Q2 / 2020 A PROMOTIONAL SUPPLEMENT FROM MEDIAPLANET WHO TAKES SOLE RESPONSIBILITY FOR ITS CONTENTS
MANAGING DIABETES Full campaign on www.healthawareness.co.uk
Muhammad Ali British Boxer “Diabetes is a condition, not an illness; I’m just like any other ordinary person.”
Page 6 Dr Alistair Lumb (PhD FRCP)
Consultant Diabetes/AGM, Oxford University Hospitals NHS Foundation Trust
“…technological advances are making a huge difference now to diabetes management.”
ONLINE Alberto Piaggesi (MD1)
Director, Diabetic Foot Section Department of Medicine, University of Pisa, Italy President European Wound Management Association (EWMA)
“It is estimated that a limb is lost every 30 seconds in the world because of diabetic foot.”
ONLINE
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IN THIS ISSUE
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Shivali spent years battling with feelings of shame and stigma associated with diabetes. A charity challenge helped kick start her weight loss. She says: “I now feel incredibly lucky to have had my daughters watch their mummy change her life.”
Dan Howarth
Head of Care, Diabetes UK
“No two people with diabetes are the same.”
Type 2 diabetes: making changes for good
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Type 2 diabetes has many risk factors, including family history, age and ethnicity. But weight can also be a major contributing factor for some, with those carrying extra weight or with obesity having an increased risk of developing the condition.
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I had to gain independence controlling my diabetes…” Vanessa Haydock (BCBA, MSc, BSc) The Diabetic Health Coach, FreeStyle Libre Ambassador
WRITTEN BY
Dan Howarth Head of Care, Diabetes UK
06 Andrew Boulton
President, International Diabetes Federation
“In the UK, 25% of deaths related to COVID-19 have occurred in people with diabetes.”
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ust like any other type of diabetes, type 2 diabetes is a serious condition, which can lead to devastating consequences such as amputations, eyesight loss, heart attack or stroke However, it doesn’t have to be like this. If managed well, you can live a healthy life and prevent complications. Although no two people with diabetes are the same, adopting a healthier diet, increasing exercise and getting support to lose weight (if needed), and stopping smoking can truly make a difference. It can significantly improve your diabetes management, lower you blood glucose levels and reduce your risk of complications. Find out what works best for you and you only You’re more likely to be successful with lifestyle changes if you find things you can stick to in the long run. Starting with something as small as switching soft drinks for water or cooking more meals from scratch could help create healthier habits. In turn, this may have positive effects on how you’ll then view the bigger shift to a healthier lifestyle and how likely you’ll be to maintain it. Aiming for at least 150 minutes of moderate intensity activity a week will raise your heart rate, make you breathe faster and feel warmer. You should still be able to talk and only be slightly out of breath. And you don’t have to do all 150 minutes in one go. You can break it down into bite-size chunks of 10 minutes throughout the week. If you live with type 2 diabetes and carry extra weight, losing a significant amount of weight could put your condition into remission, as research trials such as DiRECT have shown. This can be life changing. It’s vital, however, that before making any changes, you check in with your
diabetes healthcare team and ensure your new diet is balanced, and that your diabetes medication is adjusted if necessary. A life-long struggle with diabetes with an unexpected surprise Shivali Modha, 38, mum of two, was diagnosed with type 2 diabetes in 2008. Shivali spent years battling with feelings of shame and stigma associated with diabetes, combined with unhealthy eating habits and a lack of physical activity. “For years after my diagnosis I carried on battling with food, battling with life, with having to manage my diabetes and the emotional roller coaster that comes with that – all while working full-time,” Shivali recalls. “My medication was gradually increased, and I was feeling under pressure to deal with my diabetes. However, one day, my father-in-law decided to lose weight to raise money for charity and I decided to join him. It was not easy at all. For years, I had struggled and had flitted between following all sorts of diets, so I was convinced it wouldn’t work and that diabetes was not easy to manage or beat. But I did.” “I started small by adopting the basic rule of having half a plate of salad or vegetables, a quarter plate of protein and a quarter plate of complex carbs at every meal. My life changed in ways I couldn’t imagine, and all the effort paid off. “By eating healthier foods and losing weight, I have put my diabetes into remission. I know this won’t work for everyone and that type 2 diabetes is certainly not always related to lifestyle, but if you’re carrying extra weight, it is worth trying. “I now feel incredibly lucky to have had my daughters watch their mummy change her life and offer that example to them and other young women.”
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Living my best life with type 1 diabetes After a period of denial during her teenage years, Vanessa Haydock, brand ambassador for FreeStyle Libre, says this innovative glucose reader system technology is helping her take control of her type 1 diabetes. Do you remember being diagnosed? Yes, I was diagnosed with type 1 diabetes when I was just three and I remember it so clearly. Before receiving my diagnosis, I remember drinking pints and pints of water and I just couldn’t quench my thirst. I also lost a lot of weight, I was tired and generally did not feel well. I didn’t really understand what was going on back then. What impact did your diagnosis have on you and your family? As a little girl, I didn’t really know any different, so, overall, it had much more of an impact on my mum and dad. They needed to weigh out my food, work out my insulin dosages, administer my insulin, check my blood glucose levels and keep a close eye on me. I remember that my mum even used to come into school every lunchtime break to give me my injections. Back then, as there wasn’t the technology there is now, my mum would have to come into my room several times a night to check my blood glucose levels to make sure they weren’t dropping in my sleep.
check my blood glucose levels – rummaging around in my bag, getting the meter set up, drawing blood from my finger – I just got out of the routine of doing it consistently. Overall, my diabetes management involved a lot of guess work for me back then. How have monitoring tools changed over the years? Until four years ago, I’d only ever used a typical blood glucose meter. Since I was introduced to flash glucose monitoring, I haven’t looked back. I have a sensor on the back of my upper arm that records my glucose levels continuously. I have access to a reader I can swipe over the sensor, as well as an app, meaning I can also swipe my phone over it, which then provides me with a glucose reading. How is technology helping you manage your diabetes? The FreeStyle Libre system has been lifechanging for me. Now I feel more in control of my diabetes than I ever have. There’s a visual graphic display, which makes it so much easier to understand the impact of food, insulin dosages, and activity, which has increased my motivation significantly. My HbA1c level (a measure of an average blood glucose level across a three month period) has improved significantly; I feel healthier and more in control than ever. I am now also more motivated to help and inspire others living with diabetes.
I have a sensor on the back of my upper arm that records my glucose levels continuously.
P H OTO : V R A E P H OTO G R A P H Y
How did you cope with the condition as you grew up? The transition to adolescence was quite hard, as I had to gain independence controlling my diabetes. As a teenager I was a lot more in denial than I was as a child. I just wanted to do what my friends were doing and overall my motivation was very low. For example, it would take time to
YOU CAN DO IT
Would you change anything about your diabetes journey? If I’d had access to a flash glucose technology when I was a teenager, I am sure my diabetes control and motivation would have been completely different. It’s fantastic to see so many adults, teenagers and children able to access them now through the NHS. Now I love showing my sensor off to people and I am not ashamed to do so, advocating for all of those living with type 1 diabetes. I always say that you’ve got to learn to own your diabetes; don’t let it own you.
WITHOUT LANCETS1
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Diabetes and mental health: the side people don’t see Ups and downs are part and parcel of life with diabetes, but there is more support than ever to help individuals stay positive. SPREAD INTERVIEW WITH
Spread written by: Kate Sharma
Banishing misconceptions and confusion While awareness of diabetes is high, few people understand the difference between type 1 and type 2 diabetes. Stereotypes tend to overshadow the real facts, leaving those living with diabetes feeling overwhelmed. The pressure of constantly defending yourself or having to explain the condition can be exhausting. As Vanessa explains: “There is a lot of confusion and it’s disheartening when people make assumptions that your diabetes is linked to your lifestyle choices. I’ve chatted to people who feel so ashamed they haven’t even told their friends they have it.”
Don’t underestimate peer support In their ‘The Future of Diabetes Report’, Diabetes UK identified improving emotional
P H OTO : V R A E P H OTO G R A P H Y
Vanessa Haydock (BCBA, MSc, BSc) The Diabetic Health Coach, FreeStyle Libre Ambassador
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eceiving a diabetes diagnosis can be overwhelming. In the blink of an eye everything changes. Life becomes dictated by monitoring blood glucose levels, injecting insulin, weighing food and planning routines. Nothing is the same. “You’re having to make decisions about your health all the time and this can be overwhelming at times,” explains Vanessa Haydock, a diabetic health coach who was diagnosed with type 1 diabetes at the age of three. The decisions that those living with diabetes make multiple times a day have significant consequences, and it’s no wonder that they experience disproportionately high rates of depression, anxiety and eating disorders.
and psychological support for those living with diabetes as a key priority. This is an issue healthcare providers are aware of and working to improve. However, some of the best support isn’t always provided in a healthcare setting. As a coach working with those with diabetes, Vanessa is a huge advocate for peer support. At the age of 18 she was diagnosed with diabetic retinopathy, a complication caused by her diabetes that damages the back of the eye. Untreated it can lead to blindness. This was the wake-up call she needed to take control of her diabetes. One of the first things Vanessa did was to join a peer support group organised by the charity, Diabetes UK. Vanessa hasn’t looked back since. “The most important thing for me was just knowing that I was not alone,” she emphasises.
Technology eases the pressure The pressure of living with diabetes can be all consuming, but Vanessa has found that technology is helping her take control. Four years ago, she moved to wearing a flash glucose sensor. By simply swiping her phone or reader over a sensor on her upper arm,
she now has complete visibility over her “We have to accept that some glucose levels anytime she wants, which has days are going to be better helped to reduce her than others, but those living overall anxieties around with diabetes are much her glucose levels. Vanessa has now made it stronger than they think.” her mission to empower others living with diabetes to think positively and work towards their health and fitness goals. “We have to accept that some days are going to be better than others, but those living with diabetes are actually much stronger than they think,” she explains. “It’s a full-time job, which requires a lot of emotional and mental strength on a day-today basis, and I just want to empower people to live their best life with type 1 diabetes.” Mental health is no longer the taboo subject it used to be, and no one suffering with the burden of diabetes should feel alone. Medical advances, technological innovations and peer support are readily available and there is no shame in seeking help. Read more at healthawareness.co.uk
Digital health tools that work together for seamless diabetes management
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1. Scanning the sensor does not require lancets. © 2019 Abbott. FreeStyle, Libre, and related brand marks are trademarks of Abbott Diabetes Care, Inc. in various jurisdictions. ADC-16696 v1.0 10/19.
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“Diabetes has taught me to stay organised with my life, which helps me to perform in a good manner within boxing.” Muhammad Ali is making history as the first British professional boxer who has type 1 diabetes. Here he discusses how he manages his condition while still training as a professional athlete.
©SIMPSON33
Diabetes is a condition, not an illness; I’m just like any other ordinary person
WRITTEN BY
Muhammad Ali Professional Boxer
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COVID-19
How did you learn to manage your diabetes while maintaining an Olympic standard of sport? I was at a young age when I started boxing and my parents helped me control my diabetes. My mother took care of my nutrition, making sure my blood glucose levels were in a good range. I watched my mother prepare my meals and give me my medication (insulin). I learnt the ropes from an early age to help me get a better understanding of how to manage my diabetes. I also attended my regular diabetes appointments with my parents. If I had any troubles, I’d share my problems with my consultants and nurses in order to better my control.
a concern for all people with diabetes The COVID-19 pandemic is of great concern to people living with diabetes as they can be more vulnerable to the severe effects of the virus.
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What does an average day look like for you? On an average day, I start by organising my meals for the day so that I’m in control of my diet, as well as sugar levels, throughout the day. I also train twice a day. In the morning, I do my boxing session, which consists of sparring and technical work. In the evening, I do my strength and conditioning session. If I’m not resting during the day, I will do my nutrition shopping or go to the local shopping mall for a walk.
WRITTEN BY
Andrew Boulton President, International Diabetes Federation
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Do you think there’s enough awareness about diabetes? I think there is a lot of awareness raised regarding diabetes on social media as doctors are interacting with the diabetes community. There are also great sources of information and support out there, such as Diabetes UK, of which I am a proud ambassador. However, more awareness is needed to help people with diabetes – for example, in shopping malls on the labels of foods. People will be more aware of what they are consuming and how to go about taking insulin according to the food they eat.
he latest figures from The International Diabetes Federation (IDF) show that around 10% of people worldwide live with diabetes. The condition is also a leading cause of several life-threatening or debilitating complications, including blindness, heart attack, stroke, lower-limb amputation and kidney failure. IDF is highlighting three concerns for people living with diabetes during the coronavirus crisis: vulnerability, access to care, as well as physical and mental wellbeing. Protecting the vulnerable People living with diabetes – particularly those with poorly managed blood glucose levels – are more vulnerable to the severe effects of COVID-19. When people with diabetes develop a viral infection, it can be harder to treat due to fluctuations in blood glucose levels and, possibly, the presence of diabetes complications. Studies indicate that, depending on the global region, up to 50% of people with COVID-19 had diabetes. In the UK, 25% of deaths related to COVID-19 have occurred in people with diabetes1.
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What would you say to someone living with diabetes with aspirations for a career in sport? I believe diabetes is a condition and not an illness; it is about us as individuals, educating ourselves about diabetes for better control and management of the condition. As someone who lives with diabetes myself, I believe we can do any sport as long as we are controlling our diabetes in a good manner. The following is a motto I have put together to inspire and motivate other people living with diabetes: Diabetes is a condition, not an illness; I’m just like any other ordinary person. Life is not about waiting for the storm to pass by but learning to weather the storm. One day, I’d love to say I lived by diabetes.
COVID-19 demands have disrupted other vital medical supplies The restrictions put in place to fight the spread of COVID-19 in some countries have disrupted the production of vital medications and impacted supply chains. This could create shortages in some regions, leaving people with diabetes unable to get hold of essential medicines. People living with diabetes require uninterrupted access to essential medicines, supplies, technologies and care. People with type 1 diabetes, for example, require insulin to survive.
Around 10% of people worldwide live with diabetes.
Disruption to medical supplies or care can make it more difficult for people with diabetes to manage their condition and could lead to complications if not addressed. Lockdown measures can make it difficult to attend health appointments for advice on diabetes management and prevention. Furthermore, the reallocation of healthcare resources has made the situation worse. Lockdown’s impact on wellbeing of people living with diabetes Regular exercise and a balanced diet are important in managing diabetes and preventing its complications. The imposition of social distancing measures to reduce COVID-19 have reduced opportunities to exercise and made it more difficult to stick to a healthy diet. For some, the pandemic has been a considerable cause of stress. We have had reports of people with diabetes avoiding healthcare facilities for fear of contracting COVID-19. As a result, there is a concern that, down the line, many countries may see a spike in complications. Support for all It is critical that governments recognise that people with diabetes can be more vulnerable to COVID-19 – and at increased risk of dying. Measures to reduce potential exposure to the virus are of great importance. At the same time, people with diabetes need to manage a complicated condition. Access to care and supplies must be maintained to protect them from serious complications. People living with diabetes are advised to seek medical attention if they feel unwell. IDF is offering advice about precautions to take during the pandemic. Information, including guidance on how to best maintain physical and mental health can be found at www.idf.org/covid-19. https://www.independent.co.uk/news/health/coronavirus-deaths-diabetes-england-covid-19-a9514761.html 1
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Taking control of your diabetes Until four years ago, I’d only ever used a typical blood glucose meter. Since I was introduced to flash glucose monitoring, I haven’t looked back. I have a sensor on the back of my upper arm that records my glucose levels continuously. I have access to a reader I can swipe over the sensor, as well as an app, meaning I can also swipe my phone over it, which then provides me with a glucose reading. Vanessa Haydock (BCBA, MSc, BSc) The Diabetic Health Coach, FreeStyle Libre Ambassador Pages 4 and 5
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