EASY EATS TASTY WAYS WITH FLAT BREAD
Stefan Crooks reached out to Diabetes New Zealand saying, “I’m living with type 2 diabetes and created a zero sugar drink. I want to be able to help you guys. So where do we star t?”
With Stefan being an excellent advocate for diabetes, VIBE is now a Diabetes New Zealand Champion Sponsor.
“My aim is to inspire individuals to make changes that have a real impact on their lives!”, says Stefan.
Stefan’s journey with diabetes has seen him adjust his exercise, lifestyle, eating and drinking habits, and running the Paris Marathon for Diabetes New Zealand.
Follow Stefan’s journey, his marathon
WINTER
4 EDITORIAL
5 UPFRONT: Professors elected
5 UPFRONT:
IDF Virtual Congress
6 YOUR DNZ: Cyclone Gabrielle heroes and heroines
11 YOUR DNZ: New partnership
12 LIFE WITH T2: Marlene Lockett finds it's never too late to change
16 NOURISH: Lots of ways with wraps
19 NOURISH: Getting more fibre in your diet
20 LIFE WITH T1: Hunter Luke Aschebrook
23 CARE: Erectile dysfunction and diabetes
28
24 CARE: Claire Beckett talks kidney donation
27 CARE: Flu jabs and Covid boosters
28 ADVOCATE: Hauora kaimahi Hēmi Houkāmau
31 LIFE WITH T1: Opera singer Jonathan Abernethy
34 LIVE BRAVE MANA ORA: Summer camps
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THANK YOU TO OUR CHAMPION SPONSORS FOR THEIR ONGOING SUPPORT AND PARTNERSHIP
This quarter has been extremely challenging, but, at the same time, heart-warming in how the diabetes community has engaged and supported one another across Aotearoa New Zealand.
You will find an article in this month’s Wellness about Severe Tropical Cyclone Gabrielle in February, which devastated the east coast from Northland down to Wairoa. Over the five days, there were 11 fatalities and an estimated 10,000 people displaced, and, since then, insurance claims have passed $1 billion. Watching the news footage on the impact of the sudden deluge of rain in Auckland, Coromandel, and Northland was simply incredible. What followed in Hawke's Bay and Tairāwhiti showed even more devastation, but how the diabetes community sprang into action to provide support and care packages was just fantastic.
Our experience has shown over the last few years, with pandemics and climatic devastation, that when people with diabetes are put under such incredible stress they reach out to Diabetes NZ and our community, either for information or assistance. This reinforces our ‘reason for being’, because each time it is a learning curve for us as well and we need to show that we can be agile and respond appropriately to the need.
From an operational perspective, Diabetes NZ is continuing to extend its reach into our communities with nine Diabetes Community Coordinators across the motu. We are excited by the partnerships we have developed with Primary Health Organisations, Māori Health Providers, iwi, and Pacific Health Providers. Together, we are strong and able to collaboratively work together within communities to support those at risk of, and with, diabetes. Our success will be measured by people with type 2 diabetes who engage with their health providers to better manage their diabetes and prevent the onset of complications.
There are many changes occurring within the health system, and most recent is the next stage of transformation being launched by Te Whatu Ora. The changes are significant as they merge 29 entities into a single health system. Their proposed new structure follows a life course approach to focus on their mahi by designing a health system that supports good health, not just treat illness. Diabetes NZ is keeping a watching brief on its progress to ensure diabetes is at the forefront of any decisions on consistent and equitable healthcare being made.
Winter is now upon us, and we hope all our readers keep warm and healthy during this time. We would like to remind you that you can now book in for your Covid-19 and flu vaccinations.
In this issue of Diabetes Wellness, we feature a couple of greatgrandparents: one who helps guide those living with type 2 diabetes, and another who, with a change of diet, has managed to send her type 2 into remission. We cover the five fun family camps held around the country over summer, we meet a Kiwi opera singer who is based in Frankfurt, and in the recipe section you will find some low carb and creative ideas for wrap bread. We’re sure you’ll find plenty that informs and inspires.
HEATHER VERRY Chief Executive, Diabetes NZ
Diabetes New Zealand is a national charity that provides trusted leadership, information, advocacy, and support to people with diabetes, their families, and those at risk.
Our mission is to provide support for all New Zealanders with diabetes, or at high risk of developing type 2 diabetes, to live full and active lives.
We have a network of branches across the country that offer diabetes information and support in their local communities.
Join us today at www.diabetes.org.nz
DIABETES NEW ZEALAND
Patron Professor Sir Jim Mann
Board Chair Catherine Taylor
Chief Executive Heather Verry
Diabetes New Zealand National Office Level 10, 15 Murphy Street, Thorndon, Wellington 6011
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DIABETES WELLNESS MAGAZINE
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Disclaimer: Every effort is made to ensure accuracy, but Diabetes NZ accepts no liability for errors of fact or opinion. Information in this publication is not intended to replace advice by your health professional. Editorial and advertising material do not necessarily reflect the views of the Editor or Diabetes NZ. Advertising in Diabetes Wellness does not constitute endorsement of any product. Diabetes NZ holds the copyright of all editorial. No article, in whole or in part, should be reprinted without permission of the Editor.
Professor Rachael Taylor has been elected as a Ngā Ahurei a Te Apārangi Fellow in recognition of her contribution to the prevention of childhood obesity through high quality research.
Rachael is the Director of Edgar Diabetes and Obesity Research (EDOR). She was elected by the Academy of the Royal Society Te Apārangi, which recognises distinction in research, scholarship, or the advancement of knowledge at the highest international standards.
As well as being the Director of EDOR, Rachael is the Research Professor, Head of Department, and Karitāne Fellow in Early Childhood Obesity. As one of 34 new Ngā Ahurei Fellows, her research has been in understanding how diet, physical activity, digital screen use, and sleep can impact the health and wellbeing of our tamariki.
She was an instrumental member of the Otago group, proving that, contrary to the prevailing view, obesity was detrimental to bone health in children. This particular
proven research was the first in the world.
Throughout the past two decades, Professor Taylor has led many ‘world first’ research projects that have furthered our understanding of the prevention and treatment of childhood obesity.
We also congratulate Professor Suetonia Palmer, a practising kidney specialist and Professor at the University of Otago, Christchurch.
Suetonia is a kidney specialist who is interested in clinical studies to understand acute kidney injury, kidney failure in people with heart disease, and new ways of measuring kidney function.
She has contributed to the international evidence base underpinning treatment of kidney diseases and diabetes, and their direct impact on patients. Her work has drawn evidence from thousands of studies and trials to describe the evidentiary basis for common conditions, including diabetes, hypertension, and kidney disease.
In December this year, the International Diabetes Federation (IDF) is holding a four-day Virtual Congress. This is the third event in IDF’s educational series focused on diabetes-related complications. At the congress, you can access updates on the latest research, treatments, and tools to manage, treat, and prevent diabetes complications.
The IDF Congress is a core activity of IDF, offering a global platform to discuss a broad range of diabetes issues, from latest scientific advances to cutting-edge information on education, diabetes care, advocacy, and awareness. Participants include physicians, scientists, nurses, educators, and other healthcare professionals, as well as government representatives, policy makers, people with diabetes, IDF members, and media.
Earlybird registrations are available until 30 September. Find out more at idf2023.org.
We know that managing diabetes is a journey and we all need a little extra support sometimes. With helpful tips, information, and inspiration, the new My Diabetes Journey app truly is like a friend in your pocket! It’s totally free, so download it today.
• Food diary
• Space to record and track movement goals and emotional wellbeing
• Diabetes resources
If you have asthma, a heart condition, or Raynaud's disease, be sure to stay safe. Check with your healthcare professional about what extra precautions you should take when exercising in winter.
• Recipes
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When the MetService reports that few weather events are as terrifying or as powerful as a tropical cyclone, you take them seriously. Diabetes New Zealand Hawke's Bay Youth Coordinator Rach McQuade and pilot Bret Lucas share how their heroic work in the Hawke's Bay aftermath unfolded. As told to Ashlee Sturme and Rowena Fry.
It wasn’t labelled a Severe Tropical Cyclone for nothing. In February, Gabrielle devastated the east coast of Aotearoa New Zealand from Northland down to Wairoa. Over the five days, there were 11 fatalities and an estimated 10,000 people displaced, and, since then, insurance claims have passed $1 billion.
On the night of 13 February, while the incoming weather was sounding like a helicopter coming in to land, Taradale mum-ofthree Rach McQuade was quietly wondering how the next delivery of sensors for her daughter, Maddison, who has type 1 diabetes, would get through if the weather was as destructive as it was predicted to be.
Unable to sleep until 3am, she watched trees moving from where they had originally been growing in the neighbour’s property to her own backyard. The following morning, Rach played phone tag with her husband, who was away training with Fire and Emergency in Nelson. Cell phone coverage was sporadic, and the couple shared calls where he could hear her but she couldn’t hear him. At one point, she told him that the neighbours had received an alert to evacuate. He called her back and told her that the stop banks were
ready to burst – they needed to pack their bags and leave.
Hunkered down with her children at her mother’s house, Rach listened to the police scanner in horror. People were in boats, and helicopters were plucking people from rooftops. Rach and her children returned home that afternoon with trepidation, unsure of what would greet them. They were grateful to find their home dry, although they would be without power over the following week.
Rach has been running a Facebook support group in
Hawke's Bay for the last eight years. Networking with others in the area, upskilling and connecting, supporting wherever she could, she was in the process of getting Hawke's Bay Youth up and running. As the magnitude of the cyclone damage began to unfold, Rach imagined the chaos for the local diabetes community and started to think about how she could help.
With roads wiped out, she realised couriers would struggle to get diabetes supplies through. She considered herself well prepared and had adopted a routine of keeping her power banks charged,
but without power she had to rely on generators at work and her car when she was driving to top up her phone and her daughter’s insulin pump. It was clear that others were going to struggle too.
As the rest of the country saw the devastation reported, Rach got a message from former president of Diabetes Youth, Jacqui Van Blerk, asking what those in Auckland could do to help.
She racked her brain. ‘At this stage, we just need our sensors, but what about everyone else? Who had lost medical tech in the floods?’ It was clear they needed to find out what was needed.
A few days later, the group chat had expanded to include Lena Fendley from Tauranga Diabetes Youth and Sianne Chapman from Auckland. Across the country, Rach’s network was asking, what can we do? Rach decided to collect devices, insulin, and other supplies and distribute them to those who needed them, with support from her contacts. She popped a Facebook post on the DNZ page, and quickly her messages blew up. The magic began.
‘Calling out to everyone in the Hawke's Bay!!!! Rach McQuade is on the ground and collating diabetes devices, insulin, and treatments for those that urgently need them. If you are running low on any of the above and can’t access your supplies, please send us your name, contact phone number and tell us what you need and someone will be in touch with you as soon as possible.’
Rach said that MediRay and NZMS Diabetes came on board first. She started compiling lists of patients names in the Hawkes Bay, and then communicating those needs to her network.
Auckland, Tauranga, and Rotorua Diabetes NZ branches came together to donate juice boxes, pump supplies, test kits, and patches to go over sensors. ‘All sorts. Alcohol wipes. You name it. They were all rallying together,’ Rach says. Members of the public unaffected by diabetes also offered donations.
With all of Hawke’s Bay’s major roads blocked, damaged, or closed, flight was the only way in. So when the phone of Kerikeri
local Bret Lucas rang with a friend of Rach’s asking him if he could take supplies down to the Hawke's Bay, he agreed without hesitation. Owning a four-seater plane, he was immediately onboard with the idea. ‘I thought, this is cool, it gives me purpose. I like flying for a purpose.’
It turned out there was a lot of supplies, so Bret called in his mate, and fellow pilot, Blair Huston from Fortis Travel, and together they started making preparation and gaining airport clearances.
The two planes left Kerikeri and headed down the North Island, stopping to pick up supplies in Auckland before landing in Napier and then Hastings. For those in the Hawke’s Bay, it was a flight that changed their lives. For Bret, it was just a day where he could help. ‘I was just the taxi driver, nothing more.’
Bret, who has type 1, and is known as @Flight1diabetic on Instagram, lost his commercial pilot license when he was 22 after being diagnosed. Now semiretired, he has worked as a flight planner for Air NZ for the last 27
years, a role that involves all the technicalities of getting a plane from A to B. ‘We’ll build a “flexi track”, which picks up the best winds. We’ll work out how much gas they need so they don’t drop out of the sky and work out en route alternates, so if the engines have a problem they know where they’re going to go.’ When nature dishes out wind, volcanoes and cyclones, they are not all the same, nor predictable.
Bret is on a mix of insulin types, and his management of the condition has allowed him to keep flying privately. He gets frustrated by the psychological effect of trying to manage diabetes without a CGM. ‘It’s traumatic,’ he says bluntly. He doesn’t understand why the government isn’t helping, as to him it is such an easy fix.
Back in the Hawkes Bay, Rachel was coordinating the logistics of a massive operation. ‘It was insane.’
It took three days to determine the needs, find the equipment, and get it all ready to pick up.
‘Our volunteers were sending us pix and vids, showing off these pilots as they were taking off from the airports up north, and landing. Saying, ‘Hey they’ve arrived, they’re on their way.’ It was just amazing.’
USAR (Urban Search And Rescue) picked up the supplies from the airport and took them to Rach’s garage in Taradale and she was on hand to organise it. The next challenge was how to get everything hand delivered in a region that had damaged infrastructure, washed out bridges, houses under water, and people in evacuation centres. Her everexpanding support network helped distribute supplies across the Bay. They sighted drivers licences to ensure recipients were who they said they were.
There were some heart-breaking stories, she says. One recipient had lost everything in the flood.
‘We made up a care package of a month’s worth of sensors, a new scanner, juice boxes, two new test kits, and medical tape to go over the sensor.
‘Another picked up a sensor who was in a tight financial situation and had been in a car accident due to a very severe low. It just so happened a nurse was following her and noticed her weaving on the road. She went off the road but wasn’t injured, not knowing how a low could affect her driving. She has found the sensors are absolutely life-changing and can’t live without them now.’
Rach says this disaster highlights just how much the diabetes community relies on regular supplies. ‘Yes, we could’ve gone back to finger pricking. Did we want to? No.’
Rach says she had a conversation with her local pharmacist who had seen the news clip of Maddison, Bret, and Rach on TV. ‘He had said, ‘You do realise we have a warehouse here that supplies our medical supplies?’ Rach didn’t know this but explained to him that this local warehouse didn’t stock CGMs.
All these goods are only stocked in, and shipped out of, Auckland. So, with all the main roads connecting Napier and Hastings closed to the general public, supply trucks were now having to come via Palmerston North, and that was adding almost another three hours to the journey.
‘We met a young isolated student, and she received a package thanks to Dexcom. Glucose, juice boxes, medical tape, test kits, ketone strips. She was very grateful and turned up a week later and brought us her some little handmade melting moments, stamped with “thank you” on them.’ It wasn’t the first time that Rach had cried.
‘People have lost jobs and houses. It’s real. They can’t go back to their work because it’s been flooded or flattened.
‘In Taradale, we look pretty normal, apart from silt on the road. We recently went out to Eskdale, and parts of it are unrecognisable. Like a war zone. Cars upside down. Houses look they’re sinking in mud. It’s heart breaking.’
She says, without diabetes even coming into play, public health for everyone was compromised due to silt and contaminated water. There was potential food poisoning if people weren’t careful with what they were eating as fridges and freezers had no power. There was heightened stress. Not only houses but cars were flooded. ‘Not being able to drive to get help shows how much we rely on this medical tech that needs to be funded.
‘I think with what has happened as a diabetes community, nationwide, we need a better plan, because these weather events are going to keep happening.’
Rach says she also couldn’t have achieved her reach without all of the support of the many volunteers.
‘I think with what has happened as a diabetes community, nationwide, we need a better plan, because these weather events are going to keep happening.’
$119 each
Mahi tahi acknowledges the teamwork and support (tautoko) of the diabetes community for all those living in the Hawkes Bay.
Shop now for a beautiful piece of jewellery and support our community
LIMITED NUMBER AVAILABLE. PRICE INCLUDES ENGRAVING AND FREIGHT.
Knowing flying two planes wouldn’t be cheap, Rach says she asked Bret how they were going to pay for it all. He just said, ‘We will deal with that later.’
Diabetes NZ quickly started a Givealittle page to help support our diabetes whānau in the Hawke’s Bay. A total of $3150 has already been donated by 56 generous donors. However, as the cyclone fades from the front page of the papers, donations have stalled.
The stress and financial impact of the floods will be long lasting. This fund will be used to support those in Hawke’s Bay living with diabetes who continue to require financial support for self-funded devices and other diabetes supplies.
With Diabetes NZ being a registered charity, donations of over $5 are eligible for a New Zealand charitable giving tax credit.
‘It should be coming from the government though. I just feel we are forgotten about as a type 1 community. The army were getting food parcels into communities, but this life saving tech, which we self-fund already, we had to organise.’
There are many people who supported Rach’s mission and worked in the background sourcing supplies, coordinating pick-ups and drop-offs, and organising communications. She’d like to thank Bret for inviting NZMS to help, and their donation of G6/G7 sensors, transmitters, and insulin pump supplies. Jacqui got in contact with MediRay for Abbott Freestyle Sensors and Scanners, and a kind person from
Auckland financially donated a month’s worth of Dexcom. Jaycar Electronics, in Silverdale, was generous with a donation of Powerbanks. Rach says she also couldn’t have achieved her reach without all of the support of the many volunteers.
Rach McQuade was the designer of this quarter’s My Identity bracelet. She says she drew her inspiration from a number of areas.
She wanted something strong and with meaning. In te reo, mahi means work. And when used alongside tahi, the two words come together to describe working as one, with collective responsibility, commitment, and a shared focus. This is exactly what happened with the type 1 diabetes community over the days of Cyclone Gabrielle.
Next came decisions on colour and design. Rach chose the colour black for the bracelet to represent the dark time and uncertainty the flood victims experienced over those days. She says the combination with rose gold is versatile and looks great on everyone, regardless of gender.
Finally, the links in the bracelet represent Rach’s connections and friendships with the type 1 diabetes community. Without the coming together of the generous and wonderful pilots, donors, deliverers, organisers, and support people, this wonderful thing couldn’t have happened.
Mahi Tahi – coming together and working for a common goal.
Diabetes NZ is very pleased to report a new partnership with NZMS Diabetes, a Dexcom company.
NZMS Diabetes distributes Dexcom CGM systems and the t:slim X2 insulin pump in Aotearoa New Zealand, leading products in the CGM and insulin pump therapy space globally.
This partnership will bring together the expertise and resources of both organisations to drive campaigns for improved access to diabetes technology and better health outcomes for people living with type 1, type 2, and gestational diabetes in New Zealand.
The relationship will involve
joint campaigns and initiatives aimed at increasing awareness of continuous glucose monitoring and insulin pump therapy, improving access to these devices and supporting people to help improve diabetes management.
Heather Verry, Diabetes NZ CEO, says she believes ‘the partnership with NZMS Diabetes will help to raise awareness of the benefits of diabetes technology and the need for improved access to those who need it most.’
‘Technology can be life changing, so we welcome this partnership and the opportunity to educate and advocate on behalf of people with diabetes who are insulin dependent.’
Kirstin Brown, Managing Director of NZMS Diabetes, said ‘We are delighted to work together with Diabetes New Zealand in our shared mission to improve the lives of people living with diabetes.
‘We believe that by working together, we can make a real difference to the access and uptake of diabetes technology across the country.’
For more information about NZMS Diabetes and to learn more about their product portfolio, please visit nzmsdiabetes.co.nz
NZMS Diabetes is a subsidiary of Dexcom Inc
‘What? Me? How can I get it? I don’t get diabetes. That happens to other people.’ When Marlene Lockett was first told by a diabetes nurse that she had type 2 diabetes, her immediate response was to live in denial and wait for the diagnosis to sink in.
Marlene Lockett, 84, was diagnosed with type 2 diabetes five years ago. The finding came on the heels of a stroke that put her in hospital. While she was on the ward, she then suffered a heart attack. It was when blood tests for that were returned that the doctors noticed her higher than normal blood glucose.
‘When they hit me with “and we’ve diagnosed diabetes”, I was shocked. It was just another thing to cope with.’ Marlene says she felt a bit numb. ‘I didn’t feel I was overweight. I was eating some silly things but never thought I was obese. Then the nurse said, “We’ll get the diabetes nurse to come talk to you”.’
Once the shock wore off, Marlene says she pretty much obeyed the law and did what she was told. She started making changes to her diet but not fully. ‘I admit I strayed sometimes. I still had the odd fish and chips every couple of months.’ She says she thought it was necessary, mentally, to be able to cope with the triple whammy of a stroke, a heart attack, and a diabetes diagnosis.
Marlene lives in a purpose-built two-bedroom unit, erected at the back of the property of her youngest son, Blair, and his family in suburban Whanganui. The house out the front is the same one where she and her late husband brought
up their family of three boys and one girl. She says she likes living near her family, enjoying the reassurance that closeness to family can offer.
She has 11 grandchildren and five great-grandkids and most of her whānau has stayed put in Whanganui as well. She says the busyness of weekends reminds her of when her own kids were tearing around the section and playing sports. ‘That’s the life I remember. It’s repeating.’
For 12 years, Marlene managed each of the three Hospice opshops in Whanganui. She says she helped start up the first one in the city get it going before moving on to set up the next one when a suitable location became available. She says she loved working at the shops and still pops in from time to time, even recognising some of the longhaul opshoppers from that time.
It was when she was getting ready for work one morning that Marlene suffered her first stroke. Six months later, she decided her health was more important, and at the age of 74 she chose to retire.
Marlene says she feels she’s spent much of the last 10 years trying to get better. ‘I’ve had so many visits to the hospital. I said to my friend the other day, they’ll be thinking they’re running a bed-to-rent scheme. Got to keep it occupied to keep it going!’ She says that, before 2000, she hadn’t been to hospital apart from having children. Over the last few years, Marlene has had a knee replaced. She is booked in for another and is due to see a surgeon in the next few weeks as she’s had a haemorrhage behind an eye and her vision has become blurry. ‘So since then, if something’s there to get, I’ve got it.’
This is when her large family is there to offer support. The eldest of her brood, Geoff, is the only child not still living in Whanganui. As
well as coming up from Wellington for visits, he is always a phone call away, checking in on his mum every few weeks.
‘If I go to the doctor, he says, “Let me know how you get on. Let me know what she said.” And we’ll go through what I’ve been told.’ She says Geoff doesn’t try to remedy the situation but is excellent at researching it. ‘He goes to his computer, and he’ll read out to me whatever it says, over the phone. Two heads are better than one.’
It was during these phone calls when both mother and son expanded their working knowledge of diabetes. Geoff did internet searches on recommended foods and foods to avoid and says he remembers coming across an article that said beetroot was good for blood glucose levels.
It must’ve rubbed off on him because a month later he started
on his own journey of losing 20kg. During that year, he cut down his carb intake, investigated the keto diet, and increased his exercise. While undertaking searches for keto diets and his mother’s diabetes, he found they frequently landed in the same place.
Marlene says the hardest part of having diabetes was the mental side – the difficulty of challenging yourself on what you’ve always been eating.
‘I was very much a fan of chippies. I’d come home from work, have a couple of wines and some chippies, and it would end up being half a bag. That was the hardest thing I found. Adjusting to not having a wine, not being able to pick at sweet things, chippies, and naughty things.’ Gone are the days when she would buy sweets with her groceries and eat them on the way home.
But gradually she was able to implement changes. Using a sugar substitute has proved handy for
It is the comfort and support from both Marlene’s doctor and her family that she believes helped her get through the last five years of having type 2 diabetes.
her occasional cup of coffee, as is swapping in a piece of fruit when she craves something sugary. Before her diagnosis, she favoured chips and toasted sandwiches for meals, but this turnaround has had her return to more wholesome and traditional family-type meals. ‘Tonight, I’m going to have potato, mince, spinach, and I’ve got some pumpkin left over. And then three spoons of yoghurt to finish.’
Five years on, and with careful management of her diet and medication, Marlene has managed to achieve remission of her type 2 diabetes.
She credits her GP for her kind attitude in helping her deal with her diabetes. ‘My doctor was very good. When I went in there and she checked my sugar levels, she would be very enthusiastic if they were on the right side, which
helped me want to do even better next time. I think I got a lot of encouragement and help from her in that respect.’
So, does she have any advice for others in a similar position? ‘Mind over matter has a lot to do with it.’ She says, in the early days, she would crave something sweet or salty or fatty. ‘Thinking through whether you want it or whether you need it is what helped me. As simple as that.’
It is the comfort and support from both Marlene’s doctor and her family that she believes helped her get through the last five years of having type 2 diabetes. With her GP satisfied with the work Marlene has put in to turning things around, her blood glucose is checked once a month, and she aims to get that down to once every six weeks.
We talk of ‘remission’ and not a ‘cure’ because it isn’t always permanent. Unfortunately, type 2 diabetes can return if you don’t continue a healthy lifestyle. But even if you don’t put your diabetes in remission, eating more healthily and being more active will always improve your wellbeing, so making changes will have benefits for everyone who tries it.
Eat Well Live Well is chock-full of diabetes-friendly recipes from well-known Kiwi chefs. Each dish is quick and easy to prepare and great for your whole family.
Head to www.diabetes.org.nz for your copy – $33.00 including delivery – or purchase it directly from Whitcoulls, PaperPlus, or The Warehouse.
All profits go towards supporting Diabetes NZ’s work.
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The FreeStyle Libre Flash Glucose Monitoring System and the FreeStyle Libre 2 Flash Glucose Monitoring system is indicated for measuring interstitial fluid glucose levels in people (aged 4 and older) with insulin-dependent diabetes. The indication for children (age 4 – 17) is limited to those who are supervised by a caregiver who is at least 18 years of age. Always read the instructions for use. The system must not be used with automated insulin dosing (AID) systems, including closed-loop and insulin suspend systems. The sensor must be removed prior to Magnetic Resonance Imaging (MRI).
*Data based on the number of users worldwide for FreeStyle Libre family of personal CGMs compared to the number of users for other leading personal CGM brands and based on CGM sales dollars compared to other leading personal CGM brands. ^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. † Finger pricks are required if glucose readings and alarms do not match symptoms or expectations. #Notifications will only be received when alarms are turned on and the sensor is within 6 meters of the reading device. §The LibreLinkUp app is only compatible with certain mobile device and operating systems. Please check www.librelinkup. com for more information about device compatibility before using the app. Use of LibreLinkUp and FreeStyle LibreLink requires registration with LibreView. The LibreLinkUp mobile app is not intended to be a primary glucose monitor: home users must consult their primary device(s) and consult a healthcare professional before making any medical interpretation and therapy adjustments from the information provided by the app.
. Varughese, B.
al. Diabetes Stoffw Herz 2021; 30: 231-242
2022;16(1): 70–77. (ePub 2020). DOI: 10.1177/1932296820958754
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marks are
Auckland 0632. www.mediray.co.nz. NZBN 9429041039915. ADC-68475 V1.0
Flat bread is so simple. A disc of bread that can be used in so many ways, from a breakfast burrito to a parcel of deliciousness to a seasoned chip. This makes them perfect for lunch boxes for both little and big people. One of the advantages of Gerry’s wraps is they have lots more fibre than regular wraps, so if you are wanting to increase your fibre intake you could find them a useful addition to your diet.
MAKES 6
These little morsels look like a pinwheel scone and sushi had a baby. The moist cream cheese holds it all together, the carrot adds sweet crunch, and the olives a hint of salt. Each wrap cuts into approximately three (or more) individual pinwheel sandwiches.
80g (approx 3 tbsp) of Anchor Cream Cheese Lite Spreadable, softened
1 tsp of plain unsweetened yoghurt
2 Gerry’s low-carb wraps
2 olives, chopped
1 3 cup carrots, grated
PER SERVE: CALORIES 321kJ (77kcal) | PROTEIN 2.2g | FAT 4.7g (SAT FAT 2.3g) | CARBS 4.2g (SUGAR 0.8g) | FIBRE 4.5g | SODIUM 150mg
SERVES 10
These little parcels make a marvellous addition to any meal when fresh. They can just as easily be reheated on a sandwich press as a yummy hot lunch meal as well.
100g onion, finely diced
50g dried mushrooms (soak in boiling water for 20 minutes then chop into ½ cm chunks)
1 cup brown basmati rice
1 cup textured vegetable protein (TVP or soy wadi)
2 tbsp canola oil
2 tsp reduced salt Vegeta stock powder
10 Gerry’s low-carb wraps
In a large, tightly sealing pot, using 1 tsp of oil, sauté onions. Add mushrooms and cook for about 5 minutes on low heat.
Add rice and TVP, plus stock powder. Add 3 cups of boiling water (using the liquid from the mushrooms will add more flavour).
Cook for 40 minutes until rice is cooked and liquid absorbed.
Allow mix to cool so you can handle it. Put approximately ½ cup of mix on each tortilla wrap and use envelope wrap to enclose the filling.
Place on lightly oiled tray folded sided down. Brush oil over the parcels. Bake at 180°C for about 20 minutes until crisp.
Allow to cool on a wire rack. Store in fridge for up to 5 days.
PER SERVE: CALORIES 1183kJ (283kcal) | PROTEIN 11.7g | FAT 8g (SAT FAT 0.8g) | CARBS 33.4g (SUGAR 3g) | FIBRE 16.3g | SODIUM 382mg
Mix together cream cheese and yoghurt. Spread cream cheese mixture evenly over one side of each wrap. Stir together olives and carrots. Scatter olive and carrot mix onto the cream cheese spread wraps
Roll up the wraps firmly and wrap it in a clean tea towel.
Chill for at least an hour before cutting into 3cm slices. Makes 6.
SERVES 4
Either one of these dips goes beautifully with the tortilla chips.
1 can of seasoned, chopped tomatoes
A half or 1 fresh chilli, seeded and sliced finely
Half a small red onion, peeled, chopped finely
1 3 cup loosely packed fresh coriander leaves
1 large clove minced garlic
Juice from ½ a lemon or lime
Process tomatoes and onion.
Stir in coriander, garlic, and citrus.
Chill for an hour to let the flavours emerge.
For a nice chunky salsa, dice everything by hand and skip the food processor.
PER SERVE: CALORIES 121kJ (30kcal) | PROTEIN 1.2g |
FAT 0.26g (SAT FAT 0.01g) | CARBS 3.86g (SUGAR 2.45g) |
FIBRE 2.45g | SODIUM 60mg
SERVES TWO AS A SNACK
Here we have perhaps the most simple transformation of a wrap. Lightly seasoned, these chips make a nice snack with dips. Perhaps even with our last issue’s hummus.
2 Gerry’s low-carb wraps
1-2 garlic cloves, peeled and finely chopped ½ tsp finely chopped herbs (oregano, rosemary, thyme) or spices (cumin, harissa, pepper)
A single pinch of a herb salt, smoked salt
1 tsp olive oil (or two sprays)
Preheat oven to 200°C.
Spray both sides of wrap with oil and spread evenly by using your hands or the back of a tablespoon.
Sprinkle garlic, herbs, and/or spices over the wrap. Using a pizza cutter or knife, cut into wedges or cut into four strips and then into triangles – you’ll get more but smaller.
Arrange on tray and bake for 4 mins. Let cool on rack.
PER SERVE: CALORIES 571kJ (136kcal) | PROTEIN 11.7g |
FAT 5.8g (SAT FAT 0.7g) | CARBS 11.6g (SUGAR 1.2g) |
FIBRE 13.5g | SODIUM 330mg
SERVES 6
This lovely dip is both rich in protein and fibre, and can be made in 10 minutes.
1 can of drained black beans
Half a cup of frozen corn
1 diced yellow or red capsicum (something crunchy . you can use celery)
2 tbsp salsa (opposite)
2 (or more if you love garlic) garlic cloves, minced. Lemon or lime juice
¼ tsp chilli powder, flakes or fresh chilli
¼ cup of coriander or flat leaf parsley or sliced spring onion
Either process or use a fork to mash about half of the beans and then mix it all together.
PER SERVE: CALORIES 375kJ (90kcal) | PROTEIN 5.3g |
FAT 0.5g (SAT FAT 0.09g) | CARBS 15.2g (SUGAR 2.1g) |
FIBRE 4.1g | SODIUM 155mg
Fibre is a vital component of a balanced and healthy diet. It has numerous roles and functions in your body, including helping to control blood glucose levels, controlling weight, decreasing blood cholesterol, and controlling your appetite. Fibre is also linked to preventing bowel diseases and removing toxins from the body via regular bowel movements.
Fibre is classified as either soluble or insoluble, based on its properties in water. To promote health and wellbeing, include a balance of both forms of fibre in your diet, with at least half coming from soluble fibre. Soluble fibre is considered especially helpful for people with diabetes. Soluble fibre may help control blood sugar by delaying
stomach emptying, retarding the entry of glucose into the bloodstream, and lessening the post-meal rise in blood sugar.
It may also lessen insulin requirements. Because fibre slows the digestion of foods, it can help blunt the sudden spikes in blood glucose that may occur after a low-fibre meal. The cholesterollowering effect of soluble fibres may also help those with diabetes by reducing heart disease risks.
It is recommended that people with diabetes eat naturally occurring foods that are rich in dietary fibre. Aiming for more than 40g of fibre each day may seem like a lot, but small changes add up over time.
Include at least three to four servings each of vegetables and
fruit each day and where possible leave on the skins. When making casseroles, stews, or soups, add flavour with lentils, pearl barley, brown rice, or cracked wheat, all of which are good sources of fibre. Choose breads that contain wholegrain kernels. Pumpernickel and seed loaves have a high fibre content. Compare the fibre on the nutrition information panel, and choose the one with the highest fibre content.
Take the shortcut for a change! Don't peel those potatoes, just scrub them well. And peel and use broccoli stalks instead of throwing them out. You'll save time and money, increase your fibre, and most importantly help to keep your bowels and blood glucose regular.
At Gerry's, we are deeply passionate about creating healthy, nutritious and high quality products that are good for you. Our Go Low Carb and Super Bread are low carb and high in fibre and protein, made with a unique blend of lupin flour and seeds to support in keeping blood sugar levels stable and keep you going all day.
Available at most supermarkets and convenient online ordering at www.gerrys.co.nz/shop
Upper Hutt hunter, Luke Aschebrock, has been regularly venturing out in search of bush tucker for the last few years. It was a friend of his who first invited him to join in, and it wasn’t long before Luke was hooked. He finds the activity, the exercise, and the adrenalin a perfect mix. ‘I just love getting out and away, and pushing myself as well. And then appreciating what you’ve done after you’ve got it.’
Luke refers to hunting with the idiom, ‘You’re killing two birds with one stone. You’re getting rid of a pest and providing good quality meat.’
Luke mainly targets deer. His wife’s family has a block of land in the Wairarapa, and it’s through there that both fallow and red deer pass through. The smaller fallow deer has the more tender meat and is 20–30kg lighter, making it far easier for a hunter to carry out.
Red deer were regularly introduced as ‘game’ animals until 1926, with populations coming from the UK and Australia. With no natural predators here, they immediately thrived, so another six breeds of deer were introduced, then moose. They were brought here for hunting, but by 1910 both farmers and foresters were worried about the impact of large herds of deer. Grazing lands were being eaten, as was the undergrowth in
native forests and subalpine areas. What had slowed rainfall runoff was disappearing, and inevitably erosion and downstream flooding began to occur.
In 1930, the Department of Internal Affairs began employing teams of deer cullers, but that was phased out in the 1970s, and now it’s commercial and private hunters who are out in the hills targeting deer.
Luke fills his freezer with the locally processed prime cuts, mince, patties, and sausages, and he says his kids just mow through it. Having their dad provide fresh and local venison has also taught them to appreciate where meat comes from. ‘It teaches them about wasting food. A life has been sacrificed for you so you can eat. You’ve got to remember that.’
It’s not only Luke’s whānau who regularly enjoys his labours, but on occasion he will fire up a barbeque at work as well. Favouring herbed and spicy rubs for the venison, he enjoys sharing with his coworkers. ‘I’ll take it in and cook it up for the boys. It’s one of those things – being able to source your food and provide it to people’.
A workshop supervisor for Transit Group, Luke and his team of five take care of the Metlink fleet of buses in Wellington. It’s physical mahi, so just before his diagnosis, 13 years ago, Luke put his newlyexperienced fatigue down to the demanding nature of his work. He also noticed he always felt dehydrated, even when drinking 10-15 litres of water a day. ‘It wasn’t until I took some leave from work and made an appointment with the doctor. They took a reading. The glucose meter only goes so high, and it said HIGH.’
When he went to hospital, the triage nurse gave him another finger prick and said, ‘Grab a bed, you’ll be here a little while.’
At 22, and with no prior family history, Luke’s first encounter with diabetes was a steep and frightening learning curve. ‘I knew very little. You don’t know if it’s a terminal thing. You’re going back over all the reasons why you might’ve got it. It’s just luck of the draw, and I pulled a rubbish card.’
Luke’s journey with diabetes took a more positive turn when his work was relocated to Wellington and he enrolled under the care of the Hutt Valley DHB. As he holds heavy vehicle licences, Luke is required to have an annual medical with a specialist. When seeing the endocrinologist, he was asked if he would like to be under the care of the diabetes nurse, and from there he could look at trialling a pump. ‘I had nothing to lose, so thought, why not?’
At the same time, Luke had a few appointments with a dietitian. He says, up until then, he knew nothing about carbohydrates and the power they have on blood glucose. ‘No one had talked to me about carb counting. I was purely winging it with just some pens until then. When I think back, I go, how I did it up until then, I don’t know.’
Before discovering the pump, the possibility of having a hypo was always lurking in the background, and Luke says it is an experience he’s not too keen to repeat. He equates it with having hollow legs or having just run a marathon. ‘There’s nothing in your head, so you go instinctive. My wife knew if I’d had an episode because the pantry was destroyed; packets of things everywhere because you go into survival mode. You don’t want to be in the way.’
A new pump-user will typically consult with a diabetes nurse, who will work out the ratio of insulin sensitivity of each particular patient. Luke hasn’t looked back since taking on the pump. ‘It was doing a lot of my stuff for me. I
It might not be everyone’s cup of tea, but for Luke Aschebrock getting out into the New Zealand bush and hunting a pest animal is precisely the way he likes to acquire his meat.
could dial back my bolus. I could detune myself. It’s made my life so much easier.’
He explains that, due to pens not having decimal points, you’re either dialling too much or not enough. ‘When you’re living like that, your body is going up and down and it’s exhausting.’ His family were quick to notice that, as soon as he took on the pump, he became a calmer person and less irritable.
Luke finds his hypos are symptomatic and predictable. He has never used a CGM, saying until they are funded in New Zealand he’ll manage fine with a standard glucose monitor. ‘Although they’d be a major gamechanger, CGMs are an extra cost, and it feels like you’re just subscribing to the illness.’
The arrival of the pump coincided with Luke discovering hunting. With his new-found comparative freedom, he began tagging along with his hunter friend and learning
the art of tracking. A lot of hunting is intuition and understanding animal behaviour. Another skill is being able to tell if a track was made by humans or animals. Game trails are the animals’ highways –the quickest route between places – and deer and pigs go back and forth along these tracks. Luke says if you get in a good position and take time to watch these highways, then that’s often where your luck comes from.
Luke says, on one of his early hunts, he heard a bit of noise going on. ‘Turned out there was a goat looking at us. My friend said if you want to take it, take it.’ His friend passed him his firearm and quietly talked him what to do. Afterwards, he joked that, if it had been a deer, Luke would have missed out. Deer aren’t as inquisitive as goats and will get going as soon as they smell you.
Does diabetes affect Luke’s handling of a firearm? He has many checks in place. He hunts
with others. He carries a good stash of lollies, muesli bars, and sugary drinks with him, and his wife always knows when to expect him home from a hunt. If he’s hunting on the family’s private block, there is cell phone reception so help is on hand if needed. And if he’s heading into deep bush, then the hunting party always carries a Personal Locator Beacon.
Before he’s even taken aim, Luke tests his blood glucose on the hour, then again before loading up his firearm. His rifle is only loaded in the hunting zone, and all safeties are on, meaning he has to consciously disengage it before firing. Most importantly, he has passed the mandatory firearms safety course that anyone who wants to own a firearm must achieve, and he is licenced to carry a firearm.
Sources: https://teara.govt.nz/en/deer-anddeer-farming/page-1 and https://www.doc.govt. nz/nature/pests-and-threats/animal-pests/deer/
Fifty percent of men with diabetes can suffer from erectile dysfunction. It is one of the least-talked-about complications of diabetes.
Commonly referred to as impotence, erectile dysfunction (ED) is defined as difficulty getting and keeping an erection. ED might feel embarrassing, but it is actually quite common. It is estimated that 322 million men worldwide will be affected by ED by 2025.
Men often feel like they are the only person dealing with the issue of ED. About 75% of diagnosed cases of ED go untreated, but it is really important to talk about it with your partner and your GP.
The good news is that it’s often possible to treat. There are a range of treatments available from clinics and health professionals that specialise in impotence.
Whereas 10% of cases are psychological, another 80% are due to physical causes: diabetes, cardiovascular disease, neurological problems, and prostate cancer surgery.
Most men with diabetes don’t realise there is a connection between ED and diabetes. If diabetes has not been well controlled, it may cause irreversible damage to nerves, blood vessels, and smooth muscle function, all of which are necessary for erections to occur.
Understanding the connection between ED and diabetes could motivate men and their partners to better control their blood sugar levels and make healthy lifestyle choices.
Diabetes NZ wants to start the conversation around this link and how to understand and manage this complication. In May and June, they will be holding a series of four educational evenings on the topic with two of New Zealand’s urologists. The presentations will be in Auckland and Dunedin and will provide all the information you need to help guide you on managing this issue. Please see details on the right.
30 May, 6-8pm
Presented by Dr John Tuckey
Dine Restaurant (Manukau Institute of Technology, School of Hospitality Building) Gate 14, Alexander Cres, Otara Register here: https://events.humanitix.com/diabetes-and-edroadshow-auckland
DUNEDIN
17 June, 10.30-12.30pm
Presented by Dr Giovanni Losco from Urology Associates Edgar Centre, 116 Portsmouth Drive, Anderson Bay, Dunedin Register here: https://events.humanitix.com/diabetes-and-edroadshow-dunedin
Let’s
Presented by: Dr Giovanni Losco Urology Associates
DATE: 17th June 2023
REGISTRATION: 10:30–12:30
LOCATION: Edgar Centre 116 Portsmouth Drive Anderson Bay, Dunedin Partners, guests welcome. Refreshments served.
Space is limited, register today: https://events.humanitix.com/diabetes-and-ed-roadshow-dunedin
Part of Claire Beckett’s job as a Renal Clinical Nurse Specialist is as a Donor Liaison Coordinator. Whether you’re receiving or donating a kidney, she takes us through the ins and outs of donation.
Claire Beckett works with patients who have chronic kidney disease. She supports them with education on dialysis, begins dialysis care, assesses to see whether they are well enough for transplant, and offers conservative end-of-life care.
Having worked in the area of diabetes care for 31 years, Claire says she finds her work challenging, and she enjoys the relationships she has built up with patients over the years. UK-born and trained, she and her husband Neil, who has type 1, made the move to Aotearoa New Zealand 19 years ago.
She sees the same people she met on her first day here. She says she’s seen them get married, have families, and even become grandparents. When patients die, she has been there too, providing support.
Part of her role as a Donor Liaison Coordinator takes her further into people’s lives. This is where she coordinates kidney and pancreas donations for her patients within New Zealand and sometimes internationally.
Most people have a longer, better life with a kidney transplant than with dialysis.
Patients in need of a kidney transplant are first referred through their GP and endocrinologist. Donors may be living or recently deceased, a stranger or a relative, and are matched with receivers through their blood type. Depending on suitability, patients can wait an average three to four years for a kidney from a deceased donor.
In New Zealand, we usually transplant from slightly more live than deceased donors.
A living donor must be over 18 years old and is assessed for their compatibility and evaluated for medical fitness –they need to be healthy and well enough to handle the surgery and recovery time. The surgery itself takes up to four hours and recovery is a good six weeks. For the recipient, there is a similar recovery period. Medications will prevent rejection of the new organ, and these are taken for as long as the kidney works.
Many factors, such as severe heart or lung disease, or being overweight, can eliminate a patient, both as a candidate as well as a donor – that is, unless the donor can make some lifestyle changes.
Claire cites the example of a wife who wanted to donate to her husband. However, she had high blood pressure, weighed 120kg, had a BMI of 36, and, when her HbA1c was tested, it fell into the glucose intolerance prediabetes group. All these things would rule her out but not permanently. Claire told her the things she needed to improve were doable and to go and talk to her GP.
A year later, the would-be donor returned. She had increased her exercise and lost 30kg. Her blood pressure, cholesterol and HbA1c had lowered and she felt much better. Claire says not only had this donor avoided health complications in the future, including type 2, she was now able to donate to her husband. Claire says it will hopefully happen in the next four months.
Claire says they get a lot of enquires for transplants when someone is on dialysis. This is when the illness has become visible to the outside world and when friends, neighbours, and work colleagues start asking questions about their state of health.
Heartbreakingly, by then it’s often too late. These patients are not going to be fit for transplant. ‘We want them early,’ Claire reiterates.
You might have ticked ‘donor’ on your driver’s licence, but you also need to follow it up with a conversation with your families. When families don’t have that feel for what you want, they struggle with the decision and that’s when donation doesn’t happen.
The team also works with donors around the globe. The recipient is assessed here, and their information is sent to a transplant unit in whichever country the donor lives. The donor usually stays put, and the recipient flies over and receives the new kidney. Usually by the time six weeks is up they’re well enough to fly back. Then a local New Zealand team takes over the care.
Claire says they expect everything to be rejected until proven otherwise in first few months of transplant, with the first two to three months being the highest risk times for rejection because the immune system knows there’s something there that shouldn’t be. But the team works hard to make sure there isn’t any opportunity for rejection to start.
The odds are pretty good though. Ninety per cent of living and 95% of deceased donor transplants are still working by the end of one year. The numbers drop slightly as time goes on. You’ll get an average of 20 years from a transplanted kidney, and, for the donor, they can continue to live a long life with only one kidney.
Donors are followed up in the first
six weeks, then three months, then annually for life.
Claire says they are particularly stringent with monitoring blood pressure, because someone with only one kidney has a higher disposition to being hypertensive. If the medical team does notice a drift, they can preemptively start blood pressure medications to slow down any problems.
Claire says well-informed people who are engaged with the medical system and have a good relationship with their GP and renal doctor have the most success with transplantation. She says she has patients coming early, as a pair, and telling her, ‘My kidneys are going to be failing and, when I’m ready, this is my friend Sam who has offered to donate a kidney. How do we get this started?’
Then there are the less wellinformed; those who may not have engaged with health so well in the past. They might come from a family where a couple of aunts and a grandfather all had dialysis and died on dialysis.
Claire says this segment of the population is often unwilling to trust what medical professionals say. Unfortunately, these are the groups that are also overrepresented in the dialysis population.
Another population that is overrepresented in failing kidney health is Māori and Pasifika. Māori are 2.5 times more likely to have type 2 diabetes than their Pākehā counterparts, and Pasifika peoples double that. Adding to that, Claire says that unfortunately they are referred to diabetes services later, so that ‘by the time they’re sitting in front of me, talking about transplants, quite often a lot of those complications might make it more difficult for them to get a transplant’.
Claire tries to reach out to patients before they start feeling unwell and have to start planning for dialysis.
She shares her donor liaison role with a colleague, and the two of them are working on strategies to connect with Māori. Each year, they attend Te
Every day, an average of 40 New Zealanders are diagnosed with diabetes. A gift in your will is a powerful legacy to ensure your desire to help and support people with diabetes lives on.
No matter how big or small, your bequest will make a world of difference in helping Diabetes New Zealand to support the 278,000 New Zealanders with diabetes to live full and active lives.
Rā o te Raukura in Waiwhetū, near Wellington. This annual whānau-oriented community festival has a focus on health, education, culture, youth, and entertainment.
‘We have a table in the health stand, and we talk about kidneys. We talk to kaumātua about how to better engage people to talk about transplantation and renal disease.’ She calls it ‘getting donation out in the communities’.
There is a misconception that Māori are less likely to donate than other races due to spiritual beliefs. There are a number of reasons why there are fewer transplants from and to Māori. Tissue matching is one issue. A concern for family is another. Patients might turn down offers of kidneys because they worry more about the wellbeing of their loved ones than their own personal health.
But the theory of transplant is not foreign to Māori. We only need to look at the legend of Maui who fished up New Zealand using his grandmother's jawbone. Instead of tapu, organ donation is the ultimate koha.
‘Honoa te pito ora ki te pito mate – Graft the live shoot to the ailing shoot.’
Historically, a kumara shoot that appeared to be struggling would have another shoot planted in the same mound. In the context of this discussion, the proverb refers to the grafting of a healthy kidney to support a failing kidney, thus promoting such a practice as tikanga Māori.
SOURCES
https://www.health.govt.nz/publication/ compensation-live-organ-donorsinformation-pack
https://www.health.govt.nz/system/files/ documents/publications/compensation-forlive-organ-donors-information-pack-may21.pdf
https://www.health.govt.nz/system/files/ documents/pages/maori-pacific-attitudestowards-transplantation.pdf
For a confidential discussion, please contact Nicky Steel info@diabetes.org.nz or 04 499 7145
The Ministry of Health compensates a live donor for their loss of earnings. New Zealand was the first country in the world to offer this, with the concept being that donors should not be out of pocket but at the same time not financially profiting. The donor will receive 100% of their calculated loss of earnings for a maximum of 12 weeks from the date of surgery. This covers tax, student loans, child support, and KiwiSaver. You just have to arrange unpaid leave with your employer.
‘Each donor is treated as a person with their own health needs and not regarded as someone to be groomed for someone else’s need.’
CLAIRE
As the days shorten and we head towards winter, so rolls round that time of year when we can plan to protect our health over the cooler months.
Diabetes NZ advises people who live with diabetes to get both the Covid-19 booster and flu vaccinations. Health officials dubbed last year’s flu season as ‘one of the most challenging we’ve seen in recent years’.
‘Last year, we saw a combination of Covid and the flu adding to the strain on our hospitals. This year, we can help avoid that by getting boosted against Covid and getting a flu jab as well,’ says Hon Dr Ayesha Verrall, Minister of Health.
The new Covid booster is a mix of both the original Pfizer Covid vaccine and the Omicron variant, in one. You are only able to have the Covid booster if you have not had Covid in the last six months and are over 30 years old or at a higher risk of severe illness from Covid-19.
To get a Covid booster:
• You must have had at least your first two Covid-19 vaccinations.
• It must have been at least six months since your last Covid-19 vaccine.
• It is recommended you wait at least six months since testing positive for Covid-19.
Just like the Covid-19 vaccine, the flu vaccine will not completely stop you getting flu, but it will reduce your chances of getting flu and should stop you getting really sick and avoid hospitalisation.
The flu vaccine is free for people aged 65 years and over, and those at higher risk, Māori and Pasifika aged 55 years and over, pregnant people, and those who have long-term conditions like diabetes, asthma, or heart conditions, children aged six months to 12 years old, and people with mental health and addiction issues.
Both of these vaccines can be taken at the same time, and you will receive the vaccines at separate places on your arms and with different syringes. It takes around two weeks after your flu and Covid vaccinations to be best protected.
There are many places for you to get your vaccines. You can book through www.BookMyVaccine.co.nz, call Healthline, or contact your GP, pharmacy or healthcare provider. For Covid-19 vaccination advice, call 0800 28 29 26 (8am–8pm 7 days a week)
For general health advice and information, call 0800 611 116 anytime www.healthline.govt.nz
You can get more information about flu and the vaccine on the Ministry of Health’s websites:
www.health.govt.nz/flujab
https://www.health.govt.nz/yourhealth/conditions-and-treatments/ diseases-and-illnesses/influenza
https://www.beehive.govt.nz/release/ flu-vaccine-protect-kiwis-winter
https://covid19.govt.nz/covid-19vaccines/covid-19-vaccine-boosters/
We continue our travels around Aotearoa New Zealand, meeting each region’s Diabetes Community Coordinator. In this issue, we meet Hēmi Houkāmau, our hauora kaimahi for the Tairāwhiti region.
Suddenly needing to move house was the event that forced Hēmi Houkāmau out of retirement and back into fulltime employment. Having already celebrated his final day at work, he was served with a 90-day notice to vacate. His landlord wanted to sell up, so Hēmi had no choice but to go in search of a new home. However, with Gisborne’s housing crisis and sky-high rents up there with Wellington and Auckland, he quickly found his ‘Super’ and part-time job just wasn’t enough to get by on.
He says he stumbled on the Diabetes Community Coordinator role early in his search for a fulltime job. ‘In my past life, I’d been a facilitator of academic and pastoral care for tertiary students. That helping people thing appealed to me and I applied. Lo and behold, I was offered the position.’
A carpenter by trade and teacher by profession, Hēmi taught at both primary and tertiary level before he chose to return from Wellington to his city of birth, Gisborne. He was whāngai (adopted) as a pēpi, leaving the region when he was just a young child. Hēmi says he is pretty sure both of his mothers had diabetes. ‘I don’t know if I’m
predisposed to diabetes, but if I’m not then certainly my previous lifestyle would’ve contributed to me being prediabetic.’
A man of many hats, one part of his role involves running the Diabetes Self-Management Education (DSME) programme; a free six-week course for people who have recently been diagnosed with type 2 diabetes. Each twohour session covers everything you ever wanted to know about the condition and is supported by a team of four clinicians: a dietitian, a pharmacist, and two lead diabetes nurses.
‘I imagine my role as a facilitator or as a Kaiāwhina – the person who prepares the programme, until clinicians come in to explain the finer details of diabetes, and its complications, to the attendees.’
As the weeks go on, Hēmi notices people becoming more comfortable with each other. Whereas at the start of the course, some people hold back asking questions – he reassures them that the only silly question is the one you never ask because you’re worried what others might think. He notices that it’s not long before someone pipes up, following a leftfield question, saying ‘I wanted to
ask that question’.
No matter how intimate or curious the queries, Hēmi says the team is able to handle them with aplomb.
Hēmi freely admits it wasn’t a smooth beginning when he started last August. Not coming from a medical background, he says he felt the pressure of the new role. ‘I’d done the training, but still I felt way out of my depth in terms of diabetes knowledge.’ But as he continues to understand diabetes as a condition and make more connections within his community, he says things are now falling into place.
Patients are referred to him from a number of areas – medical centres, the extended care team, and even self-referrals brought to him by word of mouth. The courses are run during the day as well as in the evening to accommodate as many people as possible.
8351 SQUARE KILOMETRES
Hēmi has a huge geographical area to cover. It is a region with many people in need but also with too few medical professionals to service the area. Many regions were isolated before Cyclone Gabrielle came to visit, and her
aftermath still makes travelling from one area to another a challenge. Hēmi’s patch runs from Pōtaka in the north to Muriwai in the south, heading inland to Tiniroto, then across to Mōtū, with everything in between. And of course, there’s Gisborne city with a population of 37,000. Naturally understated, Hēmi says it’s going to take a while.
Although a solo role, Hēmi has connected with Kasey Brown, who works for Ngāti Porou Hauora as their diabetes coordinator for the East Coast. ‘We’re committed to collaborating with one another and trying to ignore any political boundaries that might exist.’ Hēmi says that Kasey has pulled together the numbers of people living with diabetes on the coast and that they are frightening.
‘I’m taking one day at a time, rather than trying to save the world tomorrow.’
Hēmi has seen many examples of people who come to the programme and admit to leading a lifestyle that is not consistent with keeping diabetes at bay. Inevitably, by the time we’re middle aged, a particular lifestyle is well ingrained and it can be difficult to change patterns.
He says he will come across more than a few people who are in
denial. ‘The thing is when people took at themselves in the mirror, and they look fine on the outside. That gives a false impression of good health. They don’t have any hakihaki (rash) on their face, they’re not coughing constantly, and they believe that what they’ve been eating and drinking for the last X amount of years has not done any real damage. That is until they start to lose some sensation in the feet. Or until their vision goes blurry. Or until they have renal problems.’
Isolation plays a part too, with people living away from whānau and falling into bad habits. If there is no one in your home to support or monitor you, you can basically do what you want. There’s no outside voice encouraging you to put that fizzy drink down. ‘I can think of one person at the moment who’s not making any attempt, and if it continues there’s going to be a tangihanga (funeral) soon.’
Hēmi says, ‘It doesn’t make sense. Why would you not try? Trulicity is a wonder drug for weight loss, yet some of our people haven’t been to pick up their repeats at the chemist. And it’s subsidised. Not like it’s costing an arm and a leg. It doesn’t make sense. We’re trying to help, but they’re not doing a lot to help themselves.’
He says it’s frustrating when he knows there’s a real need out there.
For Māori, there is still a residue of mistrust of Western medicine, so Hēmi is happy for the content he runs to not be the ‘be all and end all’. He encourages locals to locate and use rongoā Māori – traditional healing that encompasses herbal remedies, physical therapies, and spiritual healing. But it needn’t stop at local healing, he says. It can be from any part of the world.
‘Some people are screaming out for help and here we are spending an hour at someone’s house who couldn’t give a toss. But our boss reminds us to at least be trying everywhere we can to help people manage their diabetes.’
At the end of the day, Hēmi’s job is to share the information on how to self-manage diabetes. ‘If people take it on board, great. If they don’t, there’s not a wretched thing we can do about it.’
But Hēmi has also encountered many successes: people who have made positive changes. He has seen people make healthy changes to their diet, lose a substantial amount of weight, and go from doing no exercise at all to walking around the block two times a day.
Another of the hats that Hēmi wears is that of a Health Coach for Pinnacle, a Primary Health Organisation in Tairāwhiti region. In this role, he continues to engage with attendees from past programmes, checking in with them once they’ve completed the DSME course. He gets their consent to phone, text, or even pop in to see ‘graduates’ from time to time. He has a grand plan to pull them all together at the end of the year and celebrate achievements attained, no matter the size. ‘The celebration for me is when people
make the decision to learn how to manage their diabetes and understand as much as they can about their condition.’
After his first DSME course finished, he asked the participants for feedback. ‘Listening to the progress they’ve all made and how much they’ve appreciated the programme, I have to say that I got quite emotional.’
Being whāngai and raised far from his birthplace, Hēmi says there’s a barrier that often comes up when meeting fellow Ngāti Porou. ‘I was at the RSA, and this guy asks me “where you from?” I said I’m from here. He looked at me and said, “No, you’re not.” I said yes, I am. He says, “Where were you born?” I said here. He’s says, “How come I haven’t seen you?” I said, we moved away when I was just
starting school. He says, “Where did you go to school?” I said Wellington. He says, “Oh, you’re not from here, you’re only born here.”
Hēmi says that cut deep but that he understands where he was coming from. ‘If you’re not that snotty-nosed, cheeky little brat that everyone knew as a youngster or the guy who used to play wing for a rugby club or the one that got arrested for growing dope, then it’s really hard to crack those communities.’
He says the benefit of the DSME programme is obvious but, because no one knows him, it’s an ongoing frustration. ‘The Houkāmau name is known the length and breadth of Tairāwhiti. But that doesn’t matter diddly squat. So, there is this mistrust – “who is this guy again? Who knows him? Where did he go to school? Who are his parents? Does he have any kids?” All this
kind of stuff. If you can’t make any real connection that’s more than 15 years old, then it’s really difficult.’
‘For years I’ve anguished that this is where I should’ve grown up. It was my whāngai whānau that took me down to Wellington.’ But Hēmi refuses to let it get him down. ‘You can’t let it become baggage. I refuse to carry it around with me. If I do, it’ll weigh me down.’
Hēmi says he is committed to seeing out the rest of his days in Tairāwhiti. ‘All my kids are in Wellington. All my grandchildren, and my great-grandchildren. I’ve told them, I’m never coming back to Wellington. I’m going to die up here. With all the highs and lows, this is where I want to be. This is where I should’ve been my whole life.’
When asked how long he can see himself in this form of mahi, he replies, ‘I’ll probably work until I’m 70 and then hand my keys in.’
Are you managing your condition with Metformin, or by diet alone?
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Jonathan Abernethy talks to us about touring Europe, surreptitiously hiding a coke on stage, and nipping down to buy a CGM off the shelf in a Paris pharmacy.
Jonathan Abernethy is returning to Aotearoa New Zealand in June and July to perform with NZ Opera in Mozart’s Cosi Fan Tutte. This will be the second time he has sung the role of Ferrando, with the first time being with Opera Australia in 2015.
Based in Frankfurt, Jonathan has been singing professionally for 10 years. He has sung with opera companies in Australia, France, Switzerland, and Germany. Not bad for someone who was originally planning on working in business or IT. He was in his final year at Victoria University and taking on a music paper in order to earn some extra credits when his teacher suggested he audition for fulltime training to take his newly discovered talent further.
Jonathan’s upbringing taught him that routine is a good rule to live by. However, the life of a
touring opera singer involves little routine, which he says is ‘sometimes great, and sometimes really not.
‘I’m always travelling, so I’ve always got a different doctor. The lack of consistency is a challenge in terms of having someone that’s keeping an eye on my diabetes and helping manage it.’
It can also be difficult to maintain an exercise regime when you finish work close to midnight and are physically and mentally drained. And at the other end of the day, Jonathan says if he were to exercise too hard before performing then his singing mechanism becomes impacted. But he knows he must keep his fitness up both for the monitoring of his diabetes and the upkeep of his personal fitness.
As a teen, Jonathan rowed for Wellington College, so his go-
Pictured: Jonathan Abernethy in Pinchgut Opera's production of Orontea, Sydney 2022.to exercise is still to jump on a rowing machine or go for a run as the Frankfurt seasons allow, but in winter the temperatures hover just above freezing. He says improved fitness makes a night and day difference to how he feels. ‘I could ignore it for 10 days, but then my diabetes says, “Hi!”’
Diagnosed at age nine, Jonathan found it difficult to make sense of the condition through his teenage years. ‘I was just riding that rollercoaster of being a teenager with diabetes.’ He met a few fellow students with type 1 at university, but then after that he says he was on his own and out in the world and missing the community support.
‘There are all these online groups that are hugely helpful. I wish I had known about them three years before I did. It makes you feel part of a bigger community of people who have this awful thing.’
In his career, Jonathan has only met two other singers with diabetes. But there is a pianist he sees semi-regularly in Frankfurt, and he says they always make a bee line for each other whenever they meet up, keen to discuss what has frustrated them in the last
while with their diabetes. He says it is quite cool to have that connection with someone else in the same field, however tenuous, and be able to talk about it.
The first time Jonathan came to Europe, he started to notice CGMs becoming visible on people’s arms, and he was keen to try them out.
He says the first couple of CGMs he tried were a bit hit and miss, so he just stuck with his pump. But one Christmas he was in Paris when he found the sensor in his transmitter had died. He ran down to the chemist, thinking he needed to buy a testing kit, before realising what else was available in a typical French pharmacy. In a matter of minutes, he was connected to his first CGM. ‘That was my first CGM and that made a huge different in terms of how nonroutine my life is.’
Jonathan now runs the tandem pump and a CGM, and enjoys that it’s all connected to his pump. ‘I reckon it has taken 20% of the workload off my mind, in terms of thinking about going up or down, turning off or on. That’s been really nice.’
‘You’ve just got to go for it. You’ve got to do what you love and what you want to do. Diabetes is one of those things and it’s always going to be there and it doesn’t matter what you do, so you might as well do something you love and enjoy.’
Jonathan is adamant that his diabetes hasn’t held him back in his career. One reason for this is that he finds his hypo symptoms are clear and consistent. Emotional musical nerves are often added to the mix, but he’s used to that now and is prepared for it. On show days, he tries to keep things plain by not eating foods that will make him spike and go low later on. ‘All the things I do before the show starts help to make sure the show is a non-event, diabetes-wise. If anything, I run a little bit higher during a show, but that’s usually not significant, and then I feel safe.’
Opera isn’t famous for its brevity, so how does an onstage performer find time to mitigate a low and down some glucose without being noticed? ‘If I have a long show when I’m on stage a long time and
I don’t come off, I’ll have a Coke stashed somewhere where it can’t be seen. So, if I need something, it’s there.’
But he says the close misses he’s had are the ones he’s had in his head. This is when Jonathan is on stage and he feels his pump enthusiastically sending him a warning that his battery has only three day’s life left. There are times when it’s useful to feel that alarm, and being busy on stage is one of those times when it’s not.
Opera is an extremely physical occupation, and that is before type 1 diabetes even sets foot on the stage as well. Performing with others close by, and needing to change costumes, Jonathan finds his pump site can sometimes get knocked and rubbed. This can be a challenge, he says, but it’s not the end of the world. ‘It just is what it is.’
Jonathan Abernethy, tenor, is an excellent example of someone keeping everything in control and being passionate and positive about what they’re doing.
His advice to anyone keen on following along his path: ‘You’ve just got to go for it. You’ve got to do what you love and what you want to do. Diabetes is one of those things and it’s always going to be there and it doesn’t matter what you do, so you might as well do something you love and enjoy. You’ll learn things along the way. And you’ll have some good times, and you’ll inevitably not have some great times. The healthier you are, with exercise and food, all totally helps.’
If you want to see Jonathan, follow this link to the shows in Auckland, Wellington, and Christchurch: nzopera.com
delivered – that's $7 per issue, including P&P. RRP is $32.00. To subscribe for this special price, visit www.diabetes.org.nz and click on “Magazine Subscription”.
Raumati. Summer. That time of year when large groups of awesome kids and their families get to go on camp and have fun. Our Youth Coordinators around the motu report back on their summer of fun and give us the rundown on how it all went.
Living Everyday Brave Camp was held at the YMCA Shakespear Camp at Whangaparāoa. Our weekend was on the periphery of ex-Tropical Cyclone Hale's path, but we had 30 wonderful kids and a heap of fun, despite the weather. With rain most of the time, the programmed water activities had to be cancelled due to high swells and winds. But despite this, the kids weren’t fazed and still got beach time and made some impressive sandcastles. Activities included using UHF radios, wall climbing, pioneering bridge building, low ropes, mountain boarding, archery, shelter building, orienteering, and rifle shooting.
As with the Waikato camp, this was for type 1 youth only, so no siblings or parents. The planning and organising
that goes into executing this camp type of camp is immense. The support team involved doctors, nurses, dietitians, parent helpers, and youth leaders, all of whom are necessary, and it takes many months of planning to get all those people in place.
As initial numbers were lower than expected, the age range, which is usually from 9–12 years, was extended to 13 years, and then again to children from Whangārei who are usually outside the catchment area, to capture some that may have missed out on events during Covid-19. The camaraderie and friendships that we could see developing were heartwarming. It was especially nice to see the older kids taking some of the younger kids under their wings and helping them build their confidence if they were struggling. Some of the kids were so shy when they arrived, but they departed confident, looking like different people altogether.
This camp could not have been run without the many hands that supported Shantelle during those days.
We would especially like to thank Giltrap Trust and the Louisa and Patrick Emmett Murphy Foundation.
Marsha Mackie for Shantelle Bliss, Youth Coordinator, Auckland
Diabetes NZ Nelson Youth was thrilled to welcome whānau to Teapot Valley Christian Camp for our Live Brave Mana Ora summer camp of 2023. Known as Top of the South Family Camp, it had been cancelled last year due to Covid-19, so this year’s gathering was highly anticipated by our families.
Over the final weekend of February, we welcomed more than a hundred members of our extended Nelson Youth whānau to the valley, in Brightwater. Half of our campers were experiencing a Family Camp for the first time, so we worked hard to create an experience no one would forget.
We had 28 youth with type 1 and 23 siblings challenging themselves and each other in aspects of camp life and diabetes care. Throughout the weekend, we ran activities that focused on self-confidence, team building, connection, education, and socialisation. Teapot Valley Camp is an incredible location for trying out new things, with many activities on offer and spacious grounds to explore. Busy days were had where our campers tried out archery, downhill carts, abseiling, ziplining, swimming, waterslide, arts and crafts, giant games, and more.
As the camp was only a fortnight after Cyclone Gabrielle ripped through the East Coast, we ran an education session for our parents and caregivers. Disaster preparedness was top of our minds. Jill Julian, our Diabetes Nurse Specialist from Te Whatu Ora Nelson, ran this session. It was a great reminder for our local families to ensure their emergency plans were up to date.
Diabetes NZ Nelson Youth was lucky to have industry representatives from NZMS, InterMed, and Pharmaco NZ available as helpers throughout the weekend. Along with our teen leaders, these reps helped to run team challenges with our youth, including building a pyramid, finding an ant trail, hanging from the monkey bars and many more. This was an excellent activity for not only mixing with other children but also building bonds and developing self-care of diabetes. It was encouraging to see our older and more experienced rangatahi taking on leadership roles and caring for our younger tamariki.
Although super busy, we still managed to find downtime for social interaction and discussions. The dining hall became an active hub and was always abuzz with chatter between parents and youth alike. Many new friendships were formed and existing relationships strengthened. Our youth and their whānau have been able to develop peer support networks, increase their diabetes knowledge, participate in outdoor pursuits in a safe environment, and positively impact their mental health in knowing they are not alone in life with type 1.
Diabetes NZ Nelson Youth would like to thank Nelson City Council, Nelson Host Lions Club, Tasman District Council, and our families for their help fundraising through raffle sales, sausage sizzles, and Do Blue Days at local schools.
What a wonderful weekend we all had at Totara Springs, Matamata, in the middle of March! While it was raining when we arrived on Friday night, by the end of breakfast the following day, the sun was shining, and everyone was ready to enjoy a weekend of fun activities and connection. We had a big range of kids with type 1 this year, with ages spanning from two years old to 16 years old.
This year, families enjoyed a range of activities, including flying kiwi, crate climbing, riding the giant waterslide and hydro slide, and rock climbing, just to name a few. Goode PR came to film the fun on the Saturday and interview some families. We’re looking forward to seeing the footage.
We would like to thank our major sponsors: New Zealand Community Trust and Legacy Trust. Donations were gratefully received from the Lions Clubs of Papamoa, Katikati, Tauranga City Sunrise, Mount Maunganui, Rotorua East, Welcome Bay, Reporoa, Whakatāne, and Ōhope. Business donations were kindly donated by Commercial Door Services, Balance Tauranga, Pacific Products NZ Ltd, PRISMA
The Living Springs Camp and Conference Centre on Banks Peninsula hosted Canterbury’s first-ever family camp in the last weekend of January. With 19 children with type 1 diabetes and 40 whānau, everyone’s days were filled with awesome activities, including mountain boarding, tree climbing, DIY cart making, conquering the boulder wall, and swimming in the heated pool. Nights were spent playing games, watching movies, socialising, and interacting with others on the same journey, whether that was as a parent of a child with type 1, a sibling, or an awesome kid with diabetes themselves.
All children with type 1 wore CGMs, and the majority of them were on pumps. As always, it was great for all the children to see they weren’t alone and that lots of children wear technology to help themselves with their diabetes journey.
For most, this was their first camp, and the majority have already asked when the next camp will be held. Planning is already under way, and we hope even more families will attend in 2024!
Our camp would not have been able to happen without a grant from Kiwi Gaming.
Aleisha Mitchell, Youth Coordinator, CanterburyFacilities Management Ltd, and Consana New Zealand. We would also like to acknowledge all the fundraising efforts of our type 1 families from across the Bay of Plenty and Lakes areas and also the donations from anonymous donors. Without the support of these generous funders, we wouldn’t be able to offer the Family Camp at an affordable price for all our families.
Lena Fendley Youth Coordinator, TaurangaIt was exciting to be able to go back to Ngamuwahine Lodge in the Kaimai Mamaku Forest Park for our 19th kids’ camp. Our 35 campers with type 1 all came from the Waikato and Bay of Plenty and were aged from 7 to 12 years. As well as having four teen mentors join our group this year, we also had two young adult volunteers, both of whom had progressed from being campers to mentors to young adult volunteers, and they were a great support to campers and staff. The rest of the staffing this year came from the Te Whatu Ora – Waikato and Hauora a Toi Bay of Plenty, NZMS, InterMed, and Karapiro Charters. It is only with this support that we can run our camps the way they do.
Dodging weather bombs, our theme this year was Under the Sea and everyone had a splashin’ great time. With the river nearby, we swam, kayaked, rafted, and also headed into Tauranga to use the local pool. Drier activities included high ropes, a fantastic flying fox, the climbing wall, archery, mountain biking (courtesy of Kaipaki School), and arts and crafts.
A silent dress-up dinner on the last night was enjoyed by everyone, and it was a true challenge to communicate only by writing or drawing.
For our 2023 camp, the Potter Masonic Trust provided the majority of our financial support, after camp fees and donations from individuals. As with every Live Brave Mana Ora camp. MediRay and Pharmaco provided our campers with much loved merchandise, and Vibe kindly provided drinks.
I often get asked, why do you do this camp? It is never hard to find an answer. It is important for children with diabetes to feel like they belong. To see kids your own age getting on with having fun, being active, and being in the majority are only some of the reasons. It is also an opportunity for respite for parents, who can sleep right through the night knowing their child is in a safe environment.
Dr. Jo McClintock, Consultant Clinical Psychologist, Waikato Hospital Camp-Coordinator
(and 2022 winner of the Diabetes NZ award for services for volunteer work)
September 2023, Coronet Peak | For youth aged 13-18 years | Details TBC
Three days of skiing, snowboarding, and getting to know other youth with diabetes. Kids and their whānau need to feel supported in their diabetes journey. Connecting up with others at our camps is a great way to meet new friends, create a support network, and share and learn together. Camps are run in conjunction with local District Health Boards, who are responsible for diabetes management during camp, and we are tied by their requirements as to the numbers of campers that they can safely care for. For this reason, camps prioritise young people who live within their local DHB catchment area.
We present some of the latest research news from round the world.
A research model of dietary intake in 184 countries, developed by researchers at the Friedman School of Nutrition Science and Policy at Tufts University, estimates that poor diet contributed to over 14.1 million cases of type 2 diabetes in 2018, representing over 70% of new diagnoses globally. The analysis, which looked at data from 1990 and 2018, provides valuable insight into which dietary factors are driving type 2 diabetes burden by world region. The study was published 17 April 2023 in the journal Nature Medicine.
Of the 11 dietary factors considered, three had an outsized contribution to the rising global incidence of type 2 diabetes: Insufficient intake of whole grains, excesses of refined rice and wheat, and the overconsumption of processed meat. Factors such as drinking too much fruit juice and not eating enough non-starchy vegetables, nuts, or seeds, had less of an impact on new cases of the disease.
‘Our study suggests poor carbohydrate quality is a leading driver of diet-attributable type 2 diabetes globally, and with important variation by nation and over time,’ said senior author Dariush Mozaffarian, Jean Mayer Professor of Nutrition and dean for policy at the Friedman School. ‘These new findings reveal critical areas for national and global focus to improve nutrition and reduce devastating burdens of diabetes.’
Of the 184 countries included in the Nature Medicine study, all saw an increase in type 2 diabetes cases between 1990 and 2018, representing a growing burden on individuals, families, and healthcare systems.
The analysis revealed that poor diet is causing a larger proportion of total
type 2 diabetes incidence in men versus women, in younger versus older adults, and in urban versus rural residents at the global level.
Regionally, Central and Eastern Europe and Central Asia –particularly in Poland and Russia, where diets tend to be rich in red meat, processed meat, and potatoes – had the greatest number of type 2 diabetes cases linked to diet. Incidence was also high in Latin America and the Caribbean, especially in Colombia and Mexico, which was credited to high consumption of sugary drinks, processed meat, and low intake of whole grains.
Regions where diet had less of an impact on type 2 diabetes cases included South Asia and SubSharan Africa – though the largest increases in type 2 diabetes due to poor diet between 1990 and 2018 were observed in Sub-Saharan Africa. Of the 30 most populated countries studied, India, Nigeria, and Ethiopia had the fewest case of type 2 diabetes related to unhealthy eating.
Study: doi.org/10.1038/s41591-023-02278-8
Source: Science Daily
Australian Dr Jennifer Snaith, St Vincent’s Endocrinologist and Garvan PhD scholar, was recently awarded the inaugural Rebecca Davies Clinician Research Fellowship worth $150,000 by JDRF, an international organisation dedicated to supporting type 1 diabetes research.
Semaglutide, a medication that replicates a gut hormone, has been shown to reduce risk of heart disease, improve weight and blood sugar in people living type 2 diabetes, and Dr Snaith’s
research will explore its efficacy in reducing the risk of cardiovascular disease in people living with type 1 diabetes.
The RESET study will be the first to determine if this simple once-a-week injection improves metabolism and heart health in people living with type 1 diabetes. Concurrently the team will conduct an in-depth investigation of the nature of gut hormones in type 1 diabetes.
The clinical trial will be conducted through the Garvan Institute of Medical Research.
https://tinyurl.com/6jp633ck
The SMF Type 1 Diabetes Grand Challenge is a pioneering partnership between the Steve Morgan Foundation (SMF), JDRF and Diabetes UK that will work towards the shared goal of transforming the lives of people with type 1 diabetes and finding a cure for the condition.
The Steve Morgan Foundation’s £50 million investment – the largest ever single donation in the UK for diabetes research – will be led from the UK and bring together the world’s preeminent researchers, scientific organisations and diabetes charities to drive innovations and breakthroughs over a five-year period.
Steve Morgan, the founder of housing firm Redrow, is making the £50 million donation through the Steve Morgan Foundation. Steve and Sally Morgan's son Hugo was diagnosed with type 1 diabetes at the age of seven. It is the largestever single gift in the UK for diabetes research.
https://type1diabetesgrandchallenge.org.uk/
FreeStyle Libre Flash Glucose Monitoring System
The FreeStyle Libre Flash Glucose Monitoring System is a glucose monitoring device indicated for detecting trends and tracking pattern in persons aged 4 and older with insulin dependent diabetes mellitus, without the use of lancets.
Diabetes Care
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Order Online: www.mediray.co.nz
Dextro Energy Glucose Tablets
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The real-time continuous glucose monitoring system is now more powerful and easier to use with a small, all-in-one wearable and redesigned mobile app.
Building on the trusted performance of Dexcom
CGM, Dexcom G7 enables greater diabetes control and improved health outcomes so you can move with confidence, knowing diabetes doesn’t have to hold you back.
For more information on Dexcom G7, please contact NZMS Diabetes on 0800 500 226 or at dexcom@nzms.co.nz nzmsdiabetes.co.nz
Always read the label and use only as directed. Read the warnings available on nzmsdiabetes.co.nz/resources before purchasing. Consult your healthcare professional to see which products are right for you.
† If your glucose alerts and readings from Dexcom G7 do not match symptoms or expectations, use a blood glucose meter to make diabetes treatment decisions. ‡ Smart device and Receiver not included with Dexcom G7 CGM system. For a list of compatible devices, please visit dexcom.com/compatibility. § Results obtained with a prior generation Dexcom CGM System. || Separate Dexcom Follow app and internet connection required. Internet connectivity required for data sharing. Users should always confirm readings on the Dexcom G7 app or receiver before making treatment decisions. Compared to a prior generation Dexcom CGM System. # Healthcare providers can register for Dexcom Clarity at clarity.dexcom.com/professional/registration. ** An internet connection is required to send glucose data to Dexcom Clarity via a compatible smart device: dexcom.com/compatibility. Healthcare providers will only be able to view user’s glucose data if the user elects to share it with them through Dexcom Clarity. 1 Welsh JB, et al. Diabetes Technol Ther. 2019;21(3):128-132. 2 See Dexcom G7 user guide for more information. 3 Beck RW, et al. JAMA. 2017;317(4):371-378. Distrubuted in New Zealand by NZMS, Auckland. NZMS is subsidiary of Dexcom. LBL-1001151 REV001 October 2022
