Managing Diabetes - Ireland - Sep 2019

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Managing Diabetes HEALTHNEWS.IE

In July this year, a team of eleven players, all living with diabetes, travelled to Ukraine to represent their country at the 2019 ‘Diabetes Euro Futsal’ Championship to demonstrate that having diabetes does not stop people having an active and full life, and that includes playing high intensity sport. Teams from seven countries across Europe competed, with the Republic of Ireland having a team in the Championship for the first time.

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Plans are already in motion for the 2020 championships. For more information, contact Cathal via www.facebook.com/DiaEuroIreland

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IN THIS ISSUE

EOGHAN QUINN How fitness and technology is changing diabetes. » p4-5

PROF NAM H. CHO Four-in-five adults failed to correctly identify the warning signs of diabetes. » p6

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ANNE DALY What does it take to stay healthy with diabetes? » ONLINE © IVANKO_BRNJAKOVIC

Type 2 diabetes is increasing in prevalence because of people’s lifestyles There are two distinct types of diabetes with a common dominator – raised blood glucose levels.

T

o d ay, t h e m aj o r i t y o f us k now someone w ith diabetes. There are currently 225,000 people with diabetes in Ireland and with the prevalence of diabetes steadily increasing, we are going to see more and more people developing diabetes with an estimated 280,000 Irish people living with diabetes by 2030.

This is due largely to the number of adults who are overweight and not taking the recommended 150 minutes of physical activity in a week, therefore increasing their chances of developing T ype 2 diabetes in the future.

A 2015 survey from Healthy Ireland showed that 37% of adults

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A 2015 survey from Healthy Ireland showed that 37% of adults are overweight and 23% are obese... There is currently no known cause or cure and Type 1 is a lifelong condition.” are overweight and 23% are obese.

We are seeing an increase in diagnosis of Type 2 diabetes as a direct result of these unhealthy lifestyle behaviours.

What is diabetes?

Diabetes occurs when the body cannot use glucose (sugar). Type 1 diabetes is the result of complete

failure of insulin production and therefore insulin must be given as an injection. There is currently no known cause or cure and Type 1 is a lifelong condition.

Type 2 diabetes is the result of over-demand of the body for insulin or reduced insulin production. Healthy eating and increased activity is the mainline treatment, with medications and sometimes insulin injections required.

Being overweight or inactive contribute to insulin demand while carrying weight around the middle is particularly dangerous, hence major weight loss may prevent and even reverse Type 2 diabetes.

KIERAN O’LEARY CEO, Diabetes Ireland How Diabetes Ireland is supporting those affected by diabetes Diabetes Ireland is the national charity supporting people with – and at risk of developing – diabetes, working to actively improve access to care, support, education and information services. It supports people with diabetes and their families through a wide range of services including face-to-face contact, literature provision, a diabetes ‘lo-call’ helpline and online.

Th r o u g h it s c a r e c e nt r e s , Community Diabetes Education (CODE) programme and volunteer support network, it also provides community-based professional

education and peer group support to people with diabetes and their families throughout Ireland.

If you have diabetes or think you may be at risk of developing Type 2 diabetes, visit www.diabetes.ie or contact Diabetes Ireland on 01 8428118.

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The game-changing research for diabetes treatment AN INDEPENDENT SUPPLEMENT BY MEDIAPLANET

Genomics research could offer a significant healthcare breakthrough — namely more targeted, personalised treatments for patients with Type 1, Type 2 or rare forms of diabetes.

MICHAEL HIGGINS Clinical Programme Manager, Genomics Medicine Ireland

C

urrently, if you’re diagnosed with diabetes, you’ll be given a ‘one-size-fits-all’ treatment, which isn’t necessarily the best way to manage such a complex disease.

However, genomic research offers the possibility of more targeted, personalised, precision treatments that promise better patient outcomes.

This can’t come too soon. With rates soaring, there’s an urgent need to find new therapeutics that can treat all forms of diabetes more effectively.

Michael Higgins is Clinical Programme Manager at research company, Genomics Medicine Ireland (GMI), which was established in 2015 with the aim of building a world-class disease specific genomic database.

This will include data from

400,000 volunteers in Ireland from both ‘healthy’ participants and patients with up to 60 different diseases (including diabetes). This is one of the largest genomics studies in the world.

Understanding diabetes and identifying new drugs “Genomics is the large scale study of all our genes and their functions,” he explains. “Our genes contain sequences of DNA in our cells that act as the blueprint for every human being, controlling everything from our eye and hair colour to our likelihood of developing a particular disease.

“The hope is that this research will help us understand diabetes in more detail, and potentially identify drug targets for novel therapeutics for Type 1, Type 2 and rare forms of the disease.”

ABBY LANGTRY Director of Patient Advocacy and Community Engagement, Genomics Medicine Ireland

Genomic research offers the possibility of more targeted, personalised, precision treatments that promise better patient outcomes.”

Naturally, this research wouldn’t be possible without patient participation. “We’re very grateful for the people who participate in our studies,” says Abby Langtry, GMI’s Director of Patient Advocacy and Community Engagement.

“We believe that every patient has the right to participate in research of this kind, should they so choose.”

Educating the public about the power of genomics Participating in this research is a simple and st raight for ward process. “If a person (over the age

of 18) is deemed eligible for the study, they will be given a detailed information leaflet explaining how their data will be used, stored and accessed,” says Langtry.

“Once they consent, volunteer participants complete a questionnaire and give research staff permission to access their medical records in order for them to gain an understanding of contributing factors such as medical history and lifestyle. Participants also give a sample of blood — and that’s it.”

Data security is paramount. At GMI, personal identifiers are never used to label samples or clinical information, and data is stored on a platform with the highest GDPRcompliant standards of research and data protection regulations.

Langtry says that more needs to be done to inform people about the potential benefits of genomics.

“Last year, we carried out research

into the understanding of genomics in the Irish general public,” she says.

“The rate (of people who knew about it) was just 6%. So there’s a huge gap.

That’s why we work with patient advocacy groups to explain our studies, which is helping educate people about how genomics could deliver real change to healthcare.”

WRITTEN BY: TONY GREENWAY

Sponsored by

Read more at genomicsmed.ie

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How fitness and technology is changing diabetes Lots of challenges come with a diabetes diagnosis, especially if that diagnosis comes at a young age, but new technological advancements are empowering those with diabetes.

W

hen Eoghan Quinn was just four years old, he was diagnosed with Type 1 diabetes. The dash to the ho s pit a l b e c a me o n e

of his first memories. “I remember the look on my mother’s face, the term, ‘diabetic’ was something completely foreign to us and a steep learning curve awaited,” he says.

It was a diagnosis that was to change how he lived his life, from concentrating in class to sleepovers at friends’ houses. “I can see it must have been incredibly challenging for my parents to put their trust in a youngster when it came to monitoring blood glucose levels.”

EOGHAN QUINN Global Director, Wind and New Energy, Worley Frustrations with the glucose monitoring kit Eoghan had always been diligent as a young child, and found that sport was a great way to burn off energy, reducing the amount of insulin needed. In 2008, Eoghan took on a challenge to cycle from Ireland to Gaza, a gruelling 6,000 km in 40 days. The environment was so extreme that he had used all of his blood glucose measuring strips within

the first half of the challenge. It was these sorts of frustrations with his kit that led Eoghan to embrace the technology advancements that were on the market, which could ultimately empower him to take on new challenges with confidence.

He says: “I’ve always believed that we must embrace it, and so I was quick to get an insulin pump when it was made available. But I like a challenge, and I think it sets an example to other people

PATIENTS CAN DO IT

WITHOUT LANCETS1

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There may never be a cure for Type 1 diabetes, but I believe we will be able to manage it.”

with diabetes that there are no boundaries to this condition.

There may never be a cure for Type 1 diabetes, but I believe we will be able to manage it.”

It was while living in Australia that Eoghan came across a new technology that promised to continuously measure his glucose levels and worked via a simple scan, even when wet or t h rou g h clothing.

I could check my glucose levels out there on the water, out on a run or while in a work meeting.

Eoghan says: “It was life changing for me, suddenly I could go kitesurfing for hours and not worry about getting back to the shore.

With a waterproof phone I could check my glucose levels right then and there on the water.”

He was delighted when a move to Scotland meant that he was now eligible to receive the technology on the NHS. He says: “It allowed me to plan bigger

and better challenges to raise awareness of diabetes. Earlier this summer, I attempted to kitesurf from France to Ireland. But it was the weather, not my medical condition, that stopped me from completing the journey.”

No state funding for this life-changing tech The on ly thing that worries Eoghan is a potential move back to Ireland where the technology is only offered privately. He says: “I had hoped that the complications of diabetes – such as surgery and care – would encourage governments to look at pre-

vention first, but the technology isn’t yet available in Ireland and that surprises me. After all, we need to show everyone, especially children, that with good monitoring diabetes shouldn’t stop us from doing anything.”

Flash glucose monitoring has helped Eoghan to reach the peak of fitness, and also track trends to see just why his blood glucose may be high or low. With his blood glucose monitoring now made easy, the 31-year old will soon be planning his next adventure.

WRITTEN BY: GINA CLARKE

© PUHHHA AND SCULPIES

Welcome to Flash Glucose Monitoring The days of routine glucose testing with lancets, test strips and blood are over2 To find out more, please visit FreeStyleDiabetes.ie

1. Scanning the sensor does not require lancets. 2. A finger prick test using a blood glucose meter is required during times of rapidly changing glucose levels when interstitial fluid glucose levels may not accurately reflect blood glucose levels or if hypoglycaemia or impending hypoglycaemia is reported by the System or when symptoms do not match the System readings.

FreeStyle, Libre, and related brand marks are trademarks of Abbott Diabetes Care, Inc. in various jurisdictions. © 2019 Abbott. ADC-15917 09/19

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Do I need to cut out sugar if I have diabetes?

LORRAINE KELLY Senior Registered Dietitian in Diabetes, Midlands Regional Hospital Portlaoise and Secretary, Diabetes Interest Group, Irish Nutrition and Dietetic Institute

A sugar-free diet is not necessary for managing diabetes. In fact, dietary recommendations for sugar for a person with diabetes are the same as those for the rest of the population.

A

healthy eating plan, as is recommended for the majority of the population, is also recommended for those with diabetes. This eating plan is high in fibre and vegetables, low in saturated fat, and low in free sugars.

Carbohydrates – our fuel source Starchy carbohydrate foods, such as whole grain breads and cereals, potatoes, pasta, rice and noodles, are broken down into glucose (sugar) during digestion, and used by the body for energy. These foods also provide us with essential vitamins, minerals and fibre. Eating moderate amounts of starchy carbohydrates at mealtimes helps regulate blood glucose levels.

Foods containing natural sugars, such as fruit, milk and yoghurts, also provide us with fibre, vitamins and calcium, and are a healthy addition to our eating plan.

Less healthy sugars Free sugars, such as those found in table sugar, honey, syrups, biscuits, cakes and sugar-sweetened drinks, are not essential, and these foods are low in nutrients. It is recommended that we all, whether we have diabetes or not, limit our intake of free sugars to a maximum of 5% of total energy per day. This works out at 25g of free sugars for an average adult eating 2,000 kcals per day.

Sugar content of some common foods: Food

Grams of sugar

1 teaspoon of sugar

4g

3 digestive-type biscuits

7.5g

100g baked beans

5g

40g corn flakes

3g

For those who like the sweet taste, but wish to reduce their sugar intake, artificial sweeteners are safe and can be used instead.

When free sugars are needed Low blood glucose levels (hypoglycaemia or blood glucose less than 4mmol/l) may occur for those on certain diabetes medications. The fastest way to raise low blood glucose is to drink a liquid containing sugar. Fifteen grams of sugar is usually enough for an adult/teen of average build; younger children may need smaller quantities. 200ml of fruit juice or 150 – 200mls full-sugar fizzy drink, will provide approximately 15g of sugar.

Individual dietetic advice Dietary advice from a CORU-registered dietitian is recommended for everybody with diabetes. This can be provided on an individual basis or through structured group education programmes in either primary care or the hospital setting.

Read more at healthnews.ie

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How to help families prevent Type 2 diabetes PROFESSOR NAM H. CHO President, International Diabetes Federation

In Ireland, diabetes accounted for an estimated seven thousand deaths in 2017. Worldwide, the number of diabetes-related deaths was an estimated four million. If more had been done to detect diabetes early and prevent its complications, many of these deaths could have been prevented.

D

iabetes is a growing global epidemic that does not just affect individuals but has an impact on entire families.

O ver 42 5 m i l l ion p e ople a re currently affected by the condition.

It is fair to say that most of us know someone living with diabetes. Today, diabetes represents a concern for every family – from parents of a child with Type 1 diabetes, to people caring for an older family member with complications caused by diabetes.

The impact of this condition is all around us.

Limited awareness of the warning signs of diabetes A lack of knowledge means that spotting the warning signs can be a real problem for families. It is a disturbing trend we are seeing worldwide.

A recent study found that fourin-five adults failed to correctly identify the warning signs of diabetes. The signs can be very mild in Type 2 diabetes, responsible for around 90% of all diabetes cases worldwide, so knowing what

More action is needed to make a healthier diet more appealing. to look out for is vital to ensure prompt diagnosis and treatment.

Half of people currently living with Type 2 are undiagnosed.

The nu mbers a re a la r m i ng but there is much that can be done to reduce the impact of this condition. With early diagnosis and access to appropriate care, it can be managed, and its complications prevented.

Furthermore, the majority of Type 2 diabetes can be prevented through simple lifestyle measures such as regular physical activity and a healthy diet.

The barriers to prevention Lifestyle behaviours commonly associated with urbanisation are fuelling the rise of Type 2 diabetes so interventions and policies that facilitate and encourage individuals and families to make healthy choices are required. It takes

knowledge and resources to help families to live healthier lives.

The sad truth is that many families are unable to afford to adopt a healthy diet as the cheapest food is often the unhealthiest.

In addition, powerful advertising continues to tempt children and adults alike to over-consume foods high in sugar, salt and fat.

More action is needed to make a healthier diet more appealing.

G over n ment s shou ld adopt a health-in-all-policies approach to secure the best possible quality of life for all people potentially at risk of Type 2 diabetes.

We all have a role to play to protect family members from developing Type 2 diabetes and its life-threatening complications.

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Type 1 Diabetes Diagnose it early AN INDEPENDENT SUPPLEMENT BY MEDIAPLANET

Know the Facts...

• an autoimmune condition causing the pancreas to stop making insulin • not caused by eating sugar, being overweight or inactive • not preventable and currently has no cure • one of the most common chronic childhood conditions • managed with insulin injections or insulin pump

Onset is rapid so know the warning signs

In children under the age of 2, symptoms may not be immediately obvious.

If your child is unwell without a definite cause, ask your GP to check for Type 1 diabetes.

Less common symptoms: • Increased hunger • Lack of concentration • Vomiting and abdominal pain • Constipation • Start bed wetting again

For more information on Diabetes www.diabetes.ie Local Helpline 01 8428118 MEDIAPLANET

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Diabetes can be lonely: the power of your peers Diabetes peer support has many benefits including empowering people with diabetes and relieving the burden on our health service, yet it is undervalued as a resource.

L

iving with diabetes can feel like a very lonely place: most of diabetes management is done by the person living with it, outside of a medical setting. When I met other people with diabetes, it was like finding something I never knew was missing!

I had moved to a new town where I knew nobody and within two years, my diabetes was floundering. I was increasingly frustrated with my healthcare service, but I knew if I could find other people with diabetes, I would find information on better services. I helped set up our support group and haven’t looked back since. Our group continues to be a source of information, motivation and inspiration.

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Sharing the best diabetes information and advice We learn so much from sharing practical advice to overcoming the challenges of diabetes; this has been the most valuable information in helping me live well with Type 1 diabetes. We also keep each other up to date on research, technologies and treatments. Finding ot hers who understand what living with diabetes involves often lifts our spirits and encourages us to stay strong.

Health professionals benefit from diabetes peer support Diabetes peer support is beneficial to health professionals also. It’s

I was increasingly frustrated with my healthcare service, but I knew if I could find other people with diabetes, I would find information on better services.” very difficult for any healthcare professional to cover absolutely all the information that a person with diabetes needs to know; they also don’t have the lived experience knowledge. Diabetes peer support fills those gaps and often, by the time a new treatment is offered in clinic, the patient is already informed about it, thus saving time for our healthcare professionals.

GRÁINNE FLYNN Person With Diabetes, Diabetes Advocate and Blogger

Medical Futurist, Dr Bertalan Mesko, says: “Empowered patients empower health professionals,” and evidence of this is growing: research published in 2018 on the Effect of Diabetes Online C om mu n it y E n g a g e me nt on Health concluded that people with diabetes who are engaged with support groups improve their quality of life and improve health outcomes, which decreases hospitalisations, inpatient days, and reduces the overall cost for health services.

The impact of social media on peer support groups It’s never been easier to find diabetes peer support with social

media. An online search or using diabetes hashtags like #IreDOC (on Twitter) will send you in the right direction.

Diabetes peer support is the most under-valued, under-used resource we have, and I’d love to see that change.

Read more at healthnews.ie

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