Diabetes Matters Spring 2022

diabetes+exercise

From the Editor

Welcome to the Spring edition of your member magazine!

As the days grow longer and sunnier, even the most dedicated couch potato can find themselves wanting to get more active. I should know, having long been a potato myself. For years, I rolled my eyes at experts and so-called friends who kept telling me how much better I’d feel if I got some more exercise. The terrible thing, of course, is they were completely right.

My moment of truth came during the second Melbourne lockdown, when being outside and active suddenly became a luxury. My wife and I downloaded the free Couch to 5K app, which guided us through a seven or eight week program designed to make the impossible feat of running non-stop for 30 minutes a possibility for even the most dedicated avoider of exercise. The difference running has made to my mental and physical health has been immense. Fitness aside, I think the greatest benefit has been learning that, with the right help, I can do something that seemed too difficult to contemplate.

I hope this issue, which we’ve dedicated to exercise, helps you find a means of getting active that works for you. As always, you’ll also find the usual mix of research, recipes, reviews and advice scattered throughout.

Happy Reading!

Myke

DIABETES matters.SPRING 2022

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.

Contributors

Marian Brennan, Narelle Lampard,

Kathryn Lemon, Carly Luff, Jessica Weiss Photography

DWA staff, Shutterstock

Diabetes WA – Subiaco Office Level 3, 322 Hay Street, Subiaco WA 6008

Postal Address: PO Box 1699, Subiaco WA 6904

Diabetes WA – Belmont Office 172 Campbell Street, Belmont WA 6104

Postal Address: PO Box 726, Belmont WA 6984

Word From

Voice, Our Actions

Talking Science

and sleep

Exercising after a meal

From the Cover: Exercise and Diabetes

Work out your way

Running with a crowd

started

draft

it safe for me to be physically active

it safe to exercise when pregnant

Calendar

of Annual General Meeting

Living Well

ultimate challenge

Moving Well

Exercising on a budget

Eating Well

Healthy eating on a budget

Living Recipes

Voice

Area

in

Benefit Partners

A WORD FROM THE CHAIR

I was delighted when exercise was chosen as the theme for our spring issue of Diabetes Matters. From my own experience, I know that regular exercise, as tough as it can be to fit into a busy life, has benefits for your physical and mental health that simply can’t be underestimated.

We do talk a lot about the physical benefits of exercise – particularly if you’re managing a chronic condition such as type 1 or type 2 diabetes. But, for me, it’s the benefits for our mental health that really stand out as being important.

Exercise can help centre you mentally, whether you go out for a walk, you run, you like strength training, or you’re doing yoga or pilates. Yes, you’ll benefit from the endorphins your body produces, but you’ll also find that your mind is allowed a break from all those day-to-day worries and stresses. Instead, your mind will be very focused on your chosen activity.

As a cancer survivor, I know the difference that being active can make to your sense of wellbeing when you’re dealing with a serious health issue. Members of my family who live with anxiety have found exercise to be a crucial management strategy and an important part of their wellness.

I also know that exercise can help you feel less isolated. Growing up, my family moved around a lot, meaning that I ended up living in 12 different houses by the time I was 18. It felt like I was always the new kid at school, which is tough when you’re that young. For me, playing sport made it a lot easier to fit in and make friends. There was always a team to join and I ended up playing the beautiful game – soccer, as we call it here – at an elite level.

But exercise doesn’t need to be an elite

pursuit – or even something competitive. You don’t need to be thinking about the next Olympics or World Cup. Just walking down the street one day and then going a little further the next day is a great way to start. If you find walking difficult, there’s yoga or pilates or some simple strength training.

As we get older, exercise can get more complicated – particularly if you’re living with a chronic condition. I am due for a knee replacement, but I’m determined not to let that stop me from doing anything I want to do. Part of me wants to just keep going until I fall down and I can’t get up. But if you’re an older person or you’re living with an injury, there are always options to get active. Any kind of movement or activity will make a real difference to your sense of wellbeing.

We’re also keeping things moving at Diabetes WA, as we approach this year’s AGM (see p20) and prepare our Annual Review (see our next issue for more details). On behalf of the Board of Directors I would like to personally thank Dr Alan Wright, who is retiring from the board this year after being an amazing servant of Diabetes WA for 10 years, contributing from his deep experience and expertise as a general practitioner and providing invaluable advice to the broader Diabetes WA team. He has had a demonstrable impact on the mission and vision of Diabetes WA. Thank You Alan!

This year, we’ve been reflecting on how we’re evolving as an organisation. Melanie Gates, our CEO, and I were proud to oversee the development of our new five-year strategic plan, which will guide Diabetes WA into our next phase of growing our support services for those living with, or at risk of, diabetes.

Our focus, as always, is you – West

Australians living with or affected by diabetes. We want to evolve so that we are best placed to serve your changing needs. This means that, while we’re maintaining our award-nominated telehealth service, we’re also looking at ways of delivering differently, whether it’s our virtual workshops or our new feefor-service offerings. We want to make our services are accessible to everyone – wherever they might be in our great state!

In our next issue, you’ll read more about how we’ve developed our first Reconciliation Action Plan (RAP), which forms an important part of how our organisation is adapting to better serve the First Peoples of the land on which we work and live. The RAP is our commitment to advancing reconciliation within the sphere of our influence. We have already taken some significant actions to develop strong relationships and improve staff knowledge and understanding of Aboriginal and Torres Strait Islander cultures. By formally engaging in a Reconciliation Action Plan, we acknowledge that we still have a long way to go and commit to addressing the five dimensions of reconciliation race relations; equality and equity, institutional integrity; unity and historical acceptance. It’s been an amazing process and I’m delighted with the final results, which were endorsed in early August. Alongside our expanded DESY offerings for Aboriginal Communities and our pilot program recruiting Aboriginal Health Workers, I hope the RAP signals our commitment to continue to move forward with open hearts and minds on our reconciliation journey.

Mary Anne Stephens Diabetes WA Board Chair

actions

Seek and Support

It’s been a busy few months at Diabetes WA. In July, we marked NATIONAL DIABETES WEEK (10-16 July) with the key message of Seek and Support. We encouraged West Australians affected by diabetes to seek advice, action and answers – and to support family and friends living with diabetes. We know how important National Diabetes Week is to raising awareness, given 31 West Australians are diagnosed with diabetes every day – adding up to more than 200 new diagnoses by the end of the week.

As part of the week’s festivities, we joined forces with VenuesWest to run two interactive diabetes information sessions at HBF Stadium and HBF Arena, presented by our friendly credentialled diabetes educators, helping attendees to understand how diabetes affects the human body.

face-to-face meetings, telehealth and virtual programs, the advice and support we offer is especially important when people are first diagnosed.

“We are also assisting the type 1 community during this exciting time with the rollout on 1 July of the federal government commitment to give all Australians living with type 1 diabetes access to subsidised Continuous Glucose Monitor (CGM) products.”

Also big news is the launch of the Diabetes WA CGM StartUp Clinic. This new service is available for those living with type 1 diabetes who are over the age of 21, are using insulin injections, and will require a health professional appointment to access CGM technology.

Delivered via telehealth by our credentialled diabetes educators, the clinic is designed to help eligible NDSS registrants who want to start using the newly subsidised CGM or Flash GM technology. Find out more by calling 1300 001 880 or heading to www.diabeteswa.com.au/cgmclinic

Elsewhere that week, our Aboriginal Health Coordinator Natalie Jetta [pictured above] headed to the Hedland Well Women’s Centre to host a diabetes awareness cooking workshop.

Accompanied by a diabetes educator and nurse from the Hedland Health Campus, Nat shared how to seek action, answers and advice, alongside how to make healthy meals to be enjoyed by the whole family.

Diabetes WA CEO Melanie Gates said our organisation is uniquely placed to offer the support needed by those who live with diabetes and those who care for them.

“Diabetes WA is uniquely placed to provide support to West Australians in all corners of our state via a combination of

We were also delighted to attend the 2022 Multicultural Netball Carnival on 26 August [pictured right]. The Multicultural Carnival is a key culturally and linguistically diverse event in the Netball WA (NWA) calendar. The one-day event is an annual school-based competition held by NWA. The carnival promotes participation and engages players from a wide variety of ethnicities to foster their netball skills in a fun and encouraging environment. The Multicultural Carnival is a celebration of WA’s cultural diversity, and Diabetes WA was proud to attend. We loved meeting all the students, teachers, and parents who attended this great day!

In August, we were proud to unveil our new Healthy Tucker Guide and Injecting Insulin Guide Easy to read with informative pictures throughout, the two guides are packed with important information for anyone living with diabetes wanting to make healthy food choices, or those learning to inject insulin. Co-designed by Aboriginal and Torres Strait Islander people, for Aboriginal and Torres Strait Islander people via community consultation – and supported through an independent grant from Sanofi – the guides are go-to resources for Aboriginal and Torres Strait Islander people learning how to manage their diabetes. Our print design was created by Aboriginal artist Rebecca Morgan.

For more information contact aboriginalhealth@diabeteswa.com.au

Diabetes Matters wants to make sure our member voices are heard. If you have any thoughts, questions or stories you want to share, get in touch at media@diabeteswa.com.au

An American study looked at how different types of exercise can affect sleep patterns, even for people living with diabetes, writes MARIAN BRENNAN

Getting more sleep isn’t usually the first thing people think about when they start an exercise regime. But we’re increasingly coming to understand that improving our level of fitness has wide-reaching health benefits. Sleeping well is closely linked to health and well-being, with poor sleep being associated with an increased risk of overall mortality and a range of long-term health conditions, including diabetes. As you may have seen in our special Sleep issue (Diabetes Matters, Spring 2021), getting a good night’s sleep is proving harder and harder. Around a third of Americans report getting too little sleep or insomnia (which is defined as waking more than three times a night).

Changing how you exercise is one of the simplest and easiest ways to improve your sleep. Traditionally, studies have focused on what is called moderate-to-vigorous aerobic activity (MVPA), which might include running, cycling or walking. A recent study from American journal Sleep Health turned its attention to emerging evidence that musclestrength training (MSE) may have additional benefits. An earlier review of that evidence from 2018 showed that, when compared to no exercise, undertaking MSE led to significant improvements in sleep quality and a range of other benefits.

The new study set out to examine what benefits there might be for people who combine moderate-to-vigorous activity with strength training. While it was already known that doing so reduces your risk of dying from cancer and improves your cardiac and mental health, there was little known about specific benefits for sleep.

For the sake of the study, sleep health was measured as having five components – short sleep, long sleep, poor quality sleep, observed snoring and observed breathing stoppage. The study looked at 47,564 adults and found that, for those aged 18-64, sleep health – with the exception of short sleep – was noticeably better for those who were following a MVPA and MSE program. For those aged above 65, the news was even better – the risk for all five

components was significantly reduced. This improvement was measurable even for those living with long-term conditions such as hypertension, depression or diabetes. The defined list of aerobic exercise included jogging, walking, tennis and soccer – but not milder activity such as bowling, golf, gardening or house maintenance. Muscle strengthening activities included using your own body weight like yoga, sit-ups or push-ups and using weight machines, free weights or elastic bands. Participants were asked to self-report poor sleep (“Over the past two weeks, on how many days have you had trouble falling asleep or staying asleep or sleeping too much?”) and whether anyone had told them they either snored loudly or stopped breathing during their sleep.

Sleep health – with the exception of short sleep – was noticeably better for those who combined aerobic exercise with strength training.

This new study is seen as being important because it is the first to demonstrate a measurable improvement in sleep health for people who combine an aerobic exercise and strength training program. The authors say their data consistently showed a favourable association between a mixed program and the components of sleep measured above. At this stage, it’s unclear exactly why this mixed program does improve sleep.

Clinical studies have shown, however, that combining MSE and aerobic MVPA does have positive effects on cardiometabolic bio-markers and indicators of mental health. Both forms are also known to improve depression and anxiety symptoms, which are also associated with sleep.

One possible explanation for the improvements, of course, is that working out more – and in two different styles – uses up more energy. Basically, when you wear your body out through a combination of different activities, you feel more ready for sleep.

STUDY: EXERCISING AFTER A MEAL CAN HELP BLOOD GLUCOSE MANAGEMENT

We know that raised blood glucose after eating – and accompanying insulin resistance – are red flags when it comes to your risk of developing type 2 diabetes.

People with raised blood glucose levels can experience adverse health events prior to developing diabetes and tend to be more at risk of complications associated with type 2. The World Health Organisation has identified raised blood glucose as the leading risk of early death behind hypertension and tobacco use.

A new study published in the Canadian Journal of Diabetes suggests that increasing levels of exercise can have a powerful, positive effect on glycaemic management and insulin sensitivity, both immediately and in the long term. The study shows that these benefits can also be enhanced by considering the timing and nutritional composition of meals around exercise.

Raised blood glucose after eating and insulin resistance are, initially, the result of decreased glucose uptake in peripheral tissues such as muscles. There is a genetic component, but it is more often explained by imbalanced nutrition or a lack of physical activity. When the muscles don’t absorb as much glucose, the pancreas produces more insulin to deal with it. Over time, without treatment, this increased amount of insulin isn’t enough, generally leading to a diagnosis of type 2 diabetes.

Exercise is known to be a key part of the prevention and management of type 2 diabetes, partly because it reduces those post-eating glucose spikes. The new study attempted to establish the impact of different forms of exercise, comparing a single session (acute exercise) with repeated sessions (chronic exercise) and taking into account the efficacy and timing of the type of exercise.

The study split the effects of exercise into three phases. The first examines the way in which exercise immediately lowers blood glucose levels. Exercise increases the body’s energy demand, which can increase muscle glucose uptake by 20 times. In adults with prediabetes or type 2, an overall reduction in blood glucose concentration is usually observed during exercise, especially if performed after eating. Available evidence suggests that exercise performed after eating

prompts superior reductions in blood glucose levels. Many types of exercise are effective, including walking, resistance exercise, cycling or stair climbing, although higher exercise volumes lead to more consistent reductions.

The second phase concerns how exercise can improve how well insulin worksand glucose uptake by the muscles in the days following exercising. For example, walking for 60 minutes in the afternoon has been shown to improve insulin sensitivity the next morning in adults with obesity.

More intense exercise has been shown to improve insulin sensitivity in healthy males for up to two days afterwards. The third phase looks at how repeated sessions of exercise cause changes in the body that improve blood glucose management. Exercise training is shown to result in changes that improve insulin effectiveness and glycaemic management in adults who were previously not exercising and in adults with prediabetes or type 2 diabetes. The intensity of this exercise had a notable effect on blood glucose management for people living with type 2 and it was important that the exercise was maintained to sustain the benefits – particularly for those who didn’t lose weight as a result of exercise. These repeated sessions were also shown to be most beneficial when performed after a meal – doing so provided more consistent improvements in blood glucose management for adults with type 2 diabetes.

In conclusion, the study authors note that short- and longterm exercise provide a powerful stimulus to reduce high glucose levels after a meal. The improvements to blood glucose management brought about by exercise may be even more pronounced if exercise is performed after meals. Further research should help develop more effective recommendations around eating and exercise to help prevent and treat type 2 diabetes.

How and when you exercise can make a big difference to your blood glucose management.

PAIN,

NO GAIN?

YOUR WAY WORK OUT

We all know exercise is good for us — and a key part of diabetes management — but why does it have to be so hard? MYKE BARTLETT looks at ways of getting active, even when you don’t want to.

Let’s get personal for a minute here. I spent most of my life thinking exercise was something that only happened to other people. There were strange people who enjoyed physical activity and, well, there were me and my friends. And, yet, back in the cold darkness of a Melbourne winter during the second 2020 lockdown, I took up running. It was awful. What helped was a staggered program that saw me run for 60 seconds, then three minutes, an impossible ten minutes and, finally, for a full half hour. These days, I run five kilometres three times a week (weather permitting). I can’t say I enjoy it, but it turns out I like being fit. The only annoying thing is, now I know what it feels like to be fit, I have to keep going.

For people living with diabetes, the difference exercise can

make to your blood glucose management and quality of life is immense. If you’ve been diagnosed with prediabetes, there is compelling research that suggests regular physical activity is as effective (if not more effective) at managing your blood glucose levels than medication. Accredited exercise physiologist and credentialled diabetes educator Dr Marian Brennan PhD says the relationship between exercise and diabetes is complex, but well-established.

“The way exercise manages diabetes and blood glucose levels is fascinating,” Marian says. “When our muscles contract during activity, a special pathway is created allowing glucose to enter our muscle cells without the need for insulin, meaning glucose moves from the blood into the cells more quickly than normal. This effect can even last for a few hours after we exercise!”

Getting started with an exercise regime isn’t always easy. People with type 2 diabetes experience many of the same

barriers to physical activity as the rest of the population — such as a lack of time or a lack of access. There is also some concern about pre-existing conditions and injuries and some may worry about how to balance insulin intake with increased levels of exercise. Marian says research shows that people with type 1 also report additional diabetesspecific barriers to getting active.

“The top three barriers mentioned by those living with type 1 diabetes were a fear of experiencing low blood glucose levels with exercise; a lack of time, motivation and energy due to the high management demand of type 1 diabetes; and limited health professional advice on how to manage blood glucose levels for exercise.”

Despite these concerns, the good news is that, whatever your type of diabetes, you generally won’t need medical clearance to start a graded or moderately intensive exercise program.

“As diabetes can increase the risk of cardiovascular conditions, if you have experienced any recent new chest pain, recent heart attack or stroke, or if your blood glucose levels have been over 15mmol/L regularly, it might be worth having a quick chat to the GP just to make sure you’re safe to get started,” Marian says.

For those experiencing diabetes-related conditions like some forms of retinopathy or foot ulcers, getting advice from your specialist and an accredited exercise physiologist is recommended. It is recommended that those using insulin to manage their diabetes monitor their blood glucose levels before, during and after activity to make sure they are within their target ranges. It may also be worth chatting to your diabetes healthcare team about adjustments to your insulin dose to avoid low glucose levels.

“People living with type 1 diabetes are at greater risk of experiencing low blood glucose levels with exercise exceeding 30 minutes,” Marian says. “But regular monitoring, insulin and carbohydrate adjustment can help reduce this risk.”

Age is also a factor — but older folk shouldn’t worry too much about counting the years when it comes to getting started.

“Age is very relative!” Marian says. “But I would focus on your current ability and general health rather than the number. One consideration, is that if you’re using insulin to manage your diabetes, your risk of experiencing low glucose levels increases as you get older. But there are ways to minimise this risk so that you can still enjoy your physical activity.”

So, age and diabetes needn’t get in the way of anyone getting fit. But what about if, like me, you really don’t like exercise?

“I would say, let go of what you might perceive to be exercise and find movement or activity that you enjoy,” Marian says.

“Physical activity can take many forms and while for some that might involve structured and possibly intense physical activity, you do not have to start or even end up there! Get creative and think of ways to move your body that are within your comfort zone. If you’re struggling and are not sure of what you can do, particularly if you feel you are limited because of injury, pain, or illness, speak to an accredited exercise physiologist who will be able to work with you to tailor activity that you can do and you enjoy.”

“Let go of what you think of as exercise and just find movement or activity that you enjoy.”

“The way exercise manages diabetes and blood glucose levels is fascinating.”

WITH A

RUNNING CROWD

When Instagrammer Emily Vuong decided to tick the New York Marathon off her bucket list, she found her online community gave her the support she needed to keep going, MYKE BARTLETT writes.

Emily Vuong is an Instagram inspiration. Her page @emilysdiabetes shares the everyday highs and lows of managing type 1 diabetes, as well as encouraging her ten thousand followers to get active. Having seen firsthand the difference exercise made to her diabetes management, the 25-year-old is keen to help others follow in her fleet footsteps.

“I started weight training when I was about 17,” Emily says. “And I noticed the biggest change in my insulin sensitivity. My blood glucose is so much easier to manage when I incorporate weight training into my routine.”

She’s aware that exercise brings its own complications when you’re living with type 1 diabetes — particularly if you decide to do something extravagant like run the infamous New York Marathon. Fittingly, it was following someone else with type 1 diabetes on Instagram that inspired Emily to add the marathon to her bucket list. In turn, she documented every step of the way on her own page.

“It took me about eight months to train for it and I shared the whole journey,” Emily says. “Training was really tough, so it was really nice to feel there was all that support behind me. It gave me

the motivation I needed to keep going.”

That motivation paid off in what Emily describes as being a life-changing experience.

“It was beyond what I could have imagined. I mean, it was the hardest thing I’ve ever done, but it was just amazing. You’re running in the streets, and people are cheering for you, and then when you finish there’s no feeling like it. To this day when I’m doing something hard, I think back to running the marathon, and I just think if I could do that I can do anything.”

Sharing the experience – with all its difficulties – may have given Emily added motivation, but she’s aware that she has also inspired others to make exercise an important part of their diabetes journey. More than that, she hopes her page is helping to break down some of the stigma around living with type 1 diabetes – something she was very aware of growing up.

“When you’re growing up, you don’t want to feel different in any way. I didn’t know anyone else with diabetes, at school, in my social circles or in my family. So it was quite isolating. I felt a lot of shame around not being well, being weak or having something that people could think would hold me back. So I hid it all through school, especially in high school.”

Social media was a revelation for Emily. For the first time, she saw other people living with diabetes talking openly about their experiences – even if it was just sharing blood glucose readings or talking about diabetes tech. When she was 20, she started her own Instagram page, at first anonymously, but as she grew in confidence, she began to discuss her life with diabetes more openly.

“I started to become more vulnerable and share more about the mental health side of diabetes. And I think that’s where the strongest responses from followers have come from. So many people go through a tough time with their mental health because of their diabetes. Back when I started sharing about it, it was not something that was commonly spoken about.”

That connection with other people living with type 1, wherever in the world they might be, has given people like Emily a sense of community they had previously lacked.

“A doctor doesn’t have the time to sit you down and tell you all these little hints and tricks, but I have learned so much from the online diabetes community. And just feeling like there

are other people who understand what it’s like to have diabetes is so reassuring.”

While she treasures that connection with her peers, Emily says some of the best feedback she has had on her posts comes from the family and loved ones caring for young people with type 1.

“My favorite message to receive is from parents of young kids with type 1, who were feeling worried for their kid’s future. They message me and say, ‘your page has shown me that it’s possible to have a wonderful life with diabetes’. I know from my own mum how worrisome it is to have a child with diabetes, so the fact that I can provide that comfort to other parents is the most rewarding part for me.”

“I felt a lot of shame around not being well, being weak or having something that people could think would hold me back.”

STARTED GETTING

HOW MUCH OF A DIFFERENCE CAN EXERCISE REALLY MAKE TO DIABETES PREVENTION?

The evidence strongly suggests the exercise can have a profound effect on preventing type 2 diabetes.

A number of landmark studies suggest that people diagnosed with prediabetes have a lot to gain from lifestyle modifications including increased levels of exercise. One study showed that people with impaired glucose tolerance who modified their lifestyle were at less risk of progressing to diabetes than those who were only prescribed Metformin. Those who took both medication and made lifestyle changes significantly reduced the incidence of diabetes, but in the prediabetes phase, it seems lifestyle changes were slightly more effective.

An earlier study found similar results. People with prediabetes who undertook a lifestyle modification program with the goals of at least 7% weight loss and at least 150 minutes of physical activity per week were far less likely to progress to type 2 diabetes. The lifestyle program reduced the incidence of diabetes by 58% compared to the placebo group.

There can be no doubt that regular exercise – as part of a program of lifestyle changes – can make a great difference to diabetes management and prevention. It is important to note, however, that Metformin has wide benefits and is associated with significant reductions in diabetes-related and all-cause mortality. Any changes to your diabetes medication or management plan should be discussed with your health team.

Not sure where to start?

Strength training for the over

Training Club

FIRST DRAFT

Getting diagnosed with type 1 diabetes the week before draft hasn’t stopped Jamie Cripps building a fantastic career in AFL, writes MYKE BARTLETT.

Draft selection is a nerve-wracking time for a young footballer, knowing that getting picked for the right team – or any team! – will be a defining moment in their career. For Jamie Cripps, getting drafted was only half the stress. His first AFL draft came a week after the then-18-year-old had been diagnosed with type 1 diabetes.

“Just before the draft was about to happen I went into hospital for a couple of days and got the news,” Jamie says. “It was obviously a massive shock and I didn’t really know if I’d be able to play at the top level of AFL or any clubs.”

He had been unwell for a while, losing weight and finding it harder to get out of bed, but the diagnosis still came out of the blue, although type 1 diabetes does run in his family.

“My old boy, my dad, has type 1, so I’d grown up seeing him deal with it. But

Given how close the diagnosis was to the draft and worried no club would want him with diabetes, Jamie kept his news quiet until after St Kilda had picked him. Thankfully, they were very supportive of their new recruit.

“They said, no worries, mate, we’ll help you out. They had club doctors and specialists over in Melbourne that I could go to and they were really, really helpful. They went a bit easy on me for my first preseason and really helped me monitor my training, because I was only a couple of weeks into dealing with the condition.”

The hardest part for Jamie was getting used to how organised he had to be, managing his diabetes while settling into his new career. He was grateful to have the support of the club around him as he got used to how training affected his blood glucose levels and vice versa, but he was aware he was having to deal with things his teammates weren’t.

diabetes

“If my bloods were too high, I’d get a bit shaky so I’d try to get my bloods around 10mmol/L, because I didn’t want to be dropping too low during a game. It’s hard to keep the level around 10, because adrenaline and all that stuff kicks in as well.”

While finding the right balance during training proved hard, he says he knows he was lucky to already be fit and active when diagnosed.

“If I’ve had to have surgery and not been able to run for a month or so, I’ve always found that was harder to manage than when I was exercising.

Exercise does tend to help keep my blood at a better level and a consistent level.”

New technology has also helped. Jamie says the change to the subsidies for flash scanners has made a big difference to him.

“The scanners on the back of your arm are amazing. Now they’re subsidised I will start wearing them a lot more. It’s good to know that your blood’s dropping down to low before it gets to a dangerous level.”

Although he felt obliged to keep quiet about his diagnosis at the time, the fact he’s gone on to have such a successful career means Jamie believes AFL clubs wouldn’t think twice now about drafting someone with type 1.

“There’s other players with type 1 now, like Paddy McCartin over in Sydney. But there’s so much support, everyone backs you up. They make it easy for us.”

For his part, he’s proud to have been an ambassador for groups such as Diabetes Research WA and hopes he’s shown the next generation of footballers that type 1 diabetes needn’t get in the way of your dreams.

“My old boy was always a good role model and I know it’s good for young kids to see that their idols still have struggles. I enjoy doing stuff for kids who have type 1 and I’m always happy to have a chat and see if I can help them out in any way.”

What advice would he give himself, when he was first diagnosed, back at the very start of his career?

“Don’t let it stop you from doing what you want to do. You’ve just got to be more prepared and more organised. Get as much help as you need. If you can get your routine downpat it’ll help you with all your sport and hopefully through life.”

“Don’t let it stop you from doing what you want to do. You’ve just got to be more prepared and more organised.”

IS IT SAFE

ACTIVE?

EXERCISE + diabetes

Starting an exercise regime can be a worrying prospect for older people with diabetes, particularly if they’re dealing with complications from living with a long-term condition, MARIAN BRENNAN writes.

At some stage, everyone living with diabetes will have had a health professional tell them how wonderful physical activity is for long-term health conditions such as diabetes, heart problems, persistent pain, arthritis and mental health – and that you should do more! But many who are living with these long-term health conditions find the prospect of starting physical activity a bit frightening. After all, making our bodies and heart work hard is surely a bit risky for someone with long-term health problems, right? Although it can still be a bit scary, the opposite is actually true!

The risk of physical activity causing an adverse event is very low. We know that inactivity poses a higher risk to

speak to your GP or physiotherapist –you may need a more structured plan to get back into exercise.

Fatigue

Like pain, some temporary fatigue is normal but exercise will improve preexisting symptoms of fatigue, sleep, and well-being. Slow and steady is the key here too!

Shortness of breath

If you haven’t done any physical activity in a while, you might not be used to the sensation of being out of breath – it can be scary when you’re not used to it! Again, this is normal. Start at a low intensity and gradually build from there at a rate that is comfortable for you.

Making our bodies and heart work hard is risky for someone with long-term health problems, right? Actually, no!

our health and that the benefits of physical activity far outweigh any risks for those already living with a longterm condition. For this reason, regular physical activity, along with standard medical care, plays an important role in managing and preventing many long-term conditions, including diabetes.

If you find yourself wondering if it is safe to start an activity, try to think of any symptoms you might currently be experiencing, rather than the condition itself. Let’s take a closer look at some of these.

Muscle or joint pain

It is normal to experience a temporary increase in pain with any new activity but pain does not mean tissue damage. Usually, these pains will stop once you and your body adapt to the activity you are doing. Slowly introducing physical activity has actually been shown to help with pain management. If you do experience worsening pain that doesn’t subside,

Cardiac chest pain

If you experience ischaemic heart disease (or angina) you might experience chest pain from time to time. The benefits of physical activity outweigh any temporary, slightly increased risk of chest pain during activity. Physical activity is a good treatment option for stable angina but if you experience increasing frequency and severity of chest pain, seek a review from your GP or cardiologist.

Frailty and risk of falls

Building muscle strength and balance through activity can dramatically reduce your risk of falling. Physical activity will need to be tailored to you but is a safe and effective way to manage falls risk.

Fluctuating blood glucose levels

People living with type 1 diabetes or those with type 2 diabetes using insulin, or a type of medication called Sulphonylureas, may be at risk of

experiencing hypoglycaemia or low blood glucose levels during and after physical activity. Some people even experience a rise in glucose with higher intensity activities. Talk to your endocrinologist or credentialled diabetes educator to discuss an individual plan for managing activity. In the long-term, regular physical activity can improve daily glucose levels and reduce the amount of required insulin or medication.

Heart palpitations

As with shortness of breath, being aware of your heartrate increasing during activity can be scary if you’re not used to exercise. This is generally just a normal response to activity, but if you are concerned, check with your GP. People living with atrial fibrillation also benefit from regular physical activity.

When should I see my doctor?

You should check in with your GP if you notice a dramatic increase in breathlessness, new or worsening chest pain (or increasing GTN use), a sudden onset of rapid palpitations or irregular heartbeat, dizziness, a reduction in exercise capacity or a sudden change in vision.

It can take time to work through any concerns or fears relating to starting a new activity. We would encourage you to talk to your GP or treating health professionals about any concerns you have. Discussing these concerns can improve your confidence to get started, but of course everyone will have their own starting point. When you’re ready, choose a starting point that you’re comfortable with and build up gradually.

If you would like to speak to our dual qualified accredited exercise physiologist and credentialled diabetes educator, Dr Marian Brennan PhD about starting or increasing your physical activity, visit Perth Physical Activity and Diabetes Institute (www.perthpadi.com).

IS IT SAFE TO EXERCISE WHEN PREGNANT IF I HAVE DIABETES?

CARLY LUFF is an Accredited Exercise Physiologist, Credentialled Diabetes Educator and mum of one very active toddler.

Gone are the days when expectant mums were encouraged to take it easy and relax on the couch for nine months. While there are some activities that may need to be avoided or adapted, staying physically active during pregnancy is safe and strongly encouraged.

Your body will go through a lot of changes as bub grows. Being active can help reduce the aches and pains and help you prepare for labour, which may be the most strenuous activity you ever do (but totally worth it).

If you have pre-existing diabetes or have been diagnosed with gestational diabetes, then physical activity can help you to manage your blood glucose levels and prevent excessive weight gain. Staying active also helps to improve your mood by releasing natural ‘feel good’ hormones. Weirdly, while being more active might feel like the last thing you want to do when you’re feeling exhausted from growing a new human, it really can give your energy levels a boost.

We also know that staying active helps to reduce the risk of pregnancy complications like gestational diabetes and pre-eclampsia. And, thinking ahead, targeted pelvic floor exercises can also help to reduce your risk of incontinence and prolapse postpregnancy.

What types of activity are recommended?

Start by choosing an activity you enjoy. That way, chances are you’ll stick with it and it won’t feel like too much of a chore. The sorts of physical activity recommended for pregnant women are the same as those for everyone else. It’s a good idea to include both aerobic and anaerobic activities in your exercise regime.

Aerobic activities – such as walking, swimming, riding a stationary bike or dancing – involve most of the body moving and increase the fitness of your heart and lungs. It’s safest to avoid activities with a risk of falls such as cycling, team sports or horse riding. Some women may be able to continue running if they ran before pregnancy, but best to check with your health care team.

Anaerobic activities – using machine weights, free weights, dumbbells or body weight – aim to increase muscle strength and come in handy when carrying around a newborn or getting the pram out of the car.

How much should I aim for?

Pregnant women should exercise just as much as non-pregnant women. This means being active most days, preferably every day, to a weekly total of either:

2.5 to 5 hours of moderate intensity physical activity (your body will tell you that you are working, but you will still be able to hold a conversation at this intensity)

1.25 to 2.5 hours of vigorous intensity physical activity (evidence suggests it is safe for women who were exercising vigorously before pregnancy to continue to exercise at this intensity, as long as they listen to their body and adapt activities when needed)

an equivalent combination of moderate and vigorous activities

do muscle strengthening activities at least two days each week, such as light resistance training or bodyweight exercises.

Remember that doing any physical activity is better than doing none. It doesn’t matter how much you are doing now – start by doing some, then slowly build up to the recommended amount.

How do I make sure I am exercising safely?

Here are some tips to make sure you and your bub remain safe: include a gradual warm-up and a cool-down avoid exercising in high temperatures and humidity, stay hydrated and wear loose-fitting clothing avoid activities with the possibility of falling or where there is a risk of impact trauma to the abdomen perform regular exercises to strengthen the pelvic floor muscles and avoid activities that add extra load to the pelvic floor (jumping, lifting very heavy weights and holding your breath while doing so) avoid activities lying on your back after the first trimester, as this can reduce blood flow to bub take care with weight-bearing exercise and activities involving frequent changes in direction due to increased risk of injury and changes in balance.

I have diabetes, is there anything I need to consider?

This will depend on the type of diabetes and how it is usually managed. Continuing to monitor your blood glucose levels can help you learn how physical activity affects your blood glucose levels. Be aware of the signs and symptoms of low and high blood glucose levels.

When is physical activity not safe?

There may be some pregnancy complications that will mean physical activity is not safe and medical guidance is needed. If you are experiencing any complications or worrying symptoms, we recommend you stop and talk to your health care team.

WORKSHOPS

DESMOND

For people living with type 2 diabetes. The DESMOND (Diabetes Education and Self Management for Ongoing and Newly Diagnosed) program provides you with a welcoming and non-judgmental space where you can plan how you would like to manage your diabetes.

DATES LOCATION

10/11/22 Midland

25/10/22 & 23/11/22 Armadale

4/10/22 & 30/11/22 Mirrabooka

12/10/22 & 2/11/22 Warwick

14/10/22 Cockburn

15/11/22 Heathridge

1/11/22, 21/11/22, 1/12/22 & 6/12/22 Scarborough

19/10/22 Subiaco

20/10/22 Melville

8/12/22 Rockingham

01/10/22 & 19/11/22 Bentley

SOUTH WEST REGION

11/10/22 & 6/12/22 Bunbury

30/11/22 Busselton

MID WEST REGION

5/10/2022 Geraldton

18/11/2022 Northampton

WHEATBELT REGION

8/11/22 & 6/12/22 Northam

GREAT SOUTHERN REGION

23/11/2022 Albany

PILBARA REGION

9/11/2022 South Hedland

CarbSmart

For people living with type 1 diabetes, type 2 diabetes or gestational diabetes. CarbSmart will help you enjoy quality carbohydrates in a way that suits you and your diabetes.

DATES LOCATION

31/10/22  Midland

5/10/22 Armadale

7/11/22 Heathridge

28/11/22 Scarborough 18/10/22 Subiaco

2/12/22 Melville

16/11/22 Rockingham

9/11/22 Mandurah

SOUTH WEST REGION

8/11/2022 Bunbury

7/12/2022 Busselton

MID WEST REGION

4/11/2022 Geraldton

GREAT SOUTHERN REGION 28/10/2022 Albany

Diabetes WA Webinars

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 Teams, with new sessions added regularly.

Scan the QR code to book into a webinar

FootSmart

For people living with type 1 diabetes or type 2 diabetes. Living with diabetes means living with an increased risk

FootSmart

DATES LOCATION

31/10/22 Midland

7/11/22 Heathridge

28/11/22 Scarborough

18/10/22 Subiaco

2/12/22  Melville

16/11/22 Rockingham

GREAT SOUTHERN REGION

28/10/2022 Albany DATES LOCATION

Ready set go - let’s move

For people living with type 1 diabetes or type 2 diabetes. Get support and be empowered to take the first step in making exercise a part of your routine, or perhaps increasing the amount you are already doing.

ShopSmart

For people living with type 1 diabetes, type 2 diabetes or gestational diabetes. ShopSmart will help you to understand how to read food labels, and what to look for when choosing healthy options for yourself and your family.

DATES

24/11/22

5/10/22

5/12/22

14/11/22

LOCATION

Midland

Armadale

Warwick

Cockburn

11/10/22  Scarborough

26/10/22

8/11/22

Melville

Rockingham

9/11/22  Mandurah

SOUTH WEST REGION

8/11/2022 Bunbury

19/10/2022 Busselton

MID WEST REGION

28/11/2022 Dongara

GREAT SOUTHERN REGION

7/12/2022 Albany

13/10/22  Midland

Living with insulin

For people living with type 1 diabetes, type 2 diabetes—and who are using insulin. This program will help you understand insulin, the different products and equipment available, and the importance of looking after your blood glucose levels.

DATES LOCATION

9/11/22  Mirrabooka

For more

MedSmart

For people living with type 2 diabetes. Making sense of your medications can be diffi cult but it doesn’t have to be. MedSmart will give you information about your medications, how they work, how to take them and how they help manage your diabetes.

DATES

24/11/22

5/12/22

14/11/22

LOCATION

Midland

Warwick

Cockburn

11/10/22  Scarborough

26/10/22

Melville

8/11/22  Rockingham

SOUTH WEST REGION

16/11/2022 Busselton

MID WEST REGION

4/11/2022 Geraldton

28/11/2022 Dongara

GREAT SOUTHERN REGION

7/12/2022 Albany

NOTICE OF ANNUAL GENERAL MEETING

Notice is given that an Annual General Meeting of the members of Diabetes WA Ltd (Diabetes WA) will be held at Diabetes WA, Level 3, 322 Hay Street, Subiaco, on 23rd November 2022 at 5.30pm (AWST).

AGENDA

• Attendance & Apologies

• Confirmation of Previous General Meeting Minutes

• Financial Statements & Director’s Reports

• To receive and consider the financial report, the directors’ report and the auditors’ report for the financial year ended 30 June 2022.

• Retiring Directors

• Other Business

To register your attendance, call 1300 001 880, or email AGM@diabeteswa.com.au by 21st November 2022.

By order of the Board:

Nicola Clerk Company Secretary 25 August 2022

THE ULTIMATE CHALLENGE

Over the past 35 years, the Leeuwin Ocean Adventure Foundation has offered a unique sailing experience to more than 40,000 young people from across Australia. Our oldfashioned vessel offers hands-on, sailing experiences at sea that allow adventurous Aussies aged 14-25 to get active, try something different, meet new friends and develop skills that will serve them well in the future.

We run a range of different voyages, including our Ultimate Challenge, which caters for young people living with a chronic condition such as physical or intellectual disability. We’ve also welcomed a large number of young people with type 1 diabetes onto our voyages. Over the years, we have watched the extraordinary change in technology to support our voyage trainees with type 1, but we still do require a doctor or specialist diabetic nurse to sail with us every time.

What do the voyages involve?

Our voyages are action packed –sailing a tall ship is about working together to get all the jobs done including hauling on lines to set the sails, climbing in the rigging, taking the helm and standing watch in the middle of the night. All voyage trainees are encouraged to get involved in all aspects of ship operations, push their boundaries and take advantage of this unique opportunity to build on existing skills and develop some new ones.

Why should youth with type 1 diabetes be encouraged to take part?

STS Leeuwin II was purpose built in Western Australia for youth adventure training and development. It is Western Australia’s only tall ship and Australia’s largest sail training vessel, so coming on board is a unique experience. We aim to build resilience, tolerance, accountability, respect, problemsolving skills and an understanding of the qualities of good teamwork and leadership. We want to build courage and confidence in young people to face the challenges of their futures, whatever career they want to pursue, wherever they want to go. Our feedback from participants and their parents and research that has been conducted by us and by other sail training vessels around the world is that this is exactly what is achieved.

Of course, it’s always a case of the more you put in, the more you get

out – but we rarely have “passengers”. Once on board, young people embrace the unique environment and throw themselves into the tasks, the challenges and the adventure.

What special considerations are necessary for voyagers with type 1?

Because there may be some seasickness, and routines are different, it is vital that voyagers with type 1 diabetes are open and honest about their health outcomes. On board a ship, perhaps 24 hours away from the land, this is no time for bravery.

What sort of feedback have you received from past participants?

We gather all sorts of feedback from participants – and it is overwhelmingly positive! They tell us it was lifechanging, that they didn’t think they could do all those things, that they found courage they didn’t know they had, and that they didn’t know they could make new friends so easily. It’s wonderful to hear.

What Leeuwin Ocean Adventure gives participants is an intense, compact outdoor adventure-based experience – we’ve been recognised internationally for our work. The youth of Western Australia are incredibly fortunate to continue to have access to this extraordinary asset right here in Fremantle, sailing from Albany to Dampier each year.

Leeuwin Ocean Adventure gives young Australians living with type 1 diabetes a chance to discover hidden talents, push their boundaries and make new friends, says CEO CAROL SHANNON

We want to build courage and confidence in young people to face the challenges of their futures, whatever career they want to pursue, wherever they want to go.

EXERCISING

ON A BUDGET

The way we live today means it can be harder to get moving. Our jobs tend to keep us standing or sitting still and we’re increasingly reliant on cars to get us from one far-flung spot to another. Compared to past generations, we’re less likely to keep fit simply by living our lives. For some, the solution is to sign up to the local gym (or pool or pilates studio). These can be great places to exercise, but they can be too expensive or simply inaccessible for many people. Don’t despair – there are a growing number of free or low-cost activity options popping up!

Free outdoor gyms

For those who want to get into strength training without the commitment and cost of signing up to a gym, check out freeoutdoorfitness.net. You can search for free outdoor gyms in your local area as well as local Park Runs (more on those later). The website also has some really useful articles on various topics from how to use equipment at your local park to free exercise programs.

Although it can be easy to get caught up in the hype of exercise fads (and pay a bomb in the process), there are plenty of low-cost activities that will keep you fit, healthy and social, writes MARIAN BRENNAN.

Park Run (or walk)

Park Runs are 5km events for walkers and runners (and their furry friends) that give people an excuse to get out in their local park or reserve every Saturday. They’re a great way to socialise and exercise at the same time and, if you’re looking for some motivation, Park Run will time you, so you can work on beating your personal best! With events organised all over the place, you’re unlikely to need to travel far to find one and they can be a great thing to do while travelling! www.parkrun.com.au

If the idea of a 5km run seems overwhelming, the Couch to 5k is a great program to help you get started (even if you’ve never run before).

Get running with Couch to 5KNHS (www.nhs.uk)

Tap into your competitive side

If you’re getting tired of your regular exercise routines, change it up with a game at your local tennis courts. There are many low cost or free tennis courts maintained by local councils that are just waiting for the next Federer or Williams to come along! Just search your local council website for courts near you.

Going solo? No probs. Many parks have tennis walls that you can practice against. If tennis isn’t your thing, why not pull out the basketball and shoot a few at your local ring? If you’re anything like me, you might have forgotten how fun these activities can be.

Step it up

Looking to increase the intensity a bit? Stairs are a great, free tool to get you working harder. Stairs are not something you would necessarily do every day but can be included 2-3

The good thing about working out at a higher intensity is that you don’t need to do it for as long to gain the same benefits.

times per week on days when you want a more intense workout. The good thing about working out at a higher intensity is that you don’t need to do it for as long to gain the same benefits. You can also find stairs just about anywhere, making it an activity that’s easy to fit into a busy work day. You may even have some stairs in your own home! If you’re after stairs with a view, check out:

• Jacob’s Ladder at the base of Kings Park

• Whitfords Nodes Health and Wellbeing Park

• DNA tower in Kings Park

• Craigie Leisure Centre stairs

• Manning Park stairs in Spearwood Apps and websites

Phone apps and websites can be a great – and often free – way to access new exercise ideas. Some will also allow you to track your progress which can really help with motivation.

• Daily Yoga

• FitOn

• Nike Training Club

• 7 minute workout

• Exercise Right at Home www.exerciseright.com.au/ homeworkouts

Walking groups:

Enjoy walking but sick of your own company? Walking groups are a great way to meet new people, explore new places, and stay motivated to exercise. There are plenty of free or low-cost options out there.

• Heart Foundation walking groups www.walking.heartfoundation .org.au/walking

• The Hike Collective www.hikecollective.com.au

• Western Walking Club www.westernwalkers.com.au

Jump onto social media and look up local community walking groups in your area.

HEALTHY EATING ON A BUDGET

NARELLE LAMPARD offers a few suggestions to ease the pain of grocery bills while continuing to eat a healthy, balanced diet.

Living expenses have been rising rapidly over the past year. Housing costs, fuel prices, energy bills and the amount we spend at the supermarket have all increased.

Even if your food budget is limited, you should still be able to eat a healthy diet to help manage your diabetes. Why not stretch your dollar further at the checkout while continuing to enjoy eating plenty of healthy meals? Here are a few tips.

Cook at home

Cutting down on take-away foods or eating out can make a big difference to your budget. Prepare your own meals and snacks. If you have to work away from home, bring a packed lunch. When cooking at home, try substituting cheaper ingredients and cooking bulk – you can always freeze what you don’t use straightaway.

Eating is often a social activity, but you could try arranging get-togethers that

aren’t around a café table. Catch up with friends for a walk in the park or along the beach, instead of meeting them at a restaurant.

Make a weekly plan

Planning your meals and snacks for the week can also ease the strain on your wallet. Checking what food you already have in your fridge, freezer and pantry is a good start and it might help to get into a food shopping routine, for example once a week on a set day, rather than just rushing out to the shops to grab ingredients when needed. Avoiding the last-minute dash to the shops before dinner can stop you spending cash on things you don’t need.

Be a wise shopper

Everyone know it’s easier to spend money on groceries if you shop when you are hungry. To resist impulse purchases, write a shopping list and stick to it! Online ordering can also help

here, as you’ll tend only to search for things you want, without being exposed to other temptations. Look for specials – check the junk mail or websites –and don’t be afraid to buy generic or home brand items. There’s often little difference in quality.

Other cheaper options include marked down items or items approaching their best before date. You could also try the discounted imperfect or flawed fruits and vegetables.

Make sure to check out the unit pricing to find the cheapest option – compare price per kilo or per 100g – and remember than buying items in bulk generally works out cheaper. Also remember that items at eye level will be more expensive, so look at the bottom and top shelves. Avoid taking kids and family members who might nag you to buy foods you don’t need.

Speaking of needs, try to spend most of your money on the five main food groups and limit discretionary foods or treats (see table opposite).

Make budget friendly and healthy food choices

You don’t have to choose between being budget-conscious and health-focussed. Buying vegetables and fruits that are in season is an easy way to ensure you’re getting food that is fresh and (being plentiful) and affordable. But buying fresh isn’t the only way to eat healthily – frozen or canned vegies and fruit can be just as nutritious and often cheaper. You can also try using frozen canned fish (tuna, salmon, sardines).

Cutting down on meat can be good for your health and your wallet,

GROCERY SHOPPING Food Budgeting Guidelines

PERCENTAGE OF FOOD BUDGET FOR EVERY $100 FOOD GROUPS EXAMPLES

Plant based foods

Fruit and vegetables– fresh, frozen, canned, dried. Legumes (lentils, chickpeas, split peas, beans) – dried or canned.

Multigrain bread/wraps/crackers.

Oats and high-fibre cereals. Brown basmati rice, pasta, noodles. Barley, quinoa, bulgur, buckwheat.

Lean meat – beef, lamb, pork. Fish and seafood.

30%

Protein foods

Chicken and eggs. Milk, cheese and yoghurt. Nuts, seeds, tofu and soy products.

Discretionary foods

Biscuits, cakes, ice cream, desserts. Chips, lollies, chocolate. Sugary drinks, juices, flavoured milks. Pies, sausage rolls, pastries.

(Reference: LiveLighter - The 60/30/10 rule for grocery shopping)

so experiment with using legumes instead of meat and try using eggs as a cheaper protein source. If you’re a dedicated carnivore, use cheaper cuts of meat for casseroles, stews, curries and soups.

Avoid pre-prepared foods such as grated cheese and pre-cut vegetables – they often involve more processing and packaging and are always more expensive. Substituting tap water, tea and coffee for canned and bottled drinks can help reduce spending and sugar-intake. Finally, use wholemeal, multigrain and brown versions of bread, crackers, rice and pasta. They’re usually better for you but no more costly.

Reduce food wastage

Checking what you already have in your fridge, freezer and pantry to use can help cut down on waste, as can saving leftovers to use in the next

couple of days. Making a regular inventory and keeping an eye on the use by and best before dates will also help – remember you can use the older vegetables in your fridge to make a soup.

Other ways to cut down on waste include cutting back on individually pre-packaged snacks such as chips, muesli bars and ice-creams. And don’t forget that limiting portion sizes can be good for you waist and your budget!

Keep it local

Looking for local WA-grown produce can be a good way of avoiding a hefty price-tag, particularly if you check out your local farmers markets. You could also share produce with friends, family and neighbours to spread costs around and buy in bulk. If you have a garden (or even just a bit of outdoor space), you could try growing your own fruit, vegetables and herbs.

Don’t go hungry

Eating well and good nutrition are important for your overall health and being able to manage diabetes. Seek assistance if you need it. Call the Foodbank WA on 9258 9277 or Emergency Relief and Food Access Service on 1800 979 777.

HELPFUL WEBSITES:

Prep: 5 mins

Cook: 30 mins

Serves: 2 (as a main)

2 tsp olive oil

6 (120g) Woolworths Beef &veg Meatballs

1 small brown onion, finely chopped

1 large clove garlic, finely chopped

1 Tbsp Fountain reduced sugar tomato sauce

1 x 400g can no added salt chopped tomatoes

1/2 bunch of basil, finely chopped, plus a few whole leaves, to serve

200ml water

110g dried spaghetti or glutenfree spaghetti

Freshly ground black pepper

ONE-PAN SPAGHETTI & MEATBALLS

1 Heat the oil in a medium non-stick saucepan over medium-high heat. Add the meatballs and cook, stirring often, for 5 minutes or until browned all over. Add the onion and garlic. Reduce heat to medium and cook, stirring often, for 7-8 minutes or until the onion softens.

2 Add the tomato sauce, tomatoes, chopped basil and water to the pan. Cover and bring to the boil over high heat. Add the spaghetti and reduce heat to medium-high. Cook for 10-12 minutes, stirring occasionally, or until the pasta is cooked and the sauce has reduced.

3 Season the spaghetti with pepper and sprinkle with whole basil leaves. Serve.

Nutritional Information

PER SERVE 1780kJ (425Cal), protein 20g, total fat 12g (sat. fat 4g), carbs 55g, fibre 7g, sodium 332mg • Carb exchanges 3½ • GI estimate low • Gluten-free option

LOWER-CARB OPTION:

Replace the spaghetti with 110g Slendier Soy Bean Spaghetti. In step 2, simmer the sauce for 5 minutes before adding the Slendier spaghetti, reduce heat to medium-high and cook a further 5 minutes or until the spaghetti is cooked and the sauce has reduced.

Nutritional Information

PER SERVE 1240kJ (296Cal), protein 21g, total fat 13g (sat. fat 4g), carbs 19g, fibre 10g, sodium 333mg • Carb exchanges 1½ • GI estimate low • Gluten free • Lower carb

ONE-POT CREAMY LEMON & SPINACH RAVIOLI

Prep: 5 mins

Cook: 15 mins

Serves: 2 (as a main)

250g meat-based ravioli or gluten-free ravioli

110g (2/3 cup) frozen peas

100g baby spinach leaves, chopped

125ml (1/2 cup) hot salt-reduced vegetable stock or gluten-free stock

80ml (1/3 cup) boiling water

4 Tbsp reduced-fat ricotta

Zest and juice of 1 lemon

40g (1/2 cup) finely grated parmesan

Freshly ground black pepper

1 Preheat oven to 180°C (fan-forced).

Put the ravioli in an ovenproof dish. Sprinkle over the peas and spinach.

2 Whisk the stock, water, ricotta, lemon zest and juice and half the parmesan in a bowl. Season with pepper. Pour the mixture over the ravioli. Cover with foil and bake for 10 minutes.

3 Remove the foil and sprinkle with the remaining parmesan. Bake for 5 minutes. Serve.

Nutritional Information

PER SERVE 1590kJ (380Cal), protein 23g, total fat 13g (sat. fat 7g), carbs 36g, fibre 9g, sodium 997mg • Carb exchanges 2½ • GI estimate low • Gluten-free option

FACT OR FICTION

RECIPES

GETTING BACK TOGETHER

August was a big month for us. For the past couple of years, we’ve been working hard on our Aboriginal Health Worker Development project, in which we’ve been training up Aboriginal health professionals to lead our DESY (Diabetes Education and SelfManagement Yarning) workshops in Communities across the state. The pandemic threw a whole bunch of spanners in the works, but our first trainees are finally ready to get out there and get educating.

They were a bit nervous before the first sessions, so I did a bit of mentoring and helped them go through everything beforehand. I also made sure I was there for the first one to hold their hand a little bit. They did an awesome job, of course. After all the prep we’ve put in, I look forward to seeing them fly as they take on a pretty packed calendar over the next couple of months!

This project is so important, as we know that Aboriginal health workers have great success in connecting with people living in remote Communities, particularly when they’re delivering a culturally safe program like DESY. These health workers know the culture, they know those Communities, and they know how to communicate

vital information about diabetes in most effective and helpful way. It’s really exciting to see all the hard work we’ve put in finally pay off!

I know how important it is to be able to connect with the people you’re helping. Lately, I’ve been enjoying being able to lead a few face-to-face sessions again myself, now that we’re all able to be back in the same room. I’ve been doing regular Feltman sessions at Ngulla Mia, which is a Richmond Wellbeing Centre. One of our diabetes educators, Nyaree Lawler, comes in with me and we let people talk about diabetes and see if they’ve got any questions. I’ll start off with a Feltman — which gives you a basic introduction to what diabetes is and how it affects you — and then Nyaree comes in and talks about more specific things, like our Smarts programs. She’ll talk about carbs, and portion control, and about good fats and bad fats. We get the attendees to interact and tell us what they think is a good sized meal. We just have a yarn about it all.

When we’re there, we’re very mindful that a lot of attendees are on medication, some of them are tired, and some of them are have mental health issues. We try to just go with the flow and let them come and go as they

need to. We’ve been going there since last year, but they’re used to Nyaree and me now. When we first started, they would often just stare at us while we talked. Now they’re really happy to ask questions. It’s been great to be able to build that rapport — something that was harder to do when we could only run virtual sessions. I think it’s particularly important to be in the same room when you’re working with Indigenous people. I don’t want to generalise, but I do find that they like more face-to-face stuff and hands on stuff.

Speaking of face-to-face, I was so glad this year’s NAIDOC celebrations went ahead as planned. One event I particularly enjoyed was the Perth NAIDOC Netball Carnival — one of four that was run across the state. It was a great day. Those carnivals can give a real leg up to Aboriginal and Torres Strait Islander netballers and introduce them to competitive netball, as well helping them learn more about the history, culture, and achievements of Aboriginal and Torres Strait Islander peoples. They get to know who the Elders are for this area and maybe it teaches tem a bit of respect.

I also think it’s great to see kids from remote areas getting to meet each

After a couple of years of being apart,

great to be out there getting active and meeting up again, writes KATHY LEMON

It’s great to see so many Aboriginal kids out there on the court, getting active.

other — and to experience a bit of the big smoke! Some of them might have never have been to a city before, so it can be a real eye opener.

We also helped out at the Multicultural Netball Carnival in August, which is an annual school-based competition hosted by Netball WA. It brings together players from a wide variety of ethnicities and has a strong focus on First Nations people.

It’s great to see so many Aboriginal kids out there on the court, getting active. I was never much of a netballer myself – I preferred basketball! – but we know how important regular exercise is for health and the sooner we get kids used to being active, the more likely it’ll become a habit later in life.

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STAYING IN THIS SPRING

If you like mystery, fantasy or timeless music, MYKE BARTLETT has something for you.

drawn into the murky world of social media. It’s a ripping read and Rowling again proves herself to be a first class crime writer, with an eye for social issues that can make some quarters uncomfortable.

Books

It’s a bumper month for fans of detective fiction. Top of the pile is the delightful new page turner from Richard Osman, The Bullet That Missed. This is the third in the series that began with The Thursday Murder Club, in which the residents at a retirement village set out to solve cold cases that have a habit of getting very hot very fast. The real hero is Elizabeth, a retired spook whose plans and investigations are generally as fiendish as the villains she and her fellow retirees bring to justice. In the latest book, she faces a foe from the past who intends to finish her off once and for

all. It’s rare for a crime book to be this much fun and, while the mysteries are increasingly far-fetched, it’s impossible not to delight in how witty and twisty the whole adventure is.

Bottom of the pile (if only for reasons of weight) is The Ink Black Heart by Robert Galbraith (AKA JK Rowling). This is another instalment in his (or her) Strike series, in which a pair of modern London private eyes solve baroque and sometimes gruesome murders. In this, a web cartoonist seeks help from our heroes after being persecuted by an anonymous online troll. When she turns up dead a few days later, the detectives are

Closer to home, the arrival of a new Jane Harper (author of The Dry) is always cause for excitement. Exiles is the third and final adventure for federal investigator Aaron Falk, whose investigations have taken him to different extremes of the Australian landscape. We’ve had unrelenting rural heat, the wintery chill of the mountains and, now, the lush valleys of wine country. As always, Harper writes with a journalist’s eye for frank detail, a gift for atmosphere and a clear sympathy for her flawed characters.

If you’re after something free of murder, consider Peggy Frew’s Wildflowers – a stunning portrait of the complicated bonds that develop between sisters – or The Girl Who Fell From The Sky, Emma Carey’s incredible and inspirational true story about falling 14,000 feet and surviving, and what came next as she adjusted to life as a paraplegic.

TV

If dragons, orcs and elves are your bag, then you’re in luck. Tolkien fans the world over have been holding their breath (and polishing their rings) in preparation for The Lord of the Rings: Rings of Power (Amazon Prime). Based on the books that haven’t already been turned into blockbuster films, the series takes us back in time a couple of thousand years to the dawn of the Second Age. Which possibly means something to you if you’re a devotee of Middle Earth. Stuffed with top notch British thespians and laced with stunning visuals, the show is thought to be the most expensive TV series ever made.

Also packed with British talent and also backwards-looking is Game of Thrones: House of the Dragon (BINGE). This spin off from the fantasy series of the twenty-first century, is set

Music

two hundred years before Ned Stark and his clan. It’s good news for wig-makers, as the prequel concerns the House of Targaryen, who are as famous for their platinum blond locks as they are their dragon collection. While just as gruesome as the original, there’s a sense that show has a bit more maturity than its predecessor, content to dwell on character interplay instead of brutal action sequences.

If you prefer something weirder, Neil Gaiman’s The Sandman (Netflix) has all the makings of a cult classic. Based on a series of comics, the show follows Dream (a close relation of Death) as he attempts to restore the magical realm of The Dreaming after being imprisoned by occultists for a hundred years or so. It’s strange and seductive stuff, if a little meandering.

Riding on the coattails of the recent Beatles TV series, Paul McCartney’s Get Back (ViaVision) arrives on blu-ray met by a new wave of affection for the songsmith. Hailing from 1991, this film intercuts flashes of backstage action with footage from McCartney’s world tour of the previous year. Being his first tour in more than a decade, the set list was packed with all the hits, making this a live show well worth revisiting in this new scrubbed-up, high-definition form.

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LEFT: The Lord of the Rings: Rings of Power RIGHT: The Sandman

BACK IN TRAINING

A shock diagnosis was all the motivation GILLIAN WILSON needed to get active again.

I never really visited the doctor’s a lot. I didn’t feel like I needed to. But I started to get really weird sensations in my feet which just didn’t seem right. So I went and had a blood test and found out that my blood sugars were through the roof. I just thought, what the hell?

It was totally out of the blue, although I did have gestational diabetes 28 years ago. I was in shock, but the doctor who diagnosed me didn’t seem that alarmed about it. Because of that, I didn’t actually take it seriously. Two weeks later, I went to see a diabetic educator. She tested my blood and said, ‘Oh, this isn’t good.’ She couldn’t get a reading, which meant it was super high. When she finally managed to get one, my sugar was level was 29. I could tell from her distress that it wasn’t good.

She rushed me in to see a doctor who put me on insulin straightaway. She said I needed to start that night. It hadn’t all really sunk in until then, but now it hit me like a tonne of bricks.

I got a script and hurried down to

the chemist – it was around 6.30 in the evening by then – and I was just staring there, dazed. The chemist came back with this whole swag of stuff. I couldn’t believe it was all for me.

The diabetic educator had told me to wait for two hours after I’d had my meal to check my blood glucose, but because I was in such a daze I didn’t end up cooking dinner till nine o’clock. I had to stay up till 11.00 and I was so tired. If it hadn’t been for that educator being so clear about what I had to do –starting that night – I would have just gone to bed anyway. But I stayed up and got the whole regime going.

The next day at work, we had someone leaving, so I walked into my office and it was full of cakes and muffins. I walked in and almost panicked. I made the sign of the cross to get it away from me. But it probably took another two or three weeks to settle into a routine.

I stopped drinking alcohol and cut out all the processed foods. I probably saved a lot of money that Christmas. Once the dust had settled, I realised it’s something I can control. I realised

it wasn’t just about the diet, but about the exercise too. I’d do my finger pricks, exercise and check again and I could see the difference it made.

I wasn’t as active as I had been in the past. Things get in the way. I’ve got three grandkids and a husband who needs looking after. So I did need to get back into exercise, especially weights.

I’m doing weights a few times a week and I work with one of the personal trainers at VenuesWest. That really helps. She keeps me going when I can’t be bothered. Her name’s Lynn and she’s just relentless. She’ll call me up and ask me when I’m coming in. That was really helpful in the beginning.

I’m actually an experienced trainer myself. But I still feel like I need someone to think about it for me.

I know it’ll be the same for a lot of people out there. People have no clue where to even begin. But if you find a personal trainer, someone with all that knowledge, they’ll help you get going.

Even if you just work with a trainer for three to six months, just to get you started, it’ll make it all seem possible and help get you in the routine.

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