Diabetes Wellness Summer 2018 by Diabetes New Zealand

wellness

SUMMER 2018

DIABETES

DIABETES NEW ZEALAND | DIABETES.ORG.NZ

DESTIGMATISING DIABETES • NEWLY DIAGNOSED GUIDE • FAMILIES AND FOOD • 80+ YEARS ON INSULIN READY TO (FUN) RUN • PREDIABETES PROBLEM • GEM OF AN IDEA • GO SUGAR-FREE

ACT NOW TO LIVE WELL DIABETES ACTION MONTH

CHILDCARE CHAMPIONS Caring for children with diabetes

Regular exercise plays a vital role in the prevention and management of both type 1 and type 2 diabetes. Anytime Fitness New Zealand is delighted to support Diabetes New Zealand in helping Kiwis reach their healthier place.

Contents SUMMER 2018

VOLUME 30 | NO 4

22 EAT: Positive conversations about diabetes and food

4 EDITORIAL

5 UPFRONT: Cookbook launch

24 RECIPE: Sapasui (chop suey)

6 UPFRONT: Sugar-free September, Dr Lance O’Sullivan, new T2D drugs

COVER: SHARLEEN POINGA AND DAUGHTER SHONTAY. PHOTO: KIRI MARSTERS

8 LIFE WITH T2: Kim Thompson’s wake-up call to “Act Now to Live Well”

10 COVER: Childcare champions – the challenge of looking after T1 kids

26 YOUR DIABETES NZ: Margaret and Win: T1 role models 28 ADVOCACY: Is prediabetes being taken seriously?

30 LIFE WITH T1: Dia-preneur Hayley McDonald talks medical IDs 32 MOVE: It’s fun run season! Are you ready?

14 DIABETES ACTION MONTH: Destigmatising diabetes and the importance of family

16 DIABETES ACTION MONTH: Dates for your diary

34 EAT: The butter vs margarine debate 36 FAMILIES: Setting sail once more with Kia Korrop 38 INNOVATE: Phil Wright’s nifty invention

18 CARE: Meet your diabetes healthcare team

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DIABETES WELLNESS | Summer 2018

Editorial

As I write we are putting final touches on this year’s Diabetes Action Month “Act Now to Live Well” campaign. This November we are urging everyone – whether they have diabetes or not – to take action to improve their health. This can help those with diabetes to manage their condition, and help prevent T2D diabetes in people with a high risk of developing it. Throughout November, we will also be working to destigmatise diabetes. Research shows that people living with all kinds of diabetes regularly experience negative attitudes, even from close family members. It’s not OK to talk negatively about people with diabetes or criticise their food and lifestyle choices. And yet, as we know, this happens all the time, as you can see when you read Vanessa’s story in this magazine. Each year our Diabetes Action Month campaign gets bigger and better and we are looking forward to a bumper month in November. You can read about the highlights later in this issue, but I’m particularly looking forward to the launch of Diabetes NZ’s new cookbook Eat Well Live Well, which is full of delicious, low-cost, and easy-to-make recipes for the whole whānau. See page 5 for details about where to buy a copy. Over the past few months, I have been travelling around the country with our Board Chair, Catherine Taylor, talking to branches about changing the structure of Diabetes NZ. The general consensus from our meetings is that people are ready for a change, which has encouraged us to bring to the AGM a proposal to move from an incorporated society to a charitable trust. This will expand our representation to all people with diabetes rather than just our membership, which is reducing, like that of many other membership organisations. Recent studies show the rates of type 2 diabetes among Pacific and Māori children are up to 18 times higher than among European children, which has led to the disease being “normalised” in some communities. We are really concerned about this. We need to act boldly so Diabetes NZ can do more to support and advocate in every community and for all of the 260,000+ men, women and children living with diabetes in New Zealand. Doing nothing is not an option and we hope our members will agree. It would be lovely to see some of you at our AGM on 17 November. Have a happy and healthy summer. HEATHER VERRY

Chief Executive, Diabetes New Zealand

DIABETES WELLNESS | Summer 2018

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

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

NEW DNZ COOKBOOK

eep your eyes peeled for Diabetes New Zealand’s vibrant new cookbook, which is being launched in November during Diabetes Action Month. The book is full of recipes that use readily available and affordable local ingredients. They are family-friendly, quick and easy to prepare, ethnically diverse, and nutritionally balanced. Most of all, they are delicious and healthy for everyone, regardless of whether they have diabetes. Eat Well Live Well includes recipes from well-known Kiwi chefs, including Jax Hamilton, Simon & Alison Holst, Brett McGregor, Robert Oliver, Kit Perera, Claire Turnbull, and LeeAnne Wann. Every recipe includes nutritional information and has been given the diabetes tick of approval from Diabetes Wellness dietitian Helen Gibbs.

“This cookbook is testament to the fact that eating healthily does not have to mean denying yourself flavour. As well as providing delicious recipes, the book contains eating and exercise tips that support a sustainable wellness lifestyle,” says Heather Verry. “We’d like to thank all the chefs who have generously supported this project. The book would make a wonderful Christmas gift for a loved one.” You can buy Eat Well Live Well (RRP $34.95) direct from Diabetes NZ (see www.diabetes. org.nz), Whitcoulls, The Warehouse and Paper Plus. All the profits go to supporting Diabetes NZ’s work.

We have two copies of Eat Well Live Well to give away to two lucky readers!

To be in to win one of two copies of Eat Well Live Well published by Hyndman Publishing, email draw@diabetes.org.nz with your name and address and put EAT in the subject line. The competition closes on 1 February 2019.

INVEST IN YOUR HEALTH Subscribe for just $24 a year* Diabetes Wellness magazine is the flagship publication of Diabetes New Zealand

* Four issues delivered to your door – $6 per issue, including P&P. To subscribe visit www.diabetes.org.nz, click on ‘Join now’ and select ‘Magazine only’.

DIABETES WELLNESS | Summer 2018

Upfront

Sugar-Free SEPTEMBER Kate Walker’s innovative Sugar-Free September campaign has been helping Kiwis stop eating the addictive white stuff, raising funds for Diabetes NZ in the process.

ugar-Free September is a 30-day challenge where participants try to eliminate all added sugars from their diet. “The aim is to give your body a rest from the stuff for 30 days and see if you feel the wellness benefits of having less sugar in your diet,” says founder Kate Walker, from Lifespark Nutrition, who organises the challenge. “You don’t have to be 100% perfect but being aware and making the best choices you can over the month is a great way to start to reduce your sugar intake. “The best part is that we are partnering with Diabetes New Zealand to raise money so they can continue their great work in helping thousands of Kiwis with type 1 and type 2 diabetes.” Diabetes NZ Patron Sir Eion Edgar, founder of Forsyth Barr, loved the idea so much he offered to donate an extra $10 per person for every staff member who took part in Sugar-Free September. An amazing 28 of his workers from across New Zealand took part, scooping a gourmet hamper prize – sugar-free of course – for the workplace with the highest number of participants. Eating too much sugar can have a big effect on your mood, energy, digestion, concentration and waistline – not to mention your blood sugar levels – whether you have diabetes or not.

DIABETES WELLNESS | Summer 2018

Members of the Forsyth Barr sugar-free team.

This challenge is to help you get back to basics including looking at the ingredients in your favourite foods, identifying hidden sugars, gaining new ideas for meals and snacks, and doing all of this in a fun supportive way! One happy participant is Kelly Bates, whose son has type 2 diabetes. Kelly said: “I’m very thankful for Sugar-Free September which helped kick-start the new me! Since being sugar-free, I lost 4.9kgs.” It costs just $35 to access the SugarFree September programme, which gives you access to recipes, menu planners, a closed Facebook group, advice sheets, and more. As a special offer for Diabetes Wellness readers, Kate is extending the programme for another six months so any Diabetes NZ supporter can try the Sugar-Free September programme for themselves.

SCARY FACT

The average Kiwi consumes 29 teaspoons of sugar each day!

Are you up for the one-month sugar-free challenge? Sign up at www.gosugarfree.co.nz and $10 of the $35 fee will go to Diabetes NZ.

Upfront

Doctor calls for digital health revolution Ground-breaking GP and Māori health advocate Dr Lance O’Sullivan will give the keynote address at Diabetes NZ’s annual conference and AGM in November. Lance has had an amazing personal journey – from a young boy labelled as a “troublemaker” to a pioneer for equality of healthcare in his community. Diabetes NZ is delighted that Lance, who is also an accomplished author, international speaker, role model, disruptive leader and innovator, has accepted its invitation to speak at November’s annual conference. In 2013, Lance was declared Nga Toa Whakaihuwaka (Supreme Māori of the year), and a year later he was named New Zealander of the Year 2014 for bringing health programmes to disadvantaged people in rural areas.

Lance’s keynote speech “Kōrero from a health futurist” will set out his vision for how people can better manage their diabetes in the future. He would like people to take more responsibility for managing their own health by taking advantage of new digital platforms. He will also lay down a challenge to the government and local providers to modernise our health services and deliver more information to patients. Other speakers include leading businessman, philanthropist and Diabetes NZ patron Sir Eion Edgar, and Hamish Walker, National MP for CluthaSouthland, who has type 1 diabetes and is a big supporter of Diabetes NZ’s work. There will also be discussions about the future direction of Diabetes NZ as a result of the Destination Unity review.

Dr Lance O’Sullivan

DIABETES NEW ZEALAND AGM AND CONFERENCE Date: Saturday 17 November 2018, 8.30am-4.30pm. Location: Brentwood Hotel, Kemp Street, Kilbirnie, Wellington Cost: $115+gst For details and to register, see www.diabetes.org.nz and go to News and Events, or call 0800 342 238. Registrations close 5 November.

New diabetes drugs needed Hundreds of patients with type 2 diabetes will benefit from Pharmac’s recent decision to fund a new class of drug that helps people manage their blood sugar levels without the side-effects experienced with other medications, such as weight gain and hypoglycaemia (extremely low blood sugar levels). Since 1 October, doctors have been able to prescribe vildagliptin (brand name Galvus) and vildagliptin with metformin (brand name Galvumet). Both the medications are being supplied by Novartis New Zealand. Diabetes NZ welcomes Pharmac’s decision to fully fund vildagliptin but calls on the government’s drugbuying agency to fund other classes of diabetes medications that have more proven health benefits.

“These new drugs offer a low risk of hypoglycaemia in people who are not taking insulin. This means they are valuable for the treatment of people with poorly controlled blood glucose who are currently taking metformin. “We urge Pharmac not to forget the other classes of medication (GLP1 agonists and SGLT2 inhibitors) that international evidence reveals have further advantages over vildagliptin, including cardiovascular health

benefits. These should be funded as well,” says Heather Verry, chief executive of Diabetes NZ. Pharmac Heather Verry says the funding of vildagliptin will not prevent the funding of other diabetes treatments in the future. “Pharmac is currently assessing a number of other medicines for the treatment of type 2 diabetes and we are hopeful that suppliers will work with us in relation to other diabetes treatments now that a new type of treatment is funded,” said a Pharmac spokesperson. DIABETES WELLNESS | Summer 2018

Life with T2

WHĀNAU FIRST Mum-of-five Kim Thompson, of Christchurch, shares how her family helped turn her life around after a shock diabetes diagnosis just before her 39th birthday in October 2017. Today, Kim has lost 40+kgs and says being diagnosed was the best thing to happen to her and her family because it was a giant wake-up call to “Act Now to Live Well”.

Kim Thompson with her hubby Vince

DIABETES WELLNESS | Summer 2018

“I

was diagnosed with type 2 diabetes last October, four days before my 39th birthday – it was a huge shock, and I was totally terrified because my blood sugar count was very high and the doc was super worried about me. I was living on seven to 10 cans of coke a day, eating a huge range of bad foods, and doing limited exercise. Sadly, I had got lazy, although my birth family is riddled with type 2 (some have lost limbs to diabetes) and yet I still let myself go. This was a giant wake-up for me. I have five kids and I want to be as healthy as I can be. I want to be with them as they grow up, and I have big plans for my life when they fly the coop. I was scared after seeing the doctor, but I am stubborn, and this time I used it for good. I made the choice that day that type 2 diabetes was not going to control me. I read as much as I could, joined groups on Facebook, and taught myself about food, and what was good, bad and a “sometimes” treat. I learned new ways to cook and snack, and with the support of my family, especially my youngest daughter, I started the huge mission to reinvent myself. Today, I live on fresh veges and homemade meals so I can control what’s in my food. I gave up alcohol and fizzy drinks – I only drink water and the odd coffee without sugar. I stopped eating for the sake of it and instead eat just to fuel my body. I walk every day, rain or shine. Lucky for me, there are some awesome hill walks here in Christchurch, and

DIABETES ACTION MONTH 2018

Diabetes has had a positive effect on the Thompson family for lots of reasons. Kim and Helen with four of their five children: Connor, Noah, Abby and Jack.

I explore them three times a week and find new places to explore so I don’t get bored. In the months since having my world tipped upside down, I have found a new love for life. I eat less, I feel great, I have more energy to play with my kids and live my life to the fullest. It was scary at the start, but my gosh I have lost 40+ kgs, my clothes have dropped in size so often, and for the first time in years, I feel amazing. My advice to anyone starting out on this journey is “Don’t let diabetes define and control you, take small steps, make

small changes every day and before long they will become normal and you will forget the old days of bad foods. Find support wherever you can, especially in your whānau, take this diabetes and kick it in the butt!” I could have done without this happening, but, in all honesty, it has truly turned out to be the best thing for me. It woke me up, taught me so much, and has had a huge positive effect on my family, all our lifestyles, and my five kids’ futures.

”

One of the themes for this year’s Diabetes Action Month is “Act Now to Live Well”. The aim is to encourage as many Kiwi families as possible to take positive steps to help whānau members live better with type 1 or type 2 diabetes, and reduce the risk of other family members developing it. Throughout the month Diabetes NZ will showcase how Kiwi families are working together to support relatives who are living with diabetes by making lifestyle changes together. This includes healthy eating, incorporating exercise into daily routines, and upskilling their diabetes knowledge. Diabetes NZ wants to encourage these positive changes without the judgement and stigma that are commonly associated with diabetes.

READER COMPETITION Our friends at Ecostore are giving away this wonderful bucket packed full of plantbased goodies from their new ultra-sensitive, fragrance-free range that are gentle on your skin. The prize, which is worth $39.90, includes laundry liquid, dish liquid, two goat’s milk soaps, handwash, and bodywash. See www. ecostore.co.nz for details. To be in to win, email draw@diabetes.org.nz with your name and address and put ECOSTORE in the subject line. The competition closes on 1 February 2019.

DIABETES WELLNESS | Summer 2018

Sharleen Poinga and daughter Shontay Photo: Kiri Marsters

Ruby McGill and her son Felix

Cover Helen Booth and grandson Cameron

Bailey Cockerton

Rebecca Cheriton and son Gabe

Leaving a child with diabetes in the care of a new babysitter can be stressful for everyone, as Katie Doyle finds out when she talks to families and caregivers about their experiences.

DIABETES WELLNESS | Summer 2018

have been living with type 1 diabetes since I was 11 years old, and looking after children helped fund my travels around New Zealand and other life adventures. But it was only recently that I started thinking about what it’s like for parents raising a T1D child – and the strong undercurrent of worry that accompanies those childhood years. Whānau and other caregivers told me there is lots we can all do to help support families and caregivers, so everyone can feel confident that children with diabetes are in safe hands 24/7. But it needs to be a “village” effort! Parents shared a number of worries they had when leaving someone else in charge of their T1D child: caregivers missing a low blood sugar, forgetting to take a reading, miscalculating insulin,

CHILDCARE CHAMPIONS

Alexandra Bridger and brother Charles

or not knowing what to do during a diabetes emergency. Sharleen Poinga, from Auckland, says she feels uneasy about leaving her 12-year-old daughter Shontay with anyone outside her own whānau. Sharleen, who has two sisters with type 1 diabetes, says: “I’m lucky because my family can often step in, but it’s hard for me. Talking and checking in regularly with the caregiver is how I feel comfortable. “I also take the time to train up new babysitters so they feel comfortable taking care of Shontay’s diabetes. “I have to make sure school holiday programme staff are aware she has type 1 and also parents if she goes to a friend’s house. But when it comes to leaving Shontay with someone new, I still struggle with it.” Wellington Mum Rebecca Cheriton agrees. Her 12-year-old

son Gabe has had diabetes since he was one. “All of the babysitters we’ve used have been close friends. He’s never actually stayed with anyone who wasn’t already known to him,” Rebecca explains. “But it’s still hard to fully relax on a night out because you end up keeping half an eye on what’s going on at home. I know in hindsight we’ve been “helicopterparents” at times. For example, I’ve been involved in school help a lot more than I would have, in terms of day trips and camps.” The family relies on technology to communicate with babysitters, staying in touch by text, checking blood glucose numbers and giving advice. Finding a babysitter who can keep calm in the face of diabetesrelated chaos was a challenge for all the families I spoke to. “Everyone thinks they’ll be able to respond if it goes wrong but not everyone handles themselves well when it does,” says Rebecca. One solution is hiring a babysitter who has diabetes themself, like Bailey Cockerton, 22, from Hamilton, who has lived with type 1 for 19 years. Bailey says she plans to “expect the unexpected” when she’s looking after a T1D child. She also thinks about how she would react if things don’t go according to plan. “Having diabetes management skills definitely makes looking after T1D children easier. I also understand how parents feel about leaving their children in the care of someone outside the family.

“I recommend asking around. There will be a bunch of T1D people out there who are interested in babysitting little T1s,” she says. With any babysitter, the most important thing is to “educate them as best you can,” she says. Many parents said they felt most comfortable when leaving their children in the care of whānau, including grandparents and older siblings. Retired nurse Helen Booth, from Kāpiti Coast, often looks after her 11-year-old grandson Cameron, who has had diabetes for five years and lives in Wellington. “It is challenging and as a grandparent you do feel a weight of responsibility. I’m forever making sure he has eaten enough food to cover the insulin given. And I look at his little calloused fingers and wish I could have this for him! But he copes very well. “For the last two years he has had an insulin pump. This is a little challenging for all grandparents – his blood sugar has to be tested, carbohydrate intake entered on the pump and insulin requirement noted and entered. “Cameron can manage the pump during the day, but not at night. He is checked at 12am and 3am, and more frequently if he is particularly low or high. Even as a retired nurse, I find decision making when short of sleep – when to adjust basal rate or feed him Skittles – scary in respect of making a mistake. I therefore limit his stays to one night at a time, though both he and we would love his stay to be longer, especially to give his parents a break.”

Alexandra Bridger, age 27, from Hamilton, says that looking after her younger brother Charles taught her to know when to ask for help. Charles, now 24, was diagnosed at just over one year old. “When I was younger I was a lot less confident with injections and insulin dosages, but I knew that if he wasn’t in a state to inject himself, I could always call my parents so that they could talk me through it,” she said. “I’m now more likely to ask questions if I think something might be wrong.” Ruby McGill, Director of Youth at Diabetes NZ, from Wellington, agrees that it’s important for parents and babysitters to ask for help when they are feeling out of their depth. “I know that calling on ‘my village’ when I’m feeling a little burnt out helps my diabetes management and my family,” says Ruby, who has had T1D since she was 14 years old. “Juggling type 1 diabetes and a family can be a challenge, and you do the best you can. It’s okay to take some time out for yourself and please don’t ever forget you are not alone in this journey.”

TURN THE PAGE FOR

TOP BABYSITTING TIPS

Katie Doyle is an American writer with T1D who became more involved with the diabetes community during a working holiday in New Zealand. She has looked after children with T1D in the US and Australia.

DIABETES WELLNESS | Summer 2018

Cover

TOP TIPS

FOR BABYSITTING A CHILD WITH DIABETES PARENTS

CAREGIVERS

CAREGIVERS WITH T1D

Ask around for a caregiver who has diabetes themselves or a child/close family member with type 1 diabetes. Train up new babysitters and 2 caregivers – keep instructions simple and straightforward. What are the most important “mustdo” diabetes management tasks? What do they need to do in a diabetes emergency? Make sure the caregiver knows 3 that low blood sugars are dangerous if not treated, and they know how to test and treat a “low” if it happens. Check in regularly with 4 caregivers, including family members, by text or phone, and make sure they don’t feel out of their depth or on their own. Have a “trial run” with a new 5 caregiver while a parent is at home to build confidence and practise diabetes management tasks.

Ask the parents if you can “babysit” at least once while they are at home, so you can experience the family’s diabetes routine. Organise a written schedule 7 of when (and what) the child needs to eat, and what to do if they refuse to eat. Don’t be surprised if the 8 child “tests” you to see if you will relax the parents’ instructions about food. Have a plan of action if that happens. Give all the children in the 9 family special attention as those without diabetes may feel left out otherwise. Don’t be afraid to tell the 10 parents if they have given you too much responsibility. If you are not sure about anything, ask for help.

As above plus: Try to keep your diabetes under 11 control when you babysit. You may not be able to supervise a child properly if your blood sugar is low, so come prepared to treat this if it happens. Don’t agree to test the child’s 12 blood sugar or give an insulin injection without the written permission of your parents and the child’s parents. If everyone agrees, practise with the child’s family at home several times. Bring any diabetes supplies 13 that you will need while you are babysitting. Don’t let any of the children touch or use any of it and don’t use any of the child’s kit. Don’t assume that what “works 14 for you” works for the child, or that everyone feels the same way about diabetes as you do.

For more information, check out Beyond Type 1’s detailed guide to babysitting children with diabetes at http://bit.ly/2OuhfaE

DIABETES WELLNESS | Summer 2018

Treatment

How to beat the heat this summer WITH

DREW HARRISBERG Fitbit Ambassador and Exercise Physiologist

Advertorial

How would you do a full-body workout in Summer? One of my favourite ways to get active in the warmer months is by running outside with some bodyweight exercises incorporated along the way, then fi nishing with a swim. By wearing my Fitbit Charge 3 throughout exercises, I’m able to see how I went compared to my goals.

“Summer is a great time to get your body moving outdoors and there’s no denying that exercise is one of the best ways to manage all types of diabetes.” What are the benefits of swimming? To beat the heat on those scorching hot days, I also love to swim. It’s a wonderful, low impact, respiratory/ cardiovascular workout. It also has minimal DOMS (delayed onset muscle soreness) associated with it, which is a bonus as you can swim most days of the week without overtraining! Swimming is particularly beneficial for those who suffer from diabetes and/or joint problems as it works a large amount of muscles, ultimately improving insulin sensitivity across your entire body leading to more stable blood sugar control.

How can you make swimming a challenging workout? In summer, I also like to do HIIT training in the pool by swimming 50-100 metres as fast as possible followed by 30-60 seconds rest at the other end and repeat for 10 rounds. I use my Fitbit Charge 3 to track my heart rate in real time duration with Swim Mode. It’s important to always ensure blood sugar levels are in the safe zone before exercising, as well as having a glucose meter and fast-acting sugar source nearby during workouts just in case.

Find out more at fitbit.com

Diabetes Action Month 2018

Act Now to Live Well Diabetes Action Month is an annual campaign that encourages all New Zealanders to learn more about diabetes, increase their awareness of the condition, and take action. Here are the key themes and highlights for the 2018 campaign.

his November, we are challenging all Kiwi families to “act now to live well” – the main theme of this year’s campaign. “We are urging everyone from the government, healthcare professionals, families, communities, media and those living with or supporting someone with diabetes to take action to improve their health,” says Heather Verry, CEO of Diabetes NZ. Together with Diabetes NZ’s branches, sponsors, supporters, and partners, we will be educating and encouraging people to live

healthy lifestyles. This means giving Kiwis the opportunity to be more active, eat well, and get the information and support they need to live well. This can help those with diabetes to manage their condition, and help prevent diabetes in people with a high risk of developing type 2 diabetes. Risk factors include age, family history, lifestyle factors, ethnicity and having gestational diabetes in pregnancy. Whether you have type 1, type 2 or, gestational diabetes, are at risk of diabetes, or support someone with diabetes, everyone can act now to live well. Throughout November, we will also be addressing issues of attitudes and stigma around diabetes. Research shows people with diabetes can experience judgement from other people, a lack of support, and high rates of depression and anxiety. Unfortunately, this can make it harder for people to get the support they need, get diagnosed, or even talk about the condition – all of which can result in negative health outcomes.

“This year’s campaign is not just about advocating for the physical wellbeing of all New Zealanders, it’s about addressing the mental aspect of having diabetes and ensuring proper support is in place for people with diabetes, wherever they live in the country,” says Heather. “Stigma around diabetes is something we know exists, and it can be a barrier for people with diabetes to get the support they need,” she adds. Taking guidance from global movements to change the language of diabetes, we aim to reduce the stigma surrounding diabetes in New Zealand, and encourage better support for people living with the condition. “With the right support, we can all work together to live well.” Join the kōrero: To find out about what’s happening this Diabetes Action Month and how you can get involved, visit www. diabetes.org.nz or check out Diabetes NZ on Facebook and Instagram. You may just be one of the lucky winners of special giveaways, courtesy of our sponsors Fitbit and Equal!

World Diabetes Day – whānau first

DIABETES CONCERNS EVERY FAMILY COULD YOU PREVENT IT IN YOURS?

80%

of type 2 diabetes is preventable

World Diabetes Day is on Wednesday 14 November and this year’s theme is families and diabetes. The global campaign is about families working together – either to reduce the risk of type 2 diabetes among family members, or supporting loved ones to manage their diabetes and live more healthily. In New Zealand, we are looking at the importance of whānau and highlighting how our physical, emotional and spiritual connections with loved ones can support us all to live well. Keep an eye out for your local branch activity and ways to get involved with World Diabetes Day on Diabetes NZ Facebook page.

1 in 11 people live with diabetes www.worlddiabetesday.org/prevent #WDD2018

DIABETES WELLNESS | Summer 2018

Cookbook launch

My life with diabetes

As part of Diabetes Action Month, we are launching our new recipe book Eat Well Live Well with tasty meals suitable for the whole whānau. Featuring recipes inspired by Māori, Pacific Island, Chinese, Indo-Asian and European flavours, Eat Well Live Well gives people the chance to enjoy a melting pot of Kiwi cuisine at home, knowing that every recipe is suitable for people with type 1, type 2, gestational, or prediabetes.

This Diabetes Action Month, we’ll be sharing videos from New Zealanders candidly discussing their personal experience with diabetes. Althea Lovell talks about inter-generational diabetes as a result of her Indian heritage and shares how prediabetes has impacted her life as a mum with young kids. Kayla Uili discusses the lifestyle changes she’s made since being diagnosed with gestational diabetes and how she’s inspiring others with her journey. The Rock FM DJ Lee Weir opens up about how a recent type 2 diabetes diagnosis saw him overhaul his lifestyle for the sake of his family. And Ricky Winikerei speaks about type 1 diabetes and how this has affected him and his family. Ricky’s guitar tunes also provide the soundtrack for the videos. Keep an eye out for their videos on the Diabetes NZ Facebook page this November.

Diabetes NZ chief executive Heather Verry and the new cookbook, fresh off the press.

Ricky Winikerei and his partner Jo Chapman, with daughter Ericka and Teddy

Mr Vintage chariTEE We’ve partnered with Mr Vintage chariTEE. Since 2010, Mr Vintage have been supporting New Zealand charities with their unique chariTEE. This year marks the first time they have supported Diabetes NZ with a specially designed t-shirt that anyone will be happy to wear when they’re out and about. For every $25 t-shirt sold, Diabetes NZ will receive 25%. You can order yours on the Mr Vintage website www. mrvintage.co.nz.

Lions Clubs During Diabetes Action Month, Lions Clubs around the country will be supporting local Diabetes NZ branches. Some branches are hosting events, while others are helping to distribute ‘Warning Signs of Type 1 Diabetes’ posters to local medical and community centres. Connect with your local Diabetes NZ branch or Lions Club for more information. Lions Club volunteer Christine Kemp travels across the country offering free diabetes screening, education and blood pressure checks.

Dates for your Diary – see overleaf

DIABETES WELLNESS | Summer 2018

Diabetes Action Month 2018

DATES FOR YOUR DIARY There’s a lot of activity happening all over New Zealand for Diabetes Action Month. Listed below are a few key dates but check with your local branch or the Diabetes NZ website and Facebook page for more info.

Some of the highlights from previous Diabetes Action Month campaigns.

NOVEMBER

Launch of Diabetes Action Month

2-3

Around the Mountain Relay with Brett & Angel Renall and Steph McKenzie (Taranaki Youth Branch)

The Whānau & Diabetes Fun Day at Manukau Square (Auckland Branch)

3-4

Diabetes NZ Otago Branch at The Great Kiwi Home & Living Show, Forsyth Barr Stadium, Dunedin

3-9

Anytime Fitness open days – check with your local branch for details

Bike Beyond screening in Auckland. Contact National Office for tickets

Launch of Eat Well Live Well Recipe Book – with Dame Valerie Adams

World Diabetes Day Wellington Launch of Diabetes NZ’s Eat Well Live Well cookbook at Parliament

Diabetes New Zealand Annual Conference & 56th Annual General Meeting at Brentwood Hotel, Wellington

Jax Hamilton cooking demonstration and lunch at Club Carterton (Wairarapa Branch)

Hamilton Riverside Lions Club Strides Walk at Claudelands Park (Hamilton Branch)

Teddy Bears’ Picnic, Rangitoto Island (Auckland Youth Branch)

Relive the highlights from the month on the Diabetes NZ Facebook page

DIABETES WELLNESS | Summer 2018

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Your Choice. Your Life. Your Freedom.® Ask your Healthcare Professional if the t:slim X2 Insulin Pump or V-Go are right for you. Always read the manufacturer’s instructions and use strictly as directed. t:slim X2 information: *Charges may apply. Additional feature updates are not currently available for the t:slim X2 Pump with Dexcom G5 CGM integration and are subject to future FDA approvals. 1. Dexcom G5 Mobile CGM sold separately. Important Safety Information: The t:slim X2 Insulin Delivery System is intended for the subcutaneous delivery of insulin, at set and variable rates, for the management of diabetes mellitus in persons requiring insulin for individuals 6 years of age or greater. The t:slim X2 Insulin Pump can be used solely for continuous insulin delivery and/or as part of the t:slim X2 System to receive and display continuous glucose measurements from the Dexcom G5 Mobile Sensor and Transmitter. The t:slim X2 System also includes continuous glucose monitoring (CGM) indicated for the management of diabetes. The Dexcom G5 Mobile CGM is designed to replace fingerprick blood glucose testing for diabetes treatment decisions. The t:slim X2 System combined with the Dexcom G5 Mobile CGM aids in the detection of episodes of hyperglycaemia and hypoglycaemia, facilitating both acute and long-term therapy adjustments, which may minimise these excursions. Interpretation of the t:slim X2 System results should be based on the trends and patterns seen with several sequential readings over time. The device is indicated for use with NovoRapid or Humalog U-100 insulin. For detailed indications for use and safety information, contact NZMS Diabetes on 0800 500 226. © 2017 Tandem Diabetes Care, Inc. All rights reserved. Tandem Diabetes Care is a registered trademark and t:slim X2 is a trademark of Tandem Diabetes Care, Inc. Dexcom is a registered trademark of Dexcom, Inc. All other trademarks are the property of their respective owners. V-Go information: ^A U-100 fast-acting insulin should be used with V-Go. Humalog® and NovoRapid® have been tested by Valeritas, Inc. and found to be suitable for use in V-Go. 2. Lajara R, Nikkel C. Poster: Evaluating the effect of V-Go® therapy in sub-optimally controlled patients with diabetes: a retrospective cohort analysis on a large specialized diabetes system. Presented at AACE. May 2015. 3. Rosenfeld CR, et al. The V-Go insulin delivery device used in clinical practice: patient perception and retrospective analysis of glycemic control. Endocr Pract. 2012;18(5):660-667. NOTE: Read and follow the instructions in the pack carefully. If there are any problems/issues check immediately with your healthcare professional. Important Risk Information If regular adjustments or modifications to the basal rate of insulin are required in a 24-hour period, or if the amount of insulin used at meals requires adjustments of less than 2-Unit increments, use of the V-Go Disposable Insulin Delivery Device may result in hypoglycaemia. The following conditions may occur during insulin therapy with V-Go: hypoglycaemia (low blood glucose) or hyperglycaemia (high blood glucose). Other adverse reactions that may be associated with V-Go use include skin irritation from the adhesive pad or infections at the infusion site. V-Go should be removed before any magnetic resonance imaging (MRI) testing. Humalog® is a registered trademark of Eli Lilly and Company. NovoRapid® is a registered trademark of Novo Nordisk A/S. V-Go is a registered trademark of Valeritas, Inc. Distributed in New Zealand by NZMS Diabetes, 2a Fisher Crescent, Mt Wellington, Auckland.

Care

MEET THE (DIABETES) TEAM Being diagnosed with diabetes can be overwhelming but there is plenty of support available to help. Here is a quick guide for the newly diagnosed.

our healthcare team is made up of the people who can assist you or your child in diabetes management. It will vary in size depending on your individual needs, and whether you have T1, T2, a child with diabetes, gestational diabetes, or prediabetes. Your healthcare team depends on you to talk to them honestly and to tell them how you feel. Here is a rundown of some of the key members of your diabetes support crew.

YOU

YOU are the most important member of your diabetes team!

You are the most important member of your health care team because you are the one who is affected by diabetes and cares for it every day. You take the medicine, inject the insulin, do the exercise, make the family meals, check your own or your child’s blood sugar (glucose) levels and keep track of the results. And of course, you are the first to notice any problems. Your whānau is also a vital part of your diabetes support crew, especially when it comes to changing diets or doing more exercise – it’s much easier if everyone in the family makes the changes together.

YOUR GP AND PRACTICE NURSE

Dr Ros Wall is a Wellington GP who has a child with type 1 diabetes.

Your GP (general practitioner) is your first point of contact who will be kept updated of any changes in your care and is responsible for prescribing the medicines and supplies you may need. They can also refer you to your local diabetes centre for specialist care. Your practice nurse also plays a key role in monitoring patients’ health, offering lifestyle advice, and taking blood and other diabetes-related tests. Make sure you ask your GP for a full diabetes “WOF” once a year, including eye and feet checks, even if you are feeling well.

DIABETES NURSE SPECIALIST

Miranda Walker is a clinical nurse specialist in diabetes at Wellington Hospital, working with patients admitted with diabetes.

DIABETES WELLNESS | Summer 2018

Diabetes nurse specialists are nurses with an in-depth knowledge of diabetes. They play a role in helping and supporting people with diabetes in managing their condition. Their main role is to teach you about diabetes and how to look after your diabetes. They may also help adjust medication and insulin doses if required. Your GP may also refer you to a structured diabetes education programme, where a specially trained diabetes educator will teach you how to look after your diabetes.

DIABETES SPECIALIST

Dr Rinki Murphy is a diabetes specialist practising in Auckland.

People with type 1 diabetes are put under the care of a diabetes specialist or endocrinologist. People with type 2 diabetes, who are taking insulin, have fluctuating blood sugar levels, or are at high risk of developing complications will also need to see an endocrinologist. Diabetes specialists may be based at hospital diabetes centres or practise privately. You will need a referral from your GP to see a specialist diabetes doctor. If you develop diabetes-related complications, for example heart or kidney disease, your GP may refer you to a medical specialist in the relevant area of care.

EYE EXPERT

Dr Peter Hadden is a specialist eye surgeon who treats people with diabetic eye conditions.

Optometrists and opthalmologists are eye specialists who undertake retinopathy screening and treat eye conditions. An ophthalmologist has a deeper specialist knowledge of diabetesrelated eye health and will be responsible for any eye surgery that may be needed. Make sure you have regular eye checks and let your optometrist know you have diabetes.

PODIATRIST

Waikato podiatrist Claire O’Shea.

Everyone with diabetes should have their feet checked at least once a year by a health professional trained to spot diabetes-related foot problems. This could be your GP or practice nurse. You are entitled to see a specialist podiatrist (footcare expert) if you need help with your feet.

We need your help to help them A diabetes diagnosis can be scary, overwhelming and confusing. It’s a steep learning curve whatever kind of diabetes you have. We want Kiwis to know they are not alone, we are here to help them live well with diabetes and support their journey every step of the way. But Diabetes NZ needs your help to continue this vital work. As a charity, every dollar we raise is crucial in the fight to reduce the impact of diabetes in New Zealand. Your generous gift will improve the day-to-day lives of people living with diabetes and help us to spread the prevention message far and wide. Please support our work today:

H Give securely at www.diabetes.org.nz or call 0800 342 238.

Donate via Westpac 03 0584 0197985 09 – use your full name as reference.

m Send a cheque to Freepost Diabetes NZ, PO Box 12441, Wellington 6144.

DIABETES WELLNESS | Summer 2018

DIETITIAN

Diabetes Wellness food columnist Helen Gibbs is a dietitian working in Dunedin.

PSYCHOLOGIST OR COUNSELLOR

A dietitian is a specialist in food and nutrition who can advise you on your diet. If you need help transitioning to diabetes-friendly foods, or want to lose weight, you can ask your GP to be referred to a dietitian with experience in helping people with diabetes.

If you are having emotional or psychological issues that are affecting your life, you can ask your GP to refer you to a psychologist or counsellor with expertise in diabetes, who will be able to give you support. Waikato District Health board clinical psychologist Joanna McClintock.

PHARMACIST

Helen Cant is a Tokoroa pharmacist with a special interest in diabetes.

DENTIST

Pharmacists receive specialist training in a wide variety of medical conditions, medications and treatments. They can help you with any questions you have about your diabetes medication, including side effects.

Dr Anna Ferguson, a Wellington dentist with an interest in diabetes.

FITNESS EXPERTS FITNESS EXPERTS

Diabetes Wellness exercise columnist Craig Wise.

Your GP can write you a “Green Prescription”, which will entitle you to a free exercise programme in your local community. More and more gyms are also offering special programmes and support for people with diabetes.

It’s important to look after your gums and teeth if you have diabetes, especially if it’s poorly controlled. Have regular check-ups and don’t forget to let your dentist know you’ve just been diagnosed with diabetes.

DIABETES NZ

Deb Connor is President of Diabetes NZ. She has type 1 diabetes and lives in Dunedin.

Diabetes New Zealand is a charity that represents and supports people with diabetes. We’ve been around for over 50 years and have a National Office in Wellington, and branches across the country with staff and volunteers who help people live well with diabetes. See www.diabetes.org.nz

READER COMPETITION We have 20 full-sized tubes of DU’IT Foot and Heel Balm Plus (RRP $15.99) to give away to 20 lucky readers. The balm contains 25% urea to help the most difficult cases of very dry, rough, cracked and hard thickened skin on heels, knees and feet – with visible effects within five days. To be in to win, email draw@diabetes.org.nz with your name and address and put DU’IT in the subject line. The competition closes on 1 February 2019.

DIABETES WELLNESS | Summer 2018

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Eat

You can do it

We’re worried about you

Can I help?

You can’t eat cake l Emotiona eating

Let’s work together

TALKING ABOUT DIABETES AND FOOD Helen Gibbs explains how to have positive conversations with a loved one about diabetes and food.

t’s human nature to want to help when a family member develops a long-term condition like diabetes. The problem is that our efforts can be unintentionally hurtful or harmful, adding to their confusion and distress. Food, in particular, can be a touchy subject. Here we list six things we suggest not saying to someone with diabetes and explain why these comments might hinder rather than help your loved one make better lifestyle and food choices.

You have type 2 diabetes? That’s not “serious” diabetes, so it’s not really a problem – here, have some chocolate cake. Sadly this is still the view held by many people about T2D despite the fact diabetes is a serious disease. A person with diabetes will develop serious life-changing complications within 20 years if they don’t make diet and lifestyle changes and their blood glucose remains poorly managed. This is especially important because people are developing diabetes younger, in their 30s and 40s, rather than in their 70s and 80s. The younger you are at diagnosis, the longer you have to develop complications, including heart disease, stroke, kidney failure, blindness and nerve problems. Early intensive management of blood glucose is important and the consequences of poor control are serious. SAY INSTEAD:

I understand you have type 2 diabetes, tell me what diet changes you are making to lose weight and manage your blood sugars? How can I/the family help?

DIABETES WELLNESS | Summer 2018

Our Nana had diabetes – she went blind and had both her feet cut off before she died. Knowing your family’s health history is important, but hearing this kind of outcome could be terrifying to someone dealing with a new diagnosis. The key thing to note here is that there is no information about how Nana managed her diabetes. The definitive study demonstrating the importance of good glycaemic (blood sugar) control was published in 1998. This showed that with early detection and good management, everyone can live well with diabetes and not suffer serious side effects. Perhaps Nana was living with diabetes for years before being diagnosed and/or she didn’t get help to manage her diabetes. She may also have had other health issues or smoked. SAY INSTEAD:

Hey, did you know we have a family history of diabetes? Shall we make a time to talk about it? Nana was a real lolly queen, she had a big jar for the grandkids but she ate most of them herself. You don’t need to be like Nana. Why don’t you tell your GP about her, and ask her how to reduce the risk.

There is a cure for diabetes. I read this on the internet. Although there is some really excellent diabetes advice online, there is also some bad and dangerous information. Health professionals are required to offer “evidence-based healthcare”, which means we have to base our advice on research findings. But things take time to filter down from research to practice and it can be frustrating for people who want to try something radical and different. This is where patient-centred care comes in. If a patient wants to try a new diet to lose weight, I will help them work out if it’s the right thing for them by providing researchbased evidence. SAY INSTEAD:

I would be glad to be your support person at dietitian appointments or at diabetes education sessions. It would be good to get the latest advice about managing diabetes, diet and exercise, so we can get it right.

Don’t bother changing what you eat, it won’t work and they keep changing their minds about what’s healthy and what isn’t. No wonder people get confused about what to eat when they have diabetes. There’s a lot of misinformation, faddy diets, and healthy food “hype” out there because it’s popular and makes money for the person who dreams up a new approach to losing weight or “curing” diabetes. Professional dietitians use the government’s evidence-based Eating and Activity Guidelines for Adult New Zealanders (2015). If people followed these guidelines there would be far less type 2 diabetes in Aotearoa. See http://bit.ly/2I7wV1i SAY INSTEAD:

Let’s work as a family to make some diet changes so your diabetes is well-controlled – and this will also reduce the risk of everyone else in the whānau getting it too.

So, all the money you have been spending on dieting is a total waste. You got diabetes anyway. Harsh words and blaming language do not help anyone. If someone eats emotionally they may well be driven to comfort eating to soothe the stress caused by that kind of criticism. Being overweight is one of the risk factors for type 2 diabetes but there are many others, and some of them such as family history, increased age or having developed gestational diabetes when pregnant are things that can’t be altered. SAY INSTEAD:

You must be feeling upset about having diabetes and I’m worried about your health. What can I do to help? You shouldn’t be eating that, you have diabetes. Judging someone’s food choices is likely to cause distress rather than change behaviour, even if it is done from a place of caring. Many of my clients talk about feeling really angry and powerless when someone criticises their food choices. Some of them have secretive and hidden eating behaviours that fill them with shame but feel this is the only way they can eat the food they want. For many people, unhealthy food habits predate their diabetes. They will struggle until they get on top of the reasons they eat. SAY INSTEAD:

If you feel you need help to change your diet to lose weight or better manage your diabetes, ask your GP for a referral to see a dietitian.

Nothing if it’s a one-off. If it’s part of a pattern of eating, ask what you can do to support them to deal with their feelings around diabetes. Food is seldom the real issue, it’s more likely to be the feelings that they have about their diabetes diagnosis.

DIABETES WELLNESS | Summer 2018

Recipe

SAPASUI Here we share a recipe for sapasui, or Samoan chop suey, from Diabetes NZ’s new cookbook Eat Well Live Well. It’s a healthy version of a Pacific favourite filled with colour and heaps of flavour.

PREP TIME 10–15 MINS | COOKING TIME 15 MINS SERVES 6

250g bean-thread noodles (glass noodles) 1 tbsp oil (olive, rice bran or canola) 2cm piece of ginger chopped finely 2 cloves of garlic chopped finely 5cm chilli, deseeded and cut into very small pieces 500g chicken thighs, skin off, remove bone and chop into 2cm chunks 1 red onion, cut into fine half circles 1 large carrot, grated 8 silverbeet leaves, finely shredded 2 cups fresh bean sprouts ⅓ cup salt reduced soy sauce 1 tomato, cut into thin segments pepper

Soak the glass noodles in a large bowl with boiling water for at least 10 minutes. In a large wok or pan, heat the oil then add ginger, garlic and chilli and cook for 2-3 minutes. Add the chicken and cook for about 8 minutes until chicken is well cooked. Add the vegetables, except for the tomatoes, and cook for about 2 minutes until the bean sprouts have started to wilt. Drain the noodles and toss into the pan. Take the pan off the heat and stir using tongs. Add the soy sauce and serve with a couple of thin slices of tomato as decoration. Season with pepper as needed. AVERAGE NUTRITIONAL VALUE PER 390g SERVE: CALORIES 1280kJ / 306kcal | PROTEIN 25.2g | FAT TOTAL 7.9g (SAT FAT 0.7g) | CARBS 29.7g (SUGARS 7.5g) | SODIUM 841mg

“Congratulations to Diabetes New Zealand for producing this new cookbook and providing a tool to help New Zealanders live healthy lifestyles.” Dame Valerie Adams

DIABETES WELLNESS | Summer 2018

Big on sweetness. Small on calories Summer Pavlova Preparation 15 mins | Cooking 1 hr 10 mins | Serves 8 Ingredients 1 cup Equal Spoonful 4 egg whites 1 tsp white vinegar ½ tsp cream of tartar 2 tsp vanilla extract 2 tsp cornflour 200ml thickened cream, whipped ¼ mango, peeled, thinly sliced 60g raspberries 1 kiwifruit, peeled, thinly sliced ¼ cup thinly sliced fresh pineapple pieces Pulp of 1 passionfruit

Method 1. Preheat oven to 120°C bake. Line 2 oven trays with baking paper. Spread Equal Spoonful onto one of the prepared trays and warm in oven for 5 minutes. 2. Meanwhile, place egg whites in the large bowl of an electric mixer and beat on high, using the whisk attachment, until stiff peaks form. With the beater running, add Equal Spoonful ¼ cup at a time. Once incorporated, beat for a further 2 minutes. 3. Beat in vinegar, cream of tartar, vanilla and cornflour. Spoon mixture onto remaining prepared tray, in a mound about 18cm wide. Bake for 5 minutes, then reduce oven temperature to 100°C and bake for a further 1 hour or until firm to touch. 4. Remove from oven and set aside to cool for 15 minutes or until cooled to room temperature. Transfer to a serving plate and top with whipped cream, fruits and passionfruit pulp. Serve.

Average Quantity per Serve: Energy 534 kJ • Protein 2.7 g • Fat 9.4 g • Saturated Fat 6 g • Carbohydrates 7.6 g • Sugars 3.8 g • Sodium 38 mg

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

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Your Diabetes NZ

Here we feature two inspiring ladies of longevity with diabetes. By Caroline Wood.

73 YEARS ON INSULIN

argaret Middlemiss, 85, from Invercargill, has been living with diabetes since being diagnosed in 1945, during World War 2, when she was 12 years old. Margaret’s GP Roger Baillie says she is a wonderful role model for everyone with diabetes. She still lives independently at home, drives herself to appointments, and manages her type 1 diabetes with four insulin injections a day. Margaret, a member of Diabetes NZ’s Southland branch, has been living with diabetes for 73 years, only eight years less than the current world record holder (see right). She was awarded Diabetes NZ’s Charles Burns medal for living with diabetes for 50 years, and a

special certificate when she hit the 60-year mark. “I think having diabetes has helped me keep well. I don’t drink and I’m not overweight and I haven’t had any health issues until relatively recently. Diabetes doesn’t run in our family, I’m the only one with it,” says Margaret. Margaret was born on a farm in Southland and married a farmer. She has always been fit and strong and used to bike to work on the farm. She and her husband adopted four children and she has nine great grandchildren and a large supportive family. Diabetes NZ is arranging another special certificate for Margaret to mark her 73 years on insulin and the fact she is a wonderful inspiration to us all.

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

ALSO AVAILABLE FREE TO HEALTH PROFESSIONALS

DIABETES WELLNESS | Summer 2018

RECORD-BREAKING WIN

ccording to the Guinness Book of World Records, the longest diabetes survival record is held by Australian Hazel Davies, who had diabetes for 81 years and died in 2002. But we reckon New Zealand’s very own Winsome Johnston, who turns 90 this November, could be the new world record holder! Auckland-based Diabetes NZ member Winsome, who featured in our Winter 2017 issue, has been living with diabetes for 84 years this month! With the support of Win’s family and doctor, Diabetes NZ is writing to the Guinness Book of World Records on her behalf to ask it to consider her for the world record for the longest-surviving person with diabetes – we will keep you posted on the result. Daughter Jan Grove says she is very modest about her achievement and “doesn’t know what all the fuss is about” but her family is naturally very proud of her. Win told Diabetes Wellness magazine the key to living well with diabetes was having a good support network of friends and family who understand a bit about diabetes and can help when needed. “She’s a wonderful inspiration to us all. It would be fantastic if she did turn out to also be a record-breaking great-grandmother,” says daughter Jan. Diabetes NZ’s youth manager Ruby McGill, who has type 1 diabetes, says Win is a wonderful role model for children and everyone living with type 1. “I was so excited to hear about this. It’s awesome to know that even though I’m 19 years into my personal T1D journey, I’ve got a long way to go yet. I’m not going anywhere. Take that diabetes!” Last year Win was crowned New Zealand’s longestsurviving person with diabetes and was presented with an award by the then Minister of Health Jonathan Coleman.

CYCLE CHALLENGE Keen cyclist Gary Collins, who lives near Turangi, has had type 2 diabetes for 10 years. He has generously offered to raise money for Diabetes NZ by taking part in this November’s Lake Taupo Cycle Challenge. IT manager Gary’s personal diabetes challenge is to improve his lifestyle, so he can reduce – or even stop – his diabetes medication. He has already found following a better diet and taking more exercise have helped his overall health and made his diabetes easier to manage. Gary, 59, who is also a keen musician, says: “I want to do my bit to help others living with this challenging condition. I have a number of friends with type 1 and type 2, and I hope my small effort may in some way benefit the many.” Please sponsor Gary and help make a difference for people with diabetes, see givealittle.co.nz/fundraiser/ doing-it-for-diabetes.

DIABETES WELLNESS | Summer 2018

Advocacy

IS PREDIABETES BEING TAKEN SERIOUSLY? Vanessa Chaplow, 54, from Hawke’s Bay explains the stigma she felt following her prediabetes diagnosis six years ago. She calls for a name change so people with the condition – and their doctors – take it more seriously.

bout six years ago I was having coffee with a friend who mentioned she was going for diabetes and cholesterol testing as she was feeling pins and needles in her feet and hands. I sat there thinking I have pins and needles in my hands and feet too, remembering back to when I was pregnant with my second child in 1990. During a routine pregnancy blood test the doctor informed me that I was now “predisposed to being a diabetic”. Unfortunately there was no further discussion or information given to me. I felt fine, and at the time it didn’t seem to be a problem, so I wasn’t worried. I didn’t realise back then how this gestational diabetes

would come to impact on my future health. After meeting my friend, I went to my GP asking for a diabetes test and explained why. I was informed that I was not fat enough to be diabetic. I had experienced a slight weight gain over the last few years but had suddenly lost the extra kilos without any diet or exercise changes (I now know why, it was because I was heading towards fullblown type 2 diabetes). My GP initially refused to test me as he believed there was no need. This resulted in an argument, and I got the blood test. A week later I was back for the results, suddenly I was too fat (same weight as last week, and wearing size 12 clothes) and drank too much alcohol (I don’t drink). The GP said I was prediabetic but gave me little information about what to do about it.When I learned that I had prediabetes I was extremely upset. I found out the hard way that I wasn’t going to get much support from friends and family, except for my children who were concerned. I felt like I had to deal with it on my own and struggled for a while. Some of the unhelpful comments included I was “pathetic going on a diabetic diet”, that I don’t

Vanessa was diagnosed with gestational diabetes 28 years ago but didn’t receive any information or ongoing monitoring despite being at risk of developing type 2 diabetes.

DIABETES WELLNESS | Summer 2018

I would like to see the word pre remove from prediabetes, then perhaps GPs, people with prediabetes, and the wider community, will take it more seriously. need to do anything as I’m “not on insulin and will be okay when I go on it” (this was from someone who doesn’t have diabetes). “It’s my fault for having a sweet tooth” and “there is no such thing as gestational diabetes” were other comments I had to put up with. I was determined to take action to improve my health so I learned about different foods and changed my diet. I switched to a new GP but when I went for my first blood test, my numbers had dropped. I was told that I didn’t have prediabetes and could eat a “normal” diet, so I did. I became tired and low in energy but had no idea why. In my job I receive ongoing external supervision and in a session I mentioned that I was tired and had no energy. I thought it might have been stress. I was asked whether I had felt like this in the past. I said no, and then thought a bit more about it. Oops, yes, I was like this before I was diagnosed with prediabetes (thank goodness my supervisor remembered). I went back for another blood test, and my blood sugars were higher than my initial blood test. So I learned that, no matter what my numbers say, I have to stick to a diabetes-friendly diet and look after myself.

Advocacy I have found that if you tell people you are prediabetic they do not believe it’s serious, that you can still eat any type of food, that because you are not on medication it’s not a concern or problem. But I believe it should be treated in the same way as if you had type 2 diabetes. I now have six-monthly blood tests as I have found this supports me in maintaining my diet. I’m conscious of what I’m eating because I know a test is coming up, or I’ve just had one and I know what my blood sugars are doing. Being tested yearly is too long to maintain my diet without the motivation of aiming for low numbers. Clinically I am considered to have prediabetes but for people in my community to understand I say I have full-blown diabetes because of the lack of understanding that diabetes can be progressive. My goal is to avoid medication for as long as possible and I know this is only possible through diet and exercise. I would like to see the word pre removed from prediabetes, then perhaps GPs, people with prediabetes, and the wider community, will take it more seriously. NZ_Diabetes Wellness.pdf

31/5/18

WHAT’S IN A NAME Prediabetes is when the amount of glucose (sugar) in your blood is higher than normal. This means you are at much higher risk of developing type 2 diabetes. In recent years the HbA1c test has become the preferred test for screening and diagnosis of diabetes and prediabetes. It reveals the average amount of sugar in your bloodstream over the previous eight to 12 weeks and is more accurate than a one-off urine test. The table below sets out what a normal HbA1c blood test result looks like, compared with prediabetes and type 2 diabetes. If you haven’t had one, ask your doctor for an HbA1c test. It can be performed at any time of the day and does not require any special preparation such as fasting.

HbA1c test Fasting blood glucose test Random (non-fasting) glucose test

Normal

Prediabetes

Diabetes

≤40 mmol/ mol

41–49 mmol/ mol

≥50 mmol/ mol

6.1–6.9 mmol/l

≥7.0 mmol/l ≥ 11.1 mmol/l

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DIABETES WELLNESS | Summer 2018

Life with T1

Dia-preneur Hayley McDonald, 43, from Auckland, set up her own business selling funky medical ID jewellery after her daughter developed type 1 diabetes.

GEM OF AN IDEA

e were living in Christchurch when Payton was diagnosed. She was a normal seven-year-old, who enjoyed dancing, playdates with her friends, loads of giggling, and life was great! But one day Payton came home from school feeling really sick. She vomited all night but we put that down to the tummy bug that had been doing the rounds at school. The next day she started to breathe heavily and I googled it (bad idea) and Dr Google said that you can experience this with a gastro bug. We didn’t take her to the doctor (another bad idea). About 10pm that night, she woke up with an extreme pain just below her ribs. I phoned Healthline and they told us to go straight to a hospital.

DIABETES WELLNESS | Summer 2018

We woke up Payton’s older brother Brody, nine, and off we went. The Christchurch Hospital waiting room was full but the triage nurse took one look at Payton and we had a bed (and a diagnosis) within 10 minutes. She was presenting with all the symptoms of severe DKA – diabetic ketoacidosis – and we ended up being in hospital for about a week. I remember a lovely nurse, I don’t know her name but will remember her face forever. She said to us, as we sat there wide-eyed and in disbelief: “This is shocking now but Payton will still do everything she was always going to do – this won’t stop her from doing anything.” And she was right. But back then we were still in shock. We never considered diabetes as an explanation

for the symptoms Payton had been experiencing before our emergency dash to the hospital. She was drinking a lot of water – but it had been quite hot. She had lost a lot of weight – but she had also just had a big growth spurt. Luckily we had a wonderful team in Christchurch to educate us about how to care for a child with type 1 diabetes. They were patient, kind and very caring towards our little family and helped us come to terms with our “new normal”. Two years on and we are pretty onto it. We’ve moved back to Auckland to be closer to our family and life is still great. We are carbcounting machines! Payton has four insulin injections a day, two in the morning and two at night. We have a fabulous, resilient, brave and happy 9-year-old girl who

happens to have type 1 diabetes. It doesn’t define who she is, it is just a part of who she is. I have a medication allergy and should always wear a medical ID but I had been really slack about it. So I decided to be a role model and start wearing one. I searched high and low for a nice piece and found some great items in the USA. But they were expensive to buy and ship to New Zealand. My Identity was born after my struggle to find stylish medical ID jewellery here in New Zealand. I’m a web designer by trade, and had done online retail in the past, so I thought let’s give it a go. There are many people in New Zealand who need to wear a medical ID for a range of health conditions. But who says these have to be ugly? Why can’t they be cool, funky, and fashionable instead? This is a feelgood business venture for me. I want everybody who has to wear a medical ID to be proud and happy to put it on every day. Anyone can nominate themselves or a loved one to have a piece in the range named after them. Ian had an ugly medical ID bracelet that got in his way at work. He chose one of my bracelets, we named it after him, and he wore it with pride at his wedding. Check out My Identity at www.myidentity.co.nz. There are cool items suitable for women, men, boys and girls. Each piece can be personalised and resized to fit anyone.

EXCESSIVE T HIR ST F R EQU EN T U R IN ATION BEDWETT ING OR HE AVY NAPPY VISION C HANG E + HEA DAC HE S R APID W EIG HT LOSS INC R EASED A PPET IT E IR R ITABILIT Y + MOOD C HANGE S FATIGU E + W EAK NESS STOM ACH PAIN, NAU SEA + VO MITING F R U IT Y BR EAT H OD OUR R APID, HEAVY BR EATHING

M ISTA K EN FO R U PSET STOM AC H OR VIRUS ST R EP THR OAT GROWT H SPURT U R IN ARY T R AC T IN F EC TIO N

The signs and symptoms of T1D can be hard to spot in children and young people. Based on information provided by Diabetes NZ’s partner Beyond Type1, see www.beyondt1.org. DIABETES WELLNESS | Summer 2018

Move

Our fitness expert Craig Wise gears up for the annual summer Fun Run season.

GET READY TO (FUN) RUN

love taking part in summer fun runs, we often do them as a family and have a lot of laughs together. But the idea can be daunting if you’ve never done one before and aren’t very fit. So here is my ultimate guide on how to prepare mentally and physically for your first fun run. But be careful, it can be addictive! TRAINING

Get started as soon as you register for the event. Making a training plan is the key to success. You want to aim to cover the distance with confidence, whether you plan to run, walk or jog (most of us do all three and that’s fine). Begin by getting active, go for a long fast walk at lunchtime, take the stairs whenever possible. My advice is to work up to the event distance over a period of weeks, but you don’t have to run the full length before

DIABETES WELLNESS | Summer 2018

the race. You can get yourself ready by training over 80-90% of the distance, the rest will come on the day. Increasing the distance, time or intensity of your training is the best way to hit weekly goals and get over any mental blocks. What was hard two weeks ago will become easy and eventually the 5km is no longer Mission Impossible. BUDDY UP

Finding a friend or co-worker to do the training and fun run with you is a powerful motivator and can add a bit of a competitive edge – especially when the finish line comes into sight. Being connected with another person can help before, during and after the event. In the build-up your buddy will be there to help with getting moving. The encouragement of a friend will keep you training, especially on

those days when you might not feel like it. During the run they can help with your nerves and anxiety, and you can motivate each other to keep going. After the event they are there to share the experience with – they were in the trenches with you when the going got tough at 3.5km. PRE-EVENT NERVES

Deal with those anxieties before the race. Plan ahead and find out where you are going, where you can park, where you can meet friends and family after the event. You aren’t there to break records or win prizes, you are running/walking to prove to yourself that you can do it and help raise awareness of the fun run’s charity or fundraise for a good cause. Be proud of what you’ve done and enjoy the experience.

ON THE DAY

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I’m off now to sign up my family for our regular Christmas charity run – and yes we will be wearing Santa suits!

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1. Know the course, scope it out so you can see any little hills or places where the track may get narrow. 2. Don’t wear brand new shoes, it’s a recipe for blisters or aching soles. By all means have new shoes but break them in first. 3. Recruit a cheerleader. Seeing them will instantly boost your mood and they can take some photos so you will have memories of your achievement. 4. Get your head right – before the event I plug in my headphones and go to my happy place. Relax and focus your mind on the run ahead. I don’t listen to music when I am running. 5. Be social, it’s part of the fun. Chat with people, and you will find many are as nervous as you are. 6. Don’t stand at the front for the start, find yourself a place mid-pack and be comfortable. Wherever you start you don’t have to keep up with those around you. 7. Don’t go all out and run out of steam, keep it slow and steady like your training, and hold back something in reserve for that last 500 metres when your friends and family will see you. 8. This is a fun run, no world records are at stake, so if it takes longer than expected don’t be disappointed. You finished and that’s the main thing. 9. If you are with a friend and you get separated during the run, its not the end of the world, just go with it. 10. Smile! Even if your legs are burning and you want to stop, remember you had the courage to sign up and turn up on the day – that’s something to smile about and crossing the finish line is just the icing on the cake.

Clinically Tested Padded Socks. (CTPS). Ideal for patients with low-risk diabetes and feet that hurt.

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Eat

Diabetes NZ’s consultant dietitian Helen Gibbs busts five myths that butter is healthier than margarine.

The butter vs margarine debate

o compare the health benefits of butter versus margarine, it’s worth looking at what’s not listed on the nutrition label on the back of butter packets: Trans-fats: The World Health Organisation recommends that trans-fat intake should be minimal because of its link to high cholesterol and heart disease. These “bad fats”, highlighted in red on the table, aren’t included on butter’s nutrition label but are listed on margarine labels. The table shows that butter has six times the amount of natural transfats compared to the artificial trans-fats found in two popular margarines made in Australia and New Zealand. Good fats: Eating Guidelines for Adult New Zealanders (2015) promote the consumption of mono and polyunsaturated (unsaturated) fats. Butter labels don’t list mono and polyunsaturated fats on their labels but I have added the amounts contained in butter here (in green text). You can see that both the margarines have higher levels of both these “good” fats than butter.

Saturated fats: New Zealand’s eating guidelines also discourage the consumption of saturated fats, which cause heart disease and insulin resistance. The blue text in the table shows how butter has nearly three times as much saturated fat as the two margarines. Naturalness: This objection to margarine relates to the idea that processed food is “bad”. That argument forgets that butter is made by processing cream with salt. Butter processing is only successful because of specific chemical parts of cream which make the fat drop out of emulsion and form a solid mass – butter. Additives: Butter and margarine have a lot of ingredients in common. The following ingredients are the only ones you will find added to margarine but are not naturally occurring in butter: Lecithin – an emulsifier allowing the water and fat in margarine to remain combined. It is a very small percentage of the whole and is considered a safe additive.

vs.

DIABETES WELLNESS | Summer 2018

E number 202 (Potassium sorbate) – keeps the sodium level low and prevents the growth of yeasts and moulds. Annatto – an orange-red condiment and food colouring from the seeds of the achiote tree. Curcumin – a bright yellow chemical produced by some plants, including turmeric. Flavour – a very small part of margarine. We are not told what ingredients are used but the most likely are diacetyl, acetylpropionyl, or acetoin, three chemicals that provide the characteristic butter flavour in butter.

HELEN’S TIPS • After reading this you may still wish to use butter. If so, try to limit your intake to 2-3 teaspoons daily or less. • Margarine, like any high fat food, has quite a lot of energy per teaspoon, so limit the amount you have if you are trying to lose weight. Excess intake of any food will result in increased weight over time.

BUTTER OR MARGARINE?

Choose margarine if you want to reduce your cardiovascular risk and insulin resistance.

Eat The table below compares the nutritional information per 100g for butter and two popular margarines made in Australia and New Zealand. Nutrient

Butter

Margarine 1

Margarine 2

Energy

3030 kJ

2420 kJ

Protein

<1g

Fat – Total

81.4g

65g

Saturated

49.1g

17.2g

Trans

3.27g

0.59g

0.6g

Polyunsaturated

3.04g

27g

15.2g

Monounsaturated

21.02g

16g

32g

Carbohydrate

<1g

Sugars

<1g

Sodium

600mg

590mg

330mg

Margarine 1 also provides 10mcg Vitamin D and 14mg Vitamin E. Vitamin A and Vitamin D occur naturally in butter.

CHOLESTEROL-LOWERING MARGARINES

Plant sterols and stanols (phytosterols) are found naturally in plants and are structurally similar to cholesterol. They work by mimicking cholesterol and competing with it for absorption, and their cholesterol-lowering effects have been known for some time. Over three weeks plant sterols and stanols can reduce cholesterol levels by up to 10% when taken at optimal doses and as part of a diet low in saturated fat. You need to eat 25g per day divided into three portions of 8.3g each. Your choice of cholesterol-lowering margarine must be consumed at each meal to get the benefits of the product. They are considered to be the most effective single food that can lower cholesterol as part of a healthy diet and lifestyle.

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LAMB TACOS SERVES 4 • COST PER SERVE $4.82 • TIME TO MAKE 25 MINUTES • DIABETES FRIENDLY Ingredients

Method

8 hard taco shells 2 carrots, peeled and cut into long thin batons 1 onion, diced 2 cloves garlic, crushed 400g minced lamb 1 teaspoon dried Mexican oregano 1 teaspoon ground chipotle powder ¼ green or red cabbage, shredded 4 radishes, thinly sliced ½ cup reduced-fat Greek-style yoghurt mixed with juice of 1 lime 1 cup salsa, made up of 1 chopped tomato, 1 Lebanese cucumber, ½ chopped red onion and a handful chopped coriander leaves, reserving some for garnish.

1 Preheat oven to 120°C. Place taco shells in oven to heat through.

Make it low FODMAP Use finely sliced spring onion tips (green leaves only) instead of onion, garlic-infused oil and lactose-free or coconut yoghurt.

2 Spray a large frying pan with oil and set over medium heat. Add carrot and cook, until lightly browned. Remove and set aside. 3 Add onion and garlic to pan and sauté, until soft. Add lamb, oregano and chipotle powder and stir to break up lamb mince. Cook until browned, about 10 minutes. 4 Remove taco shells from oven and assemble with a layer of cabbage, lamb mix, carrots and radishes, topped with a dollop of yoghurt and a spoonful of salsa. Garnish with coriander.

DIABETES WELLNESS | Summer 2018

Families

Home and away The family’s beloved boat Atea

After falling sick in Thailand, newly diagnosed Braca, four, returns to New Zealand with his parents and younger sister to the care of Starship Hospital, in Auckland, where they learn how to care for a T1D child. Armed with new skills, they return to their beloved yacht Atea and set sail – insulin in fridge – for Sumatra, Cocos Keeling, Chagos and the Maldives. By Kia Koropp.

DIABETES WELLNESS | Summer 2018

s our cruising companions raised their sails and caught the wind westward across the Indian Ocean, we folded our wings and flew south. It is impossible to speak highly enough of the Starship, New Zealand’s primary children’s hospital, and its paediatric diabetes department. The team had been briefed about our case and were ready for us when we got there. The day following our arrival in Auckland, we were readmitted into hospital for observation and training. Our first session with the senior consultant was a turning point in our attitude towards living with a child with diabetes. While we were still reeling from the knowledge that diabetes was a fullcare incurable disease that might curtail our sailing dreams, the Starship diabetes team was used to supporting T1D families living in rural townships or remote Pacific Island communities. Our case as a cruising family was unique, but others had experienced similar obstacles and, from the outset, the team expected we would want to

return to the boat and a life afloat. From day one, the conversations were optimistic and encouraging – our training programme would be concentrated and accelerated, and we would be issued a supply of insulin to last us a year. The resounding message was: “Diabetes should fit into your life, not rule over it.” With the team’s unwavering support, we began to let our dreams back out of the box. But first we had to confront our level of confidence and ask some hard questions: Could we return to a life on board the boat? How capable were we to care for our son completely removed from medical support? We needed a trial run to answer these questions. A month after arriving in New Zealand, we booked ourselves on a three-week campervan tour of the South Island. We drove the length of the island and enjoyed being tourists in our own spectacularly beautiful country. It was therapeutic for our over-stressed souls and bonding for a family who had been split up for much of the preceding ordeal.

Families Finally, we were cut loose to laugh, play and bond as one unit again. After an amazing South Island tour, we had shown ourselves capable of supporting Braca away from our medical team. Now it was time to get down to logistics. Who could we talk to in the cruising community who could advise us on life onboard a boat with diabetes? All of the cruising T1Ds we were introduced to were adults who had been managing their condition for years. However, children with diabetes are different as they have smaller and less stable metabolisms. Our main question was: “How far away from expert care should a newly diagnosed four-year old T1D child travel?” There were also practical considerations. We needed a reliable refrigerator that could hold a year’s supply of insulin onboard. A replacement fridge was ordered. We needed to guarantee communication with our diabetes team should any issues arise, so we upgraded our unreliable SSB radio to a satellite link. Our all-

star diabetes team and friendly local pharmacist gave us a twoyear supply of insulin, glucose monitors, testing strips, injection pens, ketone strips, emergency glucagon kits and an assortment of other diabetes paraphernalia. In a whirlwind of planning and purchasing, we readied ourselves and spread our wings. We would have to find a new route for the season, but these four seabirds were heading back out to sea. We were too late to follow our initial Indian Ocean itinerary and an attempt to re-join the 2016 fleet would mean a long ocean passage and missing out on some of the highlight destinations completely. Another season in Malaysia and Thailand did not appeal to us. Given we would be travelling out of the main cruising season, where should we go? Sumatra and the Maldives popped up on our radar. In June, four months after diagnosis, we began our 2016 cruising season. The following six months sailing was one of our most stunning experiences to

date and an example of what can happen when the best laid plans fall through. Sumatra, Cocos Keeling, Chagos and the Maldives all proved to be top class cruising grounds and being there was a testament to what is achievable against the odds. June 2018 marked our 24-month milestone of cruising with a diabetic child. We started with small steps through those dark days when our future seemed bleak. Buoyed by an encouraging family and supportive medical team, our plans were based on risk management and the mitigation of any foreseeable complication. Finally, we trusted ourselves to let go of uncertainty and released our shore-bound tether. Two years ago, we headed Atea’s bow towards the open sea and found peace and simplicity in the wide embrace of the ocean. Through the experience we learned what the doctor said was indeed true: “Diabetes should fit into your life, not rule over it – however you choose to live it.”

“Diabetes should fit into your life, not rule over it – however you choose to live it.”

John Daubeny with Kia Koropp, Ayla and Braca (right).

Kia and family have continued their voyage across the Indian Ocean and you can follow their adventures at http://svatea.com DIABETES WELLNESS | Summer 2018

Innovate

SOMETIMES FORGET TO INJECT? Diabetes NZ member Phil Wright explains how he found a nifty solution to forgetting to inject his insulin.

ometimes, around mid-morning, I would wonder: “Did I take my morning injection?” There was really no way to know. Log books are just as likely to be forgotten as the injection itself. A psychologist friend explained that subconscious habits, like cleaning teeth, shaving, putting on lipstick, or in my case, injecting insulin, don’t engage our conscious brain and are forgotten moments after the action. You can run your tongue over your teeth to check if you cleaned them, rub your chin to see if you’ve shaved, or check your lipstick in the mirror. But there is no physical way to check whether you injected your insulin. Blister packs solved this problem for pill-taking. You only need to look at the morning blister to see if it’s empty and you’ve taken the pill. My homemade insulin organiser does the same. The pen sits in a series of holes – each one representing the scheduled injection. If the hole is empty, you’ve had your injection. It just requires you to move the injection pen after you inject. While doing this, the brain is temporarily in gear. I spoke to a number of T1Ds and T2Ds and found forgetting to inject is common, and worse, double-injecting sometimes happens! One person’s wife told me “He’s always asking me if he has injected.” There are 250 apps for smartphone users to help monitor and remember injections, but the largest group of insulin-dependent people are over 60. Research in New Zealand shows that fewer than 50% of this age group have smart phones and even fewer use apps. Apps miss the boat but a practical organiser may be the solution.

DIABETES WELLNESS | Summer 2018

It’s easy to make these handy insulin organisers designed by Phil Wright (pictured above) who is donating the plans to anyone who wants them.

I developed two designs that can be made at home. Organiser A is for a once-a-day injection of long-acting insulin like Lantus with holes for Monday to Sunday. Organiser B is for a once-a-day injection of Lantus, while the front row is for rapidacting insulin before each meal. Any arrangement of holes can be made to suit your injection routine. In no way does the organiser reduce the need to test blood glucose levels regularly. Having one of these at home helps me keep my HbA1c in the 40s. My idea caught the attention of my GP and diabetes advisors, who suggested I make

it more widely available in the community. If anyone thinks it might be useful for them, it’s easy to build from a block of wood (100 x 70 is a good size). Holes 18mm diameter drilled and a spray coat of paint. If you don’t have the skills, I’ll gladly send you the plans to give to a local joiner. To request a copy of Phil’s insulin organiser plans, or the psychologist’s report about why people forget to inject, please email editor@diabetes. org.nz or call 0800 342 238.

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