ISSUE 28
DESANG magazine
the future of insulin Designer drugs for diabetes
making carbs count: Breakfast bonanza
PLUS
• New Products • Groovy giveaways • News (for T1 and T2)
ACCU-CHEK and ACCU-CHEK MOBILE are trademarks of Roche. © 2012 Roche Diagnostics Limited.
Accu-Chek® Mobile Strip Free, Simple, Smart. NEW for INSULIN USERS
All-in-one system: test whenever, wherever. Visit accu-chek.co.uk/desangmobile or ask your healthcare professional Experience what’s possible. Roche Diagnostics Limited, Charles Avenue, Burgess Hill, RH15 9RY. Company registration number: 571546
Editor’s comment... CONTENTS
16 6 4
DIABETES KIT
NEWS How hedgehogs relate to
Pump-holding T-shirts for small children; the new BG Star blood test meter.
breaKfast time
how different ways to start your day affect your blood glucose levels
B
earing in mind some of us are described as ‘insulin dependent’, I thought we should take a little look at what is going on the world of insulin manufacturing. Designer insulins are here to stay. What would you like yours to do? Meanwhile, sticking to the basics with carb-counting, the feature on page 16 checks out the carbs in our first meal of the day: breakfast. To add to the fun in this issue we’ve a page full of offers (see inside the back cover), with money off or free meters, all of which have clever tools and assets to help you make more of the control at your finger tips.
Sue Marshall Published by Desang Ltd the aim of this newsletter is to bring news and information to people living with diabetes. Please check all matters concerning how you handle your health with your healthcare team. We welcome any feedback on the magazine or ideas for future articles. Editor: Sue Marshall sue.marshall@desang.net
diabetes care. New availability of the Freestyle InsuLinx meter.
8 FOOD NEWS
Can soup make you thin? Apparently so. A disease -centred cookbook. Plus the cracking good value of celery.
10 LIVING
A look at what’s under develpment regarding the manufacture of insulin.
16 carbs makING count:
Why all breakfasts are definitely not equal.
KIT
pumpity pump pump pump!
star turn! Sanofi’s BG Star blood glucose meter features a simple start-up with no coding required. It’s stylish with a large screen which is back lit for easy reading and a nonslip base so it won’t skid around when you’re testing. On its website, Sanofi has provided video user guides that come in a range of languages, including Polish and Hindi, Punjabi and Urdu. Along with the meter is diabetes management software which has a Daily Digest feature that shows results in graphs as well as logs of readings, and a Virtual Meter feature that lets you change the meter’s settings through your computer, such as amending time and date, hypo and hyper alarms as well as reminder alarms. www.diabetesmatters.co.uk
Kate Buckley, the mother of a small boy, Joseph, who was diagnosed with diabetes in 2009, before he was two years old. She had been sewing pockets onto her son’s clothing (with the help of both of Joe’s grandmas) and decided to offer these out to other people with children. Described as insulin vests for busy little people, they are simply pockets sewn on to baby grows and children’s t-shirts and vests that allow the kids to get on with their lives without a pump getting in the way. Worn underclothing, they are aimed at children under six years old. Made from 100% organic cotton, they have a secure pocket with holes for infusion set tubing to go through. Prices start at £8.99 from www.pumpteepump.co.uk
special offers! We have 5 contour usb meters to giveaway, or you can apply for a lifescan verio iQ meter or one of the newly available freestyle insulinx. go to the inside back cover to find out more!
WHAT DID YOUR METER TELL YOU TODAY?
Meet OneTouch® Verio®IQ. The meter with Verio® PatternAlert™ Technology.
NEW
Every time you test, it looks for hidden patterns of high and low blood sugar and alerts you when it finds one — right on screen. On insulin treatment? OneTouch® Verio®IQ may be suitable for your needs.
Put it to the test. Visit www.LifeScan.co.uk/DS or call OneTouch® Customer Care to order your FREE* trial: 0800 279 4142 (UK) quoting code AE213 Receive personalised meter training and on-going support from OneTouch® Customer Care: 0800 279 4142 Lines open 8.30am-6pm Mon-Fri, 9am-1pm Sat
*TERMS AND CONDITIONS Offer open to those who are on insulin and making their own insulin dosing decisions (e.g. Multiple Daily Injections of insulin), aged 16 or over and resident in the UK and Republic of Ireland, including users of meters other than OneTouch® meters. Applicants who currently use a OneTouch® meter must have had their meter for 12 months or more and not received a free OneTouch® upgrade during this period. Offer closing date 31st Dec 2012. Those eligible to participate in the free meter trial will be offered a OneTouch® Verio®IQ Blood Glucose Monitoring System, 25 test strips and a questionnaire about their experience of using the OneTouch® Verio®IQ to complete and return in the reply paid envelope provided. Only one free OneTouch® Verio®IQ trial per person. Meters are subject to availability. This offer is limited to a maximum of 4,000 free OneTouch® Verio®IQ meters. Allow 28 days for delivery. LifeScan, LifeScan Logo, OneTouch® and OneTouch® Verio®IQ are trademarks of LifeScan Inc. © 2012 LifeScan, Ortho-Clinical Diagnostics. AW 099-110A. 12-141
NEWS
giving voice to being heard Zoe Scott was named the winner of this year’s Quality in Care (QiC) Diabetes People’s Award. She had been inspired to develop an online community raising awareness of the psychological side of living with diabetes. Hedgie Pricks Diabetes was launched last year in May, initially on Facebook and then as a website in its own right. Having grown up with type 1 diabetes, she had felt that she did not get the emotional support she needed when she experienced anxiety and depression as a teenager. Now 21, Zoe oversees the efforts of Hedgie Pricks Diabetes in giving a voice to people who have shared her experience, and making sure healthcare professionals working in diabetes care fully understand the emotional and psychosocial impact of living with the condition.
hedgiepricksdiabetes.org.uk Zoe (pictured above right with last year’s winner Angela Allison), is based in Chelmsford,. She says, “When you work full time and have to do the whole project around your job, it can be very stressful and it can make you wonder if it is always worth it. However the feedback I have received from people and been given this award helps me to continue to make this project happen, to make diabetes teams look after their patients’ emotional wellbeing as well as general diabetes care. The award will help me
ensure that I will continue to work hard to make sure those who feel they can’t talk about how they feel, can have their voices heard.” Supported by Diabetes UK, NHS Diabetes and Sanofi, the QiC Diabetes 2012 awards event took place in September. Diabetes was chosen as the first therapy area to be covered by QiC in 2011 due to the increasing need to find the best way to tackle the social and economic burden of the condition. Simon O’Neill of Diabetes UK, says: “The standard of entries was outstanding and has enabled us to share and learn from best practice in the field of diabetes care. “ Most of the contenders were NHS teams. The People’s Award is for a nonNHS service provider. For full results visit www.qualityincare.org/awards
NEWS
on the right flightpath As of 13 August this year, the UK Civil Aviation Authority (CAA) now allows commercial flying for pilots with diabetes and also full private flying for pilots with diabetes. Douglas Cairns (pictured), who represents pilots with diabetes, says “Via our website at our group has been engaging with the CAA for five years over this, so now the UK is the only country in the world that allows both commercial flying and full private flying privileges for pilots with insulin-treated diabetes. This has caused quite a stir with the International Diabetes Federation and a number of diabetes associations such as Diabetes UK and JDRF in support and acknowledgment of this news. “ The UK’s pilots with diabetes group now has contacts in the USA, across Europe, Australia and South Africa. Says Cairns, “I will be continuing with flying projects to
support our efforts to persuade other aviation authorities around the world to introduce similar policies to enable commercial and private flying for pilots with diabetes.” To find out more see www. flyingwithdiabetes.com and www. pilotswithdiabetes.com
Insulinx available direct When originally launched, you could only get a Freestyle Insulinx meter directly from your diabetes nurse, as it needs to be programmed around your own personal treatment programme, for which an access code was required to put this information in. The meters are now available direct from Abbott in a ‘pre-easy’ mode so you can use all the main tools. You can add your own image into the phone as well as add various other personalized settings. It’s PC and Mac-compatible and comes
with FreeStyle Auto-Assist software. The touch screen is icon-driven, so you press the relevant icon to get into that part of the set-up. There’s only one button, which acts as the home button, just like a mobile phone. The code is only needed if and when you want to turn on the bolus Calculator tool, and the code can be given by your HCP at their discretion. See the advert in this issue or turn to the inside back cover of this issue for more info on obtaining one of these meters direct.
older people’s network The first national meeting of the Older People Diabetes Network (OPDN) will take place on 27th November, 2012. The themes for this free event, which will be held at Glaziers Hall, London Bridge, will include dementia and care homes. A keynote speech will be delivered by Professor Alan Sinclair, Director of IDOP (The Institute of Diabetes for Older People). The network allows the two-way sharing of good practice, research, news and development. It was launched in the spring with a series of regional events and then showcased to politicians and dignitaries at a parliamentary event in June. The national conference will run from 9am to 4.15pm. www.diabetes.nhs.uk
food NEWS
stick thin Celery is a very versatile vegetable – and can be used in stews, soups, pies, salads, or just eaten on its own. Not only is it useful in cooking, but it’s good for you. Three sticks of celery equals one of the recommended five daily servings. Wild celery has been used by man for almost 3,000 years and was originally regarded as a medicine, not as food. Celery provides useful amounts of vitamin C, potassium and folate, and some insoluble fibre. It is low in calories (one stalk contains just two calories) and virtually fat free. It is a great choice for slimmers because its high water and fibre content and crunchy texture gives it a high Satiety Value, which means it helps you feel full. And, zero carbs, so tuck in! For a quick dip, try garlic and thyme studded Camembert with celery dippers and apple chutney (for two). Preheat the oven to 200°C. Take a camembert out of its box, remove any wax paper wrapping and discard, then return the cheese to the box. Make a few deep slits through into the top of the cheese and tuck in a few slices of garlic slices and a few small springs of fresh thyme. Place the cheese, with the lid, on a baking sheet and cook in the oven for around 15 minutes or until the cheese is soft and gooey. Serve the hot melting cheese with the celery to dip in with a jar of apple chutney to hand and a hunk of bread if need be.
restoring balance Chef Christine Bailey and Nutritionist Lorraine Nicolle believe that Modern Medicine is failing us as more people suffer with chronic diseases and the nation getting fatter. “An understanding of the body’s basic systems, how they get out of balance, and how to get them back in balance allows us to create an individualised program for each person,” says Bailey. This is the focus of a radical new cookbook by herself and Nicolle. “The goal is patient centred health care rather than disease-focused medicine,” she says, “This underpins the basis of the book which aims to use food to help the body rebalance and restore health and wellbeing. ‘Treat the person not the disease’.”
absolutely souper! Fiona Kirk, nutritionist and author of two much-acclaimed fat loss books, So What the F*** Should I Eat? and 2 Weeks in the Fast Lane is on a mission to prove that soup can make you thin with her eBook. Highlighting why soup can make you thin, how it can fit into your day and which soups to eat at which time of the day to make you and keep you thin, the guide has a supporting website too. Soup Can Make You Thin is available in eBook format for £5.99 from www.souperydupery.com
The book is divided into body systems such as adrenal and thyroid imbalances, fatty acids, blood sugar balance, digestion, detoxification, hormonal and neurological imbalances and also has a chapter on healthy ageing. Each chapter includes easy menu plans to follow and recipes to help address imbalances and deficiencies. www.advancenutrition.co.uk
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LIVING
stuck on you We tend to stick to our insulins for years, maybe considering a change when a new brand comes on the scene. The future is likely to bring us far greater choices, and soon. The entire insulin market is estimated at $18 million but, ultimately, insulin is a highly specialized drug that’s used by a relatively small number of people. The complicated processes needed to make it are in the hands of a small number of companies. The biggest player on the UK’s insulin scene is indisputably Novo Nordisk, which has more than 50% of the market. Most newly diagnosed Type 1s go straight onto a Novopen with Novorapid and are likely to have a second pen with Levamir. Such brand names are familiar to many, but over time brands do evolve and some are dropped or reformulated and relaunched often due to new methods of productions. Insulins are necessarily extensively trialed, although some commentators might argue that they are not tested hard enough or long enough before coming to market. With all Type 1s and increasingly more Type 2s being treated with insulin, the market is growing. And a growing market is a lucrative one. For example,
Eli Lilly sold $1.3 billion worth of Humulin insulin in 2011. While some manufacturers who are already in the diabetes sector are expanding their offerings, new contenders are eyeing up the market. Not surprisingly, another process in the evolution is that pharmaceutical companies who have a footprint in the market are now doing ‘joined up thinking’. Blood test machine suppliers and looking at producing insulin too, and vice-versa. Sanofi, which has traditionally produced insulin, has broadened its scope by buying a blood-testing brand and offering it under its own brand, hence the new iBGStar and BGStar now in its portfolio. You can run on their insulin and use their blood test system and close the loop.
Competitive edge
Sanofi is also the proud owner of the world’s largest insulin brand, Lantus, worth $3.50 billion in 2010. Then along comes Novo Nordisk with
continued over
Since the discovery of insulin in 1921 it’s arguable that there have been very few major break-throughs in diabetes care. We have new delivery devices, particularly the pump, and neat blood test meters, but to date the choice of insulins hasn’t been up to much.
LIVING
The history of insulin
LIVING its new drug, the ultra-longacting insulin Degludec and it’s insulin combination analogue DegludecPlus. Extensive trails have shown that Degludec effectively lowers blood glucose levels while consistently demonstrating a significantly lower rate of hypoglycaemia relative to Sanofi’s Lantus (insulin glargine), especially during the night. Novo also reported that the trials had shown that Degludec can be administered once-daily at any time of the day without compromising glycaemic control or safety – so if you have it at 9pm one night, and 11pm the next, there would be ‘no drop in service’ from the drug. It seems that Sanofi has a serious competitor on its hands. Meanwhile, drugmaker Merck is buying privately held company SmartCells, which is developing an experimental form of ‘intelligent insulin’ in a deal that was reported to be worth $500 million. The smart insulin is selfregulating, so it releases only when it is needed i.e. when your blood sugar goes too high. “The acquisition marks Merck’s move into the insulin space at a time when other large drugmakers have tried to break into the market traditionally dominated by Novo Nordisk, Eli Lilly and Sanofi-Aventis,” according to a report by Diabetes Newshound.
New forms of insulin
One new formula that might quickly appeal to diabetics is an even faster acting insulin than the ones we presently have, where injected insulin takes at the very least ten minutes to get going,
and usually more like 20-30 minutes. Another dieal benefit would be an insulin that also stops working sooner – so you do not have to worry about shortacting insulin still being active in the body for up to another two hours. Over in the USA drug-maker Biodel Inc. is developing a fastacting insulin product called VIAject. The company says VIAject helps reduce the risk of both hyperglycemia and hypoglycemia (low and high blood sugar levels). The insulin will be able to be used in insulin pumps as well as injected during mealtimes. Lipoxen PLC has entered into an agreement with developing a diabetes treatment product for use with Glide Pharma’s needlefree drug delivery technology. The agreement is to investigate the delivery of Lipoxen’s longacting insulin, SuliXen (Polysialic Insulin). This offers potential for the treatment of Type 2 diabetes. It is a long acting injected form of insulin formulated using polysialic acid (PSA), a naturally occurring polymer which is biodegradable, non-immunogenic and nontoxic. The use of PSA is expected to decrease the likelihood of the body generating antiinsulin antibodies which can be problematic in the management of T2 diabetes.
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1552 B.C. Earliest known record of diabetes mentioned on 3rd Dynasty Egyptian papyrus by physician Hesy-Ra; mentions polyuria (frequent urination) as a symptom. 1st Century A.D. Diabetes described by Arateus as ‘the melting down of flesh and limbs into urine.’ c. 164 A.D. Greek physician Galen of Pergamum mistakenly diagnoses diabetes as an ailment of the kidneys. Up to 11th Century Diabetes commonly diagnosed by ‘water tasters,’ who drank the urine of those suspected of having diabetes; the urine of people with diabetes was thought to be sweet-tasting. The Latin word for honey (referring to its sweetness), ‘mellitus’, is added to the term diabetes. 16th Century Paracelsus identifies diabetes as a serious general disorder. Early 19th Century First chemical tests developed to indicate and measure the presence of sugar in the urine. 19th Century French researchr, Claude Bernard studies the workings of the pancreas and the glycogen metabolism of the liver. Czech
researcher I.V. Pavlov discovers links between the nervous system and gastric secretion, making an important contribution to science’s knowledge of the physiology of the digestive system.
FreeStyle InsuLinx. Benefits that add up for a new way to get on with your day
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For further information please contact the Customer Careline on 0500 467 466 or visit www.freestyle-insulinx.co.uk
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The history of insulin
LIVING The Glide is a new form of technology developed by Glide Pharma, a specialty pharmaceutical company. The Glide is less invasive than traditional injection methods and should make the injecting experience less painful and less upsetting via a less invasive, easy to use, patient friendly delivery system.
Piggy possibilities
There’s still a group of diabetics in the UK that use animal insulins, not the ones manufactured and called ‘human’ insulins. Interestingly, use of animal insulins may yet experience a resurgeance, with Living Cell Technologies having announced that its Diabecell porcine implant for people with Type 1 diabetes as well as xenotransplantation has been approved for use in Russia, the first country to approve the therapy. Diabecell is made of pig islets that are encapsulated and implanted in the abdomen
of patients with Type 1 diabetes. This device helps patients self-regulate insulin secretion throughout the body. Clinical trials of the porcine cell implant therapy began in 2007 with eight patients. Six of the patients showed long-term improvement in blood sugar levels as measured by HbA1c results. They also required fewer insulin injections, and two required none at all for about eight months, and they all reported reduced instances of hypoglycemia. Living Cell Technologies (LCT Global) is continuing trials in New Zealand. www.lctglobal.com
Further reading
With all Type 1s and some Type 2s depending on insulin to live, there is a niche but needy market. Why not, like Anadin, have cheap versions of lead products? Generic Insulins Out of Reach for Now by Clay Wirestone.
1869 German Paul Langerhans at the pancreas contains two systems of cells. One set secretes the normal pancreatic juice, the function of the other was unknown. Later, these cells are identified as the ‘islets of Langerhans.’ 1889 Oskar Minkowski and Joseph von Mering at the University of Strasbourg, France, first remove the pancreas from a dog to determine the effect of an absent pancreas on digestion. November 14, 1891 Frederick Banting born near Alliston, Ontario. February 28, 1899 Charles Best born in West Pembroke, Maine. July 1, 1920 Banting, now a doctor, opens his first office in London, Ontario. October 31, 1920 Banting conceives of the idea of insulin after reading an essay by Moses Barron in an issue of Surgery, Gynecology and Obstetrics. For the next year, with the assistance of Best, Banting continues his research using a variety of different extracts on de-pancreatized dogs. Summer 1921 Insulin is ‘discovered’. A depancreatized dog is successfully treated with insulin. Brief history timeline from the Canadian Diabetes Association, with thanks.
Special deliveries
LIVING
A look at some relatively new ways to get insulin inside you ‘Insulin on the outside’
This is a phrase that neatly describes the situation that insulin dependent diabetics are in. Our insulin is in cartridges or bottles and we have the unattractive task of putting it inside us. Due to the fact that it’s a hormone, we can’t eat or drink it as it is destroyed by digestive enzymes. A brief option to use an inhaler failed to take off, for many reasons when Exhubera was launched then later dropped.But long-term diabetics know that things are far better for us than they used to be, and things keep improving with sharper needles and now even infusion pumps.
For forgetful folk
Developed by Professor Peter Nixon, who has been insulin dependent for 25 years, and who describes himself as a ‘forgetful’ insulin user, the Forget Me Not I is an inexpensive reminder system which is made from sturdy cardboard. It holds
your insulin pen(s) in ‘mealtime’ slots. After an injection the pen is simply moved on to its next position. Finding a pen out-ofposition at any time of the day is a great reminder that an insulin injection has been missed. “In a world of digital reminders and ‘smart’ pen caps, this simple ‘low tech’ solution has been all I need to maintain my regular routine,” he says.
Short work
For maximum effectiveness, insulin must be injected into the fat layer below the skin. This helps ensure that insulin is absorbed slowly and steadily, helping you to achieve predictable control. Medical technology company BD recently launched 4mm pen needle has a very fine gauge (pictured right). It is suitable for all adults and children who inject insulin. An important scientific study into skin thickness in adults found that,
The Injex30 (pictured below) is a needle-free device that gives insulin users a real alternative to using (and disposing of) needles. Of immediate appeal to needle-phobics, this insulin delivery device might also appeal to those of us who find the whole issue of disposal of sharps to be what can best be described as a ‘right pain’ in itself. The skin is only penetrated by an extremely fine jet of insulin – no needle is involved The Injex30 can be used with all licensed types of insulin. www.injex.com
irrespective of age, weight, or ethnic background, adult skin is on average 2mm thick*. When used correctly at 90 degrees, this 4mm pen needle will pass through the skin and reach the fat layer for an optimal injection. Tests with nearly 200 people showed that the 4mm pen needle is more comfortable to use, less painful to inject with, and was preferred by most people over their existing longer pen needle**. If you would like to try the new 4mm pen needle, which is guaranteed to work with all insulin pens available in the UK, ask your diabetes nurse or doctor for a sample pack of BD Microfine+ 32G x 4mm Pen Needle. *Gibney MA, Arce CH, Byron KJ, Hirsch LJ. Skin and subcutaneous adipose layer thickness in adults with diabetes at sites used for injectable therapy injections: Implications for needle length recommendations. In press. Curr Med Res Opin. 2010. **Hirsch L, Klaff L, Bailey T, Gibney M, Albanese J, Qu S, Kassler-Taub K. Glycemic control, safety and patient ratings for a new 4 mm x 32G pen needle versus 5 mm and 8 mm x 31G pen needles in adults with diabetes. In press. Curr Med Res Opin. 2010. With thanks to BD for the use of images for this article.
LIVING
Good morning! Most of us have got the mesage that we should eat breakfast. For a long time there was rather bad advice about breakfast, that one cereal was much like another. But now we know better.
LIVING
Lizi’s Granola features useful labelling including the GL rating. GL shows how a food (not just one ingredient) will enter the bloodstream as blood sugar. A 50g serving of Lizi’s Granola has a GL of 5.5g, while the same serving of Cornflakes has a GL of 31g.
Most of us know that skipping breakfast is considered bad form – breaking your ‘fast’ (not eating for the hours that you sleep) is frowned up on my doctors and nutritionists. So, given that most of us do have breakfast, there is then the host of options to choose from – tea and toast, porridge, a range of cereals or going to work on an egg. But for diabetics, not only do we have to take into account convenience (are we just grabbing something as we go out of the door – can we eat it in the car / on a train / while walking to the station?), but also the carb content and the relative GI. Jam on toast, honey in porridge can make a sensible choice into a bad one. For diabetics the double-whammy is that most humans have what is referred to as the ‘dawn phenomenon’ – your body naturally starts to produce a rise in blood sugars in the early hours (6 or 7am) as it readies to get you up out of bed and out on the road to start your day. It tends to mean that diabetics are putting in food just while their body is also assisting with its own sugar boost. For a long while, Diabetes UK’s advice on breakfast was that they were all pretty much of a muchness – a dangerous bit of advice when in fact breakfast choices vary immensely, particularly in sugar and fat content.
Skipping stones According to a study of almost 2,000 men who did not have Type 2 diabetes, heart disease, or cancer, those who didn’t eat breakfast had a 21% higher risk of developing Type 2. The study, published in the April edition of the Journal of Clinical Nutrition, and as reported by Diabetes Health, followed the men for 16 years. Snacking was also associated with an increased risk of Type 2 diabetes, but the impact was weakened when body mass index was taken into account. So, it seems skipping breakfast might even lead to developing diabetes. But if you’re already diabetic, it’s no excuse not to have breakfast either, even if you skip it because you are late for work. According to breakfast brand Dorset Cereals more than half the population of the UK admits to skipping breakfast more than once a week in order to get an extra few minutes in bed. As a result, their new Breakfast Pots are designed to be eaten at work. Rob Ward of Dorset Cereals comments, “People who eat breakfast are funnier, sexier, and more efficient at work than people who don’t -- well that’s what the team at Dorset Cereals thinks any way! So helping people who might have missed breakfast but still want something tasty to eat is our primary mission, you could say we are on a bit of crusade.” From supermarkets, it’s 99p per 75g
breakfast pot. Most cereals – despite all their marketing, are chock-full of sugar. Even if you always have the same brand, remind yourself of the sugar content by reading the labels once more. You could well be amazed. Things like Frosties and Crunchy Nut cornflakes are coated in sugar. At the other end of the scale, the thought of porridge can bring to mind images of grey-coloured, gruel-like bowls of slop, but those images are seriously outdated. With the UK porridge market now worth £157 million, the hot cereal market has grown by 30% over the past two years.
continued over
LIVING
MAKING CARBS COUNT
Rudely good for you Another terribly British breakfast brand, alongside Dorest Cereals, is Rude Health. Also boasting attractive packaging and snappy marketing, Rude Health’s porridge range includes Morning Glory, Daily Oats, Fruity Date, and Top Banana. They claim that The Oatmeal, their newest recruit to the ranks, is a solution for purists and perfectionists. Made from organic Scottish oatmeal, The Oatmeal was developed by Nick Barnard, co-founder of Rude Heath, and contains a blend of steel cut pinhead and medium oatmeal. It is a porridge aimed at the new breed of ‘make it yourself’ purists, and old world traditionalists, dedicated to perfecting the craft of porridge cooking. Barnard says, “Rude Health makes porridge for the purists – young and old – who want traditional taste, texture, value and health – and to make it themselves! It’s all about the experience, and the ceremony of making your breakfast, as well as the comfort of knowing what goes into your porridge is 100% natural and unrefined.” You needn’t slave over a hot stove in the morning stirring your porridge. Bunging it in the microwave will take about two minutes. The Oatmeal is available at £2.99 per 750g box.
A little bit of toast There’s not a lot wrong with a few slices of toast in the morning, so long as you avoid white bread slathered in butter and jam. Toast is probably not the top choice for a breakfast for a diabetic, but if you do prefer it, try to have a low sugar spread where you can and try to buy brown bread.
Great granola, mighty muesli, proper porridge Granola is a lesser known breakfast ingredient in the UK. Lizzi Shaw’s breakfasts feature granola, which is a low GI option. For more on Lizzi Shaw and on sugars in cereal see the Making Carbs Count article in this issue of the magazine which explains the benefits of this superior cereal in terms of diabetics and their diets. Muesli is often delicious and is seemingly a healthy option, watch out for both sugar and fat content in muesli. They are often surprisingly high in carbs and sugars as dried fruits are used in most brands. Not a bag option, but read the labels and try actually weighing it out when you first start using it. 100g might be 40 carbs but 100g once weighed out can look like a very small portion! Porridge is fabled as an excellent start to the day, the reason porridge is so popular is not just that it’s cheap (which comparatively speaking it is), but while it does have a carb content, the sugars are released very slowly and evenly giving you a nice full feeling all morning without a huge sugar dump. You can embellish with fresh fruit and stir in yoghurt instead of cream for a touch of luxury.
special offers! contour next usb The Contour NEXT USB has advanced sensor technology and integrated diabetes management software and a colour screen while remaining so easy to use. Download data to any device with a USB port. These retail at £29.99 and we have x5 to giveaway.
GIVEAWAY We have five Contour Next USB meters to giveaway. Send your name & address to info@desang.net with ‘free USB’ in the subject line.
Offer ends Nov 11th. Email applications will be shared with Bayer Diabetes Care
onetouch verio iq Lifescan’s OneTouch Verio iQ is available on a FREE TRIAL basis. The strip port lights up when you put a strip in, you only need a ‘speck’ of blood when you test and the results are shown on the sleek colour screen. Its Pattern Alert Technology includes a high and low pattern messenger. Click the pic to visit site. Use promo code AE213
freestyle insulinx Abbott’s Freestyle InsuLinx meter has a touch-screen and is icon-driven. You can input carbs and insulin doses. Advanced features include a Bolus Calculator. Uses ZipWik tabs (blood test strips, right) for easier, faster blood application and uptake. Newly available direct from Abbott Diabetes Care. Click the pics to visit site.
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Whe you buy your first kitbag
20%
For a full range of kitbags for every occasion, as well as a directory of diabetes product information (from blood test meters to insulin pumps and other equipment) go to
discount For members
www.desang.net
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Buying your first kit bag?
Benefit from a 15% discount by quoting promo code mag11 when ordering online.
Already have a kit bag?
Then you can benefit from a 20% discount on your next purchase. Just email us at info@desang.net and ask for the code.
See our full range of kitbags online or call 0870 300 2063 for a brochure
Pen Pack
Classic
Roll up
Slim
Making living with diabetes easier