Understanding Diabetes IE - Q4 2021 by Mediaplanet UK&IE

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Take better control of your diabetes New medicines and technology can help people with diabetes live healthier lives, but there’s no substitute for weight loss, a good diet and exercise.

T Professor Cathy McHugh Consultant Endocrinologist, Sligo University Hospital WRITTEN BY Sean Duke

he impact that diabetes can have on the eyes and bodily extremities, such as feet are well known, but the heart and kidneys can also be affected. This means it is important for people living with diabetes to have their heart and kidney functions checked when they visit the GP once or twice a year. The various consequences of diabetes – which result from high blood sugar levels can be impaired vision, amputation of toes, feet or even legs and can also lead to heart failure, heart attack, or kidney failure resulting in dialysis. However most people with diabetes will die as a result of heart disease or stroke.

vessels and reduce blood pressure. The STLG2 inhibitors, meanwhile, work by lowering blood sugar and themselves reduce blood pressure in the kidney and thus can protect the kidneys. There are also new technologies which can also help. For example, the FreeStyle Libre System is a device that measures blood sugars every 15 minutes. It resembles a two-euro coin and is worn on the arm and linked to a smartphone. At the end of a given day, it can produce graphs of how a person’s sugar levels behaved during the day. These devices and medicines are effective and provide good information but not a substitute for a healthy lifestyle.

Link between obesity and It is important that people type 2 diabetes Speaking to your GP diagnosed with diabetes Obesity and type 2 diabetes go handIt is important people tell their GP in-hand, with obesity being a leading understand that complications when they are experiencing signs cause of diabetes. There is a big chest pain or shortness of breath. do not inevitably come with the of risk for diabetes among sedentary, This is because GPs may test a overweight middle-aged people, who disease. Some live healthy lives, person with diabetes for cholesterol need to exercise and eat well. and blood pressure, but not heart for many years, with diabetes. It is important that people problems themselves. People diagnosed with diabetes understand with diabetes are at risk of heart that complications do not inevitably come with the problems and furthermore they may not present with disease. Some live healthy lives, for many years with typical symptoms. diabetes. The better a person’s diet is, and the more The simple things are important, such as attending GP exercise they do, the better the chances of avoiding appointments, exercising, eating well and not to be over complications. reliant on drugs alone to mitigate the effects of the disease. It is important to watch closely for signs of complications Rise of diabetes technology and seek help when needed. High blood pressure is a risk with diabetes, this can be treated with ACE inhibitors which act to relax the blood

Stop. Reverse. Cure. Fundamentally transforming care for millions of people with CVRM diseases.

Veeva ID: IE-3263 Date of Preparation: November 2021

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Why it’s important to manage your diabetes in a ‘holistic’ way t en ev tes be Dia for Dip

Taking a holistic view of diabetes can help people with the disease live better lives, stay healthy and feel more confident about themselves.

E SPREAD AUTHOR

Erin Dolan Diabetes Health coach, owner of crazyabout diabetes.com and @crazyaboutdiabetes

WRITTEN BY Tony Greenway

rin Dolan admits that when she was first run marathons and even cycled across Central America. diagnosed with type 1 diabetes around 30 years But mindfulness practices don’t have to be as big and ago, she experienced a loss of self-identity, fear ambitious as that. “If you have diabetes, it’s constantly on of judgement and lack of confidence. your mind,” she says. “It’s exhausting. So being present These days, however, she takes a holistic approach in the moment with something you love to do gives to the disease, which entails focusing on her whole self your mind a much-needed break. It could be cooking, (rather than just her diabetes) to find a balance between gardening, knitting or dancing. As long you enjoy it her mind, body and spirit. This has and it redirects your focus, it’s a valid worked so well that she is now a health mindfulness practice.” coach with her own business called Crazy When it comes to bodily health, Dolan About Diabetes that helps those with has reassessed her relationship with diabetes to lead more fulfilling lives. food. “There’s no ‘one-size-fits-all’ diet,” Yet you don’t have to feel “Diabetes is often referred to as ‘an she says. “It’s up to each individual to alone. There are so many invisible disease’ because you can’t experiment with cooking, crowding out resources available to tell if someone has it just by looking at processed foods and bringing in healthier them,” says Dolan. “Yet it comes with alternatives.” She also advocates meal help anyone with diabetes many physical and emotional challenges. progress their health — planning and using technology such as That’s why it’s important for anyone carb-counting apps to help make the and live their best life. with diabetes to find ways to reduce their process easier. mental stress, while being aware of the To soothe the spirit, Dolan stresses that effects that physical activity, food and nutrition can have people need to embrace their diabetes (rather than wishing on their body. Finally, by embracing their diabetes, they they didn’t have it) and connect with others in the same can increase their self-esteem and lift their spirit.” position. “It can be an isolating disease,” she says. “Yet you don’t have to feel alone. There are so many resources Tapping into resources to boost physical and mental health available to help anyone with diabetes progress their To help her mental health, Dolan swims in the sea, has health — and live their best life.”

Find out more at worlddiabetesday.org

YOU CAN DO IT

WITHOUT LANCETS1

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Erin’s five ways to live a balanced life with diabetes 1. Challenge yourself

4. Identify imbalances

2. Get connected

5. Explore food flexibility

Going after goals — big or small — while managing diabetes is extra effort and sometimes scary. But when you challenge yourself and reach a goal you start to change your mindset. You can progress your diabetes forward while believing in yourself. Also, you’ll find more confidence to set new ambitions. Create realistic goals with a timeline, like running a 5km race in January. Once you achieve it, set a new goal.

Living with diabetes doesn’t have to be lonely, so get yourself connected with others. Sharing diabetes stories and daily struggles with other people who have diabetes is good mental therapy because they can empathise with you. In Ireland, there are local meet-up groups and Facebook groups in nearly every county. Get involved, be it at a diabetes-related event or advocacy group or be part of the online community like Diabuddies or the Diabetes app.

I like to call this diabetes mapping. First, take a look at your diabetes and how it relates to your lifestyle and environment. You can start to identify imbalances with your diabetes and where you need to spend more time to create a healthy balance. These areas include technology access, stress management, self-confidence, eating habits, physical activity, relationships, joy and overall health.

People with diabetes can eat all types of food and even carbohydrates. By exploring different food and cooking, you improve your relationship with food. Combine carbohydrates and starchy foods with protein and fibre to stabilise glucose levels. Keep a food journal to better understand your glucose trends with snacks and meals. This data transparency will give you more flexibility with eating.

3. Find your own meditation

Allow your mind to take a break from diabetes. Finding ways to be present in a mindful practice will help reduce stress and revitalise your body. Meditation can be anything – hiking, knitting, sea swimming, gardening, cooking, cycling, dancing, etc. Find an activity that you enjoy and that gives you a restful mind.

The FreeStyle Libre system lets you check your glucose with a scan of your smartphone2 and helps you take control of your diabetes.

Diabetes doesn’t have to be lonely, so get yourself connected with others. Sharing diabetes stories and daily struggles with other people who have diabetes is good mental therapy.

Easy to use3 The sensor is easily attached to the back of the upper arm. It can be worn for up to 14 days Discreet & convenient Check your glucose anytime4, anywhere5 with a simple 1-second scan even through clothing

REQUEST YOUR FREE 14 DAY SENSOR

No finger pricks6 You can manage your diabetes painlessly7

Start your 14 day free trial today, please visit Sample.FreeStyle.Abbott Images are for illustrative purposes only. Not actual patient or data. 1. Scanning the sensor does not require lancets. 2. The FreeStyle LibreLink app is only compatible with certain mobile devices and operating systems. Please check the website for more information about device compatibility before using the app. Use of FreeStyle LibreLink requires registration with LibreView. 3. Data on file. Abbott Diabetes Care. 4. 60-minute warm-up required when applying the sensor. 5. Sensor is water resistant in up to 1 metre (3 feet) of water for a maximum of 30 minutes. Do not immerse longer than 30 minutes. Not to be used above 10,000 feet. 6. Finger pricks are required if your glucose readings do not match symptoms or expectations. 7. Haak, Thomas., et al. Flash glucose-sensing technology as a replacement for blood glucose monitoring for the management of insulin-treated type 2 diabetes: a multicenter, open-label randomized controlled trial. Diabetes Therapy 8.1 (2017): 55-73. © 2021 Abbott. FreeStyle, Libre, and related brand marks are marks of Abbott. ADC-48114 v1.0 11/21.

05/11/2021 17:47

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The surge of diabetes: do you know the signs? More than half a billion people are living with diabetes worldwide and one in three families is affected by diabetes in Ireland.

ne in 10 people around the world has diabetes, a chronic condition listed by the World Health Organization in the top 10 leading causes of deaths globally. It is important to know that when diagnosed early and managed well people can live long and healthy lives.

SPREAD AUTHOR Dr Kate Gajewska Clinical Manager for Advocacy and Research, Diabetes Ireland

Recognise the symptoms Early recognition of diabetes and medical intervention are necessary to live long and healthy lives, and to avoid short and long-term diabetes-related complications. One of the most serious complications is diabetes ketoacidosis (DKA) – it results from insulin deficiency and is life-threatening. It often occurs at the time of diagnosis of type 1 diabetes. According to the Irish Childhood Diabetes National Register, in 2020, over 40% of newly diagnosed children with diabetes had DKA. It could have been avoided, if the symptoms were recognised sooner.

The surge of diabetes - any type, any age Diabetes occurs when there is too much glucose in the blood because of a lack of insulin (type 1 diabetes) or insulin is not working properly (type 2 diabetes). The most common type of diabetes is type 2. Risk factors for type 2 diabetes include age, family history sedentary behaviours, obesity/overweight, stress and previously having gestational diabetes. It is usually Early recognition of diagnosed in adults and its incidence increases with age. Type 1 diabetes is one diabetes and medical of the most prevalent chronic illnesses intervention are necessary in children and adolescents but is to live long and healthy diagnosed in people of all age-groups. It lives, and to avoid short and is an autoimmune condition that is not preventable and its causes are unknown. long-term diabetes-related

complications.

Awareness and education Type 2 diabetes is often treated with lifestyle modifications (healthy eating, exercise and weight management) combined with medication if required. With type 1 diabetes, insulin therapy is a must – it requires daily (multiple) insulin dosing (via injections or an insulin pump) and frequent (or continuous) glucose monitoring in order to decide about the doses. The insulin doses are calculated based on the meal content, exercise, stress levels and many other factors. In both types, diabetes education and support are

instrumental in helping the individual to self-manage their condition daily and achieve recommended blood glucose values.

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Know the signs Therefore, the TEST campaign was launched to raise awareness of the symptoms of type 1 diabetes. TEST represents the following: thirst (increased), energy (reduced), sudden (weight change) and toilet (trips increased). These symptoms are key indications that a person might have diabetes and a simple finger-prick blood glucose test is required urgently. We hope that this simple acronym will help you to more easily remember and recognise the symptoms of diabetes and take action when these are noticed. If so, contact your GP immediately, or talk to your pharmacist. The TEST campaign is supported by the Irish Childhood Diabetes National Register (ICDNR), Diabetes Ireland and Novo Nordisk Ltd.

For more information, remember to check our website diabetes.ie or call our helpline 01 842 8118

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After a century of insulin discovery – access to care is still a challenge World Diabetes Day 2021 marks 100 years of insulin discovery. After a century of this life-saving medicine, we still need better access to diabetes care.

hanks to the outstanding developments in medicine, people with diabetes can now live long and healthy lives. However, more than half a billion people with diabetes still face challenges in accessing best standards of diabetes care. As a result, the main theme of this year’s celebrations is access to care.

model is ‘free of charge’ for Medical Card holders only, meaning that approximately 40% of people with diabetes may have no access to this intervention.

Access to support Psychological support is instrumental in helping to deal with the burden associated with living with diabetes but, it is currently almost Access to education inaccessible. It is not formally embedded as In Ireland, despite the reimbursement of part of diabetes management and is not in line medicines, over 225,000 with diabetes-related people living with health-services delivery diabetes still have in Ireland. Presently, unequal access to the there is a 95% deficit of best available treatments diabetes psychologists in In Ireland, despite the and care. In many places adult diabetes services in across the country, acute hospitals and there reimbursement of medicines, there are shortages in is no access to dedicated over 225,000 people living diabetes specialists diabetes psychology (nurses, dietitians, services in primary care. with diabetes still have endocrinologists), unequal access to the best therefore many aspects Highlighting the gaps of the service (structured is also one of a available treatments and care. Ireland diabetes education, access few countries in Western to diabetes technology) Europe that does not have are unavailable. Adults with type 1 diabetes are a National Diabetes Registry. We don’t really waiting years to access education programs, know how many people have diabetes, how many whereas education is key to self-manage diabetes suffer from complications and what their clinical and should be delivered within the first year outcomes and needs are. The establishment of a after diagnosis. registry would help with tracking the prevalence For people with type 2 diabetes, HSE offers the of the condition, measuring outcomes and cost of Integrated Care Programme for the Prevention care and planning for future services. and Management of Chronic Disease. Recently Highlighting all of the above, Diabetes implemented, it aims to reshape the delivery Ireland has prepared pre-Budget submission of specialist diabetes care for people with 2022 and proposed eight immediate actions for uncomplicated type 2 diabetes. Investment in implementation to improve access to and the more than 200 posts for the Community Chronic quality of diabetes care in Ireland. Disease Specialist Teams will surely improve access to education for many. However, this

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Check the full pre-Budget submission 2022 document at diabetes.ie Here you can also find online education programs and resources about diabetes. Share, donate and help us to advocate for equal #accesstocare for people with diabetes in Ireland.

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Much can be done to reduce the impact of diabetes. Evidence suggests that type 2 diabetes can often be prevented, in some cases reversed. Meanwhile, early diagnosis and access to appropriate care for all types of diabetes can avoid or delay complications for people living with the condition. ~ Professor Andrew Boulton, President, International Diabetes Federation

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