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Understanding Diabetes
Q4 / 2020
Full campaign on www.healthawareness.co.uk
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“Nurses are vital in supporting people living with diabetes” Professor Andrew Boulton
President, International Diabetes Federation (IDF)
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“With the Government’s help we can improve access to diabetes ” Helen Kirrane
Head of Policy, Campaigns and Mobilisation, Diabetes UK
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“It seems losing weight was the best way of managing my diabetes” Rustie Lee
Chef and Television Personality
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IN THIS ISSUE
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“Type 1 diabetes is complex, and managing it requires a level of literacy and numeracy”
Why nurses are crucial in the fight against diabetes Nurses are at the heart of global healthcare and this World Diabetes Day (WDD), the International Diabetes Federation (IDF) is celebrating the vital role they play in supporting people with diabetes.
Catriona Hurley Paediatric Diabetes Specialist Nurse, North West University Healthcare Trust, Northwick Park Hospital
06 “Type 1 diabetes has a huge impact on my career and training” Khalid Keshta
Founder, Diabetes Academy, Obesity and Diabetes Control Specialist, Personal Trainer and Bodybuilder
08 “More than half of all type 2 diabetes cases could be prevented or delayed” Bridget Benelem Nutrition Communications Manager, British Nutrition Foundation Project Manager: Alice Golding alice.golding@ mediaplanet.com Business Development Manager: Josie Mason Managing Director: Alex Williams Head of Business Development: Ellie McGregor Head of Production: Kirsty Elliott Designer: Thomas Kent Digital Manager: Harvey O’Donnell Paid Media Manager: Ella Wiseman Production Assistant: Henry Phillips Mediaplanet contact information: P:+44 (0) 203 642 0737 E: uk.info@mediaplanet.com All images supplied by Gettyimages, unless otherwise specified
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T WRITTEN BY
Professor Andrew Boulton President, International Diabetes Federation (IDF)
he prevalence of diabetes globally is rising, with one in 11 adults (463 million) currently living with the condition worldwide. Nurses play a key role in helping people with diabetes understand and manage their condition. However, the global shortfall of 5.9 million nurses is leaving many without the care they need. People either living with diabetes or at risk of developing type 2 diabetes may be unable to avoid life-changing complications – such as heart attack, stroke, kidney disease, loss of sight and limb amputation. The nurse and diabetes care Nurses are vital in supporting people living with diabetes. They and the person they support are often the most important people involved in diabetes care. Nurses not only help to administer medication, such as life-saving insulin, but also offer important health and psychological advice to help people tackle the daily challenges that a lifelong chronic condition can bring. Moreover, they are often the ones who build the community support networks that many with diabetes rely on for guidance and reassurance. Nurses provide valuable dietary and lifestyle advice to help people at risk of developing type 2 diabetes to help reduce their risk. They also play an important role in raising awareness of the warning signs and symptoms to help ensure prompt diagnosis and treatment.
Education is the cornerstone of healthcare. The importance of diabetes education Education is the cornerstone of healthcare. IDF advocates for sharing diabetes information and best practices widely. This would provide healthcare professionals with the understanding and skills to provide optimal care and support for people with diabetes. It is time for urgent action It is critical for governments and healthcare systems to recognise the growing global impact of diabetes. Nurses are a key component of the response to the associated challenges. However, they will only be able to fully perform their role with sufficient investment in education, training and recruitment. We are approaching the centenary of the discovery of insulin, on which many people with diabetes depend to manage their condition. People with type 1 diabetes need insulin to survive. It is imperative that the next steps, to tackle the global diabetes pandemic, deliver real change. We must ensure that people with diabetes receive the support they require for its management and avoid its associated life-changing complications.
As part of this year’s WDD campaign, nurses and healthcare professionals can freely access the IDF School of Diabetes course on the role of the diabetes educator until the end of the year. The course is certified by the European Accreditation Council for Continuing Medical Education (EACCME), with participants earning an EACCME credit and a course certificate.
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“It never dawned on me how life-changing diabetes would be”
injections,” she says. “I thought people only have injections for serious reasons — and now here I was in hospital having to inject myself all the time.” Maddie was incredibly brave to begin with, says Helen. “I think a lot of kids are. But as the reality set in she started to feel sad and resentful. That was a very difficult period, and we spent a lot of time just me and her talking about things and coming to terms with it.” Meanwhile Helen had to come to terms with Maddie’s condition herself. Looking for reassurance from doctors in the early stages, she says “it’s taken me several years to accept that there’s no such thing as ‘under control’.”
When nine-year-old Maddie Wills was diagnosed with type 1 diabetes, she and her mother, Helen, had a lot to process. Thankfully, both received support from a diabetes specialist nurse.
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Because — and many people don’t realise this — it’s a life-long and potentially life-threatening condition.
elen Wills wasn’t taking any chances. When she suspected that her nine year old daughter, Maddie, might have type 1 diabetes, they both turned up at their GP’s surgery with a urine sample, even before he’d asked for one. “I think most mothers have a sixth sense about these things,” says Helen. “Maddie had classic symptoms. She was drinking a lot of water — we couldn’t go anywhere for more than an hour without needing to find a toilet — and she’d lost weight.” At first, the GP assumed Maddie had a bladder infection. But Helen still remembers the look on his face when he tested the urine with a dipstick. “He said: ‘There is quite a lot of sugar in it.’ I didn’t 100% know what that meant and asked: ‘Does that mean Maddie is diabetic?’ He said: ‘There
isn’t really any other explanation.’ That was seven years ago. Since then, Maddie, Helen and the rest of the Wills family have had a lot to process emotionally. “At that time, I don’t think it dawned on me just how life-changing type 1 diabetes would be,” admits Helen. “Because — and many people don’t realise this — it’s a life-long and potentially life-threatening condition.” Coming to terms with the diagnosis After seeing the GP, Maddie spent a couple of nights in hospital where she received support from Paediatric Diabetes Specialist Nurse, Catriona Hurley. Naturally, as a nine year old, Maddie didn’t fully comprehend what was happening to her. “I only realised what a huge deal it was when I started having insulin
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Getting advice and support from a specialist nurse That’s why having close contact with Catriona was so crucial, says Helen, who has written about her experiences on her lifestyle blog, Actually Mummy. “For me, Catriona was a source of reassurance. I remember a few days after we came home calling her on her mobile at the weekend to tell her Maddie had eaten Coco Pops for breakfast and I was worried because they’re so sugary. I wanted someone on the end of the phone to tell me: ‘It’s OK. You’re doing all the right things.’” That included monitoring Maddie’s blood sugar through the night with finger prick tests, which was physically exhausting and emotionally draining. Maddie — who has just turned 16 — now has a sensor on the back of her upper arm that records her glucose levels consistently, plus an insulin pump, which has made life easier. Maddie’s advice for newly diagnosed patients is to take things as they come and think about managing your condition on a week by week basis. Also, realise you’ll have to deal with people’s misconceptions. “A big one is when someone sees me eating a cake and says: ‘Should you be eating that?’,” she smiles. “Or they say: ‘So you can’t eat sweets anymore?’ But it doesn’t mean that. I can do all the things I did before. I just have to be sensible and manage things.”
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INTERVIEW WITH
Helen Wills Blogger at Actually Mummy and Podcaster at Teenage Kicks
Maddie Wills 16 year old living with type 1 diabetes
Written by: Tony Greenway
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“Young people living with diabetes and their families are not alone” Specialist paediatric nurses play a crucial role in offering support and reassurance to children and their families who are struggling to come to terms with a diabetes diagnosis.
Catriona Hurley Paediatric Diabetes Specialist Nurse, London North West University Healthcare Trust, Northwick Park Hospital
Written by: Tony Greenway
of course, is not the case at all. They may experience grief at the loss of their old way of life — and fear, too, because there’s a lot of new information to take in.” Specialist medical professionals offering support and advice More often than not, parents of a newly diagnosed child are confused about the disease or have misconceptions about it. Specialist nurses are there to enlighten and reassure them. “If you don’t have experience of diabetes, you may think it’s a quick fix or easy to manage,” says Catriona. “Unfortunately, that’s not the case.” “Type 1 diabetes is complex, and managing it requires a level of literacy and numeracy. Parents worry about their capacity to deal with the situation and, when they start to read more about it, have concerns about its potential acute and long-term complications.” Thankfully, there are Specialist Paediatric Diabetes Teams like Catriona’s across the UK. “As nurses, we support children with diabetes and their families and let them know that they can always reach out to us if they have worries, day or night,” she explains. “They are not alone and will always have someone to turn to.”
Families like the Wills’ should look at all they have accomplished. They should be very proud of themselves.”
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atriona Hurley, Paediatric Diabetes Specialist Nurse at Northwick Park Hospital, in Harrow, Middlesex, never ceases to be amazed by the resilience and fortitude of young people living with diabetes and their families. “Diabetes Nurses and Paediatric Diabetes Specialist Teams should acknowledge how wonderfully they do,” insists Catriona, who supported Maddie Wills and her family in the early days of Maddie’s diagnosis. “Diabetes is not a visible condition — look at someone living with diabetes and you wouldn’t know they have it — but to achieve wellness they have to do a lot of work. Families like the Wills’ should look at all they have accomplished. They should be very proud of themselves.” Which is not to say that specialist nurses like Catriona don’t guide families through dark and difficult times. They absolutely do. Catriona is part of a multidisciplinary team at Northwick Park caring for children with the condition — and the support that she and her colleagues give children and parents is essential. “Families are often shocked by the diagnosis,” she says. “Parents may experience feelings of guilt or worry that their child’s diabetes is down to something they did or didn’t do, which,
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I use my diabetes as my motivation Khalid Keshta got diagnosed with type 1 diabetes in October 2011, three months after his diagnosis, he broke his knee ending his football career. Since then he has found a new passion and challenge, bodybuilding. How has your diagnosis affected your career and training? Type 1 diabetes has a huge impact on my career and training. I have to understand my meals’ content. I also check my blood sugar before, during and after training to make sure it does not drop or elevate dramatically and respond accordingly. My whole life, including my career, is involved and dedicated to the diabetes community. I am an obesity and diabetes control specialist, a personal trainer and a bodybuilder that competes only to represent diabetes in the fitness community. I also own a diabetes academy to guide and mentor others.
What are common misconceptions you have experienced with type 1 diabetes? There are so many! A few that have been said to me include: I can’t eat sweets or carbohydrates nor can I do intense sports or I will be hypoglacemic. I am limited to what I can achieve because diabetes is a disease that will affect me negatively. I’ve also been told not to tell people you have diabetes as it’s so embarrassing. They could not be more wrong. What advice would you give to others who are living with diabetes? Don’t be ashamed of it. Don’t ever hide it. Don’t treat it as an illness, treat it as a condition. Show it off. You are greater than your highs and lows. Use it as a motivation and for your own advantage. We have a 24/7 job managing our condition that others are not aware of. This is something to be proud of, I praise my diabetes for that when I win bodybuilding competitions. This is how I personally use it to motivate me and use it to my own advantage in order to get my own niche and exposure. WRITTEN BY
Khalid Keshta Founder, Diabetes Academy, Obesity and Diabetes Control Specialist, Personal Trainer and Bodybuilder
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Don’t be ashamed of it. Don’t ever hide it. Don’t treat it as an illness, treat it as a condition. Show it off.
Technology has transformed the lives of people living with diabetes Over the decades, technology has rapidly evolved to become an integral part of our daily lives. Technology can transform the lives of some people living with diabetes, but many still struggle with access.
WRITTEN BY
Helen Kirrane Head of Policy, Campaigns and Mobilisation, Diabetes UK
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orty years ago, blood sugar testing was done using a urine dipstick test that told you what your blood sugar had been a few hours ago. Today, Flash and continuous glucose monitors (CGM) not only tell you what your blood sugar is doing now, but what it was doing overnight and the direction of travel it is heading in. An accurate and timely picture of blood sugar is so important for people with diabetes. The more detail they have, the better they can manage their condition. In fact, a recent Diabetes UK survey found that 67% of people who had used diabetes tech, like insulin pumps, Flash and CGM said they felt more confident managing their diabetes as a result. Tackling the challenge of accessibility However, there is a big problem with access. According to Diabetes UK research, more than half of people (51%) with diabetes, who have tried to access technology to support the selfmanagement of their condition, say they have been refused access at some point over the last decade in England. This combined with the impact on services caused by the coronavirus pandemic has left people with diabetes feeling isolated without the healthcare they need.
We can’t stop a pandemic, but with the Government’s help we can improve access to diabetes technology. This would help mitigate the risk of people experiencing devastating complications such as heart attack, stroke and eye and foot problems. Location, affluence and ethnicity can all impact access to technology In the UK, there is significant variation in access depending on where a person lives, their level of deprivation and their ethnicity – sometimes referred to as ‘postcode lotteries’. This often forces people to make the difficult decision to self-fund their technology. Diabetes UK is urging the Government to take urgent action by signing a ‘Cheque for Tech’. By providing this vital funding, the Government can eliminate the postcode lottery and ensure that anybody with diabetes who would benefit from diabetes technology will be supported to do so. This funding would save people with diabetes from distress that nobody should have to face. It could help reduce hospital admissions from preventable complications. It is vital that the Government gives people with diabetes the tools they need, today. Read more at healthawareness.co.uk
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How app technology is helping Paul back into fitness How a world-first technology helps fitness fan Paul Green to discreetly control his blood glucose levels – in and out of the gym.
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aul Green had been playing football, lifting weights and doing cardio exercises for over 30 years. Then, suddenly, in his 40s, he started feeling unwell. He struggled to get to the gym and somehow his body was no longer reacting as well to his fitness training. “I chatted to a personal trainer about it and he suggested it could be diabetes,” says Paul, an architectural consultant from the South West of England. Paul was understandably sceptical but went to his GP. After numerous tests, he was diagnosed with type 1 diabetes around two years later, aged 45. Type 1 diabetes is an autoimmune condition, in which the immune system destroys cells within the pancreas that produce the blood sugar-regulating hormone insulin. How can I stay fit and control my diabetes? “It was a shock and a puzzle. Would I still be able to carry on my life as before?” says Paul. He started taking 100 units of insulin a day, using two types of insulin injection pens, one to deliver a long-acting shot and one to deliver a short acting shot. “The biggest challenge was controlling my insulin doses to maintain the right blood glucose level. It was up and down like a fiddler’s elbow, and managing it was like a fulltime job. The pens were differentiated by colour but sometimes I would forget which one I had already used. “I also had to stop the fitness activities I had enjoyed for 30 years, such as football and weights, and I was fearful about doing cardio exercises because it could cause my levels to plummet and I’d experience hypoglycaemia,” says Paul.
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How technology helps In September 2019, Paul swapped his injection pens for a Medtrum continuous glucose monitor (CGM), a tiny sensor inserted under his skin on his abdomen which monitored his blood sugar levels. His CGM connected wirelessly to a Medtrum A6 TouchCare
It could also be a bit embarrassing in social or business situations if I had to get it out to check it. I don’t always want to share that I have diabetes.
insulin patch pump, also attached to his skin, this system was operated by a personal diabetes manager (PDM). The PDM is a small touchscreen device that remotely instructed the delivery of insulin in the correct doses to meet his body’s demand. “It is a big improvement on the pens, as it has largely stabilised my blood sugar and reduced the amount of insulin I need. The continuous feedback from the CGM also means I have learnt how to monitor my blood sugar levels more effectively, and it has a predictive lowglucose suspend feature which helps me avoid the risk of hypoglycaemia when I am in the gym.” However, the system meant Paul had to carry the PDM with him constantly. “Sometimes I would forget it,” says Paul. “It could also be a bit embarrassing in social or business situations if I had to get it out to check it. I don’t always want to share that I have diabetes.”
A world-first app solves my problems Then in June this year, Paul started using the EasyPatch App, which gives him the ability to control his pump and CGM on his smartphone. The app is the first in the world to control an insulin patch pump. “I can see my readings just by glancing at my phone. It’s less intrusive than getting out my old PDM, and I never leave my phone at home, so I am never without my monitor. No-one can tell you are using a medical device, as glancing at your phone is not unusual. It’s a huge improvement.” Paul adds: “It will be a great bonus for anyone who uses a mobile phone.” “Simple as cleaning my teeth” “The whole system has changed the task of managing my type 1 diabetes, and the app has been a huge help. Managing my blood glucose levels is no longer a full-time job – now it’s as simple as cleaning my teeth.”
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Losing weight helped me manage my diabetes TV personality Rustie Lee shares her experiences of type 2 diabetes and how a tummy bug forced her to change her food habits. Q: When were you first diagnosed with type 2 diabetes? About ten years ago. During a routine check-up I was told I was pre-diabetic. I thought that was good but within a few months, I was getting the bad news that it was type 2 diabetes. Q: Did you have any symptoms before you found out about it? I had no symptoms whatsoever. Just going about my life as always. That was what caught me out, I guess.
Making the change to reduce your risk Type 2 diabetes can seriously harm health but taking action to eat better and move more can delay or prevent the disease.
Q: What lifestyle changes have you made since then? Initially the doctor prescribed medication but that in itself did not make much of a difference. It brought the numbers down a bit, but it was not going away. So, I then started taking it seriously. I cut down on fat, calories and carbs. At the next test I had improved, my readings were down a lot.
WRITTEN BY
Bridget Benelam Nutrition Communications Manager, British Nutrition Foundation (BNF)
Type 2 diabetes is preventable It is estimated that there are over 12 million people in the UK who are at risk of developing type 2 diabetes. This condition can seriously impact health, including causing nerve damage, kidney problems and loss of vision, as well as significantly increasing the risk of heart disease and stroke. But more than half of all type 2 diabetes cases could be prevented or delayed.
I then started taking it seriously. I cut down on fat, calories and carbs. At the next test I had improved, my readings were down alot.
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Finding your balance Limiting sugary drinks and red and processed meat and eating more fruit, vegetables and fibre are all associated with reducing the risk of type 2 diabetes. You can look for practical steps that work for you such as adding frozen vegetables to dishes, swapping sugary drinks for water or sugar free versions or switching to wholemeal instead of white bread or pasta. Getting active is also linked to reduced Change that works risk and any increase There is a strong you can manage can link between body be beneficial, for weight and risk of example, fitting one type 2 diabetes – 90% or two 10-minute In the long run, most of adults with type brisk walks into approaches to weight 2 diabetes are overyour day. Change loss that cut calories have can be challenging weight or obese. It is estimated that people so it’s important to similar results and so the living with obesity remember you don’t key is finding something are seven times more have to do it alone. that works for you. likely to develop the Your GP can advise condition than peoon support available ple of a healthy weight. Even losing 1kg in your area and it may also help to get can help reduce your risk. But losing family and friends involved. Taking weight is not easy, and the effects of the action to improve your health now can COVID-19 pandemic can make it even make a real difference in reducing your more difficult. risk of type 2 diabetes and protecting In the long run, most approaches your health for the future. to weight loss that cut calories have BNF does not endorse any companies, products or brands similar results and so the key is finding that may feature in this publication. something that works for you. And it’s not just about the numbers on the scales. It’s important to improve health and this is about eating well, moving more and feeling good.
WRITTEN BY
Rustie Lee Chef and Television Personality
Then in 2017 during a filming assignment in India, I caught a bug that changed everything. I developed gluten and dairy intolerance and had to change many of my eating habits. I’m not recommending catching a bug, and everyone has a diet that works for them, but the changes I had to make surely helped to bring my blood sugar levels down. Since then, I have lost four stone, feel and look a lot better. At my last appointment my blood sugar was at a normal level. Q: What was the best advice you received to help manage your diabetes? I guess the best tip was ‘lose weight’. It is not easy for someone who loves their food I know, but ultimately even though I did it due to this tummy bug, it seems losing weight was the best way of managing my diabetes.
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How good nutrition can help in the fight against diabetes
INTERVIEW WITH
Dr Basil Issa Consultant Endocrinologist, Manchester University NHS Foundation Trust
Dr Michelle Harvie Research Dietitian Co-chief Investigator, Manchester Intermittent and Daily Diet Diabetes App Study (MIDDAS)
Dr Jamy Ard Professor, Epidemiology and Prevention, Wake Forest School of Medicine, USA
Hans-Juergen Woerle Chief Scientific & Medical Officer, Nestlé Health Science
Written by: Tony Greenway
If people living with type 2 diabetes who are overweight or obese can lose weight and transition to a healthy eating lifestyle, their condition could be significantly improved — or even go into remission.
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t goes without saying that we should be eating a healthy and nutritious diet, says Dr Jamy Ard, Professor, Epidemiology and Prevention at Wake Forest School of Medicine, USA. “The nutrients and nourishment in our food provide nourishment essential for growth development and healthy aging,” he explains. “Too many refined grains, added sugars and excess calories — and not enough fruit, vegetables and wholegrains — can significantly increase risk of disease.” Eating a healthy and nutritious diet can help promote weight loss and support weight management, which is extremely beneficial for individuals that have overweight, obesity or associated conditions such as type 2 diabetes. By losing a significant amount of weight — and then keeping your weight under control — your condition may improve, or even go into remission. “There is good evidence that weight loss can improve glycaemic control (i.e. blood glucose levels) which in turn can help reduce the risk of diabetes complications, such as damage to eyes, kidneys and nerves,” notes Dr Basil Issa, Consultant Endocrinologist at Manchester University NHS Foundation Trust. In the recent years, much has been publicised about reversing or even putting type 2 diabetes into remission with dietary interventions including the use of meal replacement drinks or nutritional bars. These have been proven to be useful in helping people with diabetes achieve substantial weight loss. Yet there are nutritional interventions available, including one in the form of meal replacements, that can help achieve the ultimate goal of weight management. The benefits of meal replacement diets The benefits of intermittent dieting versus continuous low energy dieting with meal replacements has been assessed by Dr Michelle Harvie; Co-chief Investigator of the Manchester Intermittent and Daily Diet Diabetes App Study (MIDDAS). On the MIDDAS study, one group of patients followed a continuous daily low calorie diet every day for 8 weeks, restricting their intake to nutritionally complete meal replacement shakes, supplemented with eight portions of vegetables.
The other group followed an intermittent low-calorie diet, restricting their intake to the meal replacement shakes plus vegetables for two days a week across 28 weeks. Initial findings show that a nutritious intermittent low calorie diet using meal replacement products can be a successful way to achieve and maintain weight loss. “The people following the daily meal replacement low cal diet for 8 weeks lost a significant amount of weight which can be very motivating for them, the intermittent group kept going and caught up by 28 weeks” says Dr Harvie. Dr Ard agrees with this assessment. He was the Principal Investigator of the US-based OPTIWIN study, which evaluated the effectiveness of total meal replacement programmes. “They are easy to implement because patients don’t have to calculate calories or worry about portion sizes,” says Dr Ard. Results of his study were positive, too. “We saw a significant improvement in body composition, including a greater loss of fat mass,” recalls Dr Ard. “And while only a low percentage of individuals within the study had type 2 diabetes, we also saw improvements in glycaemic control.”
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Industry and academia working together This is not to say that a meal replacement programme is a simple weight-loss fix, cautions Dr Harvie. “It can be very challenging, particularly for the first week or so,” she says. “Patients are, after all, removing themselves from a foodbased diet. However, with proper planning and the right expectations it can become easier.” Dr Issa — also Co-chief Investigator for MIDDAS — stresses that people in the study were supported by a multidisciplinary team of practitioners for optimum delivery of care. He also stressed that meal replacement interventions can’t be used indefinitely. “They should be used as a tool to help transition to a long-term, nutritious, healthy eating lifestyle,” he says. Hans-Juergen Woerle, Chief Scientific & Medical Officer at Nestlé Health Science, agrees that there is no “one-size-fits-all dietary answer” and that different solutions are required to address different patient needs. He also believes that the best way to improve nutrition and control type 2 diabetes is for industry and academia to work closely together. “Good collaboration helps us create innovative solutions,” he says. “This, in turn, helps doctors treat their patients more effectively.” Meal replacements are one method of weight loss, and may not be right for everyone. Please consult your healthcare professional if you are thinking of trying to lose a significant amount of weight.
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Type 1 diabetes - increased incidence but better treatments
Calling for a ‘culture shift’ in diabetes education Founder of the DSN Forum and guest speaker of United Through Diabetes, Amanda Epps, has called for a change in attitudes towards diabetes education.
It’s known that the condition has a genetic basis. But there’s no known way to avoid it.
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he says: “We desperately need a culture shift when it comes to diabetes education. We need better access and also a change in attitudes. “In the UK we need to change our mindsets and start looking at education as an essential part of the treatment plan. We need to improve access; it should be available 24/7, if someone wants to access it at midnight then they should be able to. “With online technology improving dramatically and people working from home because of lockdown measures, there is a real opportunity to access people who wouldn’t normally be accessible.
WRITTEN BY
Michael Connellan UK Head of External Affairs, JDRF, the type 1 diabetes charity
There has never been a more important time for healthcare professionals and people with diabetes to work together.
Learning to manage the condition It’s a challenging and complex condition to live with, requiring multiple daily blood glucose checks to know what dose of insulin is needed. A child diagnosed with type 1 at the age of five faces up to 19,000 insulin injections and 50,000 finger-prick blood tests, day and night, by the time they’re 18. Yet when people are given the right tools to manage the condition, it doesn’t have to hold them back. Theresa May was diagnosed with the condition before becoming Prime Minister. Henry Slade was diagnosed with the condition long before winning the Six Nations rugby tournament with England. Technology can provide support The right tools to manage the condition include wearable medical technology. Multiple daily insulin injections can
“Historically, some people have had issues getting time off work to attend diabetes appointments and education. However, I recently spoke to a person who has had a HbA1c of 100 mmols for over 11 years and due to lockdown and working from home they were now able to access support and have had a significant improvement in their management of their condition to target HbA1c. “Unfortunately, with coronavirus, people with diabetes and a high HbA1c are at a much higher risk of dying from the virus should they contract it. There has never been a more important time for healthcare professionals and people with diabetes to work together to ensure everyone gets the education they need to live a healthier life”.
A child diagnosed with type 1 at the age of five faces up to 19,000 insulin injections and 50,000 finger-prick blood tests, day and night, by the time they’re 18.
The United Through Diabetes virtual free-to-attend conference for people with diabetes will be held on 14 November to mark World Diabetes Day. To register visit: bit.ly/UnitedThroughDiabetes
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WRITTEN BY
Amanda Epps Founder, DSN Forum Guest speaker, United Through Diabetes
erious and potentially lifethreatening, type 1 diabetes requires those diagnosed with it to inject insulin every day to stay alive. It affects 400,000 people in the UK. Many are diagnosed in childhood and incidence rates have been climbing fastest in infants.
be replaced by wearable insulin pumps. Multiple finger-prick blood glucose tests can be replaced by less invasive monitoring technologies. NHS access to such devices is currently too low and often depends on a postcode lottery of local area provision. But at the type 1 diabetes charity JDRF, we are pushing for and winning greater access to such technologies for people with the condition. Our research programme is also focused on finding new treatments and an eventual cure. Ways to treat the condition, including these newer technologies, have progressed hugely in the last five years alone. The centenary of insulin discovery This World Diabetes Day (November 14th) will see the type 1 diabetes community begin to mark the 100-year anniversary of the discovery of insulin, which falls next year. It was one of the greatest moments in medical research history. But because using insulin to manage type 1 diabetes isn’t easy, the discovery alone is not enough. The community knows that together, it will find the next big research breakthrough, and together it will find the cure.
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A day in the life of Myrthe with the Omnipod DASH® System WRITTEN BY
Myrthe Heida Patient and blogger, Content creator and speaker for Insulet*
About Myrthe Myrthe Heida (1996) was diagnosed with type 1 diabetes at the age of 5. She blogs and vlogs about her life with diabetes on www.girl0ninsulin.com and shares her life with diabetes on Instagram and YouTube as @girl0ninsulin. *Myrthe has an ongoing commercial relationship with Insulet.
Type 1 diabetes diagnosis Eighteen years ago my mum took me to see our GP. I was five years old and got the diagnosis type 1 diabetes. Therefore I can’t remember anything about my life without diabetes. I do remember how different diabetes management used to be eighteen years ago. I injected at the same times every day and I wasn’t allowed to eat more carbohydrates than my doctor had advised my parents. Every morning I ate two slices of bread with cheese or peanut butter. For lunch I had two slices of bread with other low carb toppings and one slice of bread with chocolate sprinkles or Nutella. I thought it was annoying and unfair. I just wanted to eat what I wanted! Injecting at least four times a day was also a big deal for me. After my 11th birthday I switched to pump therapy. It was such a relief not to inject four times a day! Wearing a device like that was kind of cool, but at the same time the design of my insulin pump was big and hard to hide! I immediately tried to convince my doctor to create an insulin pump with a coloured screen, just like a mobile phone. He laughed at me and said that was something for the far future. New insulin pump After this morning’s low blood sugar, I realise how happy I am after being on
©IMAGE PROVIDED BY INSULET
T
his morning I woke up with a nasty low bloodsugar of 3.1 mmol/l. The kind of hypo that makes it almost impossible to wake up because your body is exhausted. I grabbed my insulin pump and lowered my basal rate to 0%. After that I stuffed my mouth with energy tablets. Soon I began to feel better. Just one look at my Omnipod DASH® PDM (Personal Diabetes Manager) and I saw my temporary basal rate lasted 14 more minutes. I also noticed I had no insulin on board and that my last blood sugar was 3.1 mmol/l. I checked my blood sugar once again. It was 4.8 mmol/l with an arrow upwards. Reassured and absolutely knackered I left my warm and cosy bed.
my new insulin pump. The convenience of lowering my basal rate, how quickly I can see all the data with my insulin pump and Continuous Glucose Monitor (CGM) to make diabetes management decisions, it all makes life with diabetes just a little bit easier. For a number of months I have been using the Omnipod DASH® System to manage my diabetes. That’s the insulin pump where the PDM looks more like a phone than a medical device. What I like best about the Omnipod DASH® System is that there are no visible needles involved, the beautiful and functional design of the PDM and the fact that the Pod is tubeless! The Omnipod DASH® System is a patch pump. With just one look at my PDM I know the amount of insulin on board, my last entered blood glucose measurement and my most recent bolus. My active basal rate is one swipe away. One more swipe and I see when my Pod ends and it actually ends today! Swiping on your insulin pump, how cool!
A beeping Pod After a long day at work I got home and dropped down on the sofa. Exhausted but satisfied. I realised the low blood sugar of this morning cost me a lot of energy today. I turn on the TV, relax and start writing this blog. Until my Pod and PDM start beeping. For a while I forgot I needed to place a new Pod today! My boyfriend hands me a new Pod, the insulin and my PDM and within a few minutes the new Pod is placed on my arm. I write the last sentences of this blog, put my laptop away and fall asleep. Tomorrow’s a new day!
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Love, Myrthe This Omnipod DASH® System user testimonial relates to an account of an individual’s response to treatment with the Omnipod DASH® System, user experience may vary, please speak with your healthcare professional. Refer to the Omnipod DASH® Insulin Management System User Guide for complete safety information including indications, contraindications, warnings, cautions, and instructions.
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†The sample Pod is a needle-free, non-functioning Pod that can be worn for up to 3 days. Screen image is an example, for illustrative purposes only. ©2020 Insulet Corporation. Omnipod, the Omnipod logo, DASH, the DASH logo and Podder are trademarks or registered trademarks of Insulet Corporation in the USA and other various jurisdictions. All rights reserved. 1 King St, Hammersmith, London W6 9HR. INS-ODS-10-2020-00027v1
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12 | Read more at healthawareness.co.uk
Low calorie research & meal replacements for type 2 diabetes
Since using meal replacements, my mind set has totally changed, for the better. I look at food differently now.
“I
WRITTEN BY
Bev Iceton exante customer & ReTune participant
Paid for by exante
found out I had type 2 diabetes after I received routine blood test results at a doctor’s appointment, I was absolutely devastated. I was prescribed medication for the condition and felt that there were no treatment options for me, other than to be on medication for the rest of my life.” When Bev was diagnosed with type 2 diabetes in October 2018, she weighed 80kg. Bev tried to lose weight by cutting down on her favourite snacks: cakes, bread & biscuits. Research study into low calorie diets She then began searching for information and treatment options and was referred to participate in a new study, ReTune hosted by experts at Newcastle University. Within eight weeks of starting the trial, I was down from 12st 5lb to 10st 5lb, my bloods showed I was in remission and I’ve stayed that way ever since. “They said that I’d be a prime candidate for their low calorie diet study to help me lose weight safely. Shortly after, I started my new 12 week total diet
©Image provided by Exante Diet
Bev was diagnosed with type 2 diabetes in 2018, she has now put her diabetes into remission through following a low-calorie diet plan and meal replacement products to support her weight loss.
replacement with their support. “My total diet replacement involved three low calorie shakes or soups a day, plus extra vegetables – it was so simple to do,” explains Bev. “I found prepping all my food for the day in the morning really useful, and I would try different vegetables that I wouldn’t normally eat to mix things up and keep my taste buds interested. I also found plenty of Tupperware and good scales were a god-send!” Making long term behaviour change “Since using meal replacements, my mind set has totally changed, for the better. I look at food differently now,” says Bev. “My shopping habits are far healthier and when I eat out, I’ll go for a healthier option and skip dessert – except for the
occasional treat! The programme has taught me how to enjoy the foods I love in moderation.” Bev wanted to go on to inspire others to make similar changes to their lifestyle. She says: “my husband has also lost 10kg, we’re living much healthier lives together. I get so many compliments from him, friends and family about how good I look now.” “My skin is clearer, and people say I’ve got my sparkle back – I didn’t realise that I’d lost it but now I see that I definitely had.” “I can honestly say that the low calorie diet programme changed my life for the better.” exante always recommends talking to your Doctor or Medical Practitioner before using their products or plans to help you lose weight.
exante is a market leading diet and wellbeing brand in the UK meal replacement space. It is a simple and convenient weight loss solution that can help people with type 2 diabetes manage their weight. Read more at exantediet.com
Diabetes has a huge impact on my career and training. I have to understand my meals’ content. I also check my blood sugar before, during and after training. ~ Khalid Keshta, Personal Trainer and Bodybuilder
©Image provided by Khalid Keshta