Spring 2019 $6.95
A Diabetes WA Member Magazine
Our diabetes
journey
If you’ve got it, we get it
From the Editor l of Spring is suc h an inv igorati ng sea son. It’s ful e pos itiv e cha nge and not hin g bea ts the pro mis of warm we ath er.
edition of Diabetes Matters, So, it’s fitting that in this, our Spring within Diabetes WA and we explore our own season of change . what this means for you, our members ir, Dr Moira Watson will After 10 impressive years in the Cha rd, making way for step down from the Diabetes WA boa on November 1. Andrew Burnett who will take the helm tion and begins an stitu This transition is required by our Con . exciting evolution for our organisation one and you’ll be happy You’ll find Moira’s stor y a fascinating ds. You can read about to know she leaves DWA in good han Andrew in this edition too. t we’ve achieved in the While we look back, proudly, on wha you’ll be pleased to s, diabetes sphere in the past 10 year future too. the for know Diabetes WA has big plans e a strategic long-term The Diabetes WA board and staff hav and Western Australians plan for better serving our members ough, Diabetes WA’s living with diabetes and Sophie McG t Manager outlines the Strategy and Business Developmen ion. impressive blueprint later in this edit change, why not spring And while we’re talking about positive r fridge and tidy up your clean your meal plans, refresh you , delicious meals? We have pantry with some diabetes-friendly try later in the edition and plenty of mouth-watering dishes to to win a yummy cook book. don’t forget to enter our competition get it. Remember: If you’ve got diabetes, we
Fro m the Dia betes WA Com mu nic atio ns Tea
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Contents
From the CEO ............................................................................ 3 Who’s in the Driver’s Seat? ................................................... 4 Meet the New Chair ................................................................. 5
Diabetes News
What’s It Like To Have Diabetes? ........................................ 6 Where Have We Been This Winter? ................................... 7
Reflection: Past Ten Years
Leaving a Legacy ...................................................................... 8
Vision: Next Ten Years
We’re Dreaming Big ............................................................... 10
National Diabetes Week
It’s About Time ........................................................................ 12 News .......................................................................................... 15
Workshop Calendar
Plan Your Sessions ................................................................ 16
AGM and Board Election
Join us at our AGM ................................................................ 18
Research News
Research Round-up .............................................................. 20 Diabetes Research WA Update .......................................... 21 Editor Monica Videnieks Editorial & Advertising Enquiries Diabetes WA, PO Box 1699, Subiaco, WA, 6904 Phone 1300 001 880 Email media@diabeteswa.com.au Editorial submissions should be sent to Diabetes WA, care of the above address. All care will be taken with contributions however no liability for loss or damage to unsolicited materials will be accepted. Disclaimer The opinions expressed in articles and the claims made in advertising materials presented in Diabetes Matters are those of the authors and the advertisers respectively, and do not necessarily reflect the view of Diabetes WA, unless stated. The information provided is for the purposes of general information and is not meant to substitute the independent medical judgment of a health professional regarding specific and individualised treatment options for a specific medical condition. No responsibility is accepted by Diabetes WA or their agents for the accuracy of information contained in the text or advertisements and readers should rely on their own enquiries prior to making any decisions regarding their own health. Photography DWA staff, magazine contributors, Shutterstock, Pacific Magazines, Murdoch Books. Design Brigitte James Print Quality Press Diabetes WA Diabetes WA – Subiaco Offi ce diabeteswa.com.au Level 3, 322 Hay Street, Subiaco WA 6008 Postal Address: Diabetes Helpline: 1300 001 880 PO Box 1699, Subiaco WA 6904 Email: info@diabeteswa.com.au Diabetes WA – Belmont Offi ce 172 Campbell Street, Belmont WA 6104 Postal Address: PO Box 726, Belmont WA 6984
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Moving Well
Surgery and Diabetes ............................................................22
Diabetic Living
Recipes ...................................................................................... 24
In the Community
The Kellion Victory Awards ................................................ 26 #DiabetesChatters ................................................................ 28 Burning Questions ................................................................ 28
Shared Pathways
Working Together and Making a Difference ................. 29
Eating Well
Be Prepared ............................................................................ 30 Fit Food Prep and Recipes ................................................. 33
Members’ Area
Members’ Puzzle and Competition .................................. 39
Living Well
Get the Benefits ..................................................................... 40
Members’ Area
Member Partners .................................................................. 42
What’s On
Dates for your Diary ............................................................. 43
2019-090
SPRING 2019
EO Andrew W agstaff C
From the CEO It is with mixed feelings that I farewell Diabetes WA Chair Dr Moira Watson. Having worked closely with Moira over the 10 years I have been CEO at Diabetes WA, I am sad to see her leave and will have fond memories of all that we have experienced. I am very proud of the work we, at Diabetes WA, have achieved during her tenure and I’m excited about what lies ahead for our organisation and most importantly, for you, our members. I know Moira would share these emotions. Moira’s term as Chair of Diabetes WA expires at the upcoming 31 October 2019 Annual General Meeting – a necessary transition under our Constitution.
The Diabetes WA Board have elected Andrew Burnett as Chair of the Board and he will take the position from 1 November. You may recognise Andrew – he has been a director on the Diabetes WA board since 2010 and knows our organisation well. Andrew is Of Counsel at Squire Patton Boggs and has brought to Diabetes WA not only a sharp legal mind, but a keen eye for governance. When Andrew takes the Diabetes WA Chair he will lead a refreshed Board, which includes four new highlyexperienced and skilled Directors and brings our Board to 11 Directors. In this edition, you’ll find Notice of the 2019 Diabetes WA Annual General
Meeting and all members are invited to attend. If you are unable to attend and would like to vote, a proxy form has been included in the packet accompanying this magazine. I’m sure you’ll enjoy this edition of Diabetes Matters as we reflect on how far we have come in a decade and we turn our sights to the future and the many positive opportunities on the horizon for people living with diabetes in Western Australia. Enjoy. Andrew Wagstaff
Chief Executive Officer, Diabetes WA
The Diabetes WA snapshot Look at what we’ve achieved in a decade The Board • We moved to a skillsbased board of directors
Our workforce • We invested in, and committed to, the National Diabetes Services Scheme (NDSS)
Our services • We’ve ensured our programs are delivered effectively to people with diabetes
• Developed a strategic and core business growth plan
• Through tireless work, we’ve ensured Diabetes WA is recognised as an integral part of the WA health care system
• We’ve won prestigious awards and our work is recognised by other health groups
• Transitioned DWA to Public Company Limited by Guarantee
• We’ve led key projects to help people living with diabetes
• Ensured its relevance to stakeholders • Reviewed the DWA Constitution
• Our team go the extra mile; we travel far and wide to bring diabetes knowledge to consumers
The next 10 years • We’ll expand our focus on chronic conditions • Our programs will be delivered to more people in more areas • We’ll harness technology to improve access to services for people with diabetes, no matter where they live.
*Source: Diabetes WA Board Directors’ Strategy Day, 2019.
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WHO’S IN
the drivers seat
Make an impact Travel can be a significant barrier to receiving diabetes treatment – and Diabetes WA is looking at new ways to bridge the divide. Diabetes WA entered the Google Impact Challenge in 2018 and were successful recipients of a Google Impact Grant. The Grant is to promote telehealth by increasing access to, and the uptake of, timely and essential diabetes care via video conferencing that is relevant, culturally sensitive and delivered to the person in their Community. Our Google Impact Challenge project is called “Bringing Care Closer to Country”, combating diabetes in remote Aboriginal Communities through telehealth technology and cultural co-design. Travel is a significant barrier to treatment, especially in remote Western Australia where some people travel thousands of kilometres to reach their nearest regional centre. Bringing care closer to home and country removes the burden of travel for the person and subsequent dislocation from family and community.
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The first phase of this project was to identify three remote communities or towns where telehealth could make a positive difference and begin consultation and community engagement. We flew to Kununurra, met with key stakeholders and introduced the Google Impact Challenge and Diabetes WA in the Kimberley region and the WA towns of Wyndham, Halls Creek and the Warmun Community. We also spent time in Broome engaging with various stakeholders and relevant agencies. “Bringing Care Closer to Country” has been well received and we’re now looking forward to the second phase of this project. We’ll keep you posted!
Meet the new Chair
Andrew Burnett has been a director at Diabetes WA for almost a decade and has been appointed as our new Board Chair. With an illustrious career in the law and a detailed knowledge of the diabetes landscape, Andrew Burnett takes the helm as Diabetes WA Board Chair with a wealth of legal and governance experience - and a keen interest in the issues confronting our organisation. Under the Diabetes WA Constitution, the position of Board Chair must be vacated if the role has been held by the same person for 10 years. Outgoing Chair Moira Watson has concluded a full term in the position and, in abiding by the organisation’s governance, she now leaves the post. The baton has been handed to Andrew Burnett. With Andrew’s appointment to the Chair, along with the inclusion of four new directors to the board, the Diabetes WA executive is undergoing an exciting evolutionary change and our new Chair says he is pleased to lead the team. “My vision for Diabetes WA is to continue the good work done by my predecessor and to continue building a service organisation for people in Western Australia with diabetes,” Andrew explains.
“I am proud to be part of Diabetes WA. In a federal system like we have in Australia, Diabetes WA performs a really significant role in delivering services to people in the state.” With a keen eye on governance, Andrew brings to the Chair almost four decades’ experience in the law, both in private practice and pro-bono work. He is Of Counsel at Squire Patton Boggs with expertise in employment and industrial relations law as well as experience in mergers and acquisitions. Andrew is a Rhodes Scholar (University College 1970-73). He read history at Oxford University and is hoping to complete a PhD exploring the history of Dutch involvement in southern Africa during the 19th century. “I have had an interest in history all of my life,” Andrew explains. “I read it at Oxford and I am fascinated by the paradox that occurred in the 19th century where the Dutch in the Netherlands came to believe, for about a 40 or 50 year period, that in southern Africa they had cousins, whom we now know as Afrikaners.
“In my research, I am looking at their reaction to events in southern Africa from the period of 1840 to 1900, in the context of their belief that the nascent Afrikaners were their ‘brothers and sisters’.” Married to Barbara, Andrew has three adult children and six grandchildren. He grew up in South Africa and moved to Australia in 1998 to pursue “the opportunity of new challenges”. Since completing his Rhodes scholarship, Andrew has continued to be involved in education and selecting future Rhodes scholars in South Africa and Australia. Andrew speaks and reads Afrikaans and reads Dutch, adding he speaks it slowly and with a dreadful accent. He and Barbara enjoy travel; especially caravanning. He is also a keen cyclist and rides into his city legal practice three times a week. “My wife and I are particularly interested in gardening and growing things we can eat,” he says. Andrew Burnett takes the Board Chair of Diabetes WA from November 2019.
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DIABETES
news
What’s it like to have diabetes? Anyone living with diabetes knows just how difficult and stressful it can be.
Gregg Pearce has had a tough time since his diabetes diagnosis 30 years ago. At our recent Ken Walker corporate lunch, Gregg featured in a special video revealing to guests his honest account of what it is like to have diabetes. And he didn’t sugar coat it. Many people with diabetes can relate to his experiences. And everyone can appreciate his raw and deeply personal experience. Gregg describes living with diabetes as akin to “having a noose around your neck”. “You are always waiting for it to tighten and you never know what is coming next,” Gregg says. His advice to anyone living with diabetes or at risk of developing diabetes, is to never underestimate the condition. “Do not sell it short - it is as bad as cancer, heart disease and stroke - and they can all end up with the same end.” This behind-the-scenes photograph of Gregg shows him during filming with the Diabetes WA communication team, where he told his story of living with diabetes. Education is the key, he says. He urges anyone with a diabetes diagnosis to arm themselves with as much knowledge about the condition as possible.
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He also reminds us that living with diabetes can be an emotional battle too. It can be mentally debilitating managing diabetes and he urges anyone living with diabetes to seek help if feelings of depression or overwhelming anxiety take hold. Gregg admits the stress of constantly analysing his food choices, the effect on his family and not being able to be as active with his grandchildren as he would like has, at various times, affected his mental wellbeing. Then there’s the physical toll. “I have had problems with my kidneys where the levels drop so much, I am at risk of kidney failure,” Gregg reveals. “I have had problems with my eyes to the point where I have to have steroid rods injected into my eyes every 3 months. And I have had many issues with my feet such as amputations, ulcers and Charcot Foot in both feet. “My general health is not good and this is because of all the different complications that are associated with having diabetes. “Living with diabetes is very overwhelming,” he says. We want to hear your story of living with diabetes. Every story is different, every message is powerful and helps others going through a similar diabetes experience.
Where We’ve Been This Winter
DIABETES
news
Campaigns in action
Tax appeal raises more than $20,000 A big thank you to everyone who donated to our end of financial year tax appeal.
If you’ve got it, we get it.
In our most successful tax appeal to date, you have helped us to raise just over $20,000.
This is our important message at Diabetes WA. We understand diabetes – we know the challenges and struggles that diabetes can bring.
Your generosity will help us provide support and education services to all Western Australians living with and affected by diabetes.
We want to hear your story and show others that we’re all in this together. Get in touch with us either via email to media@diabeteswa.com.au or through our Facebook page.
Aboriginal health going places Winter was a very busy season for Diabetes WA Aboriginal Health Coordinator Natalie Jetta who has travelled the state and crossed the country spreading the Diabetes WA message – if you’ve got it, we get it. Natalie has attended the Indigenous Conference Services (Australia) Chronic Disease conference in Cairns and travelled to South Hedland for the Hot North health and science event. It was here Natalie presented on Aboriginal DESMOND, which we’re pleased to report was very well received by health professionals
who said they’re excited to see what’s next from us. Also in winter, we had NAIDOC week – and Diabetes WA was busy! Diabetes WA attended three large NAIDOC week events, interacting with more than 500 people and key health professionals; spreading the message of what we do at Diabetes WA and the many ways we can offer support. Natalie also travelled to the Kimberley with Telehealth Project Coordinator Rebecca Morgan-Dann for the Google Impact Challenge (you can read more on this on page 4).
“We met with Aboriginal medical and key people for their areas including Kununurra, Warnum, Halls Creek and Broome,” Natalie says. “In my role I discussed how Diabetes WA can assist them with Feltman (our pliable mannequin man which we use to explain and show how diabetes affects the body) and in upskilling for staff. The team also explained Aboriginal DESMOND and the workshops and resources we offer. “For me, it was great that the many key stakeholders in these areas were very interested in our resources and in the Feltman training for staff – they told us they would also love Aboriginal DESMOND to be delivered to their Communities.” Natalie also organised the Diabetes WA Aboriginal Health Forum in winter and this has triggered some exciting working relationships with new agencies – critical in getting the Diabetes WA message out to the people who need it. 7
REFLECTION
Past Ten Years
Leaving a Moira first joined Diabetes WA as a board Director in 2006, but her talents and keen eye for protocol were soon identified and within a few years, she was elected to the Chair.
The Diabetes WA Board takes pride in the high level of governance at our organisation and, in strictly following our Constitution, the time has come for Diabetes WA Board Chair Dr Moira Watson to step away from the role. There’s an adage, time flies when you’re having fun, and as departing Diabetes WA Board Chair Dr Moira Watson reflects on her decade-long tenure at the helm of the organisation, the saying certainly rings true. Since she was appointed to the position of Board chair in 2009, Moira has made it her mission to have Diabetes WA operating at its absolute best – with members’ needs at the forefront of all decisions. As she prepares to leave the role; making way for incoming Chair Andrew Burnett, she reflects on her time with Diabetes WA.
“I started out with some personal connections and I soon discovered that I really enjoyed Board work and I am actually good at governance,” Moira recalls. Current CEO, Andrew Wagstaff, also entered the organisation at a similar time and the pair formed an effective working relationship – both with a clear vision for the future of Diabetes WA.
As Moira reflects on her term, she is proud to have steered the organisation from a $3 million operation when she first took the helm to an $11 million (and growing) enterprise where it is today, employing more than 70 staff and offering a breadth of services to people living with diabetes and their supporters.
“When I came in, the Board, as it was then, was filled with good-hearted people but the organisation had gone a little offtrack. So, with a new CEO and a new Chair it was a great opportunity to reshape the organisation and grow its relevance to stakeholders,” Moira recalls.
“If you look at brand recognition from 10 years ago to today, the organisation - what it stands for and what it can do - has increased. From a governance perspective, if you can build your organisation to that point, then that is really great.”
That reshaping centred on two key elements. The first was securing the future of Diabetes WA, by structuring it as a business, with a strong organisational plan to serve its customers – the members of Diabetes WA. The second was to diversify the Board; to ensure members were not only well-represented, but in safe financial and commercial hands.
Moira says the success of Diabetes WA has come down to everybody in the organisation being dedicated to helping members.
“An effective Board enables good governance and it is important for ensuring that the organisation continues beyond the tenure of any one Board member or beyond the tenure of the CEO,” Moira explains.
Why leave now? The Diabetes WA Constitution requires the Chairperson to vacate the position if they have held the position for 10 years. Moira says the rule is important as it helps to ensure transparency in governance. 8
“I think that, for me, it is recognising that I am a steward of this organisation and though I may have been here for 10 years as Chair, I will go, a new Chair will come in and the organisation will continue, we have the continuity in place.”
“The team is so important,” Moira says. “On the Board, I am the first amongst equals, I am the captain of the group but you can only ever achieve something through the group itself. We have built up a really, really good Board team that oversees the CEO’s team and that is something that benefits all of the members. “I am extremely thankful for all of the support the Board Directors have given me over the last 10 years and I certainly value the hard work and dedication of the CEO and the staff. What we have achieved has only been possible through everyone’s professionalism. “For me, I look at Diabetes WA as concentric circles; stakeholders, Board, staff, with the members of Diabetes WA being at the centre – they are our focus.
REFLECTION
legacy “Everything we do we ask; is it good for the person with diabetes? Would this help our members in their particular circumstance? The litmus test is always: is this decision that we are taking as a Board going to provide a benefit for the person with diabetes?” It is heart-warming, Moira says, that Diabetes WA has a reputation of being problem-solvers and “good guys” who are an integral part of the WA health care system.
“ The litmus test is always: Is this decision that we are taking as a Board going to provide a benefit for the person with diabetes?” “We, Diabetes WA, understand that you – the person with diabetes - are experiencing all of these difficult things and though we are not technically your family, our relationships are such that we can help you in your time of need.
We are happy to provide you with a whole range of services, which are delivered with goodwill, willingness and professionalism,” she says. Moira’s departure from Diabetes WA means she will leave seven committees and three boards associated with Diabetes WA. She will continue her existing board work as Chair of Parkinson’s Australia and Chair of Chorus Australia and Counsellor with HBF. When she officially steps down on 31 October, Moira plans to travel more with husband, Peter, and spend more time with daughters, Emma 23 and Laura, 22 as well as catch up with friends. “It is a bit sad, I established my first board relationship here at Diabetes WA, so it’s a bit like having a child all grown up and it’s time to move away, but I am proud because Diabetes WA is entering another really interesting phase in our history. “We are set to continue to innovate, with new programs based on evidence and alignment to our core functions. Increasingly, we will build our independent strength and capacity to better provide services to the people of Western Australia. I will certainly stay connected and watch these exciting developments!”
How does the Board work? The Board’s job is to set the direction for the Diabetes WA organisation and ensure it is running effectively, ethically and is financial. The Board, whose directors are appointed for terms, work with the CEO and the CEO has responsibility for members and staff.
Past Ten Years
Reflections of a decade Some highlights of Moira’s term as Chair
• Developing Diabetes WA operation into an $11 million business.
• Improving our brand
– and ensuring that Diabetes WA is the first stop for services, information and trusted advice.
• Advocating and lobbying for members’ needs at a state and federal level.
• Implementing a skills-
based board, updating the Diabetes WA Constitution and improving Board governance.
• Devising a series of mid to long-term strategic plans that have moved Diabetes WA forward.
• Transitioning Diabetes WA to a Public Company Ltd.
• Setting up the bipartisan Parliamentary Diabetes Support Group in WA, with key members of Parliament.
• Establishing a solid
plan for the NDSS contract negotiations.
• Drawing a blueprint
to financially grow the Diabetes WA business and tender for external supplier contracts. 9
VISION
Next Ten Years
We’re dreaming Diabetes WA has come a long way in 10 years and we’re not slowing down. Strap yourself in, we’ve got big plans for the future
Strategic planning. Goal setting. Future proofing. All catchy buzzwords, but what do they really mean? Diabetes WA is in the midst of some exciting change. In this edition, we’ve looked back on the organisation’s many achievements over the past decade – and now it’s time to turn our attention to what’s on the horizon. And it’s looking good. Diabetes WA Strategy and Business Development Manager Sophie McGough recalls the unbridled joy amongst people living with diabetes and their health care professionals when the first insulin pump hit the market. For so long, such an item was a fantasy. Today, it’s commonplace. “The future is bright for people with diabetes,” Sophie says. “In the 20 years I’ve worked in diabetes, I have never seen such a flurry of advancements in medical therapies and technology.” And this is where those buzzwords come in. While medical developments will continue to help in management of the condition, Diabetes WA has a blueprint to help deliver those improved services for the next 10 years and beyond.
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Some of the major initiatives for the next fi ve to 10 years are: Identifying and helping: Using the Australian National Diabetes Strategy, Diabetes WA is identifying the most vulnerable groups who face significant challenges with diabetes. We know that people who are socioeconomically disadvantaged, living in rural and remote communities and Aboriginal and Torres Strait Islander Communities often do it tough in living with diabetes. Diabetes WA wants to change that. “Since starting my career in diabetes nearly 20 years ago, the diabetes burden in these groups has not improved and we have to do things differently,” Sophie says. “I am proud to say that in the last four years, Diabetes WA has had a significant focus on providing innovative solutions for these areas of need.” Breaking down barriers: The Diabetes Telehealth Service cuts through barriers caused by inequity and remoteness. It will continue to expand to include more elements of the diabetes support team, including assistance for mental health and new imaging technologies. “This will become such an integral part of mainstream service options, we’ll look back and wonder how we survived without it,” Sophie says. Better services: No matter where you live, no matter how long it has been since you had regular care for type 1, Diabetes WA is working to get better services and new technologies without the need to come to Perth. We’ll be implementing improved diabetes training for carers of the elderly and also in schools, so teachers and
VISION
Next Ten Years
big parents will feel more confident in providing a safe environment for children with type 1.
“We heard loud and clear, what you want us to focus on in the future,” Sophie says.
Diverse Diabetes WA services: We recognise the cultural and language needs of all people living with diabetes and we’re implementing programs and services appropriate to those needs. In an Australian first, Aboriginal and Torres Strait Islander health workers will be empowered to deliver evidence based diabetes selfmanagement education and support.
But wait, there’s more…
“Culturally and linguistically diverse communities will finally have access to DESMOND, delivered in culturally appropriate settings, by culturally appropriate facilitators and supported by culturally adapted resources,” Sophie explains.
Advocating for diabetes care: Diabetes WA is working alongside the Sustainable Health Review, a state government’s blueprint for WA’s healthcare sector. Many of the recommendations, which were presented earlier this year, run parallel to Diabetes WA’s own blueprint for the future; including improving mental health, investing in digital healthcare and implementing better culture and workforce support models.
Going digital: Diabetes WA is leading the way in digital innovations and Sophie reveals “we’ve only just scratched the surface of our potential in this space”. The possibilities include wearable technology to integrate smart devices. “Diabetes WA will be looking for opportunities to harness these technologies and link them with pre-existing programs to increase access and try to reduce the burden of living with diabetes,” she says. Embracing mental health: Diabetes WA recognises the strong link between mental health and diabetes, particularly in the area of stigma and the everyday burden of living with diabetes. Did you know our tagline; ‘If you’ve got it, we get it’ came directly from you, our consumers?
Prevention focus: Diabetes WA will continue to take an active role in the prevention of type 2 diabetes and cardiovascular disease. We would like to extend the Let’s Prevent initiative beyond the southwest to the rest of the state. We would also welcome collaboration with other organisations to reduce obesity.
Of importance to Diabetes WA as we look to the future is our involvement in the Diabetes and Endocrine Health Network. The group represents all stakeholders involved in the diabetes journey; from consumers and carers to health professionals and policy makers. Its goal is to improve access, quality and effective ongoing diabetes and endocrine care across WA. Sophie steps into the position of co-lead with Professor Tim Davies; replacing Mark Shah who worked tirelessly on the project. “In spite of all of this technology, the person living with diabetes will not be forgotten,” Sophie says. 11
NATIONAL
Diabetes Week
It’s about time Time – none of us seem to have enough of it, right?
Deb took time to understand the 4Ts
But when it comes to diabetes, it is essential to make time.
Deb Kelly knows all about the 4Ts and told her story to Diabetes WA’s communications coordinator, Grace Ashby:
We marked National Diabetes Week from July 14 to July 20 raising the awareness of early detection and treatment for all types of diabetes. For type 1 diabetes, this means taking the time to learn the 4Ts (toilet, thirsty, tired, thinner) – these are the early warning signs of type 1 diabetes. For type 2 diabetes, this means taking the time to get checked. Knowing the 4Ts is essential to detect and effectively manage type 1 diabetes. The 4Ts are:
• Toilet – is the person going to the toilet a lot? – is the person very thirsty and unable to • Thirsty quench that thirst? • Tired – is the person more tired than usual? • Thinner – has the person recently lost weight? 12
Deb was 17 years old when she was diagnosed with type 1 diabetes. Ironically, Deb was on her way to a doctor’s appointment to check on some strange symptoms she was experiencing – her Mum was concerned about her sudden weight loss and Deb had noticed she was thirsty all the time, going to the toilet a lot and very tired. The symptoms turned out to be the 4Ts, but young Deb wasn’t aware they were actually warning signs of type 1 diabetes. As she drove to the appointment, Deb experienced hyperglycaemia, passed out and hit a truck. Thankfully, no one was injured, but the situation shows how serious type 1 diabetes can be if left unmanaged.
NATIONAL
Diabetes Week
“The need to quench my thirst was my priority,” Deb recalls. “I simply stood at the sink and downed glass after glass of water. “Within 10 minutes or so, I’d be back at the sink, wanting another glass of water; resulting in endless trips to the loo.” After being diagnosed by a GP and an Endocrinologist, Deb learned to manage her condition and was determined to live her life to the full. It is now nearly 30 years on and Deb has travelled the world, is married and has a 14-year-old son. “Raising awareness about type 1 diabetes has always been something I’ve been passionate about,” Deb says. “The 4Ts – toilet, thirsty, tired and thinner is a slogan that is easy to share and easily remembered. If only I was aware of these signs and symptoms 30 years ago.”
Deb Kelly
Did you know? Each year about 640 Australians become very ill and are hospitalised with dangerous high blood glucose levels because the early signs and symptoms of type 1 diabetes are not recognised in time. Half of these are children and adolescents. 13
NATIONAL
Diabetes Week
Richard took time to make changes Many of us make New Year resolutions, only to see them fail. But in January, Richard Moore decided it was time to permanently change his life and better manage his type 2 diabetes. When he tipped the bathroom scales at 120kg and was medically classified as being “extremely obese” Richard Moore knew it was time to change. He needed to lose weight, regain energy and be proactive in managing his type 2 diabetes. Richard started with a home delivery meal service and lost 2kg. It was a small, but extremely significant win – and triggered the momentum to keep going. He turned to Diabetes WA – and booked into a DESMOND workshop for people living with type 2 diabetes. Making time for the workshop – and for his health – has turned his life around. “I went to a full day diabetes session and learned so much about healthy and junk foods, blood pressure, sugar content in food and how to read food labels – something I still do,” Richard says.
The DESMOND workshops can help people living with type 2 diabetes to:
• better understand diabetes • lower their HbA1c and understand the numbers • make balanced food choices • share experiences with other people living with diabetes
Richard started to exercise too, and his weight continued to drop. Today, he has lost almost 18kg, his blood glucose has dropped 4.5 mmol/L (now at 5 mmol/L) and his resting heart rate has dropped from 92 to 68. “A big part of my success is the DESMOND day I attended back in March – I learned so much that day,” Richard says. “The downside is the cost of buying new clothes is outrageous – but really satisfying!” Richard hopes to continue his healthy weight loss and get to 89kg – a figure he last saw on the bathroom scales in August 1995. “I want to see my 11 and 13 year old daughters graduate, get married and have children,” he says of his motivation to change.
DESMOND workshops are held in over 40 locations across WA. Anyone living with type 2 diabetes and registered with the National Diabetes Services Scheme (NDSS) or a member is eligible to attend and is welcome to bring along a support person. 14
NATIONAL
Take time to get checked There are half a million Australians living with undiagnosed type 2 diabetes. Often, they have no symptoms, but the condition can cause long term damage. Ask your GP for a check.
Did you know? Each day, 28 West Australians are diagnosed with diabetes. Diabetes, whether it is type 1 or type 2, does not discriminate and is more common than you may think.
Our partners at work Podiatrist Perth stepped up (pardon the pun!) for National Diabetes Week – offering free foot assessments in July and August. Diabetes can cause damage to the nerves in the feet, reduce blood circulation and increase risk of infection. Having diabetes can increase the risk of foot ulcers and amputations. People living with diabetes should check their feet every day and have their feet checked regularly by a professional.
Making (radio) waves Clinical Services Manager Carly Luff took the diabetes message to the airwaves during National Diabetes Week, catching up with RTRFM’s Jorja Keay on the station’s Fitter Happier program. Carly explained type 1 and type 2 diabetes to listeners – and how Diabetes WA can support all Western Australians living with or at risk of developing diabetes.
Diabetes Week The Kellion awards We love celebrating people who live positive lives with diabetes – and the Kellion awards are particularly special. Awarded during National Diabetes Week, the Kellion awards celebrate people who have lived with diabetes for 50 years or more. Meet some of the WA recipients later in this edition.
Connect with diabetes It can take time getting your head around a diabetes diagnosis.
As part of National Diabetes Week, Diabetes WA ran a Connect with Diabetes event in Mandurah. The event was designed for people living with type 2 diabetes, carers, people at risk of diabetes and those who were interested to know more, but who aren’t quite ready to jump into a workshop. Connect with Diabetes events are presented by credentialled diabetes educators and the relaxed sessions cover how diabetes works, the risk factors for developing type 2 diabetes and how you can make small changes to prevent or manage type 2 diabetes. The events also explain the National Diabetes Services Scheme, what you’re entitled to if you register and the health services that are available in your area.
Spreading the word
We do like to talk about diabetes and you may have seen, heard or viewed the Diabetes WA team in these media outlets:
Chemist Magazine • Friendlies The Mandurah • Bunbury Mail Mail • Collie Mail • Esperance Express • Avon Valley and Wheatbelt Advocate • Busselton Dunsborough Mail • 15
Workshop Perth Metro
We have a range of workshops and services that can help you on your health journey. Self-management Workshops Diabetes WA runs a number of education programs, held as two-to three-hour workshops, to help you manage your diabetes and improve your health. ShopSmart – this supermarket tour or classroom session helps you decode food labels. FootSmart – everything you need to know about caring for your feet. MonitorSmart – master the art of blood glucose monitoring. CarbSmart – unravel the mystery of carbohydrates with this carb counting masterclass. MedSmart – understand what your medications are, what they do and how to address any concerns you have. Living with Insulin – everything you need to know about using insulin; including equipment, hypos and blood glucose levels. Ready Set Go, Let’s Move – make exercise part of managing diabetes each day, with your own step by step plan. Note: This is not a fitness program. Insulin Pump Workshop – learn about the features of your pump and how to get the most out of it with this hands-on session.
Type 1 Technology Night Explore pumps, CGMs and flash monitoring and meet with device company representatives to find out the pros and cons. 16
Armadale Armadale Armadale Armadale Armadale Aveley Aveley Banksia Grove Banksia Grove Beckenham Bedfordale Bedfordale Boya Boya Boya Boya Cannington Clarkson Clarkson Clarkson Cockburn Central Cockburn Central Cockburn Central Cockburn Central Cockburn Central Cockburn Central Dayton Dayton Floreat Floreat Girrawheen Halls Head Heathridge Kelmscott Lakelands Mandurah Melville Melville Melville Melville Melville Midland Mindarie Mirrabooka Mirrabooka Mirrabooka Piara Waters Rivervale Rockingham Rockingham Rockingham Rockingham Rockingham Secret Harbour Southern River Subiaco Subiaco Subiaco
CarbSmart 8 October ShopSmart 11 October DESMOND 31 October FootSmart 26 November MedSmart 3 December Living With Insulin 14 October DESMOND 18 November FootSmart 16 October DESMOND 13 November CarbSmart 12 November Classroom ShopSmart 5 December DESMOND 7 December Ready Set Go - Let's Move 9 October DESMOND 28 October MonitorSmart 6 November FootSmart 6 November DESMOND 10 October CarbSmart 23 October Classroom ShopSmart 11 November MedSmart 11 November FootSmart 2 October MedSmart 2 October DESMOND 21 October Classroom ShopSmart 30 November FootSmart 30 November DESMOND 4 December CarbSmart 1 November DESMOND 16 November DESMOND 15 November DESMOND 11 December DESMOND 29 November ShopSmart 14 November DESMOND 9 December DESMOND 22 November CarbSmart 27 November DESMOND 30 November MonitorSmart 15 October Classroom ShopSmart 15 October Type 1 Technology Night 29 October DESMOND 2 November CarbSmart 5 December ShopSmart 28 October DESMOND 11 October DESMOND 7 October DESMOND 22 October MedSmart 24 October DESMOND 8 November CarbSmart 16 October DESMOND 26 October Classroom ShopSmart 31 October ShopSmart 20 November MonitorSmart 2 December DESMOND 14 December DESMOND 3 October ShopSmart 7 November DESMOND 19 October Classroom ShopSmart 13 December CarbSmart 17 December
Calendar WA Regional
Albany Albany Albany Albany Albany Albany Albany Albany Bunbury Bunbury Bunbury Bunbury Bunbury Bunbury Bunbury Bunbury Bunbury Bunbury Esperance Geraldton Geraldton Geraldton Geraldton Geraldton Geraldton Geraldton Geraldton Geraldton Geraldton Geraldton Kalgoorlie Kalgoorlie Manjimup Manjimup Manjimup Mount Barker Mount Barker Narrogin Northam South Hedland South Hedland
Connect with Diabetes Living With Insulin FootSmart CarbSmart DESMOND DESMOND CarbSmart MonitorSmart CarbSmart FootSmart DESMOND DESMOND DESMOND MonitorSmart CarbSmart FootSmart MedSmart DESMOND DESMOND CarbSmart FootSmart DESMOND MedSmart CarbSmart DESMOND FootSmart MonitorSmart DESMOND CarbSmart FootSmart DESMOND DESMOND DESMOND CarbSmart FootSmart FootSmart MedSmart DESMOND DESMOND DESMOND DESMOND
3 October 4 October 15 October 15 October 25 October 27 November 13 December 13 December 9 October 9 October 11 October 13 November 22 November 27 November 27 November 2 December 2 December 13 December 22 October 11 October 11 October 21 October 15 November 15 November 22 November 29 November 29 November 9 December 13 December 13 December 28 October 27 November 21 October 22 October 22 October 20 November 20 November 19 November 24 October 6 November 11 December
Free to Diabetes WA NDSS registr ants and member s
Connect with Diabetes A 2.5 hour free presentation for people with type 2 diabetes, carers, families and those at risk of diabetes. Connect with Diabetes enables you to understand and manage your diabetes and learn about food choices.
DESMOND DESMOND – Diabetes Education and SelfManagement for Ongoing and Newly Diagnosed is a one day workshop designed to equip those living with type 2 diabetes with the knowledge and skills to better manage their condition. DESMOND can help you achieve lower HbA1c, weight reduction, greater physical activity, reduced diabetes distress and better overall health outcomes.
Telehealth The Diabetes Telehealth Service for Country WA is available to those living out of the metropolitan area. One-on-one appointments via video-conferencing can be arranged through your doctor, or contact Diabetes WA on 1300 001 880.
Upskilling for health professionals in country WA The Diabetes Telehealth Service upskilling sessions are typically 1–2 hours in duration and are easily accessed via a desktop computer. The sessions cover a wide range of diabetes-related topics such as chronic kidney disease, diabetes retinopathy and gestational diabetes. To find out more or to register for any upcoming sessions call 1300 001 880 or go to our website.
For more information or to book into any of these workshops, visit diabeteswa.com.au, call 1300 001 880 or email bookings@diabeteswa.com.au 17
Notice of 2019 Diabetes WA General Meeting of the Notice is given that the 2019 Annual es WA) will be held: members of Diabetes WA Ltd (Diabet Date: Time: Venue:
Thursday 31 October 2019 5.30pm (WST) Street, Subiaco Diabetes WA offices. Level 3, 322 Hay
Agenda:
These explanatory notes have been prepared to provide members with sufficient information to assess the merits of the resolutions contained in the accompanying notice of Annual General Meeting of Diabetes WA to be held at Level 3, 322 Hay Street on Thursday, 31 October 2019 at 5.30pm (WST).
eral Meeting Minutes 1. Confirmation of 2018 Annual Gen Reports 2. Financial Statements & Director’s ctors’ report and
1. Confirmation of 2019 Annual General Meeting Minutes 2. Financial Statements & Director’s Reports
3. Re-election of Directors
Section 317 of the Corporations Act 2001 (Cth) (Corporations Act) requires the last financial year’s financial report, the directors’ report and the auditor’s report to be laid before the Annual General Meeting.
report, the dire To receive and consider the financial year ended 30 June 2019. the auditors’ report for the financial
the following ordinary resolutions To consider and if thought fit, pass as separate ordinary resolutions: ctor of Diabetes WA (a) to re-elect Tony Lester as a dire as a director of Diabetes WA (b) to re-elect Mary Anne Stephens
4. Election of Directors
the following ordinary resolutions To consider and if thought fit, pass as separate ordinary resolutions: ctor of Diabetes WA (a) To elect Fiona Lander as a dire ctor of Diabetes WA (b) To elect Hannah Tagore as a dire director of Diabetes WA (c) To elect Margaret Pyrchla as a director of Diabetes WA (d) To elect Michael Ferguson as a
5. Appointment of auditors
the following ordinary resolution: To consider and if thought fit, pass ointed under section 327B(1) of That BDO Audit (WA) Pty Ltd be app of Diabetes WA. the Corporations Act 2001, as auditors 1300 001 880 or email For catering purposes, please call 25 October 2019. AGM@diabeteswa.com.au by Friday still welcome to attend is P’d RSV Any member who has not the Annual General Meeting. By order of the Board:
Andrew Wagstaff Chief Executive Officer 29 August 2019 Diabetes WA Ltd ACN 610 729 612
18
Explanatory notes
There is no requirement either in the Corporations Act or in Diabetes WA’s constitution for members to approve the financial report, the directors’ report or the auditor’s report. Members will be given the opportunity at the meeting to ask questions and comment on these reports.
3. Re-election of Directors Each of the directors standing for re-election will retire at the Annual General Meeting and stands for re-election in accordance with Diabetes WA’s constitution. (a) Re-election of Tony Lester as a director of Diabetes WA Tony joined the Diabetes WA Board in 2011. He is a Founding Partner of the WA Executive Search and Selection firm, Lester Blades. With more than 25 years in executive level recruitment, Tony has been exposed to the operations and activities of a large number of companies in the private, public and not-for-profit sectors in Australia. Tony has type 1 diabetes, as does one of his children. The Board (other than Tony Lester), recommends members vote in favour of the resolution to reelect Tony Lester. Tony Lester does not make a recommendation due to his personal interest in this resolution.
Annual General Meeting (b) Re-election of Mary Anne Stephens as a director of Diabetes WA Mary Anne joined the Diabetes WA Board in 2015. She has more than 25 years’ experience in the financial services sector in Australia and the United States. Much of her recent experience has been in senior leadership roles within both insurance and not-for-profit organisations. Mary Anne holds a Master of Accounting degree, is a Fellow of CPA Australia, a Fellow of the Institute of Public Accountants, a Fellow of the Australian Institute of Management and a Graduate of the Australian Institute of Company Directors. The Board (other than Mary Anne Stephens), recommends members vote in favour of the resolution to re-elect Mary Anne Stephens. Mary Anne Stephens does not make a recommendation due to her personal interest in this resolution.
4. Election of Directors Each of the directors standing for election will retire at the Annual General Meeting and stands for election in accordance with Diabetes WA’s constitution. (a) Election of Fiona Lander as a director of Diabetes WA Fiona Lander is a Doctor of Medicine and a lawyer, currently working with McKinsey & Company (Australia) as a strategic consultant in healthcare, including advisory work concerning Federal Government healthcare, digital and innovation strategy, aged care business unit strategy. Fiona also has experience in global health policy, international human rights law and emergency medicine. The Board (other than Fiona Lander), recommends members vote in favour of the resolution to elect Fiona Lander. Fiona Lander does not make a recommendation due to her personal interest in this resolution. (b) Election of Hannah Tagore as a director of Diabetes WA Hannah Tagore is a communications professional with extensive non-for-profit, government, emergency management, crisis communications, brand and reputation management experience. She has previously been Head of Communications at Alzheimer’s Society in the UK and was Chief Media Officer for the British Prime Minister. She is currently Chief of Staff and Director of Communications at the Department of Fire and Emergency Services (DFES).
The Board (other than Hannah Tagore), recommends members vote in favour of the resolution to elect Hannah Tagore. Hannah Tagore does not make a recommendation due to her personal interest in this resolution. (c) Election of Margaret Pyrchla as a director of Diabetes WA Margaret Pyrchla has over 20 years’ experience across financial services and energy industries in accounting, corporate finance, regulation, governance, strategic planning, project management, process improvement, and audit and assurance. She has previously worked for Ernst and Young, the Australian Securities and Investments Commission and is currently Head of Regulation & Investment Management at Western Power. The Board (other than Margaret Pyrchla), recommends members vote in favour of the resolution to elect Margaret Pyrchla. Margaret Pyrchla does not make a recommendation due to her personal interest in this resolution. (d) Election of Michael Ferguson as a director of Diabetes WA Michael Ferguson has 40 years’ experience in commercial and corporate litigation and advice, with a focus on competition and regulation and anti-trust matters. He is a member of The Law Society of Western Australia, the Law Council of Australia and its Competition and Consumer Committee in Western Australia, and is Chair of Trustees of the Legal Contribution Trust. He is currently a Partner with Squire Patton Boggs. The Board (other than Michael Ferguson), recommends members vote in favour of the resolution to elect Michael Ferguson. Michael Ferguson does not make a recommendation due to her personal interest in this resolution.
5. Appointment of Auditors BDO Audit (WA) Pty Ltd was first appointed in 2009. Diabetes WA seeks member support for the appointment of BDO Audit (WA) Pty Ltd as the auditors of Diabetes WA. The Board are satisfied that BDO’s Audit Partner Rotation Policy complies with professional audit standards.
19
RESEARCH
news
Research Round-Up Attention coffee lovers
UK scientists have discovered that caffeine may play a role in stimulating brown fat. Brown fat is the body’s ‘good fat’ that is activated when you get cold to generate heat and metabolise macronutrients, such as carbohydrates and lipids. Increasing the activity of brown fat may aid in managing blood glucose levels and help to reduce body weight, however more research is needed to explore this. Coffee anyone?
Gluten is GO
A longitudinal study conducted by Harvard University has found that healthy people who reported having higher gluten intake levels per day (6-12 g/day) had a lower long-term risk of developing type 2 diabetes than those with lower gluten intake. This could be due to a higher overall cereal fibre intake, presence of gut bacteria and nutrients such as B vitamins, iron and calcium.
Eye on reducing diabetes complications
Researchers at Joslin Diabetes Center have shown that a protein, Retinol Binding Protein 3 (RBP3), found in the eye, may influence the development and progression of diabetic eye disease. People with more RBP3 had lower diabetic retinopathy severity which is caused by ongoing high blood glucose levels.
Puzzle Solution (from page 39) 20
New device could beat type 2 complications Australian researchers are trialling a new tech device which could help identify one of the main complications of the condition. Researchers from Liverpool Hospital and Western Sydney University are trialling the prototype device, called a HeMo, to quickly spot complications in the foot that can arise from diabetes. Type 2 diabetes affects more than a million Australians and the condition can cause long-term complications such as foot problems, cardiovascular disease, nerve damage and kidney issues. The small device measures tiny pulses of blood in the leg to identify abnormalities
such as blockages that can lead to gangrene and amputations. Should the trial show promise, the researchers hope the device and checks will be cheap and easy to access for anyone with type 2 diabetes, no matter where they live. Dr Malone says early detection will ensure patients are given the right treatment, such as surgery to unblock the vessel.
A potential vaccine for type 1 diabetes? Researchers believe they may be another step closer to figuring out triggers for the autoimmune response that can lead to type 1 diabetes. The discovery could pave the way for a vaccine that could prevent the condition in high risk people. Professor Jenny Gunton, from Westmead Institute for Medical Research, has discovered that the lack of the protein in the pancreas, HIF-1A, could play a key role in the development of type 1 diabetes. Professor Gunton says if beta cells are healthy then they normally recover after stresses like viral infections and type 1
diabetes doesn’t develop, however if beta cells don’t cope with these stresses it can trigger the immune process that leads to type 1 diabetes. The research, supported by the Diabetes Australia Research Program, identified that HIF-1A could be an important factor in whether the cells recover or die. “This is the first beta cell specific model to show increased risk of type 1 diabetes with a range of triggers,” Professor Gunton said.
Please note: The information on this page is a snapshot of the latest advances in diabetes research. Please keep in mind that research findings will not necessarily apply to your individual situation and this information should not be used to make decisions about treatment and management without the input of a health professional.
RESEARCH
news
Exciting studies offer hope in diabetes by Diabetes Research WA executive director Sherl Westlund
After a successful National Diabetes Week event focusing on diabetes and gut health, we thought we’d take this opportunity to present an update on our latest Western Australian research. We pride ourselves on funding work with the potential to change the lives of people living with both type 1 and type 2 diabetes.
Type 2 Diabetes, The Gut & Statins Our funded researchers – who’ve previously found in a mouse model study that cholesterol-lowering statin medications drive changes in the body’s gut bacteria, which can trigger the development of type 2 diabetes – have made a new discovery.
energy metabolism back to “normal ranges” in patients. The group’s also progressing new strategies for exploiting nutraceutical and dietary additives to help modulate the gut microbiota towards a more healthy status.
Type 1 CGM Project This world first project aims to study the blood glucose patterns of children at risk of type 1 diabetes (T1D) who are being followed up in the Australiawide Environmental Determinants of Islet Autoimmunity (ENDIA) study, using continuous glucose monitoring (CGM) technology. Recruitment is soon to be underway and its planned participants – ENDIA children who’ve developed one or
Fergal & Jose
The team of Curtin University researchers, led by Professor Fergal O’Gara, revealed the changes in gut bacteria were linked to the activity of a key protein receptor called PXR. This regulatory receptor is also known to be involved in lipid and glucose metabolism. Interestingly, these new findings now offer exciting possibilities for therapeutic development directed at remodelling gut bacteria and host
more islet autoantibodies – will use the Dexcom Pro Q Continuous Glucose Monitoring System to examine differences in glucose patterns and levels, comparing these between children at risk of T1D who have detectable islet auto-antibodies that go on to develop clinical T1D and those who do not. The findings are highly relevant to informing future prevention strategies aimed at reversing, delaying or preventing the development of T1D in these high risk children.
Type 2 Diabetes & RAGE Research by Professor Kevin Pfleger and team into a molecule called RAGE (which sits in the membrane surrounding cells that are injured or stressed, such as in type 2 diabetes) is progressing well, with early findings now published in the high impact Journal of Clinical Investigation. When activated, RAGE triggers signalling in cells that leads to inflammation and cell injury, and this project’s found a way to inhibit this process, which should, in turn, limit the complications of type 2 diabetes developing.
Aveni Haynes with CGM final
Patent applications have now been filed to help progress this work towards the clinic.
We’ll keep you updated on the progress of these important projects. Head to diabetesresearchwa.com.au for further details. 21
MOVING
well
Surgery and What happens when moving well becomes a problem? Surgery can halt you in your tracks and put a bit of a spanner in your plans for healthy living.
22
For people living with diabetes, going into surgery can present a few extra challenges. It’s important to be mindful of all the factors to consider, particularly when it comes to anaesthetic. Managing your diabetes well before, during and after surgery can help prevent complications such as infections and delayed wound healing. The stress and anxiety associated with surgery, not to mention the disrupted routines during a hospital stay, can play havoc with blood glucose levels.
Before you go into hospital Before you go into hospital make an appointment to see your GP or diabetes specialist, so they can help you to manage your blood glucose levels as much as possible leading up to your surgery. Discuss with them what the surgery means for you and what adjustments need to be made to your medications and insulin dose, as well as what your target ranges should be. Review your sick-day management plan with them so that you know what to do when you are discharged from hospital. It is also likely they will ask you to check your blood glucose levels more often in the lead-up to hospital – consider doing this and keep a record.
MOVING
well
diabetes When you arrive
It is important that you tell all the hospital staff involved, including doctors, surgeons, anaesthetists and nurses, that you have diabetes and how you typically manage it, particularly if you have type 1. Let them know about any other medical conditions you may have and all medications you are taking – including herbal preparations. It is also important to tell the doctor or surgeon if you have had a recent hypo and how it was treated. Take your blood glucose meter, testing equipment, diabetes medication and insulin into hospital with you. Make sure you have your hypo kit on hand too if you have one.
Before you go home Before you leave the hospital make sure you understand all of the instructions that your doctor or surgeon has given you. Ask someone to collect you rather than driving home yourself. You may need to test your blood glucose levels more often in the days after your surgery – stress, pain and medication changes can cause high blood glucose levels, but you must also be aware of hypos as they can still occur. Resume your diabetes medication and insulin, if you need it, as your doctor has told you. Be aware that your insulin doses may have been adjusted while you were in hospital due to the surgery and your doses will probably need to be reviewed a number of times in the weeks following surgery as your health improves and your blood glucose levels settle. Most importantly, make sure you rest. Rest makes for a speedier recovery and you’ll be back to moving well in no time.
Checklist Things to pack for your hospital stay:
• All your current
medications – in their original packaging if possible. (The label on the box/bottle will have information about the medication name, dose and timing etc)
• Insulin pens and pen needles
• Blood glucose meter • Glucose monitoring strips • Lancet device and extra lancets
• BGL diary or record book • Hypo kit – such as jelly
beans or glucose tablets/ gel/drink
• Spare snack items – such as crackers or muesli bar
• Ketone meter and strips (type 1 diabetes).
23
Massaman Beef Curry Prep time: 10 mins Cook time: 50-60 mins
Serves 2 (as a main meal)
1 tbsp massaman curry paste or gluten-free curry paste 1 tsp garam masala 300g blade steak, trimmed of fat, cut into chunks 150ml water 100ml light coconut milk 1 brown onion, cut into thin wedges 350g Spud Lite potatoes, unpeeled, chopped 8 cherry tomatoes, halved 200g green beans, trimmed, steamed, to serve Flat-leaf parsley leaves, to serve
1. Heat a medium non-stick saucepan over medium-high heat. Add the paste, garam masala and beef. Cook, stirring often, for 2 minutes or until the beef changes colour. Add the water, coconut milk and onion. Cover and bring to a simmer over medium-high heat. Reduce heat to medium-low and simmer, covered, for 20 minutes. 2. Add the potato and tomato to the curry. Simmer, uncovered, over medium heat for 25-30 minutes or until the meat is tender and the potato breaks down a little to thicken the sauce.
3. Divide the curry between shallow serving bowls. Serve with green beans and sprinkle curry with parsley.
HEALTH TIP
By using light coconut milk in place of regular coconut milk, the saturated fat content of this dish is reduced by 30 per cent
Nutrition Info
PER SERVE 1710kJ, protein 40g, total fat 13g (sat. fat 6g), carbs 26g, fibre 11g, sodium 237mg • Carb exchanges 1½ • GI estimate medium • Gluten-free option • Lower carb
Recipe Alison Roberts, Shannon Lavery (Dietitian), Photography Ben Dearnley, Styling Bernie Smithies, Food Preparation Sarah Mayoh. 24
Mini chocolate soufflé puddings Prep time: 20 mins Cook time: 15 mins
Serves 4 (as a dessert)
15g light margarine 2 tbsp cocoa powder, sifted, plus extra to dust (optional) 1 tbsp plain flour, sifted 125ml (½ cup) skim milk 1½ tbsp caster sugar 1 egg yolk (from 60g egg) 2 egg whites (from 60g eggs) 1. Preheat oven to 170°C (fan-forced). Spray 4 x 125ml (½-cup) soufflé dishes or ovenproof ramekins with
dissolves. Add a large spoonful of egg white mixture to the cocoa mixture and mix it in until well combined. Add the remaining egg white mixture and fold in until just combined. 4. Divide mixture between dishes. Place dishes on a baking tray and bake for 10-12 minutes or until puffed. Remove paper, then dust with cocoa powder, if you like. Serve straight away.
cooking spray. Tie a piece of baking paper around the outside of each dish so it sits about 5cm above the top to form a collar. 2. Put margarine, cocoa powder, flour, milk and 2 tsp of the sugar in a small saucepan. Whisk over a low heat until well combined. Increase heat to medium and whisk until mixture thickens and comes to a simmer. Pour into a medium bowl. Set aside for 5 minutes to cool slightly. Whisk in the egg yolk. 3. Using electric beaters, whisk the egg whites in a medium bowl until soft peaks form. Whisk in the remaining sugar, in 2 batches, until stiff peaks form and the sugar
Nutrition Info
PER SERVE 438kJ, protein 6g, total fat 4g (sat. fat 1g), carbs 11g, fibre 1g, sodium 97mg • Carb exchanges ½ • GI estimate medium • Lower carb
Recipe Alison Roberts, Joanne Turner (Dietitian), Photography Steve Brown, Styling Jane Hann, Food Preparation Tracey Meharg.
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TIPS TO
Need a weight loss jumpstart? Try tinkering with your everyday routine to drop a few kilos and gain energy
SAVE
41%
Fill up on fruit and veg
3 Enlist help
Reduce kilojoules (and carbs) by sprinkling blueberries instead of croutons onto green salads and mixing in lots of capsicum, celery and cucumbers. Non-starchy vegetables such as broccoli, greens and tomatoes contain less carbohydrates than other vegies but still pack a nutritional punch.
6
Get your zzzzzzs
1
Walk it off
Thirty minutes of walking burns about 630 kilojoules – and you don’t have to do it all at once. Briskly stroll to a nearby park to eat your lunch. Or, instead of watching your kids’ or grandkids’ sporting events from the sidelines, keep an eye on the action while walking around the field. Make sure you check your feet before and after walking, and always wear sneakers to protect from injury.
TIP
Take extra carbohydrates before and during exercise to prevent hypoglycaemia. Discuss with your doctor or dietitian first.
Make an appointment with a dietitian or nutritionist to work up a meal plan that can help you lose weight. And, if you haven’t exercised before, ask your health care provider to time your medication and meal schedules to suit your workouts.
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4
Skimping on sleep can cause weight gain, add stress and compromise your immune system. When University of Chicago researchers restricted 10 dieters’ sleep to less than six hours a night, the dieters lost only half the amount of fat (and more muscle) than when they got more than eight hours. Sufficient shut-eye is also key for blood glucose control.
healthy healthylife SHALL WE PLAY A GAME MC:T1 – a modified version of the popular digital game Minecraft – is the brainchild of a Brisbane father who was inspired by his son’s diagnosis with type 1. Designed to help PWD learn how to manage their condition, the game sees players walk around the Minecraft world, but with the addition of monitoring their insulin and blood glucose. The father’s start-up was recently given a grant by the Queensland University of Technology to build the game MC:T1 (Minecraft for Type 1 Diabetes) and develop an educational plan for health professionals and parents. Visit magikcraft.io and research.qut.edu.au/dmrc for more.
Look at your blood glucose-lowering medications with your provider. Some newer medicines, such as Liraglutide and Byetta, may aid in weight loss.
Turn off the TV
7 Get fit during the commercials When watching TV, get up and do one minute of jumping jacks or a minute of knee raises when the commercials come on. Researchers at the University of Tennessee, Knoxville, found that stepping in place during commercials burns an average of 620 kilojoules in about 25 minutes.
84 JANUARY/FEBRUARY 2017 diabetic living
www.subscribetoday.com.au/DL/DWA TERMS AND CONDITIONS: Diabetic Living is published bi-monthly. Offer valid for Australian delivery only. Offer ends 31/12/19. Subscriptions may not include promotional items packed with the magazine. Pacific Magazines Pty Ltd is collecting your personal information for the purpose of processing and managing your subscription. As a subsidiary of Seven West Media Limited, Pacific will handle your personal information in accordance with Seven’s Privacy Policy, which is available at subscribetoday.com.au/privacy-policy.
&
The latest facts & global news on diabetes, body image, broccoli & positivity
Review your medications
A recent review of more than 50 studies confirms that too much screen time is linked to consuming fattening fast foods, energydense snacks and high-calorie drinks.
Latest News
YOUR
Q
15 tune up
living well
Blog life
From online forums for PWD to advice from professionals, these inspirational blogs cover the daily struggles of PWD, as well as giving tips on how to live a healthy life with diabetes.
• DIABETES STOPS HERE (diabetesstopshere.org) Produced by the American Diabetes Association, and born from their movement ‘Stop Diabetes’, this blog shares stories of courage, love and resilience from people living with both type 1 and type 2 diabetes.
• DIABETIC FOODIE (diabeticfoodie.com)
Shelby is a keen foodie who also has type 2 diabetes. Firmly believing “a diabetes diagnosis is not a dietary death sentence”, she shares many healthy, delicious and diabetic-friendly recipes for readers to enjoy.
• DIABETES SISTERS (diabetessisters.org/blogs)
There are separate blogs for type 1 and type 2 diabetes, with the goal of helping readers living with diabetes have healthier, fuller lives. The online forums are a safe place for women to freely share information.
STEP 1
Over the past 20 years, University researchers at Finland’s on a of Tampere have worked could potentially prototype vaccine that developing in prevent type 1 diabetes is not a cure, nor children. Although this altogether, it will it eliminate diabetes immunity. Clinical will, hopefully, provide 2018, although trials are set to begin in the results will not be apparent for about eight years.
A
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Health & Fitness
A DR M
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Should I avoid bread if I have diabetes and am trying to lose weight?
Let’s get physical Aerobic exercises (such as walking, jogging and light cycling) are associated with a reduction in glycemia, in comparison to a temporary increase in glucose levels during anaerobic exercises (such as sprinting, heavyweight lifting and interval sports, such as hockey). Both forms of exercise produce hypoglycemia in the
88% of Australian girls with type 1 desire a slimmer body, and 76 per cent of boys were not happy with their bodies. The stats came from a study conducted by Deakin University researchers of Australians aged between 13 and 19 who have lived with type 1 diabetes for more than 12 months. It further found that only 43 per cent of the boys studied specifically wanted to lose weight.
individual’s late recovery, which often occurs while sleeping. However, it is less common for PWD who are more physically active to get diabetic-related eye disease and kidney disease, and they also have a better chance of reaching the ideal targets for blood pressure levels, glycated haemoglobin levels and a healthier body mass index (BMI).
Confused about glucose? Diabetes Australia has recently launched a new Position Statement on the importance of glucose selfmonitoring. Being a rapidly changing area, the new Position Statement makes it easier for individuals to better selfmanage their condition, discuss the technologies available for glucose monitoring – as well as the pros and cons – and the evidence behind them. It’s all online for your perusal. To read the new Position Statement, visit diabetesaustralia.com.au.
Dr Marsh says: I get asked
this a lot. Many people think bread is something to avoid, yet the right type of bread can be a healthy carb choice. It is often lower in carbs and glycemic index (GI), and higher in fibre and nutrition than other carb choices such as cracker biscuits, rice, pasta, potato and many processed breakfast cereals. The best choices are dense, grainy breads – the ones with lots of visible grains and seeds. These breads have more nutrition and fibre, and when the grains are still intact, rather than milled into flour, they have a lower GI. If you don’t like grains, or can’t manage them due to dental or digestive problems, wholemeal sourdough bread is the next best option. There’s good evidence that eating more wholegrains can help with weight management. They also provide important vitamins and minerals. Bread is an easy way to get more grains in your diet. ➤ Dr Kate Marsh, advanced accredited practicing dietitian and credentialled diabetes educator Email your questions to: diabeticliving@pacificmags.com.au Post: Diabetic Living, Q&A: Health, GPO Box 7805, Sydney, NSW 2001.
12 JANUARY/FEBRUARY 2018 diabetic living
1300 668 118
and quote T8CDKZZA
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community
The Kellion
We marked National Diabetes Week in July and amid the celebrations we honoured those who have lived with diabetes for 50 years or more. This year, nine West Australians who have lived with the condition for more than five decades were bestowed a Kellion Victory medal – and they all have relatable stories to tell.
20 and my partner, Anita (who was diagnosed with type 1 when she was just a 9 month old baby) was told she’d only grow to 4ft tall and none of that happened; diabetes hasn’t stopped us.”
Baby steps into type 1
Brett’s first serious diabetes health scare as a baby saw him rushed to Narrogin hospital and immediately flown by the Royal Flying Doctor service to Perth’s then Princess Margaret Children’s Hospital. His parents borrowed his uncle’s car and frantically drove to the city to be by their baby’s side.
When Brett Arundel was just a toddler, his mother was told he would be lucky to live to the age of 20 - due to his type 1 diabetes. It was a grim prognosis. Brett did make it to age 20 – and even further. Today, he’s 56 – and was recently awarded a Kellion Victory Medal, celebrating people who have lived with type 1 diabetes for 50 years. “I was diagnosed when I was 18 months old, so I don’t remember not having type 1 diabetes,” Brett says. “For a long time there, I was the youngest person in Australia with it.” He has never let the condition hold him back. “I lived hard and fast, well, not really hard, but I just took every opportunity to do as much as I could in the time I had; I was told I would only live to
It was the early 1960s when Brett’s mother, Patricia, first raised concerns about his health and a friend suggested he might have “that sugar disease” – back then, no one really knew much about diabetes.
Brett’s zest for life (with type 1) has seen him embrace adventure; he’s driven road trains across Australia and safari trucks in Africa; always carrying his insulin with him along the way. When Diabetes Matters caught up with Brett, he was busy at work on his 20-acre farm in Harrismith, in the WA Wheatbelt. He credits his country upbringing with helping him and his family take type 1 in their stride and stay pragmatic about the condition.
Brett grew up on stories of him tearing around the corridors of PMH, often wearing little more than a nappy, completely oblivious to what all the fuss was about. “I guess we just got on with it, I wasn’t wrapped in cotton wool because I had diabetes,” Brett says. After 50 years living with type 1, Brett is proud to receive a Kellion Victory medal. “They gave me 20 years to live; and here I am - I’ve lived a full life, I fooled them,” he laughs.
What is the Kellion award? Also known as the Kellion Victory Medal, this award recognises people who have lived with type 1 or type 2 diabetes for more than 50 years. The award is named after the late Claude Kellion AM, who made an outstanding contribution towards diabetes in Australia following the sudden death of his son, John, due to complications of diabetes in 1972. John was aged 38 when he died, leaving his father dismayed by the lack of research into diabetes and its associated issues at the time. In a bid to remedy the lack of information, he established the Kellion Diabetes Foundation which, for many years, was the only private source of funding for diabetes in Australia. The Kellion award is modelled on the United States’ Joslin Victory Medals scheme which, until 1982, was open to international recipients. When this award was closed to 26
overseas entrants, Diabetes Australia responded to a proposal by Dr Alan Stocks to recognise and commemorate Australians for having survived with diabetes for 50, 60 and 70 years or more and Mr Kellion was invited to have his name associated with the scheme. A further addition to the award is the Kellion Carer’s award which recognises the role family and supporters have in assisting someone with diabetes over an extended time. It is an award that recognises many years of love, dedication and support. The 50-year medal is silver, the 60-year medal is gold, 70year medal is platinum and the 75-year medal is diamond.
INTHE
Victory Awards
community
Family support makes all the difference As Peter Benson Green reflects on his life with type 1 diabetes one constant rings through – his mum and her unwavering support. Peter was eight years old when he was diagnosed with type 1 diabetes and he credits his mum, Eileen, who, as a trained nurse, embraced the challenge and led her family through what would be their “new normal”.
Jan, began showing early signs of type 1 diabetes. “I was shocked and concerned, but luckily our family doctor was travelling with us and was able to get us home and Jan to treatment,” Peter recalls.
As Peter and his family adjusted to life with type 1 diabetes, little did they realise how much the lessons they had learned about diabetes and the knowledge they had acquired along the way would pay off. Eight years after Peter was diagnosed with type 1, the Green family were in for another diabetes shock. During a family holiday in the Philippines, Peter’s older sister,
Peter strongly believes that his family support, including the love and support from his mother and his wife, Sandra, encouraged him to lead a full life. Eileen and Sandra both received Kellion Carers Awards for the support they have given Peter through the years.
“Mum was a Godsend,” Peter says frankly. “As a family, we learnt to live with diabetes. “Even the family dog, Becky the boxer (who slept in my room) knew when something was up, as she would sit at my bedroom door and bark until Mum and Dad came to treat my hypo.”
and Peter and Jan had a loving and understanding father who was always there in their time of need.”
Eileen remembers initially feeling overwhelmed at having two children living with type 1 diabetes and worrying about how she would properly manage their needs against such a relentless condition. But once again, the Green family faced the challenge - and succeeded. “Our lives became quite regimented at first, but as we settled into the new regimes we learned to relax more,” she says, “I had a wonderful husband
Kellion Victory Medals, and certificates, are presented to people who have lived with diabetes for 50 years or more. As diabetes can affect the whole family, there is also the Kellion Carers award for people who support their loved ones living with diabetes to live full, happy and healthy lives.
Did you know? Insulin was first administered to a human patient in January 1922.
Congratulations! 50 year Kellion Victory Medals for 2019 were awarded to the following people: Martin Kilov; Patricia Manolas; Stephen Finch; Peter Benson Green; Brett Arundel; Anne Henley; Brenda Eltringham; Fiona Jean Guile; Maree Lesley Smith. Carer awards, celebrating the support loved ones give to those living with diabetes, went to: Andrea Kilov, Eileen Green, Sandra Green, Patricia Arundel, Bob Henley, Clifton Smith
Photos from left to right: Anne Henley with husband Robert Henley; Brett Arundel with mother Patricia Arundel and Anita Gustafsson; Maree Lesley Smith with husband Clifton Smith and family; Martin Kilov with wife Andrea Kilov; Peter Benson Green with wife Sandra Smith and mother Eileen Smith; Stephen Finch with supporter Annelieske Noteboom 27
INTHE
community
#DiabetesChatters In this new segment we will feature the trending topics on our social media channels, the common questions coming in on our
Diabetes Helpline or your responses to a specific social media post. What ARE people with diabetes talking about? #HotTopics.
“Educator�
“Doctor�
“Me�
“Nurse�
“My friends & family!!!� “You guys� “GP is awesome�
“Our beautiful educator, Daina, from the PCH midland team. My 6 year old was recently admitted with rotavirus resulting in low bgl with high ketones. Daina met us in emergency and stayed with us and made sure the ED staff where happy to work with me in regards to insulin dosing. She is amazing and so patient with my grumpy boy.�
“The practice nurse. I see a wonderful physio as part of my care plan, but that is not really related to my T2D, more wear and tear.�
Who would you say is the most supportive healthcare professional on your team? “My GP, he organizes all the appointments I need and helps keep me on track.�
“My new Podiatrist. She gave my legs and feet a full once over and educated me on what are good and bad changes to keep an eye on.�
“My Diabetes Educator ... I always walk away after an appointment with her feeling like “I’ve got this!â€?. Such a positive person. đ&#x;’•â€? “Me. own it and take care of youâ€? “My GP is one in a millionâ€?
Q: Should I start a Keto diet? Brigitte, type 2 diabetes
“Social worker.â€? “My wife Carmel Beatson! ďż˝ â?¤â€? “I have two guardian angels. My wife and my GPâ€? “My GP, wife and daughtersâ€? “My friends and family, and professionally my GP and daughter.â€?
“My GP, my daughter and daughter in law. My daughter has a T1 son and my daughter in law is studying nutrition because the kids have problems with gluten and dairy. All the family gatherings have good food choices for everyone.�
“My GP ... super man�
Burning Questions
“My GP is awesome!!�
“My partner . . My new Dr . . (Other one didn’t think I should be testing) and our local pharmacy�
“My GP - she works with me to keep all my specialists organized and on track.�
“My GP�
“Me, followed by my DE, then my GP because he obeys my DE and me�
A: Diabetes WA Diabetes Educator Narelle Lampard says ‌ A Keto diet is a very low carbohydrate diet (less than 30 grams per day) which results in the body switching to using mostly fat (ketones) for fuel instead of carbohydrate (glucose). They have become trendy of late but should be approached carefully. Keto diets restrict all carbohydratecontaining foods, including sugars, grain-based foods, starchy vegetables, legumes, fruits and milk products. A reduction in carbohydrates is often helpful for many people with diabetes,
“Megan, the dietician/nutritionist at PCH....she’s the best đ&#x;˜Šâ€?
however a very low carbohydrate/ Keto diet approach is not for everyone. It is not recommended for children, pregnant and breastfeeding women. For people with diabetes taking tablets or insulin, there is a risk of hypoglycaemia when switching to a very low carbohydrate diet, so it is advised to monitor your BGLs more often and work closely with your doctor or diabetes educator to adjust medication doses. If you choose to follow a Keto diet, consider seeking the help of an Accredited Practicing Dietitian to make sure you meet all your nutrient requirements.
If you have a diabetes-related question that you would like answered, email it to community@diabeteswa.com.au. Alternatively, you can call the Diabetes WA Helpline between 8.30am and 4.30pm weekdays on 1300 001 880. 28
SHARED
pathways
Working together and making a difference Understanding diabetes, being confident in self-management and knowing support is available were among the positive outcomes our teams have delivered to people with diabetes throughout the Pilbara. With funding from WA Primary Health Alliance, Diabetes WA’s Pilbara Diabetes Management Strategy enabled people in the Pilbara with type 2 diabetes to attend structured diabetes self-management education for the first time. One of the greatest outcomes of the project included the successful delivery of eleven Aboriginal DESMOND programs across the Pilbara, over the two-year project. With funding from WAPHA and Mawarnkarra Health Service, programs were delivered to 121 Aboriginal people with type 2 diabetes and 19 support people in the region from July 2017 through to June 2019. Moreover, interest and attendance steadily increased throughout the project. In 2019, programs delivered in Roebourne and Karratha were the
result of collaboration between multiple service providers and organisations in the region including Mawarnkarra Health Service, Karratha Central Healthcare, and IBN Aboriginal Corporation, which was a relationship facilitated and leveraged through WACHS Population Health South Hedland. Programs in Roebourne and Karratha were a huge success with 10 and 16 participants (respectively) attending the Aboriginal DESMOND program. Both participants and observing health professionals recognised the importance of the program being delivered and working together to support participation. “Your organisation, working in collaboration with others, offers a wonderful program for community members and residents and IBN was very pleased to have
been involved,” said Debbie Allcott, Community Partnerships Officer for IBN in Karratha. Participants described the program as “amazing” and “very educational” and discussed goals around food choices, exercise and medications. People who took part also said that they would recommend the program to others in that they “gained knowledge and awareness,” they liked how diabetes was explained “with locks and keys in the body” and added that the program “caused no harm and everyone in the room was all good”. Diabetes WA is working with all of these organisations and providers to explore funding and support for further Aboriginal DESMOND deliveries in the future.
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EATING
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EATING
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BE PREPARED
A healthy body starts with the fuel you put in it, and when you’re busy, it’s easy to let that slip. Who hasn’t left work late, or been rushing around, with a growling stomach but little energy or time to shop and cook? A busy schedule is one of the top reasons people choose quick takeaway meals, which are often high in kilojoules and nasty preservatives. When there is no healthy food prepared in the fridge you are less likely to make healthy choices. Amidst hectic weekday schedules, meal prepping is a great tool to help keep hungry tummies on a healthy eating track. Although any type of meal prep requires planning, there is no one correct method, as it can differ based on food preferences, cooking ability, schedules, and personal goals. But there is one guarantee – if you can get yourself organised, then meal prepping will have you stressing less and eating better, spending less and living more.
Meal prepping Meal prepping can be different to meal planning because you are not necessarily always cooking full meals for the week. Meal prepping entails getting several food items ready on a certain day, say the weekend, so that you can reduce your cooking time during the week and have some easy grab-andgo lunch options. If you are super keen though, you can also pre-cook a few meals in advance. Once you get a system in place that works for you it becomes a really simple process that doesn’t have to take over your entire Sunday afternoon.
Is meal prepping for you? •
If you eat fast food or takeaway several nights of the week, try choosing a specific day of the week to create a food shopping list and hit the supermarket.
•
If you already do your food shopping once a week and have pretty good basic cooking skills, try choosing one day a week to do most of the cooking, or try a new recipe.
•
If you already cook some weekday meals for your family, you could try creating a schedule so that you are not deciding last minute what to make and to ensure you have the needed ingredients on hand.
Image from The Fit Foodie Meal Prep Plan by Sally O’Neil
How-to meal prep The Harvard (TH Chan) School of Public Health has the following tips for meal prepping: 1. Choose a specific day of the week to: a) plan the menu, whether week by week or for the whole month, and write out your shopping list; b) food shop; c) do meal prep, or most of your cooking. Some of these days may overlap if you choose but breaking up these tasks may help keep meal preparation manageable. 2. As you find favourite ‘prep-able’ meals, or your menus become more familiar and consistent, look out for supermarket specials to stock up on frequently used shelf-stable ingredients like pasta, rice, and other whole grains, lentils, beans (canned or dried), jarred sauces, healthy oils, and spices. 3. On your meal prep day, focus first on foods that take the longest to cook: proteins like chicken and fish; whole grains like brown rice and quinoa; dried beans and legumes; and roasted vegetables. 4. Also consider preparing staple foods that everyone in the family enjoys and which you can easily add to a weekday meal or grab for a snack: washed greens for a salad, hard-boiled eggs, a bowl of chopped fruit, cooked beans. 5. If you prefer not to pre-cook proteins, consider marinating poultry, fish, or even tofu on your prep day so that you can quickly pop them into the oven or stir-fry later in the week. 6. Multi-task! While foods are baking or bubbling on the stovetop, chop vegetables and fresh fruit, or wash and dry salad greens for later in the week. 7. When you cook a recipe, make extra portions for another day or two of meals, or to freeze for a different week. Be sure to date and label what goes in the freezer so you know what you have on hand and how old it is (see storage tips below). 8. For lunches, get a head-start and use individual meal containers. Divide cooked food into the containers on prep day. 9. Consider specific meals or foods for different days of the week. Some people and families enjoy the consistency of knowing what to expect, and it can help to ease your meal prep. Examples are Meat-free Monday, Whole Grain Wednesday, Stir-Fry Friday, etc. 31
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Try simple meals first When cooking meals for during the week, don’t worry about making it fancy. Even if you’re not cooking a gourmet meal, it doesn’t mean that your food needs to be bland or boring. Add fresh herbs, spices, citrus, garlic, and/or onion to boost the flavour of your meals. Here are some common meal preparation ideas to help get you started:
• • Egg and vegetable muffins • Smoothie prep (measure out fruit into bags and freeze) • Brown rice or wild rice • Quinoa • Black beans • Roasted sweet potatoes • Roasted pumpkin • Homemade pesto or hummus • Soups • Grilled or roasted chicken • Slow-cooked pulled chicken, beef, or pork • Tuna salad • Egg salad up vegetables (celery, cucumber, • Chopped carrots, capsicum) Hard-boiled eggs
nut and fruit mix (almonds, walnuts, • Homemade pecans, goji berried, shredded coconut)
• Fruit salad grab-and-go lunch (don’t put salad dressing • Salads for on until you are ready to eat) All of the items listed above will last in your fridge for at least four days. 32
Storage and food safety Refrigeration and freezing are an important step to successful meal prep. Inattention to food safety and forgotten food, such as produce hiding in a drawer or a stew stored on a back shelf in an opaque container for too long, can spoil and lead to sickness and food waste. Label all prepped items with a date so that you can track when to use them by. Rotate stored items so that the oldest foods/meals are kept up front. Store highly perishable items like greens, herbs, and chopped fruits at eye-level so you remember to use them. When it comes to freezing, some foods work better than others. Cooked meals tend to freeze well in airtight containers. Foods with high moisture content, such as salad greens, tomatoes, or watermelon, are not recommended as they tend to become mushy when frozen and thawed. Blanching vegetables for a few minutes before freezing can help. However, if the texture of a frozen food becomes undesirable after thawing, they might still be used in cooked recipes such as soups and stews.
Avoid processed foods There’s a good chance that nobody will ever be perfect when it comes to food prep. It’s likely you’ll still have to make the best of some quick-fix food choices occasionally. But limiting those times by meal prepping, will help to stay healthy, eat well, save money, and enjoy less frantic meal times. So much of our processed foods (even so-called healthy meals) are heavy in salt, fat, and simple carbs and no amount of time exercising can out-do a bad diet. Simple meal prep and taking the time to evaluate and plan the week to come can make all the difference during a hectic week.
EATING
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Fit Food Prep Sally O’Neil, aka ‘The Fit Foodie’, has developed her book, The Fit Foodie Meal Prep Plan, as a practical guide to help people create a fridge full of healthy, ready-to-eat meals. Her advice is as follows:
STEP 1: Prep your protein:
Meat, fish, poultry and vegie proteins are the starting point of your meal — think fool-proof oven-baked salmon or chicken, falafel, fishcakes, Asian-style mince and satay tofu.
STEP 2: Batch and stash:
Get the fridge, freezer and pantry packed with healthy staples to last the week—muesli, paleo bread, hummus, dressings, fritters and loads of great healthy sweet treats.
STEP 3: Create combos:
Use the prepped protein and staples to create different meal combos. This is fast-action meal assembly that will stop you ever getting bored: try poached chicken with buckwheat and miso broth; satay tofu crumble with roast veg, salmon gravlax with zucchini fritters and tzatziki dressing; or turkey meatballs with waffles and pesto. Here we feature just a few of the delicious and clever recipes included in Sally’s book to show a little taste of meal prepping and how it can be achieved. All Images and Text from The Fit Foodie Meal Prep Plan by Sally O’Neil. Photography and Styling by Sally O’Neil. Murdoch Books RRP $35.00’. Available in all good book shops now.
Members Giveaway We have a copy of Sally’s book to giveaway to one lucky member. Sally says, “I’m here to share my favourite food hacks: the tricks and tips I’ve learned that make healthy food SIMPLE. My method is this: prep it, batch it, store it, assemble it ... you’re not going to find a faster way to eat home-cooked, healthy food.” Turn to page 39 to enter the competition to win a copy of Sally’s book. 33
EATING
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Healthy fish cakes
Prep time: 15 mins Portions: 4 These fish cakes can be made kid-friendly by shaping them into fingers and coating with rice flour instead of sesame seeds. Use the same weight of tinned tuna or salmon if you don’t have fresh fish.
Ingredients 500g fresh white-fleshed fish, coarsely chopped 1 small onion, chopped 1 garlic clove (or ½ teaspoon garlic powder) ½ bunch fresh parsley (stalks and all!) Juice of ½ lemon Sea salt + pepper 75 g (½ cup) sesame seeds Sesame oil, for frying (optional)
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Method 1. Preheat the oven to 180°C. 2. Throw the whole lot (aside from the sesame seeds) into a blender or food processor and blitz to a coarse consistency. 3. Use wet hands to roll the mixture into patties, then dip into the sesame seeds to coat. 4. Bake for 15-20 minutes until cooked through or pan-fry in a little oil for 3–4 minutes on each side. Freeze uncooked patties, before dipping them in the sesame seeds, in an airtight container for up to 3 months. I love these served with salad and coconut tzatziki (see recipe on page 37).
Make them Thai-style: • 1 cm piece of fresh ginger, grated, or 1 teaspoon ground ginger • use lime instead of lemon • use coriander instead of parsley • 1 tablespoon soy sauce or tamari
EATING
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One-tray chicken: three ways Prep time: 10 mins Portions: 6 When you’re rotating lean meats such as chicken for a lot of meals, dinner can get pretty tedious. This simple hack lets you cook chicken three different ways in one tray. Tip: Use foil to pinch up dividing walls in your pan so you can season each portion differently.
Ingredients 3 large skinless chicken breasts 2 tablespoons olive oil 1 teaspoon each salt + pepper 1 tablespoon each of seasonings, opposite
Method 1. Preheat the oven to 180°C. 2. Using a pair of kitchen scissors, trim off any white sinew from the meat, then cut it into 2 cm pieces. 3. Lay an extra-large piece of foil on a baking tray, spread out the chicken and drizzle with olive oil. Season with salt and pepper. 4. Divide the chicken evenly into three portions, and pinch two ‘walls’ in the foil to create separate sections, as shown.
5. Season each section with a different seasoning mixture, rub into the chicken, and bake for 10–15 minutes or until cooked through. 6. Keep the cooked chicken in separate airtight containers in the fridge for up to 4 days.
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One-tray chicken combos There are three types of seasoning for oven-baked chicken below, or use your own favourite. Once the chicken is cooked, add sweet or savoury accompaniments to keep it interesting for every meal. Some of my favourite additions include lime, mango and herbs.
COMBO 1
One-tray chicken: lemon + rosemary
Coconut tzatziki dressing
Pickled celery
PLUS
Olive oil
walnuts, apple, grapes, salad greens, herbs
COMBO 2
One-tray chicken: spicy barbecue
Avocado
Mango
Tomatoes
Lime juice
Black beans
PLUS
chilli
COMBO 3
One-tray chicken: maple sesame
Brown rice
Rocket
Pea + almond pesto
Tomatoes
Basil
PLUS
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almonds
Lemon + Rosemary
Spicy Barbecue
Maple Sesame
Lemon zest + lemon juice + finely chopped fresh rosemary
Smoked paprika + garlic powder + onion powder + chilli powder
1 tablespoon maple syrup + 2 tablespoons sesame seeds + 1 teaspoon garlic powder + 1 teaspoon ground ginger
EATING
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One-tray chicken combos Coconut Tzatziki Makes about 250ml = 260 g (1 cup) coconut yoghurt + ¼ cup finely chopped cucumber + 3 tablespoons lemon juice + 1 tablespoon chopped dill + ½ teaspoon sea salt. Blend or stir all the ingredients together and store in an airtight container in the fridge for up to 1 week.
Pickled Celery Portions: 6-8 per jar = 4 cups sliced, chopped or julienned celery Pickle Liquid (for a 1 litre jar) (quantities are approx.) 500 ml (2 cups) white vinegar + ½ teaspoon mustard seeds + ½ teaspoon cumin seeds + ½ teaspoon sea salt Combine the vinegar, mustard seeds and cumin seeds in a large saucepan. Bring to the boil over medium–high heat. Pack the chopped celery into clean glass jars, leaving a little space at the top for vinegar to completely immerse them. Pour the hot liquid over the vegies until the jar is full. Cool the jars to room temperature, then secure the lids and refrigerate.
Pea and Almond Pesto Makes about 250ml = 1 cup fresh or defrosted frozen peas + 1 cup almonds + 2 garlic cloves + ½ bunch fresh mint, leaves picked + 1 bunch fresh basil, leaves picked + 125 ml extra virgin olive oil + salt + pepper to taste. Blend or stir all the ingredients together and store in an airtight container in the fridge for up to 1 week.
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Five days of overnight oats
Prep time: 10 mins Portions: 5 Prepping oats in big batches ready for the week ahead is a sure-fire way of saving yourself from the biscuit jar. The fibre takes a while to digest, so these keep you full for longer (use rolled oats rather than quick ones as they take longer for your body to break down). Ten minutes’ investment equals a nutritious start to the day for five days.
Sweet: 500g (5 cups) rolled oats 40g (¼ cup) chia seeds 1.25 litres (5 cups) milk of your choice 1 teaspoon vanilla extract or ground vanilla Savoury: 500g (5 cups) rolled oats 40g (¼ cup) chia seeds 1.25 litres (5 cups) water, chicken or vegetable stock 1/2 teaspoon sea salt Note: Watch out for the high sodium content of some ready-made stocks Mix all of the ingredients together in a bowl, cover and leave to soak in the fridge. Spoon portions into small, portable jars or airtight containers and top with your favourite topping combos when you’re ready to eat them. Sweet topping combos
• Walnuts + ½ cup grated carrot + nutmeg + 1 teaspoon honey • Sliced banana + peanut butter + cinnamon • Cacao powder + raspberries + toasted coconut + cacao nibs • Mixed nuts + sliced strawberries + 2 squares dark chocolate
Savoury topping combos
• Poached egg + avocado + turkey bacon • ½ teaspoon chilli flakes + 1 teaspoon tamari or soy sauce + coriander + poached chicken • Tinned sardines + grated zucchini + lemon juice + pepper • Miso pumpkin mash + chopped Thai basil + cashews
Tip (Sweet): Add a few tablespoons of this to smoothies before blending for extra fibre and creaminess! Tip (Savoury): Spoon into your soup base before blending to make it thick and super-satisfying.
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Diabetes WA Find the following words in the puzzle. Words are hidden carbohydrates hyperglycemia hypoglycemia unsaturated cholesterol pancreas educator glucose ketones kidneys doctor specialist diabetes
lipids insulin index heart testing podiatrist fasting energy meter eyes feet pump fat
Answers can be found at the bottom of page 20
MEMBERS
S C X P O D I A T R I S T S U
area
H C S N K E T ON E S L F L P Y A S G Y H E A R T I A P H E P R J L DM P UM P S I MO C E B B U I E C Y I T N P U L I R O K C A T OD I S T A D E A GH I O B E S N U E E NO S L L Y D S E R G L S Y F C C T I Y DN E T T I T E A E R T E S C R E G E N I S TWU E O R T E A Y Z S ND E X K L A R OUM T S A G E N E R G Y S D L E I E H E DU C A T O R F E E T A S H Y P OG L Y C E M I A Z L N S A T U R A T E D J VWE
Competition
Spring
The Fit Foodie Meal Prep Plan is a three-step practical guide that gives you a fridge full of healthy, ready-to-eat meals and takes the ‘what’s for dinner’ worry out of your busy days. Sally O’Neil, aka The Fit Foodie, overhauled her eating habits and started meal prepping to save time and money, and lost 14 kg in the process. She is now a recipe developer, freelance food stylist and photographer working with major food brands around the world. Sally’s book, The Fit Foodie Meal Plan, talks about how a healthy body starts with the fuel you put in it. When you’re busy, it’s easy to let that slip… The cupboard is empty, so dial up a takeaway - we’ve all been there. Meal prepping will have you stressing less and eating better. Thanks to Murdoch books, we have copy of The Fit Foodie Meal Prep Plan by Sally O’Neil to give away. Total Value: AU$35.00
To enter, complete the competition slip below and mail to: Membership – Meal Prep Plan Competition PO Box 1699, Subiaco WA 6904 or email your entry and details to membership@diabeteswa.com.au
Good luck! Name:
Diabetes WA Membership Number:
Address: Contact number:
Email address:
Entries close 1 December 2019.
The winner of the competition from our Winter magazine was Lila from Kallaroo. Lucky Lila won the Diane Caine gift pack 39
LIVING
well
Your member benefit partners
We’re proud to partner with these businesses to offer great deals and discounts to Diabetes WA members:
• Curves • Diabetic Living magazine Caine 100% natural • Dianne skin, body and hair products • Donna Barlow Travel • Home Visit Wills • Mandurah Cruises • Podiatrist Perth • Royal Lifesaving WA • ShopRite • Tanita
Discounts and offers Shoprite can help you find great deals at over 60 businesses which include these services:
• Accounting services servicing • Air-conditioning and installation cleaning, tile and • Carpet grout cleaning as well as upholstery and leather sofa cleaning
gift cards • Discounted (on selected brands)
tickets to Rottnest • Ferry (from Fremantle and Hillarys)
• Household utility bills • Lawyers • Luxury linen servicing, vacuuming, • Pool blankets, rollers, equipment and leak detection
• Water filtration 40
Get the benefits As a member of Diabetes WA, you’re entitled to loads of member benefits – and we want you to take advantage of them. From discounts at various health services, great deals on travel and even nabbing a bargain shopping; being a member certainly does have its perks.
Have you heard of ShopRite? Local business ShopRite makes bargain-hunting easy. The ShopRite team offer a ‘best deal’ service – promising to find the best price on any product, from coffee machines to cars. Diabetes WA members receive a ShopRite card – and this entitles you to extended discounts on a range of retail products. ShopRite owner Tone Greenough says great deals happen when members contact ShopRite direct. Tell ShopRite the product you are after – and they’ll do the shopping around for you. “There is a perception that members are to show their card at store level for discounts, but this is not the process,” Mr Greenough explains. “For example, we had a member show their card in store and then they contacted ShopRite - they believed they were getting a great deal, and we in fact saved them an additional $820.”
This was the deal ShopRite negotiated for the member:
• •
Item: Samsung Fridge, $4,999 (RRP)
•
Presenting the ShopRite card in-store, the fridge was reduced to $3400
•
Another benefits program offered the fridge at: $3367
•
ShopRite negotiated the price down to: $2580
An online store offered the same fridge for $3621
“Each scenario is different, but this is a prime example of why members should contact us directly,” Mr Greenough says. “The advantage we have is that we personally negotiate each sale on the day and do not work from commercial portals or spreadsheets. Only a ShopRite team member can provide a ShopRite deal.”
LIVING
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Your member benefits As a member of Diabetes WA, for $50 for a full membership and $26 concession each year, we’ll support you on your diabetes journey by; you informed: You’ll receive a free • Keeping subscription to Diabetes Matters magazine,
exclusive access: You’ll • Offering have free entry to our workshops
you with knowledge: You’ll have • Arming access to free advice from our Diabetes WA
your voice heard: You can vote and have • Making your say at our Annual General Meeting (see
can subscribe to free monthly e-newsletters and free information resources.
Helpline and support group network.
you money: You’ll be offered discounts • Saving and offers from our member benefit partners
and information sessions, plus early tip-offs to what’s coming up.
page 18), become a Diabetes WA ambassador and we will lobby on your behalf to government to improve support for our members.
and receive a Shoprite card. Some health funds offer rebates on your Diabetes WA membership too.
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MEMBERS
area
www.diannecaine.com.au
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6-12 Octobe r
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Diabetes: Smarter ways to self-manage
Diabetes is a chronic condition that you can self-manage. The SMART programs are a range of group workshops designed to help you better manage your diabetes, wherever you are in your health journey. The two and three hour workshops focus on different aspects of diabetes management. They provide you with information and practical tips to help you, help yourself.
CarbSmart (type 2 or gestational diabetes) Confused about carbs? Learn about the different types and amounts that are best for you.
FootSmart (type 1 or type 2 diabetes) Your feet are made for walking - so let’s keep them healthy! This workshop will teach you all you need to know about checking and caring for your feet.
MedSmart (type 2 diabetes) This workshop helps you understand what your medications are, what they do and how to address any concerns you have about taking your medications.
MonitorSmart (type 2 diabetes) This session shows you how to track your diabetes results to best manage your diabetes.
ShopSmart (type 1, type 2, gestational diabetes) A supermarket tour that will help you understand food labels and what foods are right for you.
ShopSmart classroom (type 1, type 2, gestational diabetes)
2019-033
An alternative to ShopSmart, suited for those who would prefer to learn healthy shopping skills in a classroom setting.
1300 001 880 bookings@diabeteswa.com.au diabeteswa.com.au The National Diabetes Services Scheme is an initiative of the Australian Government administered with the assistance of Diabetes Australia. For more NDSS Information 1300 136 588 or ndss.com.au