September 2013 - Diabetes Help

diabetes HELP
ISSUE: SEPTEMBER 2013
tauranga NEWSLETTER
What’s happened lately?
Careers Expo - DHT Stand
DHT were very generously offered a promotional
stand at the recent careers expo at the ASB Arena
(Tauranga) on the 9th and 10th of August. The stall
was supported by DHT Committee members and
Kaitiaki Nursing Services along with student nurses
from the Waiariki Institute as a health promotional
opportunity for the community. DHT Membership
and diabetes youth flyers were available along with
information on managing hypoglycaemia and healthy
eating options.
As a two day event various institutions and business’s
were available for college students and adults to be
able to discuss potential career options. Fifty stall
holders were able to have interaction with over
2000 students from year 11-13 who attended on the
opening Friday , with many more students and adults
visiting on the Saturday.
DHT’s stand focused on promoting awareness
of diabetes and healthy drinks and snack food
choices. The team helped visitors identify the high
amounts of sugar in sports and energy drinks. It is
well known that being overweight or obese is a risk
factor for developing diabetes and the expo was an
opportunity to be able to promote healthier choices
to the community.
The stand displayed some common drinks that
some young adults drink regularly such as the
sports drink powerade, energy drinks such as ‘V’
and ‘Mother’, plus fizzy drinks such as coke and
lemonade. The comparison was made to a flavoured
water with stevia as the artificial sweetener with no
sugar. Each drink had a corresponding bag with the
amount of sugar in it based on around 5gm being
a teaspoon of sugar. For example 1.5litre of coke
equates to almost 40tsp of sugar. Most students
were shocked at the amount of sugar they drank
regularly ,with some saying that they were” horrified”
and “I’ll not have that any more”.
As a health professional these comments are really
positive to hear. It was a wonderful opportunity to
be able to encourage both young and older adults
alike to be able to choose water and low fat milk as
healthier options. After seeing the amount of fat that
is in some common snack foods many at the expo
were happy to have these more as treat foods rather
than regular snacks. The more we can educate
and promote healthier drink and food choices, the
growing obesity rates for the NZ population may be
able to be reversed. It goes without saying that this
will hopefully also have an impact in reducing the
growing rates of diabetes and heart disease.
Article : Caroline Vanstone, DHT Committee Member and
Kaitiaki Nursing Services
1
What’s going on out there?
‘Weight based treatment is
more effective for resolving
hypoglycaemia in adults’. A
randomised trial
Phase 3 Studies of Afrezza,
inhaled insulin in the USA
MannKind (USA) completed its Phase 3 Studies of
Afrezza, an ultra-fast inhaled insulin for Type 1 and
2 Diabetes. Afrezza is ultra-rapid-acting mealtime
insulin taken through an inhaler that was previously
denied FDA approval in January 2011. This insulin
dissolves very quickly after inhalation so that
insulin levels peak within 12 to 14 minutes, a huge
improvement over the typical 60-90 minutes with
current rapid-acting insulin (Humalog, Novorapid,
and Apidra).
A recent diabetes trial undertaken by Capital & Coast
District Health Board, Wellington was presented at the
NZSSSD Annual Scientific Meeting (Napier, 2013) by
Diabetes Nurse Specialist Lindsay McTavish.
The aim of the trial was to compare three
hypoglycaemia treatment protocols in adults with type
1 diabetes (T1DM). Previous studies demonstrated
that a weight based hypoglycaemia treatment
protocol, 0.3g/kg is more effective that standard
advice in resolving hypoglycaemia and avoiding
excessive re-bound hyperglycaemia in children
with T1DM and they sought to determine whether
this can effectively be translated to adults. The 34
subjects (21 male, 13 female) aged 22 - 71, were
recruited, and 24 completed 15 treatment episodes,
2 withdrew, 1 was excluded, and 10 had fewer
than 15 documented events. Blood Glucose was
significantly higher at 10mins when 0.3g/kg glucose
was provided than with either 0.2g/kg or 15g. The
0.3g/kg was more effective in men but there was no
difference between the three groups in the
women.
Conclusion: a weight based protocol of 0.3g/kg
of glucose per kg of body weight is most effective
for treating symptomatic hypoglycaemia in adults
with T1DM, and more effective than the current
recommendations of 15g glucose for all patients.
Note: Please discuss with your usual health care
provider before making any changes to your diabetes
management.
Both studies assessed HbA1c levels over 12 weeks.
MannKind expects to release data in September
2013. If successful this represents the first major
advance in mealtime insulin since Humalog, more
than 15 years ago. Since Afrezza comes in the
equivalent of 3-4 unit dose increments, it is unclear
how well it would work in Type 1 diabetes, and it won’t
be a great option for those who are highly insulin
sensitive or who take very little mealtime insulin.
Afrezza potentially could be effective for large meals
that contain a lot of carbohydrates, for those with very
high blood sugars, and for people who are more
insulin resistant. MannKind intends to submit to the
FDA (USA) in Sept/Oct 2013 aiming to market in
Spring 2014.
Note: Afrezza is not yet available in New Zealand
www.diaTribe.org
DIATRIBE #56 • RESEARCH AND PRODUCT
NEWS FOR PEOPLE WITH DIABETES
DO YOU HAVE TYPE 2 DIABETES?
Do you have difficulty in controlling your blood sugar levels using simply a healthy
diet and regular exercise?
If the answer is yes, and you are 18 years of age or older, you may be suitable to participate in a clinical
research study. This study will look at whether an investigational medication (a new medication which is
under development) is safe and effective in people with type 2 diabetes who have difficulty in controlling
their blood sugar levels even though they lead a healthy lifestyle. The study will last about 7 months. It will
involve approximately 13 visits to a study centre. Suitable participants will receive study-related medication
and health assessments at no cost.
To find out more contact: 07 579 0453 or email: info@p3research.co.nz
2
‘Food insecurity in relation to
changes in HbA1c, self-efficacy,
and
fruit/vegetable
intake
during a diabetes educational
intervention’
This longitudinal, observational analysis assessed
food insecurity in relation to self-care measures
in 665 low-income patients with diabetes who
received self-management support as a component
of an educational intervention. Food insecurity was
identified in 33% of the cohort, with such patients
typically being younger, of low income status and
more likely to be unemployed compared with
patients who were food secure. Compared with food
secure patients, those who were food insecure had
significantly (p<0.05): i) higher baseline mean HbA1c
values (8.4% vs. 8.0%); ii) lower self-efficacy and
fruit and vegetable intake; iii) greater improvements
in HbA1c over time (–0.38% vs. –0.01%); and iv)
greater improvements in self-efficacy. HbA1c values
did not differ by food security status at follow-up.
Comment: There has been a lot of focus on ‘selfmanagement’ in long-term conditions such as
diabetes. Conceptually it makes sense that if
individuals are better able to manage their own
condition, they will do better overall and have better
health outcomes. There is some evidence to support
this notion, but it is notable that the magnitude of
benefit is often modest and the effects are attenuated
over time. This study looked at whether food security
influences the effect of self-management training.
Not surprisingly, those with food insecurity, often
younger with lower incomes or unemployed had
poorer diabetes outcomes at baseline. However,
these people did much better with self-management
support and education, even though this wasn’t
specifically targeted at the financial issues, and this
may be a group who we should focus our resources
on.
Authors: Lyles CR et al,
Diabetes Care
2013;36(6):1448–53
http://care.diabetesjournals.org/content/36/6/1448.
Abstract taken from Diabetes & Obesity Research
Review, Issue 71 2013, p2.
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www.tauranga.snapprinting.co.nz
Recipe of the Month!
Strawberry Smoothie
Try the perfect combination for a smoothie that keeps
blood sugar levels stable and still tastes delicious.
Ingredients:
•
5 strawberries
•
1 cup unsweetened soy milk
•
1/2 cup low fat Greek-style yogurt
•
6 ice cubes
Place all ingredients in a blender and blend until
smooth. Pour into a glass and garnish with a
strawberry.
Servings: 1
Amount Per Serving:
Calories: 177
Carbohydrates: 17g, Sugars: 13g
Fibre: 2g, Total Fat: 6g, Saturated: 2g, Trans:0g
Sodium:171mg, Protein:14g
Handy Cooking Tip
How to lower salt or sodium
Ingredient
Replace with:
Salt in cooking
lemon juice, curry powder,
spices
Canned vegetables and
sauces
No added salt varieties,
fresh or frozen
Canned or smoked fish
Fresh fish or canned in
spring water
Corned meats
Fresh meats
Soy sauce
Lite soy sauce
Tomato Sauce
Lite Tomato Sauce
3
UPCOMING EVENTS
Annual General Meeting - Wed 18th September 2013
Time:
Venue: 7pm
St Enochs Church Lounge, 134 Sixteenth Ave, Tauranga
Agenda
7.00pm - Guest Speaker
7.30pm - AGM Commences
Executive Reports
Election of Officers
General Meeting
AGM Guest Speaker
Jaine Kirtley is a Registered Naturopath, Nutritionist and Registered Mental Health Nurse. Jaine
has been involved in the natural health products
sector for over 20 years. She works both in her
Naturopathic practice, Bay Naturopath and as
owner of Entire Katoa Ltd., a dietary supplement
company.
She has extensive knowledge of and practical
experience of the use of traditional Naturopathic
medicine, Western Herbal medicine, Homoeopathy,
Dietary supplementation, and Essential oils. Jaine
Kirtley has written and presented a number of
researched articles, including the naturopathic and
nutritional approaches to support for people with
diabetes. She has a regular column in the Bay News
and has had several television interviews related
to health. She is also a Media Spokesperson for
the NZ Society of Naturopaths.
Her expertise in nutrition includes naturopathic
nutrition, and mainstream nutrition viewpoints. She
is a member of an Expert Committee which gives
advice to government bodies regarding the future
regulation of natural health products.
Jaine Kirtley Reg. Naturopath, Reg. Nurse.
07 542 1364
email jaine@baynaturopath.co.nz
or visit www.baynaturopath.co.nz
Entire Katoa Ltd Food State dietary supplements
www.entirekatoa.co.nz
4
Election of Officers
At the AGM the election of Executive and General
officers for the committee are held. The positions
are:
• President
• Vice President
• Treasurer
• Secretary
• Committee
A number of the existing committee have made
themselves available for nomination. However we
have three resignations from our committee:
Rob Wilson has resigned from the President role ,
Ian McCoy has resigned as Vice President, and
Nick Cole will be resigning from the Treasurers role
at the AGM.
Also, Pat Fogden has resigned from doing her great
job as the Te Puke Co-ordinator. We are looking for
anyone who would like to take this voluntary role on.
We would like to thank all of them for their tireless
efforts and enthusiasm in taking the organisation
forward.
Nominations are sought for the all positions
before and during the AGM.
We would
love more people on the committee to help
share the load and take us forward.
HOW CAN
YOU HELP DHT?
You might not be interested in committee work, but
your skills built through your careers and lives may
be helpful to the many activities that DHT undertake.
Just contact us if you think you can help.
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Get to know some of the
Committee
Here are some of our newer committee members.
If you see them in the street or at meetings, make
sure you take time to talk to them. They are all
enthusiastic and passionate about helping all people
with diabetes in the Tauranga and Bay of Plenty
area.
Debbie Cunliffe
I have been married for 27
years and am blessed with
two grown-up children, a great
son-in-law and a very naughty
Spoodle who can sniff out
carbohydrates at 100 meters!
I qualified as an RN in 1986,
and have worked in New
Zealand as a nurse, tutor and clinical counsellor. I
was a diabetes nurse at Tauranga Hospital 2009 –
2012, and am currently practising as an Independent
Diabetes Nurse. Whilst living in the UK, I served as
a non-executive member of a large NHS Hospital
Trust Board, and was also elected onto the Regional
Committee of a National Bereavement Care
Organisation.
Locally, I have been involved on a number of health
related Committees and remain involved in local/
national politics. I am passionate about type one
and type two diabetes management and care, and
hope that this passion, together with my experience
in governmental/NGO’s, will allow me to be effective
in this role, and empower those living with diabetes.
Heidi-Jane James
I was diagnosed with Type
1 Diabetes in 1992, as a 14
year-old.
I am married to
Mark James and am a primary
school teacher. I am also a
swim coach, triathlon coach,
running coach, learn to swim
co-ordinator, and a school
sports co-ordinator. I compete in Ironman and half
ironman triathlons, duathlons, road cycle races, and
road running races.
I have represented NZ in cross country, duathlon,
and triathlon and travelled all around the world
to compete. I have been involved in organising
events for people with diabetes and have been a
guest speaker at the DYNZ conference, Health
Professional Conferences, and delivered lectures
to Universities sports students about Diabetes and
High Performance Sports. My passion is providing
sporting and social opportunities for people with
Type 1 Diabetes.
Elliot Gaensicke
I am an Area Representative
covering the Bay of Plenty for
Altex Coatings Ltd. I was misdiagnosed 10 years ago with
Type 2 Diabetes. It was not
until my daughter contracted
Type 1 coming up 3 years
ago that I was tested and
confirmed as Type 1. I enjoy organic sustainable
gardening, mixed with Fishing and Hunting. I
regularly walk every week taking advantage
of all the board walks Tauranga have to offer.
Both my girls’ are involved with the Young Mariners
and Diabetes Youth activities which I have great
pleasure in participating and supporting their
adventures. In the past I have played soccer and
badminton. I look forward to supporting and helping
families with my experiences
Rebecca Ryder
My 9year old son, Cameron,
was diagnosed with Type 1
Diabetes just over 2.5 years
ago. After attending a number
of Auckland Youth activities I
started organising events for
the Tauranga / Bay of Plenty
Youth and was elected onto
the DHT committee. Since then we have established
a youth committee under both Diabetes Help
Tauranga and Diabetes Youth New Zealand. My
passion is about helping Type 1 Diabetes youth and
their parents connect with one another. I am also
passionate about supporting the growing number of
families with children with Type 2 Diabetes and have
been involved in outdoor activities for these youth.
Caroline Vanstone
I am a wife and mother of four
daughters. I work full-time
as the DNE for the Western
Bay of Plenty (BOP) region
supporting General Practice
and those in the wider
community with diabetes
plus those who support and
care for people with diabetes.
I am a presenter in the local free ‘Wellness Diabetes’
education courses as I am passionate about
supporting education, so that those with diabetes
are able to improve their ability to self manage their
diabetes and live happy healthy lives. Prior to this
position I worked in a busy General Practice as a
Practice Nurse.
5
I am currently completing my Masters of Nursing
studies. This study enables me to keep abreast
of any developments in health care and supports
networking with other health professionals within NZ.
It is important to provide the highest level of support
for anyone with a chronic health condition such as
diabetes. I am motivated to support the local society
in any endeavours to provide support for anyone of
any age with their journey with diabetes.
Caresens Skins
The skins are available to order from our
website www.caresens.co.nz. The skins are
free, however a postage fee does apply.
They can also be ordered by phoning toll
free 0800 Glucose ( 0800 458 267).
Danielle Basham
Sales and Marketing Assistant
Pharmaco (NZ) Ltd
PO Box 4079,
Auckland 1140, New Zealand
P 0-9-377 3336 F 0-9-307 1307
DDI 0-9-969 2739 E dbasham@pharmaco.co.nz
www.pharmaco.co.nz
OTHER EVENTS:
Living Well with
Diabetes
A FREE Diabetes Self Management
Programme. Learn more about your diabetes
condition, including the benefits of:
Healthy eating
•
•
Exercise
•
Prescribed medication
•
Caring fo your eyes
•
Caring for your feet
•
Annual Diabetes Assessments
We provide interactive discussions from
specialised professionals.
Keep your body well
For more information contact
Mereana Waaka-Murch
Ph 577 3195
DIABETES
FUNDRAISER WALK
Mark the date in your diary now!
Diabetes Youth NZ and our Local Diabetes Youth
Tauranga group are hosting a fundraiser walk on
the 9th March 2014. If you want to assist
organising, particpate or sponsor please contact us
at info@diabeteshelp.org.nz.
For our local event we are hoping to raise funds for
people of all ages with Type 1 and Type 2 Diabetes.
6
Pharmaceutical Subsidy
Card
From the 1st of January 2013 the pharmacy
prescription charge rose from $3 to $5 per
prescription. The Pharmaceutical Subsidy Card
(PSC) is provided to all NZ families when they have
paid for 20 prescription items at $5 each (total of
$100) from February each year. After 20 items per
family there will be no further prescription charge.
Providing you go to only one pharmacy for
prescriptions the card will automatically be provided
to you as soon as the 20 prescriptions are reached.
If you use different pharmacies you need to save
your reciepts and present them to your preferred
pharmacy in order for those items to be added to
your total.
Who is entitled to a PSC?
Any member of a family unit, usually the primary
caregiver, will hold the PSC. A Family Unit can mean:
• A married or de facto couple
• A married or de factor couple with one or more
dependent children, or
• One person with or without children.
Your PSC is valid until 1st of February each year, so
keep it safe.
Although your preferred pharmacy will not need you
to present your PSC when prescriptions are filled,
you will need to present it if you obtain prescriptions
at any other pharmacy. Pharmacies do not charge
for this service.
Looking for Exercise
Options?...then try:
Come on get fit for life!
Gentle exercise for the more mature person. Also
for injury or illness rehabilitation. Your first hall class
is FREE. So come on and try it out.
Want to know more?
Contact Jennifer on:
Phone 571 1411
Mobile 027 20 60 776
Classes cost $3.50 - $4.00
Getting Connected
There are many websites out there that cover
diabetes topics and issues. Here are just some you
can try out:
www.diabeteshelp.org.nz Our Society
National Societies
www.diabetes.org.nz
NZ
www.diabetes.org American
www.diabetesaustralia.com.auAustralia
www.diabetes.caCanada
www.diabetes.org.ukUK
www.idf.org International Diabetes Federation
NZ Societies
www.nzssd.org.nz NZ Soc for the Study of Diabetes
Other interesting ones:
www.dlife.com
This website has some great recipes, discussions
and video’s of diabetes related topics. It is US based
so not everything here is relevant to us here in NZ.
Video of the Month
If you have the internet go to www.dlife.com
website to the video section or YouTube and search
for video’s on Eva Saxl. There are two parts to the
story which are very interesting.
Eva Saxl, a Holocaust refugee who survived
WW II with your husband’s home made insulin.
We want to hear
from you!
If you have any ideas
or topics that could
be covered in the
newsletter send them
to us at:
info@diabeteshelp.org.nz.
7
Youth News:
Parents Evening
Tuesday 10th September
2013, 7pm Upstairs at Imbibe
Restauranga and Bar, Bayfair
A parents evening will be held for parents of
children with Type 1 Diabetes. Several presenters
will discuss key topics:
• Getting ready for leaving home
• What funding are you entitled to
• Managing the stress of it all
This is a chance to meet other parents of children
with Type 1 Diabetes and share your experiences
and in general relax amongst people who know
your life!
Contact: youth@diabeteshelp.org.nz to register (its
free!) or phone Rebecca on 07 570 3261
November Family Camp
From the 15th - 17th of November our youth and
their families will be attending a combined Family
Camp with the Rotorua Diabetes NZ Youth Group.
We have about 30 people already registered to go.
If you are interested please contact Rebecca on
07 570 3261 or at youth@diabeteshelp.org.nz
Registration forms and costs will be available via
our youth newsletter.
Connecting
our Type 1’s
Part of our role in the
Youth Group is to connect
our Type 1’s with other
events
around
the
country. In August three
of our Type 1 children were lucky
enough to attend Diabetes Youth Auckland’s
“Riding on Insulin” Snow Camp at Snow Planet in
Auckland. Pro Snowboarder Sean Busby and his
wife Molly, from the USA, ran an amazing camp.
They managed, alongside Starships Diabetes Team,
the childrens blood sugars whilst encouraging them
to try and do anything they wanted. One of our
committee members, Heidi-Jane James went along
as a volunteer and ran one of the groups.
8
Supporting our Children
with Type 2 Diabetes
Most of the work we do is with children with Type
1 Diabetes. However through the growing of the
Youth Group we are coming across children with
Type 2 Diabetes. We are keen to help support these
children and their families. If you know of anyone
with a child with Type 2 Diabetes let them know
about us and Diabetes Help Tauranga. By doing this
you could change a life!
Society Contacts
Committee:
Alison Wilson Secretary
Rebecca Ryder
Youth Debbie Cunliffe
Heidi-Jane James
Elliot Gaensicke
Caroline Vanstone
emails:committee@diabeteshelp.org.nz
secretary@diabeteshelp.org.nz
treasurer@diabeteshelp.org.nz
youth@diabeteshelp.org.nz
Support Group Co-ordinators
Mount Maunganui Pix Elsey
Katikati
Jeune Thomlinson
574 2231
543 4383
HELPLINE - 07 571 3422
email: info@diabeteshelp.org.nz
www.diabeteshelp.org.nz
Diabetes Help Tauranga
PO Box 15219
Tauranga
Articles and advertisements published in this newsletter are the
opinion of the authors and not necessarily of the Society. They
are intended to interest and inform and do not constitute medical
advice.