it wasn’t abnormal. That it was OK to have diabetes. You just have to make sure it’s under control and stay cheerful, that’s important.” Paying tribute to Lady Beattie, Diabetes NZ President Deb Connor said: “Lady Beattie was a wonderful ambassador for diabetes over many years. Her positivity, energy, and sage advice will be sorely missed.” Lady Norma Beattie died on 9 May 2018 at Te Hopai Hospital, Wellington, aged 92.

Upfront

Dress diabolical Please help a child with diabetes today by organising a dress diabolical event this October.

ress Diabolical is a FUN-raising, mufti-day event designed to increase the awareness and impact of type 1 diabetes in young people. Since its launch two years ago, Dress Diabolical and our event partner The Warehouse have raised over $11,000. This has helped fund Diabetes New Zealand’s projects and branch activities for our youngest T1D members. Children like Liam Fryer, seven, from Dunedin, who received a Jerry the Bear learning pack as part of our programme for children 4–10 years old living with T1D. Liam was especially grateful to have Jerry with him on a recent family holiday when he was medically evacuated from the Plantation Island resort, in Fiji, with dangerously high ketone levels, and Jerry went along for the helicopter ride. As Liam’s mum Paula says: “These bears are making a massive difference

in our children’s lives.” This year we want Dress Diabolical to be the most dynamic yet so we can help even more children like Liam live well with diabetes, setting them up for long healthy lives. The Warehouse will once again donate a portion of their fun dress-up wig sales during the month of October, as well as hosting a Halloween Dress Diabolical event at head office for employees and their families. And, of course, we invite you to do your dastardly best as well! During October we encourage you to dress as diabolically as you want while raising money for kids who must deal with a diabolical disease every day. You can get involved by hosting a Dress Diabolical party at your house or encourage your school, kindy or workplace to have a mufti day and charge a gold coin donation. Type 1

Children raising money for diabetes during last year’s Dress Diabolical. Liam Fryer with Jerry the Bear being airlifted to hospital for treatment.

diabetes isn’t much fun – but helping spread awareness and understanding about it can be. Please register your interest at fundraising@diabetes.org. nz today. For more information about how to organise an event, please email or phone 0800 DIABETES (342 238).

DIABETES YOUTH AWARDS Do you know any young people living with T1D who have exceptional skills in academic, sporting or cultural fields? Please encourage them to enter Diabetes NZ’s 2018 John McLaren Youth Awards and be an inspiration to other young people across New Zealand. Diabetes NZ is pleased to announce there will be three awards this year and each of the winners will receive $1500. Awards organiser Steph Mills said: “Young people with type 1 diabetes are achieving amazing feats every day and this is our way of celebrating

those that are going above and beyond in their chosen field whether it be education, sport or culture. It’s a fantastic chance for anyone under the age of 25 to enter and receive one of our prestigious awards and the prize money will hopefully help them to achieve even more in their lives and help other T1Ds do the same.” Entries open 15 August and close on 28 September 2018. Application forms will be uploaded to Diabetes NZ’s website and Facebook page and will also be available from your local Diabetes NZ branch.

Former McLaren award winner Nicole Chan, left

DIABETES WELLNESS | Spring 2018

Cover

A DIET FOR DIABETES?

I Dr Nick Wright talks to Caroline Wood about the BROAD diet study which may hold the key to reversing type 2 diabetes symptoms, while helping T1Ds reduce their insulin requirements.

DIABETES WELLNESS | Spring 2018

magine embarking on a healthy eating regime where you get to eat as much as you like, as long as it’s plant-based and low fat. You don’t need to cut carbs, count calories or exercise, and yet you still lose weight, reverse your type 2 diabetes, and increase your quality of life. The same wholefood with no added-oil diet allows you to eat unlimited wholegrain carbs, including bread, pasta and rice, so it’s also safe for people with type 1, who should find they need to inject less insulin because they are eating very low amounts of fat. This diabetes-friendly diet does exist and was developed using research from around the world. It’s called the BROAD diet and has been tested in Gisborne over the past five years by local GP Dr Nick Wright and his team, with very encouraging results especially for people with type 2 diabetes. During the BROAD diet study, which began in 2013, four patients with diabetes took part and followed the recommended diet (see panel right). One was injecting insulin before the trial but he was able to stop taking it after making the recommended dietary changes. Two of the remaining three improved their condition to the point where they no longer met the diagnostic criteria for diabetes. Dr Nick Wright says the diet is safe for

anyone with diabetes, including people with type 1, who could expect to reduce their insulin requirements by 30-40% if they follow it strictly. He recommends people with T1D work with their healthcare provider when making these changes. During the BROAD diet study, 65 participants with obesity, diabetes or heart disease took part in a randomised trial with 33 of them following a low-fat, wholefood, plant-based diet. They came from all walks of life – farming, forestry, teaching, and retirees – and were randomly split into two groups. Those who changed their diet were allowed to eat potatoes, beans, wholegrain pasta and bread and brown rice, spreads, soups, salads, and stir fries. They also received cooking classes and lifestyle change education during the 12-week intervention. Food was not provided and participants were instructed to eat whenever they were hungry and until they were full. The diet programme excluded animal foods and refined oils, in favour of unlimited amounts of wholegrains, legumes, vegetables and fruits. Those who changed their diet also took 50mcg a day of vitamin B12. After a year, participants who changed their diet had lost an average 11.5kg, decreased their waist circumference by an average of 9cm,

THE BROAD STUDY DIET

RED – STOP Fried animal foods • eggs • dairy (cow’s milk, yoghurt, cheese, including low-fat versions) • meat (including fish and chicken) • fats and oils (including margarine, coconut, olive oil) • sugar-sweetened soft drinks

This stop-go traffic light graphic shows the foods you should and shouldn’t eat if you want to try the BROAD wholefood plant-based diet.

ORANGE – CAUTION High-fat foods: fake meats • tempeh/tofu • avocado • olives • coconut cream • nuts and seeds • alcohol • diet drinks • coffee • plant-based milks without added oil • refined flours • dried fruits or fruit juice

Dr Wright says it may be hard for people to cut out all of the “red” foods all of the time but people with diabetes, heart disease, obesity, high blood pressure, and/or high cholesterol should be stricter and are likely to see bigger benefits if they stick to the guidelines as closely as possible.

GREEN – EVERY DAY Starches, complex carbohydrates • fruits • vegetables • legumes (beans, peas) • spices and herbs • Vitamin B12 • Omega 3 from flaxseed or chia seed

reduced their cholesterol levels and improved their overall HbA1c levels. The results of the first study, which began in 2013, were published last year in the Nutrition & Diabetes journal with Dr Wright as lead author. It attracted international interest because the Gisborne group achieved the biggest weight loss in any randomised control trial where participants had no restriction on calories and didn’t have to exercise. Dr Wright said: “The wholefood, plant-based approach shows very promising weight loss results that appear to be sustained over time. People don’t have to worry about going hungry and can still lose weight. “This diet is designed to be followed long-term and is safe for people with both type 1 and type 2 diabetes. It’s about eating fewer refined foods and much less fat and the weight loss is a consequence of people making these healthy eating choices. “We find that those who stick with the lifestyle changes closely have the biggest benefits. We know people’s taste buds do change over time and they get used to eating a low-sugar, low-fat, plant-based diet.” The BROAD diet recommends limiting foods with more than 20% energy coming from fat, which means

cutting out eggs, chicken and fish. Low-fat dairy products like yoghurt and milk are also off the menu. Research has suggested that A1 beta-casein cow’s milk protein is a primary causal trigger of type 1 diabetes in those with a genetic susceptibility, says Dr Wright. “There are complicated metabolic pathways at play with diabetes. You have to treat the whole body, not just the pancreas but also the liver and other organs. We found it was vital to not only cut out refined sugar but also to drastically reduce high-fat foods,” he said. “Recent research shows a high-fat diet is linked to insulin resistance. If you have type 1 diabetes and cut back on fats, and are strict about it, we’ve seen a 3040% decrease in insulin requirements. We have also had a number of type 2 diabetes patients who have come off their medications and no longer meet the criteria for having diabetes.” Gisborne has the highest rates of obesity and type 2 diabetes in New Zealand. The researchers included Dr Wright, co-researcher Dr Luke Wilson who works in general practice, and exercise physiologist Morgen Smith who is programmes director. The research was overseen by Hauora Tairāwhiti public health physician Dr Bruce Duncan, and GP trainer/ emergency medicine physician Dr Patrick McHugh.

People at risk of developing diabetes, for example those with a family history of the disease, should aim to cut out the red foods and limit the orange foods if they want to improve their health and reduce the risk of developing diabetes in later life. While involving a small number of participants, the BROAD diet study had such a positive impact on blood sugar levels, the charity set up to carry on researching its impacts is currently running a second trial looking specifically at the benefits of a plant-based diet for people with T2D. The published BROAD article is open-access, and Dr Wright works on promoting the diet in his own time, when he is not being a full-time GP in Gisborne. He and Morgen Smith run an online video programme for people interested in trying plant-based diets, with all profits being given to charity. For more information, see thebroadstudy.com and plantbasedvideos.com.

DIABETES WELLNESS | Spring 2018

Cover

EAT WELL LIVE WELL Marsha Mackie tests out one of the fish recipes in the upcoming Diabetes NZ cookbook

ou asked for it and we’ve listened! Every week we receive requests for diabetes-friendly recipes and advice on how to eat more healthily on a budget. There are few Kiwi-specific diabetesfriendly recipe resources available in New Zealand so the team at Diabetes NZ is excited to announce we are planning to launch a new cookbook in November. From day one our vision for the cookbook was clear: we wanted to focus on recipes that use readily available and affordable local ingredients. They had to be family friendly, quick and easy to prepare, ethnically diverse, and nutritionally balanced, while being delicious crowd-pleasers for everyone, whether they have diabetes or not. We are delighted to confirm that our new cookbook ticks all those boxes and more. For the past few months I have been working with diabetes dietitian Helen Gibbs, who, as many of you know, writes a regular food column in our Wellness magazine. We have been choosing, cooking, and testing dozens of recipes and whittling them down to a final 50 or so that

A new diabetes cookbook for New Zealanders is set to roll off the presses later this year, as project manager and recipe-selector-in-chief Marsha Mackie explains. will be published in the book. Every recipe will be diabetesfriendly and delicious. The book will contain a selection of chicken, fish, vegetarian, and meat main dishes and vibrant salads and vege side dishes. There will be plenty of healthy dessert and snack ideas and some great lunch box options, including 49 sandwich filling ideas. Each recipe will also include a comprehensive nutritional analysis per serving size to help people watching their fat, carb and salt intake. There will be tips on how to eat and live well with diabetes, including exercise advice. The project is being supported by some of New Zealand’s most renowned and respected chefs and health and fitness professionals, who have kindly donated some of their diabetes-friendly recipes to our book. They include Jax Hamilton, Simon and Alison Holst, Brett McGregor, Robert Oliver, Kit Perera, Claire Turnbull and Lee-Anne Wann. Our thanks also go out to some of New Zealand’s wonderful communitybased chefs, whose passion for healthy wholefoods and cooking has meant our recipe book is all the better. John Norris, Chris du Fall, Tersha

Coppell and Joyce Shankar-Kay have all contributed recipes ensuring this is a cookbook for the whole community, with recipes for Māori, Pacific Island, Chinese and IndoAsian tastes. The idea is that there will be something for everyone. Recipes from all corners of the world are included, variety and delicious flavours are guaranteed. Old favourites are also included, such as Simon and Alison Holst’s healthy take on fish and chips, and beef stroganoff. Ultimately, we hope this cookbook will become a firm favourite for the entire family, from children learning to cook to the seasoned master of the kitchen who wants to know that any recipe they choose is guaranteed to please, and is diabetes-friendly whether you have type 1, type 2, gestational or prediabetes. Diabetes New Zealand’s Eat Well Live Well cookbook is set to hit the shops in November during Diabetes Action Month. It will also be available to buy from Diabetes NZ and its branches. Every book sold will help provide funding for Diabetes NZ’s vital work. They will also make a great Christmas present!

See right for a sneak preview of two recipes from the cookbook. 10

DIABETES WELLNESS | Spring 2018

OATY BISCUITS PREP TIME 10 MINS • COOKING TIME 10 MINS

PUMPKIN, SPINACH AND PEA CURRY SERVES 6 • PREP TIME 20 MINS • COOKING TIME 30 MINS

Auckland chef Kit Perera created this healthy curry especially for the diabetes cookbook. See p28 to find out why he supports Diabetes NZ. 3 tablespoons olive oil 1 large onion, finely chopped 1 teaspoon black mustard seeds 1 sprig curry leaves 1 fresh chilli, split lengthways 1 teaspoon each crushed garlic and ginger ½ teaspoon turmeric ½ teaspoon paprika 2 teaspoons curry powder (see recipe, below) 300ml light coconut milk 250g pumpkin, peeled and diced 1 bag baby spinach leaves, wilted in a little olive oil 50g peas Salt to taste

Heat oil in a saucepan over moderate heat, add mustard seeds and allow them to pop. Add the curry leaves and onion, fry until golden then add the ginger, garlic, curry powder and spices and stir-fry for 1 min. Add the pumpkin and coconut milk and the chilli; mix well and season with salt. Cover and simmer over low heat for 20-25 mins. Add the spinach and peas, mix well and cook for 5 mins. Serve with steamed brown basmati rice.

AVERAGE NUTRITIONAL VALUE PER SERVE (SERVING SIZE 150g): CALORIES 666kJ / 159kcal | PROTEIN 3.5g | FAT TOTAL 11.5g (SAT FAT 4.4g) | CARBS 8.5g (SUGARS 5.3g) | SODIUM 23mg

KIT’S CURRY POWDER 3 tablespoons coriander seeds 2 tablespoons cumin seeds 2 teaspoons fennel seeds ½ cinnamon quill, broken into pieces ½ teaspoon cloves ½ teaspoon cardamom seeds 2 tablespoons dried curry leaves (if using fresh curry leaves, you can dry these in a frying pan over low heat for 2-3 minutes) In a heavy-based frying pan over low heat, separately dry roast the coriander, cumin and fennel seeds, stirring constantly until each becomes fairly dark brown, but not burnt. Set aside. Using a spice grinder or a blender, blend the roasted spices on high speed with the cinnamon, cloves and cardamom and curry leaves to a fine powder. Put in a bowl and mix well before transferring to an airtight container.

A lovely crispy bite to have with a cup of tea and best of all they have the tick of approval from Wellness dietitian Helen Gibbs, who donated this recipe. 70g plain flour ¼ tsp baking soda 30g white sugar 70g rolled oats 3ml vanilla essence ¼ cup monounsaturated vegetable oil 15ml water 15ml maple syrup Place flour, baking soda, sugar and oats into a food processor and mix. In a small bowl, mix vanilla essence, oil, water and maple syrup, then add to the dry mixture and blend until the mixture resembles cornmeal. Press the mixture into a patty shape, wrap in glad wrap and refrigerate for 30 mins. Preheat oven to 180°C. Unwrap the chilled dough and place onto a large piece of baking paper then put a second sheet on top. Roll the dough out until it is approximately 5mm thick. Slide the bottom piece of baking paper onto the baking tray and cut the dough with a blunt, floured knife. Prick the dough with a fork to release air from the dough. This ensures the biscuits bake flat. Place in the oven for approximately 10 mins on fan bake, 25 mins on bake or until golden brown. Remove from oven and allow to completely cool. Store in an airtight container. Tip: This biscuit recipe also makes a great base for slices and desserts. AVERAGE NUTRITIONAL VALUE PER SERVE (SERVING SIZE 26.4g): CALORIES 492kJ / 117kcal | PROTEIN 1.5g | FAT TOTAL 6.2g (SAT FAT .5g) | CARBS 13.4g (SUGARS 4.2g) | SODIUM 28mg

DIABETES WELLNESS | Spring 2018

Cover

WHICH DIET IS FOR YOU?

Mediterranean diet The Mediterranean diet emphasises eating plenty of plant-based foods, such as vegetables and fruits, whole grains, legumes (such as lentils, split peas, chickpeas, kidney beans and baked beans) and nuts; replacing butter with monounsaturated fats, mainly from olive oil; and eating a moderate amount of fish, poultry and dairy products, with little or no red meat. PROS

A Mediterranean diet is effective for weight loss when a person follows it for 12 or more months. The diet is consistent with the Ministry of Health’s Eating and Activity Guidelines for New Zealand Adults. Research has shown that the traditional Mediterranean diet reduces the risk of heart disease and stroke, and improves glycaemic blood sugar control in people with type 2 diabetes.

Dietary Approach to Stop Hypertension diet The Dietary Approach to Stop Hypertension (DASH) diet was developed to help treat and prevent high blood pressure (hypertension). The DASH diet emphasises plenty of vegetables, fruits and low-fat dairy products, and moderate amounts of whole grains, fish, poultry and nuts. It provides a person with a healthy eating pattern that is consistent with the Ministry of Health’s Eating and Activity Guidelines for New Zealand Adults. PROS

The DASH diet is an effective way to lose weight and become healthier at the same time. Studies have shown that the DASH diet lowers blood pressure, improves glycaemic (blood sugar) control and lowers the risk of heart disease and cancer.

CONS

None

ADVICE

Recommended.

Diabetes NZ recommends Eating and Activity Guidelines for New Zealand Adults published by the Ministry of Health. These are evidence-based recommendations based on the latest research and are regularly reviewed and updated. Search for Eating and Activity Guidelines on www.health.govt.nz. Check out the Diabetes NZ pamphlets: Diabetes and Healthy Food Choices and Ina te kai ora – Here’s Healthy Food. Download them from our website, order online, or phone 0800 DIABETES (0800 342 238). Organisations can order bulk copies online at www.diabetes.org.nz.

DIABETES WELLNESS | Spring 2018

Intermittent fasting diets, including the 5-2 diet Intermittent fasting is a pattern of eating that involves periods of fasting (restricting your energy intake) and non-fasting. The most common example is the 5-2 diet, in which a person eats normally for five days, and then takes in much less energy (usually 500–600 calories per day, which is 25% of recommended requirements) on the remaining two days of the week. Over time, the diet reduces a person’s total energy intake, which leads to weight loss. PROS

Intermittent fasting diets can be as effective as other energyrestricted diets, and some people may find them easier to stick to. CONS

Possible side effects from ‘fasting days’ include hunger, low energy levels, light-headedness and poor mental functioning. There has been little research about the long-term effect of intermittent fasting on a person’s weight or health. ADVICE

The 5-2 diet may be suitable for some people. Talk to your GP to develop a weight management plan that is best for you. The Ministry does not recommend the 5-2 diet for people with insulin-dependent diabetes.

There’s a myriad of diets and advice out there for people trying to lose weight. It can be confusing and sometimes downright dangerous to follow some of these diets if you have diabetes. Here we put six popular diets through their paces and look at what’s good or bad about them and whether they are recommended.* People with diabetes should always seek advice from their GP, diabetes nurse specialist or diabetes dietitian before embarking on a major weight loss diet.

Very low-carb diets

Paleo diet

Detox diets

Some people see very lowcarbohydrate (very low-carb) diets as a better way of losing weight than diets that contain more balanced amounts of carbohydrate and fat. However, research shows that it is not the proportion of macronutrients (carbohydrate, fat and proteins) in a diet that affects weight loss but the total energy (calories).

The Paleo diet is an eating pattern claimed to be based on the diet of our ‘hunter-gatherer’ ancestors from the Palaeolithic period (around 2.5 million to 10,000 years BC). It consists of vegetables, some fruit, nuts and seeds, naturally occurring fats and oils, meat, eggs and seafood. While different variations of the Paleo diet exist, the diet usually excludes dairy products, grains, legumes and processed foods, including processed oils, sugar and salt.

Detox diets claim to rid your body of ‘toxins’ resulting from poor diet and lifestyle, improve your energy levels and result in rapid weight loss. They often involve expensive supplements, and require you to cut out whole food groups, typically dairy foods. Some eliminate food altogether and allow juice only. The concept of detox diets is unscientific. The body has its own built-in mechanisms to remove waste and toxins. Organs such as the skin, gut, liver and kidney continually ‘detoxify’ the body.

PROS

A Paleo diet includes many healthy foods, such as whole and less processed foods, vegetables, fruits, meat, eggs, nuts and seeds.

Cutting out or having a break from alcohol, caffeine or junk food and eating more fruits and vegetables and fewer processed foods is good for your health.

PROS

Cutting poor-quality carbohydrates (sugar-rich foods and drinks, and food made from refined grains, like white bread, cakes, muffins, and biscuits) from your diet is good for your health. CONS

Whole-grain and high-fibre grain foods, such as heavy-grain bread and legumes, contain important nutrients, and are good for your health. People can lose weight on very low-carb diets, but they can also do so on other energy-restricted eating plans. Importantly, there is no evidence of the long-term effects or safety of very low-carb diets. The Ministry recommends diets that contain moderate amounts of carbohydrate.

CONS

The key concern with the Paleo diet is that it excludes entire food groups that are important to healthy eating patterns, including grains, legumes and dairy products. Also, the diet may encourage eating large amounts of meat, which can be expensive, and runs counter to the Ministry of Health’s recommendation to eat no more than 500g cooked red meat each week.

CONS

ADVICE

Not recommended.

Detox diets can be expensive. There is no evidence that they actually remove toxins, and they can be harmful. You may lose weight quickly on a detox diet, but this is likely to be because you are losing water and your carbohydrate store, rather than stored fat. You are likely to regain the weight as soon as you start eating normally again.

*These diet reviews were written by Ministry of Health experts and are published on its website. They also reviewed commercial weight loss programmes (recommended for some people), and very low calorie diets (not recommended without medical advice), see http://bit.ly/2MISYMW.

DIABETES WELLNESS | Spring 2018

Life with T1

Last year we took over Beyond Type 1’s social media channels and showed the world how people live beyond type 1 diabetes in New Zealand. In August 2018 we are doing it again! Here we hear from three children about how they feel about living with T1D.

TAKEOVER TIME IT’S NOT A WEAKNESS: Mischa Saletele, 12, from Wellington

CONNECT TODAY www.beyondtype1.org

Beyond Type 1 has over 1 million followers on Facebook and is read in over 170 countries in multiple languages. They are leveraging the power of social media and technology, changing what it means to live with a chronic disease, while creating a global type 1 community. As part of the “Kiwi takeover” we’ll share our stories on the Beyond Type 1 Instagram wall. This is a place for T1D warriors to share their #LivingBeyond truth every day. Check out the three stories here and you will find many more at beyondtype1.org during August.

DIABETES WELLNESS | Spring 2018

I never look at type 1 as a weakness, it is just something I have. I don’t even consider it when I want to do something. I have completed in 7s rugby at AIMS games for a whole week, play netball, flag football, rugby league and waka ama. I love sports and hope to go further with them. I will do blood glucose tests in a team huddle. No one cares, because I don’t. I’m proud of who I am!

IT’S NEVER STOPPED ME: Gabe Nilsson, 12, from Wellington

Type 1 is just something I do in my day, it’s never stopped me playing sport, or going on school camp or being part of the school community. I love educating people about the technology that I use to manage my diabetes. I love that I live in a time where technology is making it so much easier to manage and making me feel more like a normal kid even though I have a condition called type 1 diabetes. IT’S HELPED MY CAREER: Victoria Cubitt, 25, from Auckland

Having diabetes has helped me fulfill my passion of becoming a nutritionist and personal trainer. My job involves helping those who want to change their lives and become healthy and active. I love it! I also love travelling and spending time with my amazing family. I don’t let diabetes hold me back, in grabbing every awesome opportunity that comes my way.

Visit the Diabetes NZ Facebook to see more inspiring stories about how people are going beyond T1D and living life to the full: www.facebook.com/diabetesnz/

Advertising feature

Talking health with

Drew Harrisberg Fitbit Ambassador and Exercise Physiologist

“As a trainer with diabetes, I combine my own experiences with expertise to help improve the health of others.”

Tell us about yourself and your experience with diabetes. Diabetes is a very small part of what makes me Drew. I’m an exercise physiologist, diabetes educator, sport scientist and most importantly – I’m a happy, healthy guy thriving, with type 1 diabetes. I’ve not only accepted living with it, I’ve learned to love it and manage it so that it doesn’t manage me. Sure, my world shifted when I was first diagnosed, but after making positive changes to the way I live, eat, move and approach life, I can honestly say I am happier and healthier today than I was before my diagnosis. One of the biggest lessons that diabetes taught me is that exercise is a form of medication that we can freely and happily administer to ourselves. I use an array of different exercises every day which I track through my Fitbit to help manage my diabetes. Since making exercise the core of my management strategy, I’ve been able to achieve a 70% reduction in total insulin requirements as well as very stable blood sugar levels.

Does diabetes affect your professional life as a personal trainer? My clientele is predominantly people living with diabetes and other chronic conditions on the spectrum of autoimmune disease. I see a very diverse range of clients such as: people living with type 1 diabetes, type 2 diabetes, pre-diabetes, metabolic syndrome, obesity, young kids and the elderly. As a trainer with diabetes, I combine my own experiences with expertise to help improve the health of others. Tracking exercise and health is even more important for someone living with diabetes, this is why I’ve become an Ambassador for Fitbit and am using Fitbit devices to help better understand how my own sleep, activity and nutrition affects overall health. I also work to educate my clients to do the same.

How do you help your clients who have diabetes? Are there any tips you can share?

Find out more at fitbit.com

My top two tips always come back to exercise and nutrition. Firstly, make exercise your best friend - it’s the most reliable and trustworthy friend you’ll ever have. We all know types of exercises have very specific impacts on the human body, in particular when it comes to insulin and blood sugar levels. I encourage everyone to walk after meals. Just 10-15 minutes is all you need to stabilise your blood sugar levels and reduce your insulin requirements. I also encourage resistance training. Be it bodyweight training or lifting weights in the gym, resistance training really is one of the most useful tools in your toolkit. Muscles are like sponges that soak up excess sugar in the bloodstream, but they only work when you use them! When it comes to nutrition, save the bulk of your daily carbohydrates for the pre- and post-workout window. Pre-workout carbs will likely be used to fuel a productive workout, and post-workout carbs will be stored in the form of glycogen in the muscles, rather than fat. The best time to eat carbs is when you’re most insulin sensitive which is why the post-workout window is such a good time to enjoy the carbs you want.

Community

Members and staff from Anytime Fitness gyms went hard out for diabetes during July raising more than $15,000 for Diabetes NZ’s vital work.

MY REASON TO RUN

uring July hundreds of people of all ages and stages of life walked, ran, cycled and rowed their way around New Zealand for diabetes. Aiming to raise much-needed funds for Diabetes New Zealand, the team at Anytime Fitness challenged their members and staff to donate 20 cents for every cardio-kilometre they personally completed. Vicky Aitchison, from Christchurch, took part in the Cardio KMs for Diabetes challenge during July, running 100 kilometres in honour of her son Finlay. Finlay, aged 10, is a member of a very special club. About 30 people in the world have his condition, which is called pancreatic agenesis. It meant he was born without a pancreas and his body couldn’t make insulin. This condition means Finlay has lived with diabetes all his life. He was also born without a gall bladder and with a number of congenital heart defects. The condition is so rare – Finlay is the only person in New Zealand that has it – that doctors from Starship Hospital didn’t realise his health issues at birth were due to him not having a pancreas. His parents knew he had a congenital heart defect, which had been picked up in an ante-natal scan, and he had been closely monitored in-utero,

Vicky Aitchison with son Finlay

but there was no indication of any other problems before his birth. So it was a shock for everyone when Finlay, who was just 1.3kg (3lb) at birth, immediately had an issue with unstable blood sugar levels. After an ultrasound noted that he may not have a pancreas or gall bladder he was sent for an MRI scan which confirmed this rare condition. In another first, Finlay became the youngest baby in New Zealand to be given an insulin pump. He was just 10 days old. “The first five years were hard, very much about Finlay surviving, however the last few years have seen him thriving” says Vicky, who works for New Zealand Police. “Diabetes was completely new to us, the endocrinologist warned

us that T1D can be a bit tricky and that the road ahead would be hard. He was right. It’s been a rollercoaster ride and a huge learning curve and we’re enormously grateful to all Finn’s doctors, diabetes nurses and the Christchurch diabetes community for all the help and support they gave us. “Finlay is now a healthy, happy 10-year-old who, despite the difficult start in life, takes everything in his stride giving new meaning to the word resilience. He inspired me to put my name down to complete the Cardio KMs for Diabetes. “It’s a cause very dear to my heart, I want to help with awareness; there is a lot of information out there and yet there are still many people who think diabetes is caused by a bad diet and lifestyle which isn’t the case. I also hope sharing our story will shine a light on what it’s like supporting a child with T1D. “I’d like to give a huge personal thank you to everyone who has signed up for this challenge – every little bit helps make a huge difference to the great work Diabetes NZ is doing.” If you missed the Anytime Fitness fundraiser but would like to make a donation to help Diabetes NZ support children like Finlay, go to www.diabetes. org.nz or call 0800 342 238.

Special Diabetes NZ member offer – free 14-day Anytime Fitness trial Your free 14-day trial can be redeemed at any Anytime Fitness New Zealand club nationwide. To get started, simply take this voucher into your preferred club during staffed hours. To find your nearest club, visit anytimefitness.co.nz/find-gym. This voucher must be redeemed by 29 September 2018. New customers only. Terms & Conditions may vary – each location is independently owned and operated.

DIABETES WELLNESS | Spring 2018

“It speaks volumes to the generosity of spirit of New Zealanders that they were prepared to walk, run, cycle and row more than 82,000 kilometres during July. Between them, they have travelled the equivalent of Auckland to London 4 times over. We are very grateful to Anytime Fitness for making this fundraiser happen.” RICHARD BALL, CHIEF EXECUTIVE, ANYTIME FITNESS

HEATHER VERRY, CHIEF EXECUTIVE, DIABETES NEW ZEALAND

FIRST NATIONAL FUNDRAISER Anytime Fitness gyms are located in local communities across New Zealand. There are currently 38 New Zealand gyms making up part of a global health franchise. The company decided to team up with Diabetes NZ after CEO Richard Ball developed prediabetes and decided he needed to make some lifestyle changes himself or risk developing T2D (see the Winter 2018 issue). He changed his lifestyle and eating habits, and altered his workout schedule to increase his cardio fitness. Richard, who also has a family

member with diabetes, decided he wanted to do more to help others with diabetes and the idea for the Cardio KMs for Diabetes fundraising challenge was born. Participants could do any form of cardiovascular exercise, including walking, running, cycling and rowing, and their kilometres could be achieved inside the gym or outdoors. Each Anytime Fitness club recorded the final tallies by each member taking part. He said: “Our aim was to devise a style of challenge that engaged as many Anytime Fitness members and staff members as possible,

while strongly emphasising the importance of regular cardiovascular exercise in diabetes management and T2D prevention. “At Anytime Fitness, our purpose is to help people overcome the barriers to reach a healthier place. With this in mind, we’re delighted to be working in partnership with Diabetes NZ to effect long-term changes in the daily choices New Zealanders make. “The money raised for Diabetes NZ will be a big bonus and will be used to support Kiwi families affected by the condition.”

DIABETES WELLNESS | Spring 2018

Advocate

DON’T LET BULLYING GET YOU DOWN Hearing about the struggles people with diabetes face at work on a daily basis continues to motivate Diabetes NZ to find positive ways to support them.

“I

t is bitterly disappointing to hear of such challenges from former New Zealand track cyclist Steph McKenzie, who was diagnosed with type 1 diabetes as a child,” says Diabetes NZ’s Chief Executive Heather Verry. Steph McKenzie lifted the lid on a “bullying and toxic culture” in the New Zealand cycle squad under former sprint coach Anthony Peden. During an interview with

Newshub in June, McKenzie said she was dropped two years ago because she was deemed overweight by Peden. “Every day, he would say ‘skin folds, skin folds, skin folds’. I felt very uncomfortable and you could tell when he was happy or upset, all around my weight,” she told Newshub. The 24-year-old, who featured on the cover of Diabetes NZ’s magazine in Spring 2011, was hoping to compete in the Rio Olympics before she was dropped from the squad. “Bullying on any level is unacceptable. It shows a disappointing lack of understanding of what it’s like living with type 1 diabetes,” added Heather Verry. “Being a high-performance athlete while dealing day-to-day with a life-threatening condition like

Steph McKenzie, from our Spring 2011 cover

diabetes was a real achievement. What Steph needed was support and understanding from her coaches.” If you are experiencing diabetes discrimination or bullying in your workplace, please seek support from your medical team or contact the Diabetes NZ team on 0800 diabetes (0800 342 238).

REPLACEMENT METERS

DIABETES NZ CONFERENCE & AGM

A reminder that CareSens meters and test strips are now the only fully funded glucose and ketone meters and test strips for people with diabetes in New Zealand. In November 2017 PHARMAC notified a decision to fund four Caresens meters. People who need to change meters are those who are currently using a publicly funded: • CareSens II meter and CareSens test strips • Freestyle Optium or Freestyle Optium Neo meter and their test strips • Accu-Chek Performa meter and test strips. If you still need a meter, you need to ask your GP or diabetes specialist for a script for one. You will also need to pay a $5 prescription co-payment when collecting your new meter from a pharmacy. More information about the meter and test strip changes can be found on www.pharmac.govt.nz.

Save the date for this year’s Diabetes NZ AGM and Conference, which will be held on Saturday 17 November at the Brentwood Hotel, Kemp St, Kilbirnie, Wellington. Registration costs $115+GST and the programme details will be advised via our website and Connect e-newsletter. The hotel has limited rooms available and you can book direct with them. Please let the reservations staff know you are attending the Diabetes NZ conference. Call free on 0508 273 689 or email reservations@brentwoodhotel.co.nz. As a Diabetes NZ full member you are entitled to vote to elect two key positions on the Advisory Council, which gives advice to the Board and Chief Executive. Enclosed with this magazine are candidate bios and a voting form. Please return your voting form by Friday 24 August. The successful candidates will be officially announced in November at the AGM and conference.

DIABETES WELLNESS | Spring 2018

Families

SUPPORTING OUR KIDS

D We know that a type 1 diabetes diagnosis can be an overwhelming experience and a steep learning curve for young people and their families.

iabetes NZ has begun distributing Newly Diagnosed Packs that support the training provided by health care professionals when someone is first diagnosed with type 1 diabetes and admitted to hospital. Each pack is designed to become a fantastic reference tool for young people with diabetes and their families when they return home. Each pack includes resources to help people: • learn more about managing type 1 diabetes • share key diabetes information with their school or childcare centre • record their blood glucose levels • keep their daily diabetes supplies all in one place.

Newly Diagnosed Packs, previously distributed by Diabetes Youth NZ, will now be sent from Diabetes NZ’s National office in Wellington and ordered via our website. The new online ordering system and central location for distribution mean Newly Diagnosed Packs can be quickly dispatched direct to paediatric wards around the country – where they are needed the most! Newly Diagnosed Packs are also available to health care providers who support young people with type 1 diabetes when they are first diagnosed. Visit www.diabetes.org.nz/type1-diabetes-newly-diganosed-packs/ for information about ordering.

SPECIAL DIABETES NZ OFFER Access hundreds of diabetes-friendly recipes and healthy eating tips by signing up for a Healthy Food Guide digital membership for a specially discounted rate of $15 a year (saving $8.40).

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BROCCOLINI, PEA AND POTATO FRITTATA WITH GOAT’S CHEESE SERVES 4 • $3.50 PER SERVE • HANDS-ON TIME 15 MINUTES • COOKING TIME 40 MINUTES • DIABETES FRIENDLY • GLUTEN FREE • VEGETARIAN TIPS

Ingredients

Method

375g baby new potatoes, unpeeled 1 tablespoon olive oil ½ cup frozen peas 8 eggs whisked with ½ cup trim milk 80g goat’s cheese, crumbled 1 bunch broccolini, ends trimmed, halved lengthways, or 2 cups broccoli florets 4 cups mixed salad leaves, to serve 2 tablespoons vinaigrette (see tips)

Preheat oven to 180°C. In a medium saucepan of cold water, place potatoes and bring to the boil over a high heat. Cook potatoes for 10 minutes, or until tender. Drain and cut into 2cm pieces. In a medium cast-iron or ovenproof frying pan, heat oil over medium. Cook potatoes and peas, stirring, for 5 minutes. Season whisked eggs and milk well with black pepper, to taste. Add to the potato mixture and cook for 4-5 minutes, or until frittata is beginning to set around the edges. Top with goat’s cheese then broccolini. Transfer to oven and bake for 15-20 minutes, or until golden and just set.

Balsamic vinaigrette

Make up a week’s worth in a jar using 1 part olive oil to 2 parts balsamic vinegar.

Make it low FODMAP Swap peas for chopped green beans. Use lactose-free milk instead of trim milk and broccoli florets rather than broccolini.

Slice and serve with dressed salad leaves.

DIABETES WELLNESS | Spring 2018

Care

HEALTH HERO Diabetes NZ joined forces with Brett Renall and Men’s Health Week/Te Wiki Hauora Tāne to remind every man living with diabetes to get regular health checks, as Jo Chapman explains.

e all know that men aren’t always the best when it comes to looking after their health, going to the doctor, or following a dietian’s (or anyone else’s!) advice. Thinking about MANLY health concerns, Diabetes NZ is always keen to spread the word about the importance of men looking after their health and knowing their numbers (blood sugar, cholesterol and blood pressure). So, when we were asked to partner with the Men’s Health Week campaign for 2018 we said yes without hesitation. But we needed a health hero with widespread public appeal to help us get across some key diabetesrelated messages that would connect with our wonderful Kiwi men and their loved ones. We wanted someone who “gets it”, who understands the importance of investing in their health and successfully managing diabetes for a long and healthy life. Someone with a trusted media profile in New Zealand who could connect with men of all ages and walks of life. We chose to partner with small business owner and reality TV star Brett Renall, who was up for the challenge. During Men’s Health Week in June, I was lucky enough to spend the day with Brett filming TV3’s The Café show. In some ways Brett, 35, is a typical Kiwi guy. He has his own business called Woodpecker Signs, which creates signs for farms and other businesses. He plays rugby,

DIABETES WELLNESS | Spring 2018

Brett, with Geoff Barton, director Men’s Health Week, preparing for The Café interview Top: Brett and his wife Angel

touch, likes crossfit, mountain biking, cricket and snowboarding, hangs out with his mates, has travelled around the world, lived in different countries. He’s a son, a brother, a husband and doggy dad to Cashew, the super-loved French bulldog. Brett has also lived with type 1 diabetes since 1990, when he was diagnosed as a 7-year-old. You may also know Brett as the man who shot to stardom as the groom from the successful couple from Married at First Sight NZ. During the series, Brett talked with his new wife Angel about type 1 diabetes and what it was like

living with the condition day-to-day. This televised exchange hit the headlines and got people talking. Since then Brett has done more than any other celebrity in recent times to highlight and champion the diabetes cause, becoming a positive T1D role model in the process. Before Brett and Angel appeared on national television last November, they contacted Diabetes NZ and asked to wear our branded t-shirts. This was wonderful publicity for the organisation and it helped create a positive connection with parents of children with type 1 diabetes and other T1D adults. Then in February, Brett and Angel pulled on their trainers, attached Fitbits to their wrists, and recorded their steps for the Diabetes Fitbit MoveMeant challenge. Determined to be an incredible role model, Brett progressed to the finals week. Brett’s passion is to help support young people living with type 1 diabetes. He also understands the importance of helping people to make lifestyle choices that improve their overall health whether they have diabetes or are at risk of developing it. Brett advocates that all men need to invest in their personal health. His motto for life was handed down from his grandad, who told him: ”Health is your wealth”. “It’s really important to make an effort to go and see your GP regularly, especially if you have diabetes. I know that when I do my diabetes tests and go to the doctors, I feel really good. It’s about the fact I’ve been.” When Brett and I chatted about the key messages for his interview, we

PREVENT

talked about the health checks all the contestants had to do before being accepted onto the Married at First Sight show. Brett told me how nervous he was about the tests because he was worried that having type 1 diabetes might have ruled him out of taking part. “Health is important. If you could choose, would you marry someone who might not be around for a long time? Fortunately, as I found out, love often overrules everything else,” he said. During The Café show, host Mel Homer asked Brett about his tips for the contestants of series two of Married at First Sight. He answered that he would encourage all the men to take the What’s your Score? test, developed for Men’s Health Week 2018 (see below). During the week Brett also helped raise awareness about prediabetes and how to change your lifestyle to prevent it developing into type 2 diabetes. He shared advice on how to live more healthily with all kinds of diabetes and the importance of being aware of other health issues that affect men, including male-specific cancers. The Men’s Health campaign lasts all year. You can be a health hero like Brett by visiting your doctor and getting your annual diabetes health check-up. And women can help too by reminding the man in your life, whether it be a partner, father, brother or son, to take some time out to get regular health checks. It might just help save their life.

Every three hours a Kiwi man dies of a preventable illness like heart disease. Here are some tips on how to reduce the risk. Get a diabetes checkup at least once a year and remember to ask for an eyes and feet check too. If you have diabetes you have double the risk of a heart attack or stroke. Diabetes-related complications are easier to treat if caught early. Know your blood pressure Check it, understand it, tame it – it’s the ‘silent killer’. Watch your mouth! Understand your intake of salt, fats, processed food, sugar and alcohol. Don’t ignore the warning signs It’s not “probably nothing” – your body warns you for a reason. Manage your stress Make and take time for regular breaks, enjoy hobbies, exercise and up your mood. Sleep more and smoke less Both will instantly improve your health and reduce your risk factors.

Proud supporters

18 - 45

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•

WELL DONE - you are making the right lifestyle choices and keeping in control healthy health. Make sure of your you with your local healthc maintain a good relationship are professional an annual check-u and have p. Why not make Men’s Health Week the time you have your annual visit to your local healthcare professional?

KEEP YOUR HEALTH IN THE FOREFRONT YOUR MIND. It OF is important that you book in for your annual men’s health check and discuss all age appropriate health risks with your local professional. Men’s healthcare Health Week is a great time to start being proactiv e with your health.

“Financial health is important, but you can’t achieve this without your physical health.”

ENCE*

JUN

E, 20

“A healthy construction workforce results in a well-built New Zealand.” Chris Jack Registered Master Builder

How healthy are you? Find out by taking SMyour ALL the online Accuro What’sLIF * score? test at ESTYLE CHANGES www.menshealthweek.co.nz * MAKE A *

11-17

No matter what you scored, Men’s Health Week is a great reason to go for your annua l men’s health check with your local healthcare profes sional. Don’t forget to bring along this survey can cover everyt so that you hing off.

BIG DIFFER

Week

Mike Whittaker Mike Whittaker Mortgages

IS IT TIME FOR A CHANGE? Call your local healthcare professi onal today and book appointment for an a full men’s health check. Find out about your health risks and what change you can make to s your lifestyle to lower illness. Take this the risk of survey with you to assist with your discussion and testing.

Healthy eating and 30 minutes of daily exercise can help prevent some cancers, type 2 diabetes and improve heart health. Reducing portio n sizes, salt, sugar and alcoho fats, l have a positive impac will t on your overall health . Feeling pain in your joints? Regular stretching can help reduce pain.

of Men's Health

Sam Wallace TV / Radio Personality

Greg Murphy Racecar Driver

Dr Lance O’Sullivan Former New Zealander of the Year

Hamish McKay Rural Exchange Host

CHALLENGE YOUR MATES

Make a change now and see how much better you feel.

DIABETES WELLNESS | Spring 2018

Life with T2

A CAUTIONARY TALE Christina Friedlander stopped eating sugar when she was diagnosed with prediabetes and her blood sugar levels returned to normal. Then she went back to eating the way she used to before her diagnosis. Guess what happened next?

hristina Friedlander went to her GP about three years ago and had a blood test that showed she was prediabetic – she had elevated blood glucose levels but hadn’t yet developed type 2 diabetes. The 72-year-old, who lives in Auckland, has a sister with diabetes. Her grandmother had it too, so she has a higher risk of developing type 2 because of her genes. Christina, who admits she has a sweet tooth, was determined to do everything she could to stop herself getting diabetes. She cut out most of the sweet things in her diet and went back to the doctor for another test and was delighted to find her blood sugar had returned to the normal range.

“My doctor told me I was on the right track and not to worry about it any more, just forget about the test. So I did and I went back to my normal diet and then I had another test and it was even higher than before. “I was horrified, how could they say it was all right? I have other people in my family with diabetes and I don’t want to get it, I already have high blood pressure and am taking tablets for that, I don’t want any more.” Christina was determined to do everything she could to get back on track, so she went back to basics and cut out all added sugar in her diet. She also went online to Diabetes NZ’s website to look for tips on how to eat healthily,

and portion control. Cutting out sugars saw her weight drop from 69kg to 67kg. Christina also goes to the gym regularly as she wants to keep mobile and keep up her muscle strength. Christina says she doesn’t eat any more cakes, biscuits or chocolate. She does eat a lot of fruit and knows she may need to cut down on that too if her blood sugars don’t stabilise soon. “I’m going to keep being vigilant. I’m just scared type 2 diabetes will creep up on me without me realising it. I really don’t want that happening.”

READER COMPETITION The most popular fitness wristband from Fitbit just got better. In addition to heart rate tracking, the Fitbit Charge 2 now features an enhanced exercise experience, new health and fitness tools, the smart notifications you need most, and a new design with a larger display and interchangeable bands that easily let you go from a workout to a night out. We have two Fitbit Charge 2s (RRP $269.95 each) to give away to two lucky readers. To be in to win, email draw @diabetes.org.nz with your name and address and put FITBIT in the subject line. The competition closes on 30 September 2018.

DIABETES WELLNESS | Spring 2018

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WORKS WITH THE DOUBLE ACTION OF PL ANT STEROLS AND BETA GLUCAN TO REDUCE CHOLESTEROL ABSORPTION *

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DIABETES WELLNESS | Spring 2018 Serving suggestion

Eat

Busting diabetes food myths Registered dietitian Helen Gibbs gives some advice on how to avoid getting stressed by food “do’s and don’ts” when you have diabetes.

n celebration of this issue’s healthy eating theme, I thought I would roll out a list of food myths I hear day in and day out from my clients with diabetes. Some of these misconceptions are unfortunately perpetuated by health professionals and fashionable faddy diets. When you are diagnosed with diabetes it may seem that everything you like is forbidden. Being unsure about what is and

isn’t “allowed” can be stressful because food has a big impact on people’s perception about their quality of life. Making dietary changes is hard but most foods are OK to eat if you have diabetes, although you may need to moderate how much of them you have or change to healthier versions of your favourite foods depending on your blood sugar levels and whether you want or need to lose weight.

If you eat a lot of fruit every day, you will have to cut down because of the impact on your blood sugar levels. Most people with type 2 diabetes can have 2-3 servings of fruit a day. A serving of fruit fits onto the palm of the hand without falling off. So your hand size and the serving of fruit are related. If you look at bananas, that’s maybe half a banana per serve. Grapes are somewhere between 8-15 grapes per serve depending on the size of the grapes and your hand. Having your fruit with some protein, for example natural yoghurt, can reduce the blood glucose spike. A word of caution – fruit juices and smoothies are a problem, limit these to 200ml maximum per day.

MYTH 2 I can’t ever touch white bread, white rice or pasta again

MYTH 3 I can’t enjoy a sweet pudding or restaurant dessert

Current healthy eating guidelines for adult New Zealanders, which are published by the Ministry of Health, encourage us to eat mostly wholegrain and high fibre foods, which are better for your blood sugar levels and fill you up longer than the low fibre equivalents. “Most of the time” are the keywords here because occasionally it is OK to have lower fibre options, for example because you are short on time or the other options are worse!

Many sweet treats are high in saturated fat and sugar. If you are a keen cook, try modifying your favourite recipe to reduce the sugar and change the fat to a monounsaturated oil, or check out Diabetes NZ’s soon-to-bepublished cookbook for some lovely dessert ideas. The most important way to reduce the effect of a sweet treat on your blood glucose is to have only a small amount – sharing dessert when eating out is a great way to have a smaller portion.

Summary: It’s OK to eat some fruit but watch your portion size and count

Summary: Eat whole grain and high fibre foods most of the time

MYTH 1 I can’t have fruit, especially bananas and grapes

DIABETES WELLNESS | Spring 2018

Summary: Smaller portions less often and choose healthier choices

MYTH 4 My favourite takeaways are off the menu, including fish ’n’ chips

MYTH 5 I’m going to have to give up eating cheese

Takeaways often have lots of fat because they are deep fried and/or include large servings of carbohydrate such as chips or rice. So you may need to have takeaway foods less often and choose smaller servings, but again there is no reason you can’t ever have them again. Try making homemade crumbed fish lightly pan fried in a healthy oil and oven-baked chips with the skins on.

This myth is about the saturated fat in cheese and other dairy. High saturated fat intake increases insulin resistance. Portion control and ensuring that you stick to a maximum of 2-3 portions of dairy per day are ways of enjoying these foods without eating excessive amounts of saturated fat. Tip: carve up your cheese into 30g servings when you buy the block. That way you are not portion controlling when you are hungry!

Summary: Eat fewer takeaways, have smaller servings, or make your own healthy versions

Summary: Portion control means you can have your cheese and eat it

MYTH 6 I won’t be able to go out and enjoy an alcoholic drink at a party Alcohol is energy dense and if you need to lose weight this can be a problem. If you are on insulin or the sulphonylurea tablets, your blood glucose can go low because of the way the liver processes alcohol. Stick to the safe drinking limits and if you do drink alcohol make sure someone knows what to do if you have a hypo. Summary: it’s OK to drink a small amount of alcohol

MYTH 7 I shouldn’t eat carbs if I have diabetes

MYTH 8 I’m going to have to give up all fizzy drinks and energy drinks

With the media coverage of paleo and keto diets it is easy to believe this may be a good option for people with diabetes. The problem is that they can be difficult to sustain and may increase cardiovascular risk factors. Stick to evidence-based guidelines that recommend eating carbs that are mostly wholegrain and high in fibre, while reducing the amount of sugar in your diet. This is a more sustainable, healthy, long-term diet that can improve cardiovascular health and support good digestive health.

OK sorry, this one is true! High sugar soft drinks and energy drinks are going to cause your blood glucose to spike. So are large amounts of juice. Cutting these out is a good move. Some people will find it almost impossible to switch from their favorite high sugar drink to water overnight, so you may want to use diet soft drinks and energy drinks as a transitional product. You can move to a diet soft drink then reduce the amount over time, replacing it with water. Some people are afraid of the health risks of artificial sweeteners but the total amount we take is very small because they are 300-1500 times sweeter than sugar. The risk-benefit equation of sweeteners needs to be considered this way – which is going to cause me the most harm, very small amounts of artificial sweetener or high sugar intake?

Summary: Cut back on the sugar and refined carbs

Summary: Cutting these out is a good move for everyone, not just people with diabetes

DIABETES WELLNESS | Spring 2018

Eat

Sometimes we “experts” need to listen to what the patient is saying before jumping in with a negative response to questions about low-carb diets, says Helen Gibbs.

TYPE 1 DIABETES AND THE LOW CARB QUESTION

ecently on Facebook I noticed a mother asking about low-carb diets for her type 1 daughter. I don’t often respond to these kinds of posts but I was worried about the advice she was being given, so I messaged her. She told me her daughter’s diabetes team hadn’t been helpful when she asked them questions about a low carb diet and diabetes. “We don’t advocate that kind of diet” was the response. I asked her about what was happening with her daughter. She said her 12-year-old daughter felt much better if she limited the carbs she ate. I asked a bit more about what she was eating, whether she was pumping and using a CGM. It turned out that her daughter wasn’t really eating a low carb diet. Low-carb eating is generally defined as no more than 40g per day of total carbohydrates. She was typically having that much for each meal and was mostly in low GI form because she was eating a lot of whole grains. Overall I would estimate she

DIABETES WELLNESS | Spring 2018

was consuming about 120-160g carbohydrate daily. I asked what made up the other energy sources in her diet and we had a productive conversation about the value of monounsaturated fats and being careful to avoid excessive amounts of saturated fats. I also said her daughter was getting to an age where she might make less than ideal choices around food, but it was part of growing up and it was important that she was given increasing amounts of autonomy over her food choices. I encouraged her to talk to her daughter about our conversation and also to her daughter’s diabetes team so they knew what was going on in relation to food when their next appointment came around. When I started as a dietitian, T1Ds had to decide what they would eat, count the carbs, dial up the insulin, and inject it 15 minutes before they ate. It made life complicated and difficult in so many ways. Now with fast-acting insulins, pumps and CGMs, life with type 1 is very different from the bad old days.

Make sure you tell your diabetes team about any radical diet changes you plan to make so they can support you. Still, I can see how frustrating conversations about food can be. Mum wanted to know if what she was doing was okay, but she used the wrong terminology and got a big pushback. Instead, the clinicians should have been asking “what have you been doing that your daughter has found helpful?” Even if mum had been giving her low carb, it would have been a useful teaching moment about getting the balance right for longterm health and growth. Modern diabetes technology is amazing, and in my opinion we health professionals need to modernise our approach too and ask for more information, even in stressful busy clinics. Badly timed negative messages can lead to disengagement which is no good for anyone – patient, family or their diabetes team.

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Profile

CRICKET AND COOKING Kit Perera is a former professional cricketer turned chef. He explains how he ended up coaching Black Caps like Martin Guptill, why he’s supporting Diabetes NZ’s new cookbook, and his mission to help children learn to cook healthy food.

DIABETES WELLNESS | Spring 2018

was born in Sri Lanka and left to live in London at the age of 16. While growing up in Sri Lanka, my grandmother influenced me in cooking and played a pivotal role in my childhood as my parents were living in London as medical professionals. Making spice blends in her clay kitchen (made of clay, with a large chimney), everything was cooked in clay pots over a wood fire. Spices were dry roasted in the clay pots over a wood fire and pounded in a large pestle and mortar called a “van gediya”. Picking fresh herbs, chillies, and other ingredients from the garden was a regular feature every evening. High tea on the front lawn on the weekends with my grandma’s freshly baked treats and the finest Ceylon tea is a vivid memory to this day. In 2013, I went to Sri Lanka to cook for her 100th birthday dinner and I got the nod of approval from her after

she did a taste test and she informed me, ”I taught you well”. I was given a cricket scholarship while studying in the UK, where I learned all about sports management and sports science. I came to New Zealand in the 80s as a professional cricketer, this continued for 15 years where I spent six months in the UK for the cricket season and travelled back for the New Zealand season. While playing in New Zealand, I started getting involved in coaching Canterbury age group rep teams and I coached at St Andrews College and Christ’s College, Christchurch. The “Chef for a Night” idea was born at Christ’s College when I cooked for a cricket fundraiser and I was auctioned off and went to the winner’s home to cook them and their guests a beautiful Sri Lankan meal. I also coached in Sydney and Canberra before leaving Australia to

“There are lots of kids growing up not eating well and the best way to change this is to educate the children how to cook. This will stand for the rest of their lives, they will become self sufficient and teach their children.” — KIT PERERA

return to New Zealand in 2002. I set up my business Chef for a Night in 2003. My dad had type 2 diabetes and some of the professional cricketers I’ve known had type 1 diabetes, people like Craig McMillan. Many Sri Lankans are at higher risk of developing type 2 diabetes like many people living in South-East Asia. I’ve donated a dinner that’s been auctioned off to raise money for Diabetes Auckland for the past 15 years. Each Chef for a Night package goes for about $5,000 and I cook a dinner for the successful bidder and about 12 guests. I’m very excited about being part of the Diabetes NZ cookbook, I created NZ_Diabetes Wellness.pdf

31/5/18

three recipes especially for it, they are healthy curry recipes using ingredients you can easily source in New Zealand. I coach talented young cricketers and have my junior cricket academy, where I use cricket as a “tool for life” developing skills and building futures through sport. Some of the players I’ve coached are now Black Caps, including Martin Guptill and Jeet Raval. I’m in the process of duplicating the cricket tool for life model to cooking and I’ve been trialling my “Kids cooking with Kit” model with families across Auckland,

including in low socio-economic areas. Parents shop for the ingredients and do the washing up and the kids make the food and everyone sits down together to eat. It’s fun and social, and everyone is learning the value of good nutritious food. There are lots of kids growing up not eating well and the best way to change this is to educate the children how to cook. This will stand for the rest of their lives, they will become self sufficient and teach their children. My aim is to help young people build a positive future through cricket and cooking.

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There are lots of reasons why walking is good for you so give it a spin this spring, says Craig Wise.

BEST FOOT FORWARD

recently spent some time chatting with a new client who was feeling down because she wanted to be a runner but she could only walk due to her health issues. She was feeling down about this until we discussed some of the reasons why walking can be a great physical activity. As a personal trainer, I really rate walking as a basic form of physical activity. Firstly, it’s low to medium intensity – walk so you elevate your heart rate but aren’t gasping for air. It is easy on the joints, it promotes good blood flow, can be done on a whim at any time of day or night, it’s free, and not complicated, just place one foot in front of the other, repeat, and you are exercising. Let’s clear up one thing from the start, when I’m talking walking I mean doing it at a brisk pace, not a leisurely stroll around the park smelling the spring flowers. Active walking promotes good blood flow by increasing your heart rate without making it pound out of your chest. Once you become a more accomplished walker, you can make it more challenging and make your heart work a little harder. But the best thing about walking is that it can be done

DIABETES WELLNESS | Spring 2018

GETTING STARTED

ONLY 30 MINUTES A DAY 5 TIMES A WEEK CAN MAKE YOU HEALTHIER & HAPPIER with minimal preparation. There is no psyching yourself up, no getting up early to head to crowded gyms, no preparing the night before (except making sure your shoes are ready to go) and you can do it in the middle of the day without having to be concerned about at-the-desk sweats which make you the person to avoid in the office.

First and most importantly get some good shoes to walk in, this is especially important if you have diabetes. Make sure they are comfortable and have plenty of padding in the innersole. Old worn out shoes can cause stress on joints, aches and blisters. If you have diabetes-related foot complications, talk to your podiatrist about shoe and sock recommendations. We have all been walking since we were toddlers, so we should be experts at it, right? Wrong. Like most things we get lazy when we do things all the time, so ensure that you are thinking about your posture, walk tall with your shoulders back. Long strides may make you cover more distance but make your footsteps harder when they hit the ground which can lead to sore shins. Get your arms going, keep them relaxed and bent so that they swing naturally. Your body is designed so that your arms swing as you walk to counterbalance the movement of your legs. Keeping your arms stiff or actively swinging them when you walk can slow you down and cause pain in the shoulders. You may also notice swelling in your hands if you walk with them held stiff at your sides (especially when the weather is warm).

BENEFITS OF WALKING STRENGTHENS MEMORY INCREASES SELF-CONFIDENCE, RELIEVES ANXIETY AND DEPRESSION INCREASES VITAMIN D LEVELS

WALK YOUR WAY TO BETTER HEALTH

BOOSTS ENDORPHINS NEXT STEPS

The next thing to decide is where and when to walk. Start somewhere relatively flat, then get out there and pound the pavement. As you become more accomplished walker and the flat is no longer challenging, you can add something new. Find somewhere hilly or incorporate tricks used by professional athletes by adding in some interval training, change the pace as you walk, alternate between your regular walking pace and a faster pace for short distances. You can also add in some squats, star jumps, lunges and stretches to change it up a bit and exercise different parts of your body. Some council-run parks have fitness equipment installed that you can include as part of your walk. Although walking is easy, it is still a physical activity and should be treated as such. Remember to stretch after your walk (especially if you are adding in some of the exercises above), ensure you are drinking plenty of water and get some rest. You may not be lifting heavy weights at the gym but your body still needs time to recover. Once you are comfortable walking you might want to put your new talent to good use. There are always charity walks happening and taking part in these is a great way to get involved in your community. So, strap on your shoes, grab a friend or buy a dog (optional!) and head out there.

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DIABETES WELLNESS | Spring 2018

Dig

Strawberries for summer It’s the perfect time of year to prepare strawberry beds for a top crop in early summer, as Rachel Knight explains.

S RACHEL’S TOP TIPS Buy your strawberry plants from shops stocking named varieties and choose the biggest plants you can afford for earlier fruiting.

tart some strawberries now and you’ll be sampling some delicious berries sooner than you think. They grow well in much of the country and with a little care and protection will be a rewarding crop. Strawberry plants appear in garden centres from the beginning of July and the sooner you get them planted, the sooner you’ll be picking. Some varieties fruit earlier than others, so if you’ve got space to grow two or three different kinds you can extend the fruiting season. They come in individual pots or punnets of four to six. Some places sell bare-rooted bundles that you’ll need to plant straight away or put in pots yourself. It’s worth paying a little more for larger plants with a well-developed root system. If you’ve got plants in your garden you can collect ‘runners’ in autumn and grow them in pots until you’re ready to plant them in spring. Strawberries like a well-drained fertile soil in a sunny location. Dig some compost into the soil before planting and make sure the ‘crown’ of the plant remains above the soil. Mulch around the plants with straw or pine needles. This reduces weeding, improves the soil and helps keep the fruit clean.

Nine plants will fit into a raised bed one-metre square. You can grow them in pots, “strawberry towers” or even hanging baskets. Just make sure you can keep them moist. Feed the plants once a week with seaweed tea once they start flowering. Strawberry plants will fruit well for up to three years but produce most fruit in their second year. Take out three-year-old plants and put replacements in a new spot in your garden. Blackbirds love strawberries and will infiltrate the tightest netting barricade. Keep mesh at least 30cm away from the plants by supporting it on hoops of water pipe, otherwise birds will sit on the mesh and peck the fruit through it. If you’re not getting a good crop or you find damaged berries, monitor your plants carefully and you may find where the birds are getting in. Or you may catch some human predators from your household! Nobody complains that they have too many strawberries. Six plants for each member of your household still won’t be enough. Don’t wait until Christmas to sample this sweet sensation. Get set to savour some homegrown strawberry goodness.

Varieties to try Albion large red berries with red flesh fruiting later than other varieties Aromas large fruited plant producing well the whole season Camarosa popular medium sized fruit with heavy crop in high summer

DIABETES WELLNESS | Spring 2018

Community

STRAWBERRY, PISTACHIO & QUINOA SALAD SERVES 2

Strawberries and pistachios make a great colour and texture contrast with salad greens, avocado and quinoa. ½ cup quinoa, rinsed well 1 cup vegetable stock 1 spring onion, thinly sliced Half an avocado, diced Generous handful of fresh salad greens 20g pistachio nuts, roughly chopped Handful of strawberries, de-hulled and sliced Dressing Zest and juice of one lime 1 teaspoon runny honey 1 teaspoon miso 1 tablespoon white wine vinegar Put the quinoa and vegetable stock in a pan over a low heat and cover. Simmer for 15 minutes. Remove from the heat and allow to stand until any remaining liquid is absorbed. Put the cooled quinoa, spring onion, avocado and greens in a large bowl.

NUTTY STRAWBERRY ICE CREAM SERVES 4-5

If you have a strawberry glut you can freeze the berries and make a delicious, dairy-free, creamy frozen dessert to give you a taste of summer all year long with no added sweeteners. 50g peanut or almond butter mixed with 50ml boiling water to a smooth cream 200g frozen strawberries 200g frozen banana (the riper the better) Put the nut butter cream, strawberries and banana in a blender and process until smooth. The mixture will probably need a little time in the freezer before serving. Garnish with chopped peanuts or slivered almonds. If stored in the freezer allow to stand for 15 minutes or so at room temperature before serving. AVERAGE NUTRITIONAL VALUE PER 4 SERVES: CALORIES 291kJ / 79kcal | PROTEIN 1g | FAT TOTAL 3g (SAT FAT 0.5g) | CARBS 13g (SUGARS 7g) | SODIUM 18mg

Whisk the dressing ingredients together in a jug and pour over quinoa, onion, avocado and greens. Mix together gently. Spread on a serving platter and top with the pistachio nuts and strawberries. AVERAGE NUTRITIONAL VALUE PER 2 SERVES: CALORIES 1571kJ / 376kcal | PROTEIN 10g | FAT TOTAL 14g (SAT FAT 2g) | CARBS 55g (SUGARS 17g) | SODIUM 169mg

Berries keep best in the fridge if you’re not using them on the day you picked or bought them. Wash your strawberries just before using them, and keep the stems on until you’re about to eat them to prolong their shelf life.

DIABETES WELLNESS | Spring 2018

Branch spotlight

CELEBRATING 60 YEARS With 11 support groups, a mobile awareness service, HOPE programme and fun fundraising events, life is always busy at Diabetes NZ’s Auckland branch, as manager Sheena Duffy Vakatale explains.

he Auckland Diabetic Society was established in 1958 to support, educate and advocate for people with diabetes. Thank you to all the volunteers, committees, staff, patrons and ambassadors who have worked tirelessly to deliver services and support in Auckland over the past 60 years. Each month 11 diabetes support groups meet in various locations across Auckland. Each of our volunteer support group co-ordinators provides a positive atmosphere where members feel supported, and learn how to cope with diabetes and its day to day challenges. Strong friendships are built and group members feel less isolated. For the past 10 years, our HOPE (Healthy Options = Positive Eating) programme has been delivered to high-risk communities by our community champions. HOPE brings families together to learn about healthy food choices and family fun activities. Attention is focused on Māori, Pacific Island, and South Asian communities, where the increase of diabetes and heart disease is escalating. Diabetes is on the rise in Auckland with more than 94,000 people diagnosed. An important part of Diabetes NZ’s Auckland’ s work is

DIABETES WELLNESS | Spring 2018

operating our Mobile Awareness Service. Each month this free community service visits at least 12 sites in high-risk communities. Our staff, including a mobile nurse and health navigator, engage with people of all ages about the risks and symptoms of diabetes and lifestyle changes that can prevent or help manage it. Those deemed most at risk of diabetes are HbA1c tested and if the result is high (suggesting prediabetes or diabetes) the person is put in touch with their health professional for further tests and treatment.The Mobile Awareness Service is also in demand for community events and paid workplace visits as employers increasingly recognise the benefits of good employee health and wellbeing. The Diabetes Youth Auckland team, which includes paid staff and a volunteer committee, works with young people with diabetes and their families to create support networks, educational events, fun events, camps and practical resources. The very popular Summer Camp will celebrate 50 years this January. Other camps held during the year include a Teen Camp and Family Camp.

Our focus over the past year has been to lift Diabetes NZ’s profile, raise awareness of diabetes and increase understanding of what it’s like for people living with diabetes day-to-day. We want to provide leadership on significant issues affecting Aucklanders with diabetes or those at risk of developing it. Fundraising is also an important part of our work. We have organised a corporate fundraising luncheon, 147 people participated in the last Round the Bays run, and we are planning to enter 80 people in the ASB Marathon in October. Educational nights are coming. With the move from Diabetes Auckland’s historic Mt Eden premises four years ago, our walkin diabetes shop closed but items such as glucose meters and test strips, sharps disposal containers, insulin cooling bags and other items are still available online at www.diabetesauckland.org.nz. If you live in Auckland and would like to connect with your local support group, we’d love to hear from you. Please see www.diabetesauckland.org.nz, call 09 622 0551 or email office@diabetesauckland.org.nz.

Technology

Dr Gillian McCarthy’s research is contributing to the design of new technologies that will help young people manage their diabetes without stigma.

DESIGNING FOR DIABETES

blood glucose meter that can be used while swimming avoiding the need to get out of the water to test and medical devices designed to look like attractive jewellery so people can decide for themselves whether or not to disclose their diabetes. These are two diabetes technologies of the future that young T1Ds would like to see developed. Research by Victoria University of Wellington PhD graduate Dr Gillian McCarthy will hopefully help turn these diabetes technologies into reality. Gillian spoke to 16 teenagers and young adults with type 1 diabetes for her research, building up a detailed picture of what life is like for young people living with a lifelong condition. She found that while devices for managing diabetes met medical requirements, they didn’t always fulfill the wider social and personal needs of individuals. “We’re getting more and more complex medical devices emerging but the health outcomes haven’t been getting much better. So we’re asking what requirements adolescents have

that aren’t being met, but that we should be meeting as we develop new and better technologies,” Gillian explains. “Managing type 1 diabetes requires close monitoring of blood sugar levels throughout the day and regular injections of insulin. For young people this often poses challenges, as it can disrupt participation in everyday activities and present problems of dealing with the stigma that can surround the condition. “In my research I’ve particularly focused on the psycho-social aspects of type 1 diabetes. If adolescents are too embarrassed to use their device in a public setting, that’s going to be a problem. When it comes to designing a medical device my focus is on practical, everyday uses. It’s not just responding to a disease, but responding to a disease for an individual person.” Gillian also looked at Pharmac’s usability criteria – what the agency thinks about when deciding which devices to fund – and compared this with the criteria adolescents think of as important. The aim was to identify any mismatches and

report back, highlighting some things companies might like to consider in their design. Her research was recognised at last year’s MedTech CoRE Annual Conference, where she was awarded the Consortium for Medical Device Technologies Researcher Award 2017. Now a lecturer at Victoria University’s School of Design, Gillian is supervising a Master’s student, Madeleine Hazelton, to help continue with the diabetes research. Madeleine will explore how diabetes medical technologies draw attention in both positive and negative ways. Gillian believes that thinking about smart, practical and engaging ways to design medical tools is crucial for the future. “We’re living longer, which is great, but we’re going to be living with health issues like diabetes. There’s going to be an increase in people having to use medical devices in their own homes and daily life, at work, in the middle of the night, wherever it may be. So there’s less tolerance for these devices to be badly designed or embarrassing to use.” DIABETES WELLNESS | Spring 2018

Families

Sailing into diabetes In the last issue we featured four-year-old Braca, who nearly died after developing type 1 diabetes while sailing with his family off Thailand. Luckily his parents Kia Koropp and John Daubeny ignored a Thai doctor’s advice that Braca was fine and took the lifesaving decision to return to port and seek medical help. Here mum Kia writes about Braca’s road to recovery and the family’s struggle to learn about diabetes in a foreign country.

DIABETES WELLNESS | Spring 2018

ollowing Braca’s period of stabilisation, we were transferred from Phuket to Bangkok under the care of the diabetes specialists at Bangkok Hospital. The luxurious five-star accommodation notwithstanding, there were some significant drawbacks to our situation. For one, when discussing medical education and treatment, language fluency is a must. I sat through sessions where the diabetes doctor smiled widely and repeatedly pointed to pages in a booklet translated to English, without being able to discuss the material it contained, or answer a single question. The nutritionist walked me through lists of diabetes-approved foods, none of which fitted our western diet. The doctor was very knowledgeable but her ability to transfer knowledge to me was very poor. I had travelled all the way to Bangkok to get training from the top experts in their field, but a

Braca and Kia belting out tunes to an absent audience in the wild blue yonder

week into the programme and I was still mystified about the disease. Gradually Braca’s energy returned, and he took on the appearance and attitude of a healthy four-year-old. Keeping him entertained in hospital was becoming more and more challenging. We both wanted out of the sanitised walls of the hospital, but I was far from being confident that I could take him into my care. As a parent, it is mindboggling to lose the confidence of being able to care for your child’s basic needs. I would have to get comfortable pricking him for blood, jabbing him with a needle, and micromanaging every aspect of his dietary intake. I would have to constantly survey his body for signs of a low. Is he sweating, pale? Are his hands shaking? Did he simply trip or was that the result of a sugar-crash? Having a four-yearold self diagnose is an impossible task, so I would have to become his

internal monitor from the outside. “You may have water, but no, you may not have a glass of milk,” I would tell him. Regimen and restriction – welcome to our new world. We were finally booted from the nest following three weeks of hospitalisation and rudimentary training acquired predominately through sign-language. We were discharged, but we were not allowed to fly. Before we could cut the umbilical cord to our medical support team, we needed to prove we could keep Braca stable under our own care. Excitedly we packed our bags and headed for a nearby hotel, ready for the next step. Rather than glide, we crashed hard. Not five hours under my supervision and we were racing through dense traffic back to the hospital with severe food poisoning. It was a painful but important lesson learned: caring for a diabetic is hard; caring for a sick diabetic is 10 times harder. Over the weeks that followed we learned to take small steps, we learned to deal with each problem as it presented itself to us, and we learned not to look too far into the future. Our small steps took us further and further into Bangkok’s crowded streets,

down muddy canals, up towering golden Buddhas and through vast shimmering temples. We set out each morning with our tourist map, our insulin kit and the doctor’s direct number. Day by day we crossed items off the list of Bangkok’s finest attractions and wrote down blood levels and calculated insulin doses. At the end of two weeks, we were ramped-up and touristed out. We’d proven to the doctors and ourselves that we could fly. Which brought us to our next quandary: Where to fly to? We looked at our options: Expatriation to America, repatriation to New Zealand, or to continue under the support of the team in Thailand. Each had its merits and its drawbacks. We’d been in contact with the Madison Clinic for Pediatric Diabetes at UCSF, a leader in children’s diabetic research and treatment, and Braca was accepted into their programme, however we weren’t guaranteed medical insurance coverage. We could repatriate to New Zealand and the diabetic team at Starship was ready to receive us, however it meant leaving the yacht in Thailand for an undetermined amount of time and our Auckland home was rented out. We could

continue under the care of the Thai diabetic team and live onboard our boat but we were not prepared to transit oceans with a newly diagnosed child so travel would be restricted to Thailand for another year. Eventually we chose repatriation. A return to New Zealand would get us another shot at a comprehensive diabetes training, this time in our own language. It is worth noting that our insurance was footing the bill for our medical expenses and incidental costs. In a stroke of luck, it was the first year we’d ever purchased medical insurance as a requirement for visiting the Chagos archipelago, a group of atolls in the middle of the Indian Ocean. Due to this planned stopover, we had paid for insurance and were consequently absolved of paying the substantial bills we’d incurred through our ordeal. After a mere month on their books, we called on TopSail for assistance and they stepped up to shoulder the considerable burden of our diabetes-related bills. Their final action was to assign a flight nurse to escort us back to New Zealand. While they didn’t say it, their unspoken words were: “You are Starship’s problem now.”

In the next issue: The third and final part of Braca’s story: The family return to New Zealand under the care of Starship Hospital, where they learn how to look after him properly. Newly confident in their diabetes skills, they decide to return to their beloved yacht and set out – insulin-in-fridge – for Sumatra, Cocos Keeling, Chagos and the Maldives.

DIABETES WELLNESS | Spring 2018

CONTACT LIST 2018 DIABETES NEW ZEALAND NATIONAL OFFICE (04) 499 7145 PO Box 12441 Wellington 6144 admin@diabetes.org.nz www.diabetes.org.nz For general enquiries 0800 DIABETES (0800 342 238)

Branches marked with a * have youth teams and/or representatives UPPER NORTH ISLAND Auckland* PO Box 13578, Onehunga, Auckland 1643 0508 DIABETES (0508 342 2387) (09) 622 0551 office@diabetesauckland.org.nz www.diabetesauckland.org.nz Support: Phone support with nurse. Support groups across Greater Auckland, Silver Medal Club celebrating those 50 years on insulin. Healthy Options = Positive Eating (HOPE) courses run in at-risk communities throughout Auckland. Awareness: Awareness sessions through workplaces as well as community organisations. We attend events to raise awareness about diabetes and diabetes prevention. Mobile Diabetes Awareness Service with free diabetes testing throughout Auckland. Online Shop: All full members receive 10% off online orders. Youth: Diabetes Youth Auckland organise camps for children, teenagers and parents. Education evenings in conjunction with Starship. Events and get-togethers throughout the year for the whole family. Gisborne PO Box 1029 Gisborne 3801 (06) 867 7341 Contact: Guy Riki (Chair) Rotorua* Taylforth House, 1147 Pukaki Street Rotorua 3010 (07) 343 9950 info@diabetesnzrotorua.org.nz www.diabetesnzrotorua.org.nz Notes: Free drop-in morning tea/support group every Thursday morning between 10am and 12pm.

DIABETES WELLNESS | Spring 2018

Taupo PO Box 2379, Taupo 3351 Contact: Tim Tumanako (Chair) diabetestaupo@reap.org.nz

SOUTH ISLAND Nelson Youth dnznelsonyouth@gmail.com Otago* 135 Frederick St, Dunedin (03) 474 0240 diabetesotago@vodafone.co.nz

Waikato* 20 Palmerston Street, Hamilton Central, Hamilton 3204 (07) 853 9854 diabetesw@xtra.co.nz www.diabeteswaikato.com

Notes: Information & Education Centre open 10am-2pm Monday to Friday.

Notes: Office/drop-in centre open Monday to Friday 9am-12pm for information, pamphlets and products. Services include regional support groups, events and education, support and advocacy. LOWER NORTH ISLAND Horowhenua (06) 368 8740 diabetesnzhorowhenua@gmail.com Taranaki Area* PO Box 896, Taranaki Mail Centre, New Plymouth 4340 (06) 758 7873 diabetesnztab@xtra.co.nz Wairarapa 021 973 350 juju0@windowslive.com Contact: Julian Heyward (President)

South Otago (03) 418 0803 or 021 383 105 Contact: Colin Ward Southland* 151 Gala St, Invercargill (03) 218 3422 diabetes.southlandfo@xtra.co.nz Notes: Drop-in support centre operates every Friday from mid-January to midDecember. Opening hours are 11am–3pm. A diabetes nurse is available to take blood glucose and blood pressure readings, discuss problems, and provide other support. West Coast Greymouth (03) 768 5969 billstanley@xtra.co.nz Contact: Patricia Stanley

Wanganui Community House, 60 Ridgway Street PO Box 102, Wanganui 4541 (06) 281 3195 lizrobertson@infogen.net.nz Notes: Office open 10am–2pm Monday to Friday

AUCKLAND WAIKATO

TARANAKI

TAUPO

ROTORUA

GISBORNE

WANGANUI HOROWHENUA NELSON YOUTH WEST COAST

SOUTH OTAGO SOUTHLAND

WAIRARAPA NATIONAL OFFICE WELLINGTON

OTAGO

Big on sweetness. Small on calories Lemon Meringue Pie Preparation 20 mins | Cooking 30 mins | Serves 8

Base

Method

2 sheets frozen shortcrust pastry, partially thawed (approximately 300g)

1. Preheat oven to 220°C. Grease an 18cm round or 30cm x 8cm rectangular loose-bottomed fluted tart tin with cooking oil spray.

Filling 2 1/4 cups water 1/2 cup lemon juice 1/2 cup cornflour 2 eggs 2 egg whites 1 tsp finely grated lemon zest 1 1/2 cups Equal Spoonful 40g butter, chopped Yellow food colouring, to tint

2. Line base and sides of tin with pastry sheets, slightly overlapping at the join. Use a small knife to trim off excess overhanging pastry. Pierce the base of the pastry with a fork several times. Line with a sheet of baking paper and fill with baking weights or raw beans or rice. Bake for 10 minutes. Remove paper and weights, beans or rice and bake for a further 4-5 minutes or until pastry is light golden. Cool on a wire rack. 3. To make lemon filling, combine water, lemon juice and cornflour in a medium saucepan over medium-high heat. Bring to the boil, stirring constantly.

3 egg whites 1/4 tsp cream of tartar 2/3 cup Equal Spoonful

4. Meanwhile put eggs, egg whites and lemon zest into a large bowl and whisk until smooth. Whisk in Equal Spoonful and half the hot lemon cornflour mixture until smooth. Return to saucepan and whisk until combined. Cook, stirring constantly over medium-low heat for 1 minute. Remove from heat and stir in butter. Add a few drops of food colouring to tint yellow. Pour mixture into prepared pastry.

Energy 1090 kJ • Protein 7.0 g • Fat 13.4 g • Saturated Fat 6.6 g • Carbohydrate 28.1 g • Sugars 3.9 g • Sodium 248 mg

5. To make meringue topping, put egg whites in the bowl of an electric mixer and beat on high until foamy. Add cream of tartar and beat until soft peaks form. Gradually add the Equal Spoonful 1 Tbsp at a time, beating well after each addition until stiff peaks form.

Meringue Topping

6. Spoon meringue into a piping bag fitted with a plain 1cm round nozzle. Pipe peaks of meringue onto hot lemon filling to cover filling completely. Bake for 3 minutes until lightly browned. Set aside to cool to room temperature then transfer to fridge to cool completely. Serve.

The essential ingredient Equal Spoonful has almost no calories and measures spoon-for-spoon like sugar. Perfect for your recipes, cereals and drinks.

Find more delicious recipes at

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Diabetes Wellness Spring 2018

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