Summer 2021/22 $6.95
A Diabetes WA Member Magazine
WHAT’S YOUR EATING STYLE?
If you’ve got it, we get it
From the Editor
member magazine! Welcome to the summer edition of your of the season, with I write this on the first properly hot day this time of year can Christmas approaching fast. We know it's a time of celebration, be difficult for many, partly because strategies can go out the when the usual health-management ) window (or do I mean up the chimney? y these hot, festive enjo to s way This issue, we're looking at s. In our main goal th heal our days without losing sight of diets that lar popu e mor the feature, we look at some of we're keen As t. abou d dere won you might have heard of or work for will that style g eatin to point out, there is no one and speak , cons and pros the of everyone. We look at some it makes hope the in , diets r icula to a couple of experts in part style – if any – will work it easier for you decide which eating for you.
ive the party We also offer a few tips on how to surv etes and look at a onslaught while managing your diab ises to make keen popular exercise program that prom h potatoes. I must runners out of the most reluctant couc ble for curing me of confess, the Couch to 5K was responsi it out during lockdown my lifelong aversion to exercise. I tried three times a week. We and, a year later, am still running 5km for people with type 1 look at how well the program will work ghts! diabetes, so I'm keen to hear your thou a guide to the best As a summer treat, we've also included iews of some of prev and days books to while away the hot s. stma Chri after the main events coming to WA Happy reading! Myke
Contents
From the Chair ..................................................................... 1 Your Voice/Our Actions ................................................. 2 Latest News ........................................................................... 3 In the Community ............................................................. 4 Talking Science Gestational Diabetes and diet ................................................ 6 The benefits of exercise........................................................... 6
From the Cover What's you eating style?.......................................................... 7 The Low-carb diet...................................................................... 8 The Mediterranean diet.......................................................... 10 Other eating styles.................................................................. 12
Our Annual Review.......................................................... 14 100 Stories for 100 Years .......................................... 17 On the Line ............................................................................ 18 Workshop Calendar Workshops Update................................................................. 22
Editor Myke Bartlett 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. Thanks to Diabetic Living magazine, Pan Macmillan Australia. Contributors Denise Brownsdon, Natalie Jetta, Teena Townsend. Photography DWA staff, Shutterstock. Design Diabetes WA – Subiaco Office Brigitte James Level 3, 322 Hay Street, Subiaco WA 6008 Print Postal Address: Vanguard Press PO Box 1699, Subiaco WA 6904 Diabetes WA Diabetes WA – Belmont Office diabeteswa.com.au 172 Campbell Street, Belmont WA 6104 Diabetes Helpline: 1300 001 880 Postal Address: PO Box 726, Belmont WA 6984 Email: info@diabeteswa.com.au
Living Well Living With Less: Cleaning products................................. 24
Moving Well Does the Couch to 5K work? ............................................... 24
Eating Well Getting festive with diabetes ............................................... 26 Gut Recipes .............................................................................. 28
Diabetic Living recipes ................................................ 30 Aboriginal Voice ............................................................... 32 Take A Hike .......................................................................... 35 Eating Well Summer reading guide ......................................................... 36 Our favourite things to do this summer .......................... 39
Members' Area Member Benefit Partners .................................................... 40 Members’ Competition and Sudoku .................................. 41
2021-069
SUMMER 2021/22
FROM
THE CHAIR What a year this has been on a number of different levels! At our Annual General Meeting in October, I was pleased to announce the release of Diabetes WA’s Annual Review for 2020-2021, which provides an overview of Diabetes WA’s health services activities for the past 12 months. I reflected on what could only be described as a very challenging year, as our amazing team continued to deliver vital services in an environment never before seen in the 56 years since our organisation was founded. Through all the challenges this year has brought, I was proud to report on the incredible resilience our organisation showed in adapting,
Diabetes WA offices will be closed to the public from 24 December 2021 to 4 January. Our Call Centre will still be taking calls with reduced staff and will only be closed on Christmas Day.
innovating, and expanding the work we do in WA to support people living with diabetes and those vulnerable communities at risk of diabetes. The Annual Review highlights some great achievements and is available, alongside our audited financial reporting, at www.diabeteswa.com.au. While visiting our website please take a moment to visit our new webstore. This one-stop shop allows you to renew your Diabetes WA Membership, make a donation, or purchase a wide range of diabetes products including those supported by the NDSS and available to all NDSS Registrants. Take a look at what is available or call one of our friendly customer service team members for information on 1300 001 880. On 22 November our new CEO, Melanie Gates, commenced her role with Diabetes WA. Melanie is a highly experienced leader, who has worked in a number of executive roles within the healthcare sector. Her appointment marks the beginning of an exciting new phase for our organisation and I'm delighted to welcome her aboard. I look forward to working closely with her to build on the great work Andrew has done during his time with us. In October the board and executive management team came together to kick off the development of a new five-year strategic plan. We are very excited about the opportunities to reach more consumers using
innovation and technology, in addition to our successful face-to-face programs, to provide an expanded ranges of services to new audiences. I will bring you more on our new directions in coming editions of this magazine. In this summer edition of Diabetes Matters we are looking at different diets or eating styles. We profile many of the popular programs as we seek to help people decide what might work for them. Inevitably, given the timing of this magazine, we also discuss different strategies for coping with the festive season when you’re living with diabetes. So, grab a tea or coffee, sit back and relax and read all about food strategies. I want to close this piece by wishing everyone all the very best for the forthcoming festive season. Let us join together in hoping that 2022 brings relief to the stresses and challenges that have affected us all during 2021. I look forward to speaking with you all again in 2022.
Mary Anne Stephens Diabetes WA Board Chair
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YOUR
voice
Diabetes Matters wants to make sure our member voices are heard. If you have any feedback, thoughts or stories you want to share, get in touch at media@diabeteswa.com.au
Feedback and bad advice
There’s been a lot going on since the last issue of Diabetes Matters. It’s been great hearing from members who dropped us a line to say they were enjoying the new look mag. Back in September, we celebrated Women’s Health Week with the story of Amy King [pictured], who recounted her experiences of being teased as a teen for having type 1 diabetes. Others shared their own experiences of confronting stigma around diabetes — and some of the terrible advice they had received! “I had an old boss suggest I use an essential oil blend she had made instead of taking my insulin injections! Needless to say I did not.” Ashleigh Jones, Facebook “My very well-educated and respected friend’s husband told me to stop taking insulin as it was killing me. He said to drink turmeric and ground up sesame seeds – plus a whole host of other seeds and spices – that he claims helped him… I couldn’t leave fast enough. His wife has apologised since, though she shouldn’t have.” Bianca LM, Facebook A reminder — if one was needed — to always consult a medical professional before making changes to your medication regime.
OUR
actions
Diabetes WA welcomes a new CEO The big news at Diabetes WA is that we have a new CEO! We’re excited to announce the appointment of Melanie Gates as Chief Executive Officer, effective 22 November 2021. Melanie has more than 16 years of senior leadership experience across several industries. For the past 10 years Melanie has worked within the healthcare sector and her experience includes time as a Hospital Chief Executive Officer, Head of Business Transformation for Australia’s largest private hospital group and, recently, Head of Virtual Care for Australia’s largest health software provider. Diabetes WA Chairperson, Mary Anne Stephens said Melanie is passionate about the health sector, using innovation and technology to enhance models of care, consumer experiences and improve health outcomes and wellness for all Australians. Welcome Melanie! 2
Where we’ve been Our staff members have been all across WA in the past few months. On 10 November, we were at Have A Go Day [pictured], as part of WA Seniors Week, offering lots of prizes and giveaways. We also got our running shoes on to support the Fremantle Running Festival on 28 November — for which we’re a charity partner — and to raise awareness about foot care for people living with diabetes. The day featured a range of events stretching from 300 metres to 21.1 km. If you missed out this year, now’s the time to start training for 2022! At the end of October, we took part in ARMED 2021 (Annual Review of Metabolism, Endocrinology and Diabetes), an annual, hands on education event for GPs and practice nurses at Fiona Stanley Hospital, presented by HealthPathways WA and WA Primary Health Alliance in partnership with South Metro Health Service, Fiona Stanley Hospital and Diabetes WA. This important event, featuring several workshops, helps ensure general practitioners are kept up-to-date with the latest developments in the prevention of type 2 diabetes, diabetes foot disease, diabetes medications, diabetes remission and issues around diabetes before, during and after pregnancy.
DIABETES
news
Stepping down, moving on It’s change at the top of Diabetes WA, as CEO Andrew Wagstaff steps down. On his last day in the office, he chatted with MYKE BARTLETT and looked back over 13 rewarding years leading our organisation. Ask Andrew Wagstaff why now was the right moment to step down as CEO of Diabetes WA and he’ll tell you that, after more than a decade of leading the organisation from strength to strength, the timing felt right. “We have a new Board developing a new, exciting strategy, so it makes sense to hand the reins over to a new CEO,” Andrew says. Given his not-so-secret love of fishing, there’s another reason you suspect might have had the greatest influence. “My theory is, and you can call it a conspiracy theory if you like, all of the good boating weather occurs Monday to Friday and all the crap weather occurs on Saturday and Sunday. I’m now going to put the theory to the test.” What does he feel is his biggest impact on Diabetes WA? “When I joined Diabetes WA, there was a sense that the organisation had lost its way a little bit and they were looking for somebody to come in and provide some leadership,” Andrew says. Part of the new direction was to define a new sense of identity for Diabetes WA and to ensure the organisation and its work were relevant to people living with diabetes and the health sector. Andrew drew on his experience working in the commercial sector. “I joke with people and say, I come from the dark side, because my business training and all my business experience is around commercially profit driven organisations.” One change was to concentrate on providing real world health solutions for people living with diabetes. “We were looking all the time at the needs of people with diabetes, but we were also looking for where there was unfulfilled need within the health system. We were looking to identify the gaps and say, is this something that we think
we've got a solution for? And that became pretty defining of the business model that we've been operating with ever since.” This approach has become progressively more sophisticated over the past decade, leading to increased collaboration to develop solutions and programs that address issues in the diabetes space, guided by state and national health strategies and the voice of the consumer.
"The number of people who receive a service from the organisation in the community has grown exponentially." “We can look at those guiding instruments and can identify focus areas in the obesity space or in the Aboriginal health space, the focus area and say, 'Here's a program and service option. This is why we think it's a gap. This is what we think you should do about it. This is what we think should be funded'.” Under Andrew's leadership, a more commercial mindset has allowed Diabetes WA to flourish and expand, even through some challenging times. During his tenure, the organisation has more than doubled in size. “We had about 30 staff when I started, we now have 80 staff. That doubling of our staff reflects the wider range of programs and services we now have and the volume of program delivery that exists. So the number of people who receive a service from the organisation in the community has grown exponentially over that period of time. We’ve moved from a very Metro centric organisation to a statewide one.” Andrew says he feels confident he leaves Diabetes WA with a bright future ahead, as Melanie Gates takes on the role at the end of November. And what does the future hold for him? “I plan to take a break, look around in the new year to see what's out there and see what I can do to help some other organisation. And catch a few fish in the meantime.”
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IN THE
community
OUR KIDS CAMP RETURNS!
After being derailed by COVID-19 last year, our camp for kids with type 1 diabetes returned with a splash this September.
Jointly hosted by Perth Children’s Hospital and Diabetes WA, and cofunded by the National Diabetes Services Scheme and Lotterywest, our annual camp connects and supports young children with type 1 diabetes. This year’s camp was held across three days at the Swan Valley Adventure Centre and jam-packed with fun-filled activities — from Morning Fitness and Witches and Wizard games to the Amazing Magical Race, Quiz Night and Dress Up Disco. As part of our commitment to supporting all West Australian kids living with diabetes (currently about 1000 students across WA) our type 1 diabetes camps give children the opportunity to build their confidence being away from their families, have fun with their peers, and be supported to focus on self-care while learning to independently manage their diabetes throughout their stay. There were 34 troopers in attendance this year having fun, sharing and learning with their peers. This year’s cohort were inspired by guest speaker Sabrina Davies, who spoke about her journey with type 1 diabetes and how she hasn’t let that diagnosis stop her from pursuing her dreams as a singer and hairdresser. We know how vital these activities are to creating a sense of community for West Australians with diabetes, particularly those younger members who might need extra support. We have camps for various ages. To learn more about our kids camps contact our HELPLINE at 1300 001 880 or contact info@diabetes.com.au
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TALKING
science
DO THE BENEFITS OF PHYSICAL ACTIVITY OUTWEIGH THE RISKS FOR PEOPLE LIVING WITH LONG-TERM CONDITIONS? OUR DIABETES WA HEALTH TEAM BREAKS DOWN THE LATEST STUDIES AND FINDINGS TO HELP YOU UNDERSTAND WHAT’S HAPPENING IN THE WORLD OF DIABETES SCIENCE. A consensus statement from global health professionals helps bring clarity about the benefits of exercise for people dealing with long-term conditions such as diabetes, writes CARLY LUFF.
specific concerns they wish to discuss. It also seems that people living with long-term health conditions are more likely to participate in physical activity if they feel their concerns have been addressed successfully by a health professional.
People living with long-term conditions, including diabetes, are often hesitant to start a new physical activity plan because they worry about making a current issue worse or experiencing a new problem. A new statement from professionals provides a clear consensus that the benefits of exercise outweigh the risks for people living with long term conditions. This consensus statement was developed in consultation with healthcare professionals and people living with long-term conditions.
If you are interested in beginning an exercise plan, your health professional (if following the guidance) might discuss the following points with you:
The World Health Organisation has stated that physical inactivity is higher, in fact doubled, in people living with long-term conditions compared to those without. Those living with a long-term condition might want to consult their doctor before beginning a physical activity plan gradually, but medical clearance is not essential. Guidance may be useful to those with
1. for people living with long-term conditions, the benefits of physical activity far outweigh the risks 2. you may feel the risks are high, despite the risks being very low 3. person-centred conversations are essential for addressing perceived risk 4. everybody has their own starting point 5. you should stop and seek medical attention if you experience a dramatic increase in symptoms. The consensus statement also addresses several symptom and syndrome statements. People who experience muscle or joint pain should know that being physically active will
not increase their pain in the long term. There may be a temporary increase but as the body adapts to the activity this will decrease. There is no evidence to suggest this pain is associated with any further injury. For those living with diabetes the benefits outweigh the risks in both type 1 and type 2 diabetes. While hypoglycaemia is the most common adverse event associated with physical activity in people whose diabetes is managed with insulin or some other forms of glucose lowering medications, there are strategies to help reduce any risk. Your health professional can access results of this consensus statement in an interactive website movingmedicine. ac.uk, which provides support for having person centred conversations about physical activity. Diabetes WA runs two physical activity workshops for people living with diabetes – Ready, Set, Go, Let’s Move and Type 1 TACTICS. Both workshops provide people living with diabetes a chance to discuss their individual concerns about physical activity, hear from other people living with diabetes and develop a plan that suits their needs. 5
TALKING
science
CAN THE 5:2 DIET HELP PREVENT TYPE 2 DIABETES IN WOMEN WITH A HISTORY OF GESTATIONAL DIABETES? Studies show that there are many different approaches to weight loss which should be tailored to suit each individual, writes MELISSA ROBINSON. Gestational diabetes mellitus (GDM) is a form of diabetes that can occur during pregnancy. Rates of GDM in Australia have more than doubled since 2010, with around 15% of pregnant women now diagnosed with the condition each year. There are many reasons for this rise, including increased maternal age, increased rates of overweight and obesity and changes in diagnostic criteria. Other risk factors for gestational diabetes include family history, ethnicity (women from Asian, Indian, African, Middle Eastern or Aboriginal and Torres Strait Islander backgrounds), a history of polycystic ovarian syndrome and rapid weight gain during the first half of pregnancy.
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(about 500 calories or 2000kJ) for two days. There is debate around whether this style of eating for weight loss is easier to maintain due to individuals only having to change their eating habits for two days each week compared to seven. One recent study published by the University of South Australia (pubmed.ncbi.nlm.nih.gov/33831950) looked at these two approaches to see if one was superior to the other. The study compared weight loss outcomes over 12 months in overweight or obese women with a history of GDM, with half following the 5:2 approach (regular eating habits for five days and only 500 calories/2000kj for two days) and half following a continuous energy restricted diet (1500 calories/6000kJ per day). The study found that both approaches were equally successful, with an average weight loss of 4.3kg observed in both groups over the 12-month study period.
GDM can be managed during pregnancy through small changes in diet, increasing movement and in some cases injecting insulin. It should be noted that women with gestational diabetes should not restrict their food intake or try to lose weight during pregnancy as this may affect the growth and development of their baby.
A reduction in HbA1c (a longer term blood glucose measurement) and fasting blood glucose were also observed across both groups. There was no significant difference in weight or blood glucose levels between the two groups. Similarly, dropout rates were high at around 50% for both groups, indicating that the 5:2 diet was no easier to follow compared to the continuous energy restriction diet.
Although GDM usually goes away after the baby is born, women who have gestational diabetes are more likely to develop type 2 diabetes later in life. Studies have shown that losing as little as 5kg after delivery can reduce the risk of these women developing type 2 diabetes by half. Unfortunately, barriers such as fatigue, lack of family support, family responsibilities and further pregnancies can make weight loss difficult in this group.
These findings demonstrate that achieving and maintaining weight loss can be difficult, however they also show that there are many different approaches to weight loss which should be tailored to suit each individual. Due to the many barriers that make weight loss challenging in this group, women with a history of GDM would benefit from being supported by a range of health care professionals to adopt a healthy lifestyle that suits them and their current situation.
Traditional strategies for weight loss have typically involved small continuous reductions in energy (kilojoules) of approximately 25–30% per day compared to regular intake. While this method is successful for reducing weight, it can be difficult to stick to for many people. The 5:2 diet is another approach to assist with weight loss which has recently received considerable media attention. This involves making no changes to usual intake of food and drink for five days, and restricting intake to around 25% of usual energy intake
Baby Steps is an online program run by the National Diabetes Services Scheme (NDSS) aimed at women with a history of GDM, to provide support and advice around how to reduce their future risk of developing type 2 diabetes. The program can be accessed any time and is perfect for those early months when mothers may be ‘nap trapped’ on the couch! Visit the NDSS website www.ndss.com.au for more information on how to join.
YOUR DIABETES
eating style
WHAT’S YOUR EATING STYLE? With so many diets on the menu, there has never been so much choice when it comes to healthy eating – or so much confusion! MYKE BARTLETT examines the cream of the crop to separate the food from the fad. What do you feel like eating tonight? Once the options might have been as exotic as pizza, pasta or Chinese takeaway, now you’re more likely to hear Mediterranean, keto, paleo, Atkins or vegan. We are overwhelmed by dietary options like never before, to the extent that it can be hard to sort the genuinely healthy options from the dubious wellness fads. Another complication is working out which approach to eating might suit you. Are you low-FODmap, nut-averse or pescetarian? When you take into account health requirements, personal tastes and a daily schedule that might not have much time to hunt for new ingredients, find the right eating style can seem almost impossible. This issue, as Christmas approaches, we’re going to try to make that an easier choice. We’re looking at some of the most popular diets and eating styles currently out there, examining the evidence, considering the benefits and helping you decide which approach to food might work for you.
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YOUR DIABETES
eating style Low carb diets are often put forward as a good way to help manage diabetes, weight loss and blood glucose levels. But as MYKE BARTLETT discovers, not all carbohydrates are created equal. The topic of carbohydrates can be very confusing when it comes to managing diabetes, with many conflicting messages either promoting or demonising carbohydrate rich foods. What we do know is that not all carbohydrate foods are created equal. Low glycaemic index (GI) foods such as wholegrain bread, pasta, rice, potatoes, legumes, lentils, buckwheat and quinoa contain fibre which slows down digestion, giving us a slow, steady rise in blood glucose levels, keeping us feeling fuller for longer. High GI foods such as pastries, chips, confectionery, cakes and biscuits break down into glucose quickly which spikes our blood glucose levels. We can’t paint all carbohydrate foods with the same brush – some will help to stabilise our blood glucose levels and others won’t. We often hear the term ‘low carb’ used to describe a new food product, a new diet or style of eating. The fact is, there isn’t a specific number or criteria to define exactly what ‘low carb’ means. A diet termed ‘low carb’ could mean anywhere between 20g to 200g of carbohydrates per day (between 10% and 45% of your daily energy intake). With any low carb diet, foods high in fat and protein are increased to replace carbohydrate-rich foods. Foods high in good quality fats and protein can help to make us feel fuller for longer which can also have a positive impact on our blood glucose levels. However, like carbohydrates, not all fats are created equal. Healthy fats from plants or seafood are known to offer protection against some serious conditions, but eating too much of the wrong type of fat – saturated fats such as animal fats – can have negative effects on our health. Professor Grant Brinkworth (left) is one of the authors of The CSIRO Lowcarb Diabetes Everyday guide, a new book designed to help people with diabetes adapt their eating habits to reduce carbohydrate intake, while focusing on including good quality carbohydrates in addition to healthy fats and protein. The guide is based loosely on a research paper that reviewed 23 studies on the impact of low carb diets for people with type 2 diabetes. Low carb diets were defined as those as containing less than 130g of carbohydrates per day. “If you look at what the CSIRO low-carb diet is, it’s really just grounded in the core nutrition principles of healthy eating,” Grant says. “I don’t think it’s too radical, because it’s still using the same food people are already consuming, we’re just changing the portions.”
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YOUR DIABETES
eating style
THE LOW-CARB DIET One important element of the CSIRO diet is it’s a complete diet (meaning that, if followed properly, it won't lead to the nutritional deficiencies that can result from simply reducing carbs), it will work for those living with diabetes, without putting them at risk of other chronic conditions. “I think as an Australian population, we could all do better in terms of improving our nutritional quality.” Packed with recipes and food plans, The CSIRO Low-carb Diabetes Everyday guide helps Australians living with diabetes to follow this way of eating without feeling overwhelmed. But Grant stresses there’s no one-size-fits-all approach to going low carb. "The guide enables people and empowers people to personalise their plan and tailor it to their personal preferences, energy requirements, or weight loss goals, if that's how they want to use the plan.” The guide lays out how many serves of each of the food groups Australians should be eating each day, empowering the reader to identify how much food they need to reach their nutrition and energy requirements. "What it does is it enables you to select ingredients that you want to consume as part of your eating plan and helps you consume them in the right quantities. And then it helps you mix and match those ingredients as you see fit.” The intention is to balance prescription with flexibility, providing guidelines that can be bent to fit the reader’s needs. Grant hopes that books such as The CSIRO Low-carb Diabetes Everyday will help clear up some of the confusion around which diets are mere wellness fads and which diets actually have concrete benefits. "All the all the diet plans CSIRO has put out into the community are grounded in strong scientific evidence. We're trying to translate the science into simple self help guides.” Individuals on low carb diets have demonstrated significant improvement on blood glucose control, triglyceride levels and weight at six months compared to individuals on a low fat diet, although one study suggests the majority of these benefits had diminished by 12 months. It is difficult to know whether the lack of any demonstrated long-term benefit is due to the diet itself or the fact that people tend to drift away from its principles as time goes on. Melissa Robinson, one of Diabetes WA’s dietitians and educators, says that sticking with any one diet can be hard. People might find it more helpful to make small, sustainable changes to their current diet. “We don’t yet know the ‘ideal’ amount of carbohydrate that someone living with diabetes should eat each day,” Melissa says. “For some, improving the quality or reducing the quantity of carbohydrates in their diet may be one option to help them manage their diabetes. Small changes can make a big difference over time!” Individuals with diabetes, in particular those on insulin or medication that increases the risk of hypoglycaemia (low blood glucose), should test more frequently when reducing their intake of carbohydrates, to avoid blood glucose levels dropping too low. But if you are looking for some new, tasty and healthy recipes with lower amounts of carbohydrates, The CSIRO Low-carb Diabetes Everyday guide may be a good place to start.
The basics The CSIRO Low Carb Diet focuses on the use of quality carbohydrate foods with low glycaemic index (GI) to maintain lower, more stable blood glucose levels. The diet includes foods that are lower in carbohydrate and proportionally higher in protein and unsaturated (healthy) fat.
Will this style work for you? You may wish to incorporate a few recipes from the book into their own diet without sticking rigorously to its low intake of carbohydrates. Eating small portions of a variety of quality carbohydrate foods such as grainy bread, pasta and rice, can still fit into a lower carbohydrate diet, without depriving yourself. Remember, there is no one definition for a ‘low carb’ diet. For more advice on how to eat a lower carbohydrate without compromising on nutrition, speak to your local dietitian. See page 41 for some tasty low-carb recipes from The CSIRO Low-carb Diabetes Everyday 9
YOUR DIABETES
eating style Most diets tend to be based around what they cut out – carbs, calories or large portions. One of the oldest and most successful is much more about changing your eating style. MYKE BARTLETT speaks to Dr Antigone Kouris-Blazos about the potential benefits of a Mediterranean approach to food. Backed by decades of study, the Mediterranean diet encourages a shift away from the stodgy staples of Western cuisine towards lighter, more varied fare. Its key elements are plenty of plant-based and seasonal foods, nuts, moderate amounts of dairy, poultry and fish, and olive oil as the principal source of dietary fat. It’s also renowned for being one approach to eating that doesn’t sacrifice taste for health! Dr Antigone Kouris-Blazos is an experienced and highly published dietitian and academic who has extensively studied the benefits of the Mediterranean diet for the general population and people living with chronic conditions. She says she recommends the Mediterranean diet, along with a shift towards eating more plant-based food, to all the patients she sees in her private practice. Why is that? “Because of the overwhelming evidence showing that plant based diets are protective against the development of chronic conditions such as heart disease, diabetes, cancer, dementia, depression.” Her early work has underpinned further research into the broad health benefits of a Mediterranean eating style over the past three decades. In 2020, a wide-scale review of the evidence surrounding the health benefits of the Mediterranean diet was compiled which showed very positive results. A large study of more than 7000 people conducted from 2003 until 2011 found similar benefits. For people living with diabetes, this research found greater benefits on glycaemic control, body weight and total cholesterol for individuals who closely followed a Mediterranean diet compared to those who followed a low fat diet. Researchers have suggested several theories around why this style of eating has shown such
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YOUR DIABETES
eating style
THE MEDITERRANEAN DIET a positive long-term impact on weight loss, blood glucose levels and cardiovascular risk. Most theories agree that the potent anti-inflammatory and antioxidant effect of the Mediterranean diet is what makes it so effective. It is well known that individuals living with diabetes are more prone to inflammation in blood vessels Many people find themselves eating less meat and more plant-based foods on switching to a Mediterranean style of eating, sometimes going vego for a few days every week, which Antigone says mirrors the meat-free days devout Greeks would traditionally observe. She’s aware the Mediterranean eating style might involve a big shift in how many Australians think about food, but they shouldn’t be discouraged if the thought of preparing a radically different cuisine seems too much to take on. “The cuisine aspect of the diet might be off-putting if people think that they have to cook in a Greek way, or Mediterranean way, but that’s not really the case. The principles of the Mediterranean diet can be worked into any plant-based diet.” Anyone curious about giving the Mediterranean way could start by following three key steps, Antigone says. Step one: become a part-time vegetarian. “Try to include two or three vegetarian meals a week into your diet. A vegetarian meals doesn't mean eating vegetables and pasta, that's not a vegetarian meal. It's got to have vegetable protein. Protein needs to come usually from legumes, and legumes can include tofu.”
The basics The Mediterranean diet is based around the traditional Greek approach to cuisine. In short, it means less meat, more vegetables, more fruit, more nuts, more seafood and a whole lot more olive oil – principles that can be applied to any style of cooking that appeals to you! .
Will this style work for you? If you love your meat, a Mediterranean eating style might feel like an adjustment, however, any small change that reduces your meat intake and increases your plant and fibre intake is a step in the right direction! If you don’t fancy swapping straight from mince to lentils in your bolognese, start small by combining the two. You will be surprised how little difference it will make to the taste. Try introducing a new vegetable into your diet each week.
Her second tip: olive oil is the magic ingredient. “Use extra virgin olive oil as your source of fat. It’s been shown that all the polyphenols in olive oil seem to help reduce blood sugars and improve the gut microbiome.” Number three: eat more tomatoes. “Cooking meat and vegies in tomato salsa (or sofrito) is a key feature of the diet. Tomatoes are very high in antioxidants. In one study, participants went from eating 20 grams of tomatoes a day to 100 grams a day. There was a very strong correlation between eating more tomatoes and increased antioxidant levels in the blood.” Dr Antigone Kouris-Blazos is the director of Skinnybik lowcarb lupin biscuits. 11
YOUR DIABETES
eating style
ON THE MENU: A Mediterranean or low-carb diet eating style can work for some people living with diabetes, but not all. No one style will suit everyone, but it's worth thinking about what might work for you. Taking the best components out of a few different eating styles might work better for you than trying to stick to any one regime. If you try a different approach, make a note of what did work and what didn’t work for you, even if you didn’t stick with that approach or achieve your desired goal. If you're trying a different eating style to help manage your diabetes, remember to speak with a dietitian, diabetes educator, pharmacist or other diabetes health professionals to obtain individualised advice. Any diet that requires an extreme shift in eating patterns may need additional consideration and support from your health care team.
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Very low-calorie The basics?
A very low calorie diet is a clinically supervised medical nutrition therapy that involves eating about 25%-30% of a person’s usual energy intake per day over 12 weeks. The diet usually involves replacing normal food with low-calorie foods that have been medically designed to provide a nutritionally complete diet. This sort of rapid weight loss has been linked to achieving diabetes remission.
Will it work for you? There are several things that someone should consider before adopting this type of diet. Anyone wanting to adopt this diet should work under the supervision of their GP and dietitian to monitor any potential risks or adverse effects. Social eating or eating out also becomes very difficult on this diet, with some people feeling deprived or socially isolated. Reducing energy intake so drastically may also leave you feeling tired, irritable and more prone to headaches and constipation.
The Fast-800 The basics?
Popularised by English TV presenter and author Dr Michael Mosley, the Fast-800 diet involves eating lower carb, Mediterranean style fare without restriction for five days, and eating only 800 calories (approximately one-third of usual food intake) on two days. Although the diet claims to be developed from scientific research, there is little evidence around this specific combination of very low calorie eating and fasting. Crucially, it might not provide all the nutrition you need.
Will it work for you? If you are looking to reduce your overall carbohydrate intake and are willing to reduce your food intake by two-thirds over two days per week, the Fast-800 may work for you. As with any diet that promotes restrictive intake, consult your GP and dietitian before starting.
Keto
The basics?
Although it's had a lot of press in recent years, the Keto diet is just another lowcarb eating style. Unlike the CSIRO low-carb diet, it is not nutritionally complete, so can increase the risk of heatlh issues. Eliminating carb intake means missing out on many nutritious carbohydrate foods such such as legumes, lentils, whole grains and many types of fruits and vegetables. The majority of foods eaten on this diet are high in fat and high in protein.
Will it work for you? Very low carbohydrate diets can be less effective than less-restrictive lower carb diets as they can be harder to stick to long-term. They also often lack fibre and other essential nutrients found in carbohydrate rich foods. This can lead to gastrointestinal issues and other nutrient deficiencies. Eating foods high in saturated fats can also increase the risk of developing heart disease. Speak to your GP and dietitian first, especially if you are taking insulin or other medications that can increase the risk of low blood glucose.
YOUR DIABETES
eating style
OTHER EATING STYLES Paleo
The basics?
Wellbeing personalities all over the world over have been spruiking the paleo diet for years now. The idea is pretty simple – eat like a caveman (or, at least, like celebrities imagine cavemen ate!). Avoid processed foods in favour of large slabs of meat and the sort of nuts and fruits our distant ancestors might have grazed upon. This style of eating also eliminates many carbohydrate and fibre- rich foods such as wholegrains (bread, pasta, rice, barley, rye), legumes and lentils in addition to dairy foods (milk, yoghurt, cheese).
Will it work for you?
There is no evidence of any long-term benefits to going paleo. In fact, eating less high-fibre foods and (potentially) more saturated fats is likely to cause more health issues than it fixes. Some of its benefits, such as the focus on unprocessed foods, can be carried over to diets that are more sustainable and nutritionally adequate.
Australian Guide to Healthy Eating The basics?
The Australian Guide to Healthy Eating (AGTHE) is a style of eating based on the Australian Dietary Guidelines which has been found to reduce the risk of developing chronic conditions such as type 2 diabetes, certain cancers, and cardiovascular disease. The AGTHE visually represents the proportion of the five food groups recommended for consumption each day including fruit, vegetables, wholegrains, lean protein and dairy or dairy alternatives. It also encourages limited intake of alcohol and discretionary foods high in saturated fat, salt and sugar.
Will it work for you?
The AGTHE is based on current, good quality evidence and promotes a style of eating that is flexible, varied and nutritionally adequate, however, like any recommended approach to eating, individuals may still find the guidelines confusing and difficult to follow. Dietary advice and recommendations should still be individualised based on income, education, housing, access to healthy food and cooking or storage facilities. People living with diabetes may need to adapt the recommended carb intake. Working with your health professionals will help you to identify an eating pattern that is right for you.
What works for you
Whatever approach you take, it is important to keep on top of your diabetes checkups such as HbA1c, cholesterol, blood pressure, weight and waist, as this will help you to know if you are heading in the right direction. Monitoring your own blood glucose levels before and 2-hours after eating is another great way to know the impact your meals are having on your blood glucose levels. Diabetes WA dietitian Sheryl Moore says that any decisions around diet should be guided by what will work for you and what your body needs. "The ultimate goal of any food-related strategy must be to enable an individual to consume a safe, efficacious, healthy, nutritionally adequate, culturally acceptable and economically affordable diet, regardless of their weight status. Otherwise, some eating patterns can do more harm than good – physically, mentally, or even emotionally, especially when related to a chronic disease." 13
ANNUAL
review
LOOKING BACK AT THE YEAR THAT WAS Published in September, our Annual Review shows Diabetes WA continues to make play a crucial role in the lives of West Australians living with diabetes. This year marks 100 years since the discovery of insulin as a vital medication for helping people manage their diabetes. At Diabetes WA, we’ve been marking that centenary by encouraging people to share stories about their own diabetes journey, each of them unique. It’s been a powerful reminder of the impact diabetes has on people's lives and their amazing resilience. We’ve heard firsthand exactly how helpful and important our services, workshops and webinars are for West Australians living with diabetes.
We’ve continued to target gestational diabetes via our popular Baby Steps program, which aims to prevent women who have experienced gestational diabetes from getting it again – and to prevent them developing type 2 diabetes in the future.
By partnering with the Australian Department of Health we have seen the DESMOND, MyDESMOND, Baby Steps and the SMARTS series become embedded in the National Diabetes Services Scheme (NDSS) providing free access for West Australians to quality evidence based self-management education. This year we have seen the modality of programs expand from more traditional face-to-face programs towards digital platforms and webinar sessions. Nearly 2,000 people joined our digital sessions this year, including webinars, online support groups, Facebook Live sessions and information sessions.
Our work in regional Western Australia has been a focus, particularly the work we’re doing capacity building the Aboriginal Health Workforce in diabetes self management. We’re working hard in collaboration with Aboriginal health services and organisations to tailor our programs so they are culturally safe, while training local community healthcare workers to deliver them to their communities.
Over the past financial year, almost 5000 people accessed our DESMOND self-management program for people with type 2 diabetes either in person or online. We ran more than a hundred sessions in the metro and another 47 in regional areas. Our topic-specific and SMARTS programs also continue to prove popular. A total of 1,108 people with diabetes attended the 171 SMARTS sessions, with around one third attending sessions in regional WA.
14
Thanks to a Lotterywest grant, we were also able to expand our successful Let’s Prevent diabetes prevention program into a digital offering that will allow us to reach even more people right across Western Australia.
Our Aboriginal community education events attracted more than 200 face-to-face participants, and a further 600 people were helped through our outreach clinics and DESY program. We reached more than 1,000 people through our Noongar radio interviews and social media. In the 2021 fiscal year, we supplied almost 25,000 diabetes products, including free blood glucose meters, to regional, remote and Aboriginal communities. We’ve continued to work as an NDSS Access Point under the Regional and Remote contract, supplying products worth more than $1.4 million.
ANNUAL
Person-centred care is at the heart of everything we do. Our Diabetes WA Helpline continues to provide education, advice and support to people living with diabetes, and their carers, health professionals and support workers across WA. Our team has taken almost 13,000 calls from West Australians over the past year, with the majority concerning type 2 diabetes. Around 2,500 of those calls were put through to a credentialled diabetes educator. Our Telehealth service helped more than 500 people, with over 1000 appointments saving nearly 350,000km of travel for clients across the state.
review
behalf of the NDSS. Diabetes WA continues to exceed many of the NDSS targets resulting in more people being able to access much needed services. We have continued our collaborations with local agencies across the WA health system in a year that has provided unprecedented challenges to all health system arrangements. As well as COVID, we’ve also seen the Wooroloo bushfires, the terrible flooding in Carnarvon and all those in our midwest impacted by cyclone Seroja.
Throughout the year our management team has been working with the Australian Government Department of Health and Diabetes Australia to finalise the new NDSS Agreement for the period 1 July 2021 to 30 June 2024.
Our Diabetes WA team has stepped-up, navigating not only the constraints imposed by lockdowns and social distancing, but also the special challenges and risks the COVID-19 virus presents to those living with diabetes. Throughout the year, the commitment and resilience of our team never wavered.
West Australians living with diabetes have benefited significantly from the services provided by Diabetes WA on
www.diabeteswa.com.au/about-us/our-board/annualreview/ 15
KNOW YOUR RISK Did you know that one in four adults are at high risk of developing type 2 diabetes?
Diabetes WA is urging Western Australians to “know your diabetes risk”
TAKE THE STEPS Use the Risk Assessment Tool on our website by scanning the QR Code below. Learn about our FREE digital prevention programs – Let’s Prevent and Baby Steps.
Subscribe to our e-newsletters to get inspired to live a healthier lifestyle with tips on nutrition, activity, and overall wellbeing by visiting “get involved” on our website.
We’re with you every step of the way WA 1300 001 880 info@diabeteswa.com.au diabeteswa.com.au
2021-072
Call our Helpline on 1300 001 880 with your questions or concerns.
100 STORIES
100 years
DESMOND MAKES A DIFFERENCE After losing family to diabetes complications, JAMES BELL was determined to take control of his own health journey Being diagnosed with diabetes is not a death sentence, according to James Bell, despite sadly losing his mother, father and two sisters to diabetes complications. James has worked hard to completely transform his life by improving his nutrition and joining diabetes group education programs like DESMOND (Diabetes Education and Self-Management for the Ongoing and Newly Diagnosed). Diagnosed with type 2 diabetes in April 2021, James decided to explore and learn as much as he could about diabetes and how to best manage his physical health while also managing mental health challenges. At the DESMOND program, James learned new things and
gained confidence that he was on the right track with his newly adopted approach to eating. “I didn’t realise I was doing as well as I am with the big changes I made in my life - DESMOND helped confirm things for me,” James says. “I learned more about blood sugar testing and measurements and what it all means, and I learned a lot about cholesterol which I knew nothing about.” By changing his eating habits, James lost 10 kg and decreased his blood pressure and blood glucose levels in just three months. As well as helping reduce his medications, these changes significantly improved his mental health. James’s message to people living with diabetes is be open to learning new things and to talk to people, especially those going through similar experiences. “Come to a Diabetes WA group program like DESMOND, connect with people, ask every question you possibly can, talk to a diabetes educator at Diabetes WA.”
HIGHS AND LOWS When ISOBEL HALL was diagnosed with type 1 diabetes at age 19 she feared the worst. Now, 60 years on and a Kellion Victory Medal award winner, she reflects on the highs and lows of managing a chronic condition. When I started showing symptoms of type 1 diabetes, my older sister Margaret was alarmed. Just thirteen years earlier our other sister, Phyllis, had died from undiagnosed diabetes at boarding school in South Africa. I was worried the same fate awaited me. When our family doctor confirmed their worse fears, it was a terrible blow to our mother. I remember her being visibly upset. That was in the early 1960s. I’m grateful for how technology has made it much easier to manage my health. I currently use the Freestyle Libre sensor which allows me to test my BGLs as often as I need. Years ago, we only did urine tests with a test tube and Bunsen Burner. We got weekly blood tests at our local doctors. The syringes we used were the glass ones with cc measurements and mistakes were often made. This year, I decided to nominate for a Kellion Victory Award medal which marks living with diabetes more than 50 years.
It’s been a long learning journey. Having grown up in South Africa, I am grateful for the help, assistance and advice that is available in Australia. That said, I do wish people would be aware of what diabetes actually involved and what was needed in the treatment of it. The biggest challenge for me has been controlling hypoglycaemic episodes. The Libre sensor and regular checks is key. I’m currently getting used to navigating my way around the App CalorieKing and it’s been amazing how easy it is to share data with my doctors and dietitians. I still live a very active life. I live with my daughters, one of whom fosters a twenty-one year old living with autism. I’m also heavily involved with caring for my other grandchildren and local community activities. I do craft weekly and have a weekly ladies church group who meet in our home or, in these COVIDSafe times, via video chat. All Australians who have lived with either type 1 or type 2 diabetes for 50 years or more are eligible for a Kellion Victory Award. Find out more at diabeteswa.com.au 17
ON THE
line
ON THE LINE
The Diabetes WA Helpline and Telehealth Service provides free comprehensive access to personalised diabetes management advice and support from a Credentialed Diabetes Educator. Meet our educators as they share some of the common concerns they hear from our members. Narelle Lampard Narelle is an accredited practising dietitian. She has worked for Diabetes WA over the past 20 years and also for South Metro Health Service for 13 years. Narelle enjoys the diversity of experiences working in roles across both community and clinical health care. She especially likes facilitating group education sessions that assist people with diabetes to better understand and manage their condition. Witness the ‘lightbulb moments’ and helping to lighten the burden of living with diabetes is a real privilege, she says. Outside of work, Narelle likes to spend time with family and friends, read books, cook, travel and go walking in the bush. She regularly conducts DESMOND, which is a one-day diabetes self-management program.
“Is coconut oil healthy? Which oil is healthiest for cooking?” There has been a lot of health hype around coconut oil over the past few years. It has been promoted as being beneficial for heart health, body weight, diabetes and reducing inflammation. But is this fact or fiction? Coconut oil is a tropical oil made from the coconut palm fruit. Australia does not have a local coconut industry and imports all our coconut oil from the Philippines, Indonesia and Thailand. Coconut oil can be expensive, especially the organic versions. Coconut oil contains around 92% saturated fat (mostly the long-chain saturated fatty acids called lauric, myristic and palmitic). You can clearly see coconut oil is high in saturated fat because it is solid at room temperature. A recent article in the journal Circulation reviews all the evidence and concludes that coconut oil significantly increases total cholesterol, LDL and HDL cholesterol. Elevated cholesterol levels are known to be a risk factor for cardiovascular disease. The researchers also found no evidence that coconut oil lowered blood sugar, lowered inflammation or affected body weight as compared with other vegetable oils. 18
In summary, we should not view coconut oil as a healthy option for heart health. Ideally don’t use it as a regular cooking oil, but it can be used sparingly for taste and texture. Think of it as an occasional ingredient rather than an everyday staple. So, what is the healthiest option for oil? As a dietitian, I have a few suggestions: 1. Limit saturated fats that will have a negative effect on cholesterol levels. These include coconut oil, palm oil, butter, ghee, lard, dripping, copha, tallow, duck fat. 2. Include unsaturated fats that will have a positive effect on cholesterol levels For example: olives and olive oil, avocados and avocado oil, nuts and nut oils (macadamia, peanut, walnut), seeds and seed oils (sunflower, safflower, canola, soybean, sesame), rice bran oil, grape seed oil, oily fish. 3. Watch quantities, as all types of fat are high in energy (kilojoules and calories) and can therefore contribute to weight gain. 4. Choose Australian grown and locally sourced produce whenever possible. My top pick? An Australian extra-virgin olive oil.
ON THE
line
Melissa Robinson Mel is an accredited practising dietitian and has worked in the diabetes space for more than 10 years. Mel is passionate about supporting individuals to self-manage their diabetes by making small, realistic and achievable changes. Facilitating diabetes group education sessions in remote Aboriginal communities is another passion and she loves meeting new people and hearing their stories. Mel’s other areas of interest include the role nutrition plays in managing conditions such as polycystic ovarian syndrome, infertility, gut health and autoimmune conditions.
“What fruit should I eat if I have diabetes?” People are often confused about what types of fruit they should eat when they have diabetes. They are often told or hear about certain fruits like banana, watermelon and mango being ‘bad’ for diabetes and that only berries are ‘safe’. The truth is, all types of fruit are a fantastic source of fibre, vitamins, minerals, and antioxidants, and higher fruit intakes have been shown to reduce the risk of heart disease, stroke and certain cancers. No fruit should be off limits if you have diabetes, although how much you have and how often you have it may affect your blood glucose levels (BGLs). One standard serve of fruit (a medium apple, small banana or cup of chopped fruit) contains around 15g of carbohydrate, most of which is digested slowly due to the high fibre content, giving a slow, steady rise in blood glucose. One small banana or one large slice of watermelon contains 15g of carbohydrates and is therefore unlikely to cause a spike in blood glucose levels.
Mangoes typically contain more carbohydrate, simply because they are larger in size. One small mango weighs nearly twice as much as one small banana (220g vs 135g) and contains approximately double the amount of carbohydrate (30g vs 15g). Dried fruit contains more carbohydrate compared to fresh fruit because the water has been removed, meaning the carbohydrate is more concentrated. Two tablespoons of dried fruit has the same amount of carbohydrate (15g) as one cup of chopped fresh fruit. The best way to find out how fruit affects your blood glucose levels is to test using a blood glucose monitor. You will need to test before eating the fruit, then test again two hours later. If your blood glucose levels have jumped more than 2–3mmol/L in that time (for example, they have jumped from 6mmol/L before eating to more than 9mmol/L two hours later), the size or type of fruit you have eaten may have contributed to this. If you do find that certain fruits have a greater impact on your BGLs than others, it doesn’t mean you need to completely cut them out of your diet, especially if you love them! You may want to consider eating those fruits with other foods containing protein or fat (a handful of nuts or seeds, or small tub of plain yoghurt), as fat and protein slow down digestion and reduce the glycaemic index (GI) of food. So which fruit is ‘best’ for diabetes? We can safely say that no one fruit is best, and all can form part of a healthy diet. It really comes down to how much you eat and how often you eat it – if you are eating two large mangoes for breakfast each day (approx. 100g carbohydrates), you might expect to see an increase in blood glucose levels after breakfast. If you are eating two or three standard serves of fruit spread over the day, you likely won’t see a big impact on BGLs. Just remember – everyone is different, and the best way to know exactly how fruit affects you is to test blood glucose levels before and two hours after eating. For more information about foods containing carbohydrates, attend Diabetes WA’s CarbSmart program or book into one of our online webinars.
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Diabetes WA Webinars If you’re still isolating from home, Diabetes WA’s series of online educational webinars offers a convenient way to hear about a variety of hot topics on diabetes from our Credentialled Diabetes Educators from the comfort of your living room. Free for Western Australians who are registered on the NDSS, the webinars are held via Zoom, with new sessions added regularly. To book into a webinar, head to diabeteswa.com.au/ eventscalendar.
Perth Metro Armadale
ShopSmart
21 January
Armadale
FootSmart
21 January
Melville
DESMOND
24 January
Floreat
DESMOND
28 January
Midland
CarbSmart
29 January
Midland
FootSmart
29 January
North Beach
DESMOND
31 January
Rockingham
DESMOND
2 February
Bentley
DESMOND
5 February
Armadale
DESMOND
9 February
ShopSmart – understand how to read food labels and learn how to make the best food choices for your health.
Mirrabooka
DESMOND
11 February
Floreat
CarbSmart
14 February
Floreat
MonitorSmart
14 February
FootSmart – this session will teach you all you need to know about checking and caring for your feet.
Heathridge
DESMOND
17 February
Melville
DESMOND
19 February
Midland
DESMOND
21 February
Cockburn
DESMOND
23 February
Karawara
Ready-Set-Go Let's Move
25 February
Karawara
ShopSmart
25 February
Mandurah
DESMOND
26 February
Mirrabooka
MedSmart
28 February
Mirrabooka
CarbSmart
28 February
Rivervale
DESMOND
2 March
Living with Insulin – learn all about insulin and the importance of looking after your blood glucose levels.
Fremantle
DESMOND
3 March
Scarborough
DESMOND
8 March
Ready Set Go, Let’s Move – this session gives you the facts on diabetes and exercise and provides tips on how to start exercising and stay motivated.
Rockingham
CarbSmart
10 March
Rockingham
MonitorSmart
10 March
Heathridge
ShopSmart
12 March
Heathridge
MedSmart
12 March
Insulin Pump Workshop – this practical session will show you how to get the most benefit out of your insulin pump and its features.
Floreat
DESMOND
14 March
Cockburn
FootSmart
16 March
Cockburn
ShopSmart
16 March
Type 1 Tactics For Exercise – Learn how the body responds to different types of activity and how to effectively adjust insulin, carbohydrates, and exercise to manage blood glucose levels.
Melville
DESMOND
17 March
Heathridge
DESMOND
19 March
Rockingham
DESMOND
23 March
Melville
CarbSmart
24 March
Melville
MedSmart
24 March
Mandurah
ShopSmart
24 March
Mandurah
MedSmart
24 March
Karawara
DESMOND
25 March
Armadale
DESMOND
29 March
Subiaco
Living With Insulin
30 March
Mirrabooka
DESMOND
31 March
Self-management Workshops
Diabetes WA runs a number of education programs, held as two or three-hour workshops, to help you manage your diabetes and improve your health.
MonitorSmart – learn how to effectively monitor you blood glucose levels. CarbSmart – learn how you can choose the type and amount of carbs that are healthier for you. MedSmart – understand how your medications can help you manage your diabetes.
Type 1 Technology Night
Explore pumps, CGMs and flash monitoring and meet with device company representatives to find out the pros and cons.
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. 20
Workshop
Calendar WA Regional Albany Albany Bunbury Bunbury Bunbury Bunbury Busselton Geraldton Geraldton Geraldton Geraldton Geraldton Geraldton Harvey Kalgoorlie Kalgoorlie Northam South Hedland South Hedland
DESMOND DESMOND DESMOND CarbSmart FootSmart DESMOND DESMOND CarbSmart FootSmart DESMOND ShopSmart MedSmart DESMOND DESMOND FootSmart ShopSmart DESMOND DESMOND DESMOND
TBA TBA 2 February 1 March 1 March 25 March 14 March 31 January 31 January 18 February 4 March 4 March 18 March 11 March 25 January 16 February 16 March 9 February 23 March
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, diabetic retinopathy and gestational diabetes. To find out more or to register for any upcoming sessions call 1300 001 880 or visit our website.
Keeping you safe Diabetes WA has a comprehensive COVID-19 plan in place, strictly following the WA Roadmap and including elements such as – venues with plenty of space; screening before people attend a program (there’ll be extra questions we need to ask); hygiene safety advice for the session itself; and adjustments made to the delivery of interactive parts of the workshops so everyone can stay at a safe distance from each other. We know that people are better able to manage their diabetes after attending our workshops, so we want to offer support as soon as possible. Keep an eye out for updates on our website and in our e-newsletters for the sessions starting up in your area, or call 1300 001 880 for more information.
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 21
LIVING
well
LIVING WITH LESS: CLEANING On a mission to minimise, TEENA TOWNSEND looks at how we can keep the house tidy and wellmaintained without being wasteful.
In our Spring edition, we looked at ways to live your life with less, focusing on our food habits, from what we eat, to how we source it, store it, and how we prepare it. For summer, we’re touching on some changes we can make to the way we maintain, clean and manage our home environment. By reassessing our lifestyle habits and making improvements we can not only enhance our own mental and physical health, but can also contribute to a more positive impact on our environment and planet. The added bonus is that there's often an economical benefit!
22
LIVING
Cleaning
•
Create a regular cleaning routine – daily, weekly, monthly and by season. If it’s planned and regular, it reduces stress and anxiety which can be overwhelming.
•
Spend less time cleaning. Clean more often but less overall – 15 minutes per day rather than once per week. That quick 10 minute whip around and tidy before bed can mean waking up to a better, more positive frame of mind each morning.
•
Understand the difference between tidying and cleaning. You can’t clean properly if things aren’t tidy or organised to begin with.
•
Reap the benefits – cleaning can also have the following health benefits: good exercise and physical activity, improved mental health, and lessened allergies and hayfever.
Clean for better health and a healthier environment
•
Recycling and repurposing
• • • •
Old towels cut into pieces make great cleaning cloths – ditto for old clothes, tea towels, pjs. Old toothbrushes and paint brushes can also be put to a new use for cleaning in the home. Old sheets and bedding can make perfect drop sheets, dust covers for painting and home maintenance tasks. Kitchen containers – whether takeaway or just the unwanted variety, spare containers can be used for storage, cleaning, organising all over the home and garden. Ideal for toys, hobby items, the bathroom and hardware or handyman items and gardening items. Be creative about potential uses before disposing of them.
•
Buy recycled or secondhand products rather than brand new.
Miscellaneous
•
Everything has a place – there is no reason for things to be left lying around or for them not be able to be found when you really need them.
Reduce the sheer number of cleaning products used and needed for floors, windows, walls, kitchen, bathroom, and toilets. Many all-purpose products have multiple uses.
•
Reduce use of heavy and potentially toxic chemicals – vinegar, lemon, bicarb, salt, sugar all have many very effective uses.
•
Reduce use of disposable products – dryer sheets, paper towels, disposable bags, disposable razors. Swap paper kitchen towels for washable reusable cloths. Tissues for handkerchiefs. Invest in reusable batteries. Stop using single-use surface wipes and cleaners – they may be convenient but are not economical or environmentally friendly.
•
• • • • • •
Switch to refillable containers, buy products in bulk and reduce packaging and waster. Fill your home with indoor pot plants, which can filter and keep air clean and healthier. Let the fresh air and sunshine inside where possible. Use natural aromatics and fragrance oils alternatives instead of artificial or chemical based ones.
Maintenance
•
Keep your machines clean for better health and longevity. Clean your fridge, freezer, washing machine, clothes dryer, ovens and dishwashers regularly – the filters, trays, seals and so on. Floor drains too.
• • • •
Clean and condition your leather chairs and sofas regularly for longevity. Clean your mattresses, carpets, rugs and fabric sofas regularly for longevity and better health.
well
Try to get all the household members involved in the process – young and old. Educate everyone and assign tasks and responsibilities, ensuring age appropriateness. Make your bed every day – not only does it make your room instantly tidier but it’s an immediate task completed which gives you a little mental boost each morning. Washing and laundry – when possible, air dry your washing rather than using a dryer. Not only does it save energy and money but the sunshine is a natural sanitiser, making your clothes smell fresher. Airdrying also means your clothes won’t shrink or stretch out of shape.
•
Compost as much as possible – food scraps, coffee grounds, shredded paper and so on. If you’re not doing it already, make composting a non-negotiable habit which not only reduces waste but also enriches your garden.
•
Declutter and purge – sort through those cupboards and drawers and reduce what you have and get rid of what you don’t use or no longer need. Can it be repurposed? If not, then donate it.
•
Conserve water where possible – send grey water into the garden and try to avoid doing half loads of washing or dishes. Shower for a shorter time and check for wasteful leaks.
•
Remove hazardous waste from your home. Don’t stockpile batteries, old paint, motor oil or toxic chemicals in your attic or garage where they can leak and do damage to your health and the environment. Dispose of them responsibly and correctly on a regular basis. Contact your local council.
Invest in mattress and pillow protectors and replace your pillows every two years or so. Pillows do have expiry dates. Check and set cooling and heating temperatures and thermostats on fridges, freezers, water heaters to ensure optimum performance. 23
MOVING
well
WILL THE COUCH TO 5K RUNNING PROGRAM WORK FOR YOU? When the UK went into lockdown in 2020, ALEX SILVERSTEIN, Diabetes Education Lead for Know Diabetes, decided to get back into exercise by trying out the Couch to 5K program. During lockdown, I tended to spend the majority of my working day sitting on my “couch” akin to Garfield the cat. I work as the diabetes education lead for the NHS Know Diabetes Service, which involves overseeing the rollout of programs and information to help people learn about diabetes in a way that suits them. One such program, is the NHS Couch to 5K. Given my current predicament, I decided I would give it a go myself. It’s worth saying at this point, I also have type 1 diabetes. I have lived with diabetes since I was 18 months old and trust me, in my 30 years of living with type 1 diabetes, every day is an experiment. In fact, I don’t think Einstein had full appreciation of the challenge of experimenting with exercise and of type 1 diabetes when he said that “the definition of insanity is doing the same thing and expecting different results”. The NHS Couch to 5K program is a nine-week course that utilises a popular concept called interval training, where you move at different speeds during a running session (lasting no more than 30 minutes at a time). By varying your pacing, your body is forced to adapt to different speeds and your heart and lungs have to adapt to various levels of strenuous activity (and get stronger and healthier as a consequence). As a result, you actually burn more calories and get fitter, compared to just training at a constant speed. That said, it is not a weight loss programme, the goal being only to increase fitness. I know that looking after your feet when you have diabetes is incredibly important and therefore, I needed to make sure I have adequate and well-fitting running shoes before I began. As I have type 1 diabetes, treated with an insulin pump and a continuous glucose monitor, I also had to ensure that my blood glucose was at a safe level before going for a run. When I first started, I didn’t wear my pump. I found that two hours after my run, my sugars started to spike. I had a few theories as to why, but it seems the culprit was adrenaline and the 45 minutes or so that I wasn’t wearing my insulin pump, which just shows the importance of basal insulin to people with type 1 diabetes. As soon as I started running with my pump, the spikes experienced a few hours after a run were smaller. 24
Was I able to complete the Couch to 5K? Yes. After nine weeks of running three times a week, nine weeks of getting up early to run around my local park and nine weeks of sharing my running stats with uninterested friends and family, I had managed to complete Couch to 5K.
Was I able to run 5 kilometres in half an hour? Again, yes! That said, the programme is about helping you to increase stamina and teaching you to reach 30 minutes of running without stopping. It is definitely not about speed, so please don’t let that put you off. I actually ran quicker, and had fewer stitches, when I wasn’t trying to run fast.
MOVING
well
Alex's Observations:
Running when you have a lot of insulin on board is a bad idea. Having too much active insulin before you exercise can cause a hypo.
Running when you have not enough insulin in your body is also a bad idea. Not enough active insulin to prevent the liver from making glucose before you exercise can cause a high blood sugar level.
Later in the day you may see lower sugar levels. Delayed onset hypoglycaemia can occur up to 12 hours (sometimes even 24 hours) after prolonged exercise.
The longer I ran, the steeper my drop in sugar levels. I began to put some jelly babies or a tube of glucotabs in my pocket once I began to run 5K+. From www.knowdiabetes.org.uk/blog/ couch-to-5k-part-2/
Did I feel better?
What is the Couch to 5K program?
One thing that should never be overlooked is the mental health boost that running or regular exercise can bring, which again is even more important than usual right now. Couch to 5K definitely improved my mood and made me more productive at work.
Couch to 5K is a running plan for absolute beginners. It was developed by a new runner, Josh Clark, because he hated running and wanted to make it easier. He also wanted to help his 50-something mum get off the couch and start running, too.
Doing anything with type 1 diabetes takes a little extra planning, but it should in no way act as a barrier to completing Couch to 5K. Whether you have type 1 diabetes or not, it provides a gentle introduction to regular exercise. Read Alex’s full experiment at knowdiabetes.org.uk/blog/ nhs-couch-to-5k-and-type-1-diabetes-an-experiment-of-n-1/ Diabetes WA regularly runs a free course called Type 1 TACTICS for exercise. Find out more at diabeteswa.com.au
The plan involves three runs a week, with a day of rest in between, and a different schedule for each of the nine weeks. Download a schedule at downloads.bbc.co.uk/ scotland/makeyourmove/c25k_printable_plan. pdf 25
EATING
well
GETTING FESTIVE The festive season is coming. CHELSEA CHOI TSZ YAU finds out how people living with diabetes can safely enjoy themselves as the parties begin. It wouldn’t feel like Christmas if we didn’t enjoy ourselves a bit more than usual. Eating is part of that celebration, but the yuletide season – with its numerous Christmas and New eY ar’s parties – can present a challenge for people living with diabetes. Thankfully, there is no need to feel left out, even if you do need to think about managing your blood glucose levels. Classic festive dishes tend to be high in sugar, fat and salt – all those temptations that can make diabetes management difflcult! While people living with diabetes can still enjoy a slice or two of Christmas pudding, thinking about your approach to food during the party season can help you stick to your management plan.
a W tch your alcohol intake Regardless of whether you are living with diabetes or not, national guidelines recommend no more than 10 standard drinks per week and no more than four standard drinks on the same day for both sexes. While it’s flne to drink alcohol in moderation as part of a celebration, try to limit drinks with high sugar content such as liqueur, cocktails made with fruit juice, and sweet wine. If you are taking medication that can potentially cause hypoglycemia, be aware that drinking alcohol can make hypoglycemia more likely. Monitor your blood glucose levels more often and speak to your GP or diabetes
26
educator about how to avoid hypoglycaemia when drinking. Remember not to drink on an empty stomach, as this can send your blood glucose levels plummeting. A proteinbased snack, such as unsweetened yogurt, can help to slow the absorption and effects of alcohol. It’s worth noting there are also a wide range of nonalcoholic options easily available. These range from non-alcoholic wines and spirits (Australian company yL re makes booze-free spirits perfect for transforming a martini into a mocktail) to ultra-low alcohol craft beers and ales that make it easier to join in the celebrations without risking a hypo.
a H ve a of od plan To reduce the chance of being carried away by gourmet food on the table, it can help to plan ahead. If you’re eating out at a restaurant, try to make sure you’re the flrst to order, as research shows you’re more likely to be swayed by other people’s choices if you wait. It’s a small thing, but can make a difference when it comes to making healthy decisions. Include plenty of non-starchy vegetables to your plate to flll yourself and kick the hunger away. Be aware that while it’s good to flll up on vegetables, at this time of year
EATING
well
WITH DIABETES veggies are often glazed with honey, which will increase their calorie content. Chew your food slowly and mindfully to prevent overeating. Research shows it can take the brain 20 minutes to register that you feel full, which means people who eat quickly are more likely to overeat.
Turkey: Remove the skin and eat light-coloured meat to reduce your fat intake.
Protein foods are filling – try to include a serving of lean meat, egg, fish or beans. If you are not the one preparing the meals, you can always check in with friends and family to see what will be on the menu.
Stufflng: Use vegetarian stuffing such as sage and onion or chestnut and cook in a separate dish to the meat.
Have a glass of water before eating Drinking water before you eat can help you to feel full earlier and moderate your food intake. Try filling your glass every 30 minutes. Walking away and having a pause during eating can also help you to feel full more quickly.
Roast potatoes: Keep the amount of fat you add to a minimum by air-frying or using spray oil. Instead of potato mash, consider substituting mashed cauli-ower.
Vegetables: Fill at least two-fifths of your plate with vegetables. If possible boil or steam.
What about Christmas pudding? The trick to enjoying Christmas desserts is to be mindful of your portion size. Try reducing your portions by half and limit the amount of cream or ice-cream you add to your pudding.
Make healthier choices
Don’t get stuck on the sofa after eating
In recent years, we’ve seen Australians move away from traditional European ideas of Christmas fare. The dinner table is just as likely to be heaving with seafood as it is to be weighed down by a glazed ham or roast turkey. Vegetarian options beyond the everpresent green salad are increasingly common.
Maintaining a certain level of physical activity is important to lower your blood glucose levels. Instead of sitting down at celebrations, try playing games with the kids in the house, dancing the night away or even offer to wash the dishes!
If you’re cooking for yourself or contributing to the catering, it might be worth trying something more suitable to the warm climate (and your management plan) such as poached salmon. If you’d rather stick to the classics, here are a few tweaks that might help.
lB ood glucose glitches Don’t be surprised if you find you have higher blood glucose levels than normal during the party season. This may be due to being less active than usual, overindulging or changing your routine. One or two high readings shouldn’t have an impact on your long-term diabetes management, but try to avoid consistently high readings.
27
EATING
well
SPANAKOPITA PIE WITH AVOCADO GREEN SALAD 1. Preheat the oven to 200°C (180°C fan-forced) and line a 20 cm round cake tin with baking paper. 2. Heat the olive oil in a large frying pan over medium–high heat. Serves: 4 Prep: 10 mins Cook: 1 hr Difficulty: Medium 1 tablespoon extra virgin olive oil 1 onion, thinly sliced 3 cloves garlic, thinly sliced 12 x 55 g free-range eggs 500 g frozen spinach, thawed
3. Add the onion and cook for 4–5 minutes, until translucent. 4. Add the garlic and cook for a further minute until fragrant. Set aside. 5. Whisk the eggs in a large mixing bowl. 6. Squeeze the thawed spinach and grated zucchini over the sink to remove as much water as possible. (This will ensure your pie isn’t soggy.) 7. Add the spinach and zucchini to the bowl with the eggs, along with the sautéed onion, ricotta, dill and some freshly ground black pepper. 8. Whisk everything together well using a fork.
1 zucchini, finely grated
9. Pour the mixture into the prepared tin and smooth the top.
100 g reduced-fat ricotta
10. Crumble the feta and sprinkle it and the sesame seeds on top. Bake on the middle shelf of the oven for 40–45 minutes until the pie is set.
1 bunch dill, roughly chopped 40 g feta 2 teaspoons sesame seeds
Green Salad
6 cups (300 g) butter lettuce leaves, roughly torn 1 Lebanese cucumber, thinly sliced 1 small avocado, sliced lengthways 1 tablespoon of a Simple Vinaigrette Dressing
11. Transfer to the top rack and bake for 5 minutes, until the feta and sesame seeds are crispy and golden. 12. Remove from the oven and allow to sit while making the salad. 13. For the green salad, place the lettuce, cucumber and avocado in a large bowl, drizzle with the vinaigrette dressing and toss gently to combine. 14. Cut the spanakopita pie into four slices, divide between four plates and serve with the dressed salad.
Nutrition Information PER SERVE 1671kJ, protein 30g, total fat 26g (sat. fat 7g), carbs 7g, fibre 13g, sodium 474mg • GI estimate low 28
EATING
well
BUCKWHEAT BROCCOLI SLAW WITH LEMON FETA AND YOGHURT DRESSING Serves: 4 Prep: 15 mins Cook: 28 mins Difficulty: Medium 80 g raw buckwheat groats 8 x 55 g free-range eggs 60 g feta Juice of 1 lemon 1/4 cup (60 g) natural Greek-style yoghurt 1 large (450 g) head broccoli, including stems 150 g Brussels sprouts, trimmed 2 cups finely shredded Tuscan kale, white stalks removed, shredded 2 teaspoons extra virgin olive oil 70 g chestnuts, roughly chopped 1 Lebanese cucumber, sliced into half moons
1. Place the buckwheat groats in a medium saucepan over high heat, add water to cover and bring to the boil. 2. Reduce to a simmer and cook, covered, for 20 minutes, until the buckwheat is tender to the bite. 3. Drain and set aside to cool. 4. Boil the eggs in another saucepan of water, undisturbed, for 8 minutes. Remove the eggs with a slotted spoon and run them under cool water. Peel the eggs and set aside. 5. Mash the feta in a bowl using a fork. Add half the lemon juice, the yoghurt and ¼ teaspoon freshly ground black pepper and mix until smooth. 6. Using a box grater, mandoline
or food processor with a grater attachment, shred the broccoli and Brussels sprouts, then place them in a large bowl with the kale. Add the remaining lemon juice and drizzle in the olive oil. Use your hands to massage and scrunch the veggies until they soften, about 2 minutes. Add most of the chestnuts (reserving some for garnish), the cooled buckwheat groats, the cucumber and half the feta dressing and toss to coat well. Divide between four bowls. 7. Slice the eggs in half lengthways and divide them between the bowls. 8. Drizzle with the remaining feta dressing, season with freshly ground black pepper and serve.
Nutrition Information PER SERVE 1600kJ, protein 30g, total fat 16g (sat. fat 5g), carbs 24g, fibre 13g, sodium 382mg • GI estimate low 29
WARM & LIGHT
Brazilian-style beef with sweet potato salad Serves 2 (as a main) 1 large brown onion, peeled and left whole 2 tsp olive oil Zest and juice of 1 lime 2 tsp tamarind paste 1 tsp ground cumin 2 Tbsp chopped coriander, plus a handful 1 tsp smoked paprika 1 tsp water 400g can no added salt black beans, drained 2 (about 125g each) beef fillet steaks, trimmed of fat 160g orange sweet potato, cut into 2cm cubes 1 red capsicum, deseeded and chopped 1 zucchini, sliced
1. Grate the onion into a bowl until you have 3 Tbsp grated onion. Leave the remaining onion in one piece and set aside. Add 1 tsp of the oil, the lime zest, tamarind, cumin, 2 Tbsp coriander, smoked paprika and water. Mix well, then use half the spice paste to coat the steaks all over. Mix the remaining spice paste with the lime juice, remaining coriander and the beans in a serving bowl. 2. Preheat a barbecue grill on medium (or cook in oven – see Cook’s tip below). Take a large piece of foil and drizzle with the remaining oil. Finely chop the remaining onion and mix with the sweet potato, capsicum and zucchini. Wrap in the foil along with the bay leaf, if using, to make a parcel. Cook on the barbecue rack for about 20 minutes, turning several times with tongs until the vegetables are tender. 3. Tip the barbecued vegetables into the beans and toss well. Add the steaks to the barbecue and cook for 2-21/2 minutes each side, for medium, or until cooked to your liking. Transfer to a plate, cover loosely with foil and set aside to rest for a few minutes. 4. Serve the steak with the bean mixture.
Nutrition Info
PER SERVE 2130kJ, protein 43g, total fat 13g (sat. fat 3g), carbs 46g, fibre 14g, sodium 103mg • Carb exchanges 3 • GI estimate low • Gluten free
For more great recipes and articles check out the latest issue of Diabetic Living.
Recipes & Photography Immediate Media
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ABORIGINAL
voice
TALKING TO COMMUNITY As our Aboriginal Health Worker development project gathers pace, NATALIE JETTA is enjoying the chance to get out there and meet people face-to-face. With summer here at last, I’ve been thinking about what our priorities at Diabetes WA will be for the coming year. Right now, I’m busy with the Aboriginal workforce development training. How it works is someone nominates a manager from one of the state’s Aboriginal Medical Services (AMS) to be our contact. We meet regularly with that contact, and then they nominate an Aboriginal Health Worker or health professional, whether it's a nurse or a dietitian or someone else, and that person is assigned to us.
The next step is to organise a week block of training. As I write, I’m about to head off to lead our next batch of training. We have 10 or 11 people registered from across the state who will go on into the next stage, which is the mentoring stage. That means that, having been trained, they’ll take 32
that knowledge back to their Communities, where they’ll run Diabetes Education Self-management Yarning (DESY) workshops. Because we have the managers or the CEOs of those medical services on board as advocates, they make sure the people we train have the time they need to deliver and run these workshops in their Community. Before we started this program, I was always running around, flying about the state, delivering DESY sessions and then leaving the Community to it. Now we’re training health professionals within their own Community, they can stay there, nurture their clients and make sure they have the support they need. I’ve been really pleased by the response from Aboriginal health workers so far. We’ve had a lot of interest, although we’re having to work alongside the rollout of the COVID immunisations, which is understandably a priority for a lot of Aboriginal health staff right now. But when we got our funding grant, we said we’d train 20 and if we do more than 20, that's a bonus. We’re on track now to end up with 20 Aboriginal Health Workers and an additional 10 health professionals. I'm doing the training with two other diabetes educators from Diabetes WA. When I say I’ll be doing the training, the other educators are doing
most of the content, while I tackle the cultural side of things and build relationships, because I'll be their mentor after training. The fluffy stuff, I suppose. What this tends to mean is I go in to chat with participants on a more personal level. I make people comfortable. I do a little introduction, I talk more about the health profession, the studies they've done and I say, we're just going to sit and have a yarn. I think taking this approach is important as, for some people it can be quite intimidating if you put yourself out there as a professional. I try to make the focus more on who I am, who my community is, who my family is, what we love doing on the weekends. When you do that, that person that you're talking to feels a lot more relaxed. And when they're relaxed, they're more likely to open up to talk about their diabetes journey and more likely to connect with you. They’re more likely to take onboard the information that you're talking about. This is what we teach our health professionals when they go out into their communities. I know that when our clients are first diagnosed with diabetes, they are often in shock. They’re full of questions, but their local GP only has a 15 minute consult with them and then they’re on their own. A lot of people go into denial and don’t even want to think about their diabetes for a couple of years until the
ABORIGINAL
voice
long-term effects have kicked in. If we can make a nurturing and personal connection with them early on, they can take in all the necessary information. That information is crucial, because there are some basic misunderstandings that otherwise don’t get addressed. A common one is that it’s not just sugar that can raise your blood glucose levels. In some Communities we go into, people don’t know what certain food groups are. They wouldn't know what a carbohydrate is. They could be eating a bowl of two minute noodles thinking, oh, yeah, I'm not having a sugary snack. It's just noodles. It's OK. But they don’t realise that the noodles are high in calories and carbohydrates, so their blood glucose levels will hit the roof. That’s why they need our workshops, where we get down into the nitty gritty of carbs and portion sizes in a really accessible, nonthreatening way. That connection only becomes easier if the Aboriginal Health Worker is leading sessions in their own community. Of course, there’s the risk that people with diabetes might feel ashamed talking an Aboriginal health worker they know, which is why we always also have a health professional in our DESY workshops so they can have a choice on who they want to speak to. This community connection is so important to me, personally. I love getting out there and meeting people face-to-face. I love talking with other people about their diabetes or their health concerns. I find it so rewarding.
Whenever I get a chance and there’s an event running, I’ll be first to volunteer. The next few months around Christmas are always a bit quiet when it comes to events, unfortunately. From mid-December through to the end of January, we don't book anything in Aboriginal health because we know no-one's home. There’s a lot of movement, especially up around Karratha, with people leaving to avoid the hot seasons.
When you make a nurturing and personal connection with people. they can take in all the necessary information
But come February, we’ll be heading off to Kununurra in the Kimberley to train up some more health professionals. I can’t wait.
The Aboriginal Health Workforce Development project is funded by a grant provided by the Commonwealth Department of Health as part of the Indigenous Australians Health Program. 33
DESY
Diabetes Education Self-Management Yarning
The DESY Program involves sharing stories about living with diabetes and yarning about: How can I take care of my diabetes, my way?
How diabetes affects me
Who else can help me take care of my diabetes?
DESY is where we learn from you and you learn from us. DESY (Diabetes Education and Self-Management Yarning) is for Aboriginal and Torres Strait Islander people living with type 2 diabetes, their families and people at risk. The program teaches skills and practices to self-manage diabetes.
What is diabetes?
How to manage diabetes your way Medication Blood glucose levels
Diabetes WA is training and mentoring Aboriginal Health Workers across the state to deliver the DESY program in their communities. This means that each DESY program is personalised “I’ve learned to the community and more today than their needs. I’ve learned in six years
Healthy eating
DESY Participant 2021-073
Keep your mind strong
about diabetes. I reckon’ DESY is wicked.”
For more information call 1300 001 880 or visit diabeteswa.com.au/aboriginalhealth
TAKE
a hike
GETTING BACK ON TRACK
A knee problem has meant a break from hiking for DENISE BROWNSDON, just as the weather starts getting better! She writes about the long road to getting back out on the track. Spring has always been my favourite time of year. The weather warms up enough to enjoy some sunshine but it’s still cool enough to wrap up in blankets at the end of the day. I use my love of this weather to get out more and sneak in some exercise without having to think about it. This year, I’ve been briefly slowed down in my adventures so I’ve had to adjust what I do so I don’t lose momentum. I have a slight issue with my patella (kneecap) that required a cortisone injection. It’s a simple and easy procedure but to get the most out of it I have had to modify what exercises I do for a few months. That means there’s no jogging or jumping for me and the weights I lift have been reduced. I’m now focusing on strengthening my quads because my sports doctor has said this will help me. Genetics plays a big part in knee issues but so does excess weight (which I have) and a lack of muscle. Learning this has given me the motivation I need to focus on really building up my quads over the next few months and dropping some more weight. Although I’m not able to hike on uneven terrain for now, that doesn’t mean I need to stop entirely! I keep to more level surfaces for now but after one week of rest I was back to doing three to five km walks. Every Sunday morning my friend and I go for a walk around a local park and then we stop in at the community market they hold there. We grab our fresh produce and then sit back to enjoy a coffee. My current exercise regime means I’m doing a cardio and weight circuit Mondays and Wednesdays, an upper body weights session on Tuesdays, walks on Fridays and Sundays and leg weights on Saturday. This might sound like a lot, but it’s actually doable,
even if you do have to factor in a fulltime job! I work five days in an office so being active outside of work is very important to me. If you are looking for a way to get moving and improve your fitness, one easy to way to get started is by increasing your step count. To do this, just set a goal for each day and stick to it! I am hoping I’ll soon by back on my feet properly and getting out on the hiking trail. Check in next issue and I should have some more hiking adventures to share with you. Until
then – if you are wanting something fun to do, book yourself on a hike with the Hike Collective (their gift cards make ideal Christmas pressies if you have friend or family looking to get out into nature). If you don’t have a friend or family member to go with you on one of their hikes, don’t be afraid to go it alone because you’ll certainly make new friends on the day! They have so many different hikes to choose from and I have already picked a few more that I will be heading out on as soon as I can. 35
SUMMER
reading
SUMMER READING GUIDE
Whether you’re looking for a relaxing read for the holidays or a Christmas gift idea for the kids (or grandkids), we have a suggestion for you as we check off some of our favourite books from the past year. The Man Who Died Twice Richard Osman
The ability to make brutal murders feel like warm and cosy fiction is a particularly British gift. The sequel to Richard Osman’s blockbusting The Thursday Murder Club, in
You’re Doing It Wrong Kaz Cooke
Tired of mansplainers? You’re not the only one. This amusing, smart and infuriating volume offers a frolic through centuries of bonkers and bad advice foisted upon women.
Small Joys of Real Life Allee Richards
Eva is an actor, going places. The only problem is she feels like a fraud. She meets Pat and a bright future beckons, but Pat dies, leaving her lost and pregnant. This engrossing
Piranesi
Suzanna Clarke
Piranesi lives in the house. We can be sure of that. Except not even Piranesi – our narrator – is sure who Piranesi is or where the house might be. This acclaimed, strange novel from
Silverview
John Le Carre
The final complete novel from the late John Le Carre, master of the spy genre, is as clear-eyed and brisk as the best of his canon. Having retired early from a career in finance,
Go Tell The Bees That I Am Gone Diana Gabaldon
Outlander fans have been waiting seven years for the latest installment in this timetravelling romance. For those who are new to the series (either the books or the popular TV adaptation), well, this isn’t the place to start.
36
which the inhabitants of an English rural retirement home investigate cold cases (and stumble on a hot one), offers a winning blend of twists, thrills and hot cocoa. The plotting is clever and the writing crisp and funny, but the real joy is the characters, who provide a convincing and engaging crosssection of modern Britain, even if they feel like they belong to the past.
Humorist, columnist and author Kaz Cooke has spent decades researching all the things women should do (the housework, look beautiful, be quiet) and shouldn’t do (frown, lead a country, have pockets). The historical directives here cover everything from employment to parenting, via sex, fashion and health. Read it and weep, mostly with laughter.
debut Australian novel captures that mid-20s anxiety when adulthood, with all its seriousnesses and responsibilities, encroaches on the abandon of youth. Eva keeps her pregnancy secret, aside from her two closest friends, and tries to find a way forward through to the future, with all its unknowns, while still coming to terms with the past.
the author of Jonathon Strange and Mr Norrell starts out like an allegorical fantasy and slowly edges closer and closer to the real world. To say more is to risk spoiling the experience for a reader yet to find their way through its wonders, but a little patience with the oddness is soon rewarded. After the first third, it becomes unputdownable.
Londoner Julian sets up a bookstore in a coastal town, where he soon encounters the enigmatic and eccentric Edward. As befits a spy mystery, Edward is not what he seems. The result is an appealing mystery and a deftly-painted character portrait involving the failings of the secret service in the 1990s Balkans War.
The original premise saw 1940s nurse Claire rocketed back to 1700s Scotland, where she met and fell in love with hunky Highlander Jamie. Since then, they’ve been separated, reunited and wound up in the middle of the American Civil War. The new book focuses more on the adventures of their daughter and her husband, but promises more of the same blend of lusty historical drama.
SUMMER
no one is talking about this Patricia Lockwood
The problem with trying to capture the present in fiction is that the present has a habit of very quickly becoming the past. Like most influencers, social media icon Patricia Lockwood has a gift for tapping into the zeitgeist, as does the protagonist of her novel – a woman who travels the world talking to
This Much Is True Miriam Margoyles
British actor Miriam Margoyles is one of those talents that you’ve possibly seen in heaps of things but couldn’t name. Best known know as Harry Potter’s herbology teacher, she’s been
Great Furphies of Australian History Jim Haynes
Did you know that Portuguese and Spanish explorers probably found the east coast of Australia before Captain Cook, and that the Rum Rebellion was not caused by rum? And
The Christmas Pig J.K. Rowling
Jack is still coming to terms with his father walking out on the family when Holly, the daughter of his mum’s new husband, throws his beloved soft toy pig out the car
Julia and the Shark
Kiran Millwood Hargrave with illustrations by Tom de Freston Julia is living with her parents in a lighthouse on a remote island for the summer. Her dad
The Australian Climate Change Book
Polly Marsden and Chris Nixon
Asking children to come to terms with climate change can be a big ask. As parents, we tend
reading
fans of her viral posts. When real life clashes with the surreal nature of online life, our unnamed hero is forced to confront the jumble of contradictions that is life in 2021, where we’re bombarded by good and bad news, kindness and cruelty from one Facebook post to the next. One area where real life overtook this particular work of fiction is there’s no sign here of the pandemic. That might be a relief to some readers, but it leaves a big hole at the heart of what it means to alive – and online – at this moment. That aside, this is an inventive, irreverent and amusing read.
in everything from classic TV series Monkey (voicing a host of different characters) to Mulan and from Blackadder to Babe. Judging by her memoir, she’s also led a pretty extraordinary life. Conceived in an air raid (to which she attributes her curly hair), she was a childhood prankster, posed nude as a teen for legendary painter Augustus John and has been impertinent to all manner of celebs – including the Queen!
what about Banjo Paterson writing Waltzing Matilda? As for Ned Kelly being a brave freedom-fighting rebel, in truth he was a thief, a thug and a murderer. The Ashes have nothing to do with cricket, the Ghan is not named after Afghan cameleers and Hargraves lied about discovering gold in New South Wales. This surprising and fun book offers a revealing journey through Australian history and folklore.
window – never to be seen again. By way of apology, she buys him a replacement. The new pig is no comfort but ends up accompanying Jack on an imagined adventure to rescue his lost friend from the clutches of the evil Loser, destroyer of toys in the Land of the Lost. This delightful festive read from the Harry Potter author should appeal to kids of all ages.
is working, while her mum obsesses over finding the elusive Greenland shark. But when her mother’s passion for shark hunting unbalances their world, Julia sets off on her own quest. This beautifully conceived and illustrated children’s tale tells an exciting adventure full of courage, love, family and friendship. Perfect holiday reading for 8-12s. to want to shelter our kids from more frightening possibilities, but many will already be aware and anxious about what might happen. This practical and reassuring book for children, written by the creator of documentary series Big Weather (and How To Survive It) will help them understand climate change and the ways in which they can make a difference.
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COMING
up
OUR FAVOURITE THINGS TO DO THIS SUMMER It isn’t just the weather heating up in WA. We’ve got a packed calendar of cultural treats ahead of us!
Films The French Dispatch Director Wes Anderson (The Royal Tenenbaums, Fantastic Mr Fox) has assembled his usual stellar cast for this enjoyable and beautifully stylised love letter to journos. Set in the offices of an American newspaper in France, the film weaves a series of tales around a broad bunch of quirky characters. Dune This year’s big sci-fi blockbuster has been waiting in the wings since the pandemic broke out. Based on a classic series of weighty tomes, it involves wealthy families squabbling over the mining of a magical rarity called Spice. Like Star Wars for intellectuals (but still great fun for the rest of us).
A Boy Called Christmas Based on the bestselling book by Matt Haig, this festive tale giving Father Christmas a backstory manages to walk the line between sweet and saccharine. Accompanied by a talking mouse, a young boy goes in search of a secret Elf village, hoping to find his missing dad. Great fun in the same ballpark as the Paddington films.
Festivals Once the flurry and excitement of the festive season is done, there’s still plenty to look forward to. Next year’s Perth Festival runs from 11 February to 6 March and brings together the best creative talent from Western Australia and beyond.
No Time To Die Daniel Craig’s final outing is unusually emotional for a Bond film. There’s still the usual ridiculous stunts, quips and thrilling action, but by giving Bond a personal life, the film somehow raises the stakes beyond the usual end-of-theworld-as-we-know-it threats.
Highlights include Panawathi Girl, billed as the next big Black musical. Set in a small town in the northwest of Western Australia in the 1960s and produced by Yirra Yaakin Theatre Company, the production features hippies and cowboys, politicians and protesters in an all-singing, all-dancing night of entertainment.
Ghostbusters: Afterlife The Ghostbusters franchise returns from the dead with this reverent but enjoyable sequel to the first two films. Borrowing heavily from Spielberg, director Jason Reitman (son of the original director) cleverly puts kids centre stage, making this feel very much like one of those family films we oldies enjoyed during the 80s.
Starting at Fremantle’s Bathers Beach, the festival’s opening spectacular Escape will celebrate the ocean and the diverse voyages, cultures and experiences that define us here in Western Australia. From the Noongar stories that enter from the western horizon to the waves of subsequent migration, from sail to steam, from convicts to Irish revolutionaries,
from the flowering of Mediterranean cultures to the contributions of the African diaspora, to the greatest escape of them all – the Catalpa rescue. There’s also the festivals-withinthe-festival. The Lotterywest Film Festival features an array of local and international films, including the world premiere of saucy comedy How To Please A Woman, filmed right here in WA. The Literature & Ideas Festival (formerly the Perth Writers Festival) features acclaimed authors including Helen Garner, Hannah Kent and Lisa Taddeo. If you need a warm up act, don’t forget Fringe World festival, featuring leftfield acts from across the state, running from 14 January to 13 February.
Music Priscilla Queen of the Desert the Musical This iconic, award-winning musical arrives at Regal Theatre in Subiaco in January. Fans of the classic film will get a chance to witness the glitz and glamour up close and personal in this new, intimate venue and enjoy outrageous costumes, fullscale live production numbers and non-stop hits. John Williams: Birthday Bonanza The WA Symphony Orchestra present some of the greatest film soundtracks including music from Indiana Jones, Jaws, Jurassic Park, Superman and Star Wars at a pair of special concerts on 4 and 5 February. 39
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Australia’s Largest Selection Of Discount Gift Cards
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Keen to explore WA and get fit while doing it? The Hike Collective is for anyone in Perth looking for a safe space to explore the rugged beauty of WA. The hikes empower wellbeing and discovery through movement, connection, and nature, providing unique and inclusive trail experiences. 1300 038 924 HELLO@HIKECOLLECTIVE.COM.AU HIKECOLLECTIVE.COM.AU Diabetes WA members receive a 10 per cent discount on standard day hikes. Simply use the code ‘diabeteswa’.
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Diabetes WA
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Train Your Brain Give your brain a good workout with this number-crunching Sudoku puzzle.
The aim of the game is to fill the entire 9 by 9 grid - which is made up of nine 3 by 3 boxes - with the numbers 1-9. Note that each of the 3 by 3 boxes must also contain the numbers 1-9. (Answers below)
Good luck!
Competition
Summer
The CSIRO Low-carb Diabetes Every Day is about making a low-carb way of eating an easy part of everyday life. Featuring 80 brand-new recipes, it will help you to prevent and/or manage type 2 diabetes, reach your weight-loss goals and improve your overall health and wellbeing. Thanks to Pan Macmillan Australia, we have five copies of CSIRO Low-carb Diabetes Every Day (valued at $39.99) to give away!
To enter, complete your details below and send it to: Membership – The Low-Carb Every Day Guide comp 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 January 31, 2022.
The five winners of The CSIRO Gut Care Guide (thanks to Pan Macmillan Australia) in our Spring 2021 edition were Janice Alexander, Jan Macaulay, Julie Apse, Colin Waterhouse and Alison Hutchinson. 41
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