Its not all about sugar_ by leader6


									                                    Newsletter for the Families of Young People with Diabetes Autumn 2010

   Inside this issue:                                                                           CONTENTS
                                                                                                 It’s not all about sugar!                 1 & 4-5
                                                                                                 Editorial & Chair report                       3
                                                                                                 DYA committee & meeting dates                  3
                                                                                                 Food tips                                 5 & 6-7
                                                                                                 Diabetes Camp review                           8
                                                                                                 Living gluten-free                             9
                                                                                                 Youth Press                                10-11
     Diabetes Camp Review                          Family Camp 26-28 March. Book now!            Family Camp details – book now                11
                                                                                                 Penny’s web guide                             12

                                                                                                 Having a life with diabetes                   13

        April                                                                                    2010 flu vaccine                              14
                                                                                                 School seminar dates                          14
         Annual ip
         Starsh caregiver                                                                        Starship contacts                             14
          parent/ion evening                                                                     Diabetes Youth AGM
          educat                                                                                 	   •	24	March	–	come	along	                  15
     You’re invited!                               Youth Press - young people’s views            Starship education evening                    15

It’s not all about sugar!
For many people when their child is diagnosed with diabetes
one of the first questions they have is “what will my child be
able to eat?!” In return a common question asked of parents
of newly diagnosed children by friends is “Did your child get
diabetes from eating too much sugar?”

Caroline Adamson is a Starship Children’s Health diabetes dietitian
and in this article she explains GI and carbohydrate counting.

Although we have always known that eating too much sugar is
not the cause of type 1 diabetes, in type 2 diabetes eating too
much sugar can promote weight gain which helps create insulin
resistance, which can be one of the contributing problems in type 2

Years ago the “Diabetic Diet” was a strict no-sugar diet as it was
believed that was the key thing in the diet to help prevent high          NEXT ISSUE: JUNE
blood sugar levels. Things have changed over the years as we’ve           DYA Press is the official publication of Diabetes Youth Auckland.
learnt more about carbohydrates.                                          If you have something to share or advertise in the next issue
                                                                          please contact the Editor: Shona Willis, email
Carbohydrates are the main fuel foods for our bodies and there are
                                                                 or phone 021 630 311 by 23 April.
3 main types: sugar, starches and dietary fibre. Dietary fibre is not
digested in the body and has no direct effect on blood sugar levels       To join our mailing list or if you’ve changed address recently
but sugar and starches do (for this article the term carbohydrate         please send your name, your child’s name, DOB, address and
encompasses sugars and starches). Sugars are classified as mono           phone number to DYA Database Update, PO Box 67 041, Mt Eden
or disaccharides (meaning 1 and 2 molecules joined together),             or email
                                               Continued on Page 4...
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editorial - the food issue                                                    Chair Report
There’s a family tradition in our house that for the kids’
                                                                              Well here we are, 2010 a new year with
birthdays Mum bakes the cake and Dad decorates it. How
                                                                              lots of great events both new and old
‘cool’ the birthday person thinks their cake is comes down to
                                                                              happening, it is through the generous
how many lollies per square millimetre Dad can squeeze on
                                                                              time given by volunteers that we are
to it. When Henry got type 1 I thought that would be the end
                                                                              able to carry out these activities.
of fancy birthday cakes for us. Three years down the track I
know a lot more about food and diabetes.                                      The AGM is around the corner and we
I want Henry to have as normal a life as possible. That                       have been fortunate enough to source
includes being able to take part in celebrations and special                  a guest speaker. I ask that you try and join us for a meet and greet
occasions that involve not-so-good foods without being                        followed by a glass of wine.
treated differently. I know he has a balanced healthy diet                    We still have a few vacancies to fill, such as DYNZ Regional Rep and
most of the time so we still make fancy birthday cakes.                       Secretary, so if you feel you can contribute to these or any other
In this issue Caroline Adamson from Starship and Penny                        event please let me know.
Harrison have each put together an article about food which                   There are still a few spaces left for family camp so get in early if
I’m sure you’ll find useful. And Katherine Cave shares her                    you wish to join us at Chosen Valley Christian Camp for a fun filled
experience of having two children with coeliac disease.
                                                                              weekend. We all know it’s the kids that benefit and that is what
Thank you to all of you for writing.
                                                                              these events are all about........our kids.
Easter isn’t far away. Here’s a tip - Kinder
                                                                              Once again thank you to the committee for all they do to keep DYA
Surprise chocolates are a good Easter egg
                                                                              a success and I hope to see you all at the up and coming events
alternative as they have a very thin layer
                                                                              of 2010.
of chocolate and the added bonus of a toy
inside.                                                                       Craig Sumpton
Shona Willis

Calendar 2010
Further information will be available in the next DYA Press
or mailed out closer to each event.

24 March                 AGM with guest speaker, Catherine de Vos
26 - 28 March            Family Camp, suits up to 13 year olds and their families/whanau
29 April                 Starship parent/caregiver education evening

Held monthly at Diabetes NZ Auckland, Nesfield House, 62 – 64 Valley Road, Mt Eden, 7.30pm, Wednesdays.

All parents/caregivers are welcome. Contact Sara-Maria Broekhoff, 623 2508 or just turn up!
10 March, 24 March - Annual General Meeting with Guest Speaker, note earlier time (7pm), 14 April, 12 May, 9 June, 21 July,
11 August, 15 September, 13 October, 10 November

DIABETES YOUTH AUCKLAND                          The committee is run by volunteer parents and caregivers of children with diabetes.

Chairperson                                             Craig Sumpton                                                      Ph: 535 5190
Treasurer                                               Lana Finn
Secretary                                               vacant
Fundraising Co-ordinator                                Brett O’Neill                                                      Ph: 271 3980
DYNZ Auckland Rep                                       vacant                                                             Ph: 817 9149
DNZA-Y Field Rep                                        Sara-Maria Broekhoff                                               Ph: 623 2508
Buddy Co-ordinator                                      Rochelle Le Pou                                                    Ph: 277 2664

Bank account for direct payments                        ASB 12 3048 0283381 02

                           Articles published in the DYA Press are intended to interest and inform. They are not to be
                           interpreted as medical advice. That is the function of your diabetes specialist and should be
                           discussed with him/her. Articles published are the opinion of the author and not necessarily
                           that of Diabetes Youth Auckland.
       It’s not all about sugar! Continued...
    whereas starches are also known as polysaccharides (meaning                feel fuller for longer, assisting people to control the amount of food
    many molecules joined together). Because of their structures               they eat in a day.
    carbohydrates were then classified as simple (sugar) and complex
                                                                               There is some evidence that choosing low GI foods can produce
    (starches) carbs. It was believed that avoiding simple carbohydrates
                                                                               lower postprandial glucose excursions (glucose levels after eating)
    (or sugar) was key in the management of blood glucose levels as
                                                                               and can have small, but clinically significant effect, on glycaemic
    these would have a rapid effect on blood glucose levels and thus
    this became the cornerstone in what used to be a “Diabetic Diet”.
                                                                               Another important point to note about GI is that low GI doesn’t
    Over the years and with the development of the glycaemic index
                                                                               always mean healthy. Fat in foods slows the digestion process down
    (GI), we now know that it’s not quite as simple as that.
                                                                               thus slowing the rate at which sugars appear in the blood. Therefore
                                                                               high fat foods such as chocolate are actually low GI. Also the GI of
     Glycaemic Index (GI)                                                      foods can change by combining foods, i.e. if you combine a high GI
                                                                               food with a low GI food the result is a moderate GI meal. As fruit
    Not all carbohydrate foods are created equal. The glycaemic index,         ripens the GI changes, and cooking can also change the GI so it can
    or GI, describes this difference by ranking carbohydrates according        get a little confusing.
    to their effect on our blood glucose levels. Carbohydrates that
                                                                               To determine the GI of a food it must go through the testing process,
    break down quickly during digestion and release glucose rapidly
                                                                               you cannot tell by looking at the nutritional information - i.e.
    into the bloodstream have a high GI; carbohydrates that break
                                                                               the carbohydrate, fat and fibre content - what the GI of a food is.
    down more slowly, releasing glucose more gradually into the
                                                                               The GI of foods is determined by testing only 50g of each food.
    bloodstream, have a low GI.
                                                                               Consequently GI doesn’t actually take into account the quantity of
    Glucose which is a monosaccharide (single sugar molecule) has              carbohydrate consumed - so the amount of carbohydrate consumed
    a GI of 100 (the fastest to enter the bloodstream) and all foods           will also impact on blood glucose levels. Unlike Australia there is no
    are measured against it. Foods are ranked between 0-100 and                legal obligation in NZ to state the GI, but some manufacturers are
    classified as low 0-55, moderate 56-69 or high GI greater than 70.         now getting their products tested and putting this on food labels;
                                                                               there are also a number of books and websites that list the different
     Low GI             0-55       eg. raw apple, carrots, chocolate,          GIs of foods.

     Moderate GI        56-69      eg. sweet corn, raw pineapple,                SO WHAT THEN IS
                                   spaghetti, porridge (oat), basmati
                                   rice (boiled)
                                                                                 CARBOHYDRATE COUNTING?
     High GI            >70        eg. white bread, baked potatoes,            We know that the
                                   jasmine rice (boiled), Coco Pops            greatest dietary effect
                                   and Rice Bubble cereals, instant            on blood glucose levels
                                   porridge, Roll Ups (Heinz)                  is the total amount
                                                                               of carbohydrate
    Plain sugar (white sugar such as used in baking) is also known as          consumed. Total
    sucrose which is a disaccharide (2 molecules joined together).             carbohydrate is the
    Sucrose is a molecule of glucose joined to a molecule of fructose          total amount of starch
    (another monosaccharide or 1 molecule sugar)                               and sugar (combined) in
                                                                               a food. So when we are
       Sucrose (GI 60) = Glucose (GI 100) + Fructose (GI 20)                   looking at what effect
                                                                               the food will have on
    With glucose having a high GI (100) and fructose having a low GI           blood sugar levels we
    (~20) this means that when combined to make sucrose this has a GI of       need to look for the
    around 60, meaning it has a moderate GI. White bread in comparison         total carbohydrate in
    has a GI of 71, placing it in the high GI category. Therefore in regards   the serving of food,
    to GI, the fact that white bread raises blood sugar levels faster than     it’s not just about the
    sucrose (sugar), means that classifying carbohydrates as simple and        sugar. The amount of
    complex based solely on their structure is a bit simplistic.               sugar in relation to the
                                                                               total carbohydrate reflects more whether it is a healthy choice
    Low GI diets have become popular with people with both type 1
                                                                               rather than what effect it will have on blood glucose levels. Some
    and type 2 diabetes due to the fact that low GI foods produce a
                                                                               people count carbohydrate in grams, portions or exchanges. They
    slower rise in blood glucose levels. They are also popular for people
                                                                               are basically the same, just different ways of counting the total
    concerned about their weight as low GI foods tend to make people
                                                                               carbohydrate. At Starship we currently use grams for counting.
The important thing to note regarding sugar is that too much sugar
(especially added sugar) is not healthy for us. Added sugar provides
no nutrition (goodness), it is not essential to the body (we can live
without it), it can damage teeth and provides often unnecessary
calories which can promote weight gain. With the rising tide of
obesity in New Zealand this is an important consideration. Unlike
added sugar, natural sugars which are found in fruits and dairy
products do usually provide some nutrition due to the foods they
are found in but still need to be eaten in controlled amounts as part
of a healthy diet.

The emergence of rapid acting insulins (Novorapid/Humalog) in
the late 90s has lead to further changes in how we manage diet and
diabetes. Novorapid/Humalog can be adjusted in relation to the

                                                                         artificial Sweetners
amount of carbohydrate consumed, allowing more flexibility with
food. At Starship, carbohydrate counting is taught on 3 levels:
                                                                                                                  By Penny Harrison

(1) Basic Carbohydrate counting:                                         Artificial sweeteners are chemicals or natural
The simplest form of carbohydrate counting. Patients/families
                                                                         compounds that offer the sweetness of
are taught to read food labels and how to use food lists to count
carbohydrates. With fixed insulin doses it is important to eat the
                                                                         sugar without as many carbohydrates. Keep
same amount of carbohydrate for meals and snacks at a similar time       in mind that some foods containing artificial
each day to help keep blood glucose levels within the target range.      sweeteners, such as sugar-free yogurt, or
                                                                         sugar-free chocolate can still affect your
(2) Intermediate Carbohydrate counting:                                  blood sugar level due to other carbohydrates
Individuals start to learn to recognise patterns of blood glucose        or proteins in the food. Some foods labelled
response to carbohydrate intake and how it is modified by insulin        “sugar-free” — such as sugar-free biscuits and
and exercise. For those on rapid analogues (Novorapid/Humalog)
                                                                         chocolates — may contain other sweeteners,
the concept of carbohydrate to insulin ratios and correction factors
                                                                         such as sorbitol or mannitol, which contain
may be introduced.
                                                                         carbohydrates and can affect your blood sugar
(3) Advanced Carbohydrate counting:                                      level. Some sugar-free products may also
Individuals taking short or rapid-acting insulin (Novorapid/
                                                                         contain flour or other ingredients which will
Humalog) before meals can vary the amount of insulin                     raise blood sugar levels. It is always a good idea
depending on the carbohydrate content of the meal by looking at          to check the carbohydrates on the nutritional
carbohydrate to insulin ratios. The carbohydrate content of a meal       label to be sure.
is more accurately determined through the use of weighing foods
and carbohydrate factors.                                                NON-NUTRITIVE SWEETENERS -
Whilst carb counting has allowed greater flexibility and food            PROVIDING NO KILOJOULES (ENERGY)
choices for people with diabetes than in the past, it is not a licence   In New Zealand there are five common non-nutritive
to eat a poor diet. Healthy eating and good nutrition is still the       sweeteners (the figures in brackets are the additive
backbone to our diets but it does allow an understanding and             numbers): Aspartame (951) sold as Equal; Acesulfame-K
ability to be able to balance bigger meals and/or treat foods into       (950); Cyclamate (952) and Saccharin (954) sold as Sucaryl and
the diet without effecting blood glucose levels.                         Sugromax (saccharin and cyclamate mixed); and Sucralose
                                                                         (955) which is Splenda.

   SUMMARY OF DIETARY MANAGEMENT                                         FEATURES OF THESE SWEETENERS:

   FOR TYPE 1 DIABETES                                                   •	 Intensely	sweet,	but	contain	few	or	no	kilojoules	(energy)	
                                                                         •	 Do	not	affect	blood	glucose	levels,	so	can	be	useful	for		
   1) Healthy eating is key - children with type 1 diabetes have           people with diabetes
      the same nutritional requirements as other children                •	 Do	not	cause	dental	decay.

   2) Try incorporating at least one low GI food at each meal            Despite safety concerns, there is no evidence to substantiate
      and snack (ideally a healthy low GI option)                        claims made against these sweeteners. However, saccharin
                                                                         and cyclamate are not recommended for children under 2
   3) Watch the total carbohydrate content of meals and snacks           years old. Aspartame and sucralose are considered safer.

   4) For those on Novorapid/Humalog at meals talk to your               In pregnancy, aspartame, acesulfame-K and sucralose
      dietitian about how you can get more flexibility                   are considered safe. Saccharin and cyclamate are not
      by adjusting rapid acting insulins in relation to total            recommended for pregnant women.
      carbohydrate                                                       (Source: Diabetes NZ)

    NUTRITIVE SWEETENERS                                                fruit drinks. Fructose has an advantage when using it in food
                                                                        like meringues which require a great quantity of sugar. With
    Nutritive sweeteners - providing kilojoules (energy)
                                                                        fructose, you could use less and therefore decrease the
    Nutritive sweeteners are called sugar polyols or sugar              kilojoules.
    alcohols because of their chemical structure. However,
                                                                        Penfold’s Sweetaddin, which is 100% fructose, is promoted
    they do not contain sugar or alcohol.
                                                                        as tasting like sugar with a similar texture but some people do
    Sorbitol (420), Mannitol (421), Xylitol (967), Lacitol (966), and   not find the taste comparable.
    Isomalt (953) are the common sweeteners of this type in
    New Zealand.                                                        (Source: Diabetes NZ)

    Features of sugar alcohols:                                         STEVIA
    •	 Occur	naturally	in	fruit	and	vegetables                          This plant-derived sweetener is made from the leaves of
    •	 Provide	sweetness	but	with	fewer	kilojoules                      the Stevia plant – you can find the plant for sale in most
      (0.8 –12KJ/gram) than sugar (16KJ/gram)                           NZ nurseries – try chewing a leaf! The Australian food
    •	 Absorbed	more	slowly	and	incompletely	than	sugar		               authority FSANZ has approved it as an ingredient in foods and
      requiring little or no insulin for metabolism resulting in        beverages in Australia and New Zealand. Stevia is considered
      lower blood glucose levels                                        the primary zero-calorie sugar substitute in Japan, a country
    •	 Often	used	with	a	variety	of	other	artificial	sweeteners,		      which does not allow artificial sweeteners. Originally
      with each contributing unique characteristics                     only obtainable from health shops, it is now found in NZ
    •	 Used	to	sweeten	confectionery,	jams,	baked	products	and		        supermarkets. I use it 2 forms – in powder form, which I use
      jellies                                                           for making lemon cordials etc and in baking, and suspended
    •	 Do	not	cause	dental	decay                                        in liquid, which is less powerful and useful for sweetening
    •	 May	cause	bloating,	flatulence	and	diarrhoea	when		              liquid-based dishes. I have been using it for a few years now,
      consumed in large quantities                                      mostly adding it to poached fruit or something that needs a
    •	 Approved	by	the	World	Health	Organisation	(WHO)	and		            touch of sweetness. It is supposedly 300 times sweeter than
      widely used throughout the world.                                 sugar and can have a slightly bitter aftertaste, but in smaller
    Foods containing sugar alcohols but no sugar (sucrose) can          quantities it is almost indistinguishable from regular sugar.
    be labelled ‘sugar-free’. However, this does not mean these         It doesn’t have the bulk of sugar so it is not always a good
    foods will not raise blood glucose levels, as they may contain      substitute, but it is definitely worth experimenting with, as it
    other ingredients which affect blood glucose.                       is a natural food and carbohydrate free. Coca cola has got on
                                                                        the band wagon and is marketing their product Truvia (not yet
    (Source: Diabetes NZ)
                                                                        available in NZ), with a patented ingredient they call rebiana,
                                                                        which is a stevia derivative.
                                                                        Personally I try to avoid providing ready access to too
    WHO classifies this sugar alcohol as totally natural and safe
                                                                        many sugary-type foods as I don’t feel that it adds value
    with no consumption restrictions. It is recommended for all
                                                                        to our nutritional needs, and we all know how much sugar/
    ages, infants and safe in pregnancy. Xylitol has beneficial
                                                                        glucose our children eat anyway just to cope with their lows.
    dental properties decreasing oral acidity. It has a low GI of 17,
                                                                        However, I don’t believe that a blanket ban of all the not-so-
    half the energy value of sugar and therefore fewer kilojoules,
                                                                        good foods that every child loves is going to make them stop
    and has a minimal effect on blood glucose levels. The body
                                                                        eating it – I think that it is more likely to encourage them to
    adapts to Xylitol over a shorter period of time than other
                                                                        eat it behind my back. My philosophy is about openness, role-
    sugar alcohols, so gastrointestinal discomfort is less likely.
                                                                        modelling and negotiation and hopefully somewhere along
    You can use it in cooking 1:1 for sugar.
                                                                        the lines the good eating message will get through, so that as
    Dentasweet, marketed by Annies, is 100% pure natural Xylitol        an adult they will make their own good choices.
    extracted from rice husk. Unfortunately, the cost means it is
    an expensive substitute for sugar.
    (Source: Diabetes NZ)

    Fructose is the natural sugar found in fruit and berries. It has
    the same energy value as sugar but has a lower glycaemic
    index (GI of fructose is19, sugar is 61) so is absorbed
    slowly, and being 1.5 times sweeter than sugar you can use
    smaller amounts and need smaller amounts of insulin. If it
    is used in large amounts it may affect triglycerides and LDL
    cholesterol. It can be used as a table sweetener, in baking
    and in cooking, but it is more often used in manufactured
    products, for example, confectionery, baked products and

   healthy food tips
Children with diabetes need a normal, healthy diet.
But encouraging healthy eating habits in our kids
can be a struggle at times – diabetic or not!
Penny Harrison shares some practical tips.

•	 Create	consistent	eating	times.	If	kids	are	hungry	out	of	those		
  times, particularly those on injections, keep a stock of ‘free
  food’ so that they can help themselves. (eg small cans of tuna,
  carrots, tomatoes, celery, left-over meat and veg, small amount
  of nuts ) This is a good rule also for the non diabetics in the
  family. Good dietary habits are good for everyone.

•	 Try	not	to	use	food	as	a	reward.	This	encourages	bad	habits		       HOME-BAKING
  which are hard to break as an adult (if I get this piece of work
                                                                       •	 When	home-baking,	cut	sugar	by	a	third	of	what	the	recipe	says		
  finished I can have a piece of cake…)
                                                                          – if it asks for 100 grams, use 66. (My family doesn’t notice!)

SNACK IDEAS                                                            •	 When	a	recipe	asks	for	melted	butter,	try	replacing	that		
                                                                          quantity with a good vegetable oil to reduce the saturated fats.
•	 Keep	healthy	carbohydrate-rich	snacks	on	hand	for	‘backup’	and		
                                                                          Sunflower is good as it has a mild taste, and it is amazing how
  for those moments when food is not ready and insulin is kicking
                                                                          moist your cakes will be.
  in, so that they don’t have to eat too much highly processed
  food with unnatural additives. Eg:                                   •	 Find	the	exact	carbohydrate	count	for	your	home	baking	to		
                                                                          ensure accurate insulin doses using this calculator provided
•	 Annies	Wiggles	11	CHO	each	strip.	Low	GI	and	handy	package		
                                                                          by the Food Standards authority Australia and NZ. This great
  to carry. Available in most supermarkets, or you can order them
                                                                          website lets you enter your own ingredients and portion
  online along with a great range of
                                                                          sizes and it will create a nutritional breakdown for your recipe
  other healthy snacks. (beware of eating too many of these, as it
                                                                          exactly the same as you find on packaged goods.
  is a trap for teeth, and it is easy to consume a large amount of
  fruit in one sitting, which is not necessarily good.

•	 A	home-made	‘scroggen’	made	of	nuts,	assorted	dried	fruit	and		     DRINKS
  small amounts of dark chocolate
                                                                       For good health, water is the drink of choice. However we usually
•	 Crackers	made	with	whole	seeds	such	as	sesame	                      have a bottle of diet ginger beer or lemonade in the fridge for
•	 Frozen	orange	juice                                                 special occasions, or we use soda water (which is carbohydrate-
                                                                       free) to which we add to a diet lime juice – we like Baker Hall ‘low
WHEN YOU’RE SHOPPING                                                   calorie’ cordials every now and then. They also make blackcurrant,
                                                                       lemon and barley, and orange and barley versions all of which are
•	 Check	the	ingredients	of	processed	food	snacks.	Read	the		
                                                                       nice – available at most supermarkets and also from Diabetes NZ.
  nutritional labels and lists of ingredients and make informed
  choices. Some are not even close to being a healthy snack.           Another special carb-free drink that my family loves is an old-
                                                                       fashioned lemon cordial that my mother used to make, where I
•	 Sometimes	packaged	foods	with	reduced	fat	will	mean	that		
                                                                       substitute the sugar with stevia. It contains bits of lemon rind and
  there is more added sugar or vice-versa. Both fat and sugar
                                                                       juice, and uses citric and tartaric acid so has a nice ‘bite’ to it, and
  are ingredients that are used to increase flavour, so look for
                                                                       although it has a slightly more bitter taste than the sugar version,
  moderation in both of these.
                                                                       no-one seems to mind - judging by how quickly a batch disappears.
•	 Sometimes	less	is	more,	e.g.	if	you	(gasp)	buy	chocolate	or	ice		   (If you want a list of ingredients you can email me at pennyh@xtra.
  cream buy the ones with the ingredients you can pronounce. It is – you really need to play around with the quantities until you
  probably more expensive, but eat less and better.                    get it right for your own taste.)
•	 Buy	yoghurt	powder	from	the	supermarket	and	make	your	own		         FURTHER READING :
  using a yoghurt maker (Easiyo do a very reasonably priced one)       •	 The	sweet	taste	of	sugar:	what	are	the	alternatives?	Diabetes	NZ
  which only involves mixing the powder with water and leaving  
  overnight. This allows you to add the ingredients that you              and__tips/food/sweetners

  choose – delicious with a bit of stewed fruit, and mostly not        •	 The	Glycemic	Index	website: contains recipes,
                                                                          advice, and a searchable database listing the GI of foods.
  needing any added sugar. It costs about half of the ready-made
                                                                          The content on these pages has been researched and written by Penny Harrison.
  and is much more delicious.
                                                                          She offers practical advice to parents based on her experience as a mother to a
                                                                          teenager with diabetes. For medical queries please ask your diabetes team.
    Diabetes Camp 2010
    The 41st Diabetes NZ Auckland annual camp was
    held at Long Bay in January. It’s always a great
    week of fun and new experiences for 9 – 12 year
    olds with type 1 diabetes.

    When I got to camp I wasn’t sure what to expect and I was quite
    nervous but then a nice group of girls came over and made me feel
    welcome. The next day I found out that there was definitely no
    sleeping in at camp. We had to get ready by 7.30 for testing and
    breakfast by 8 o’clock. We did activities such as rock climbing,
    kayaking and sailing. My favourite was tree climbing which was
    when you climbed a 100m tree. My group got to the top. It’s very
    scary but also exciting and the view was amazing. On Thursday
    was the disco and that was really fun. We danced all night long
    until we had to go to bed which no-one wanted to do. On Friday
    everyone was a little sad to be leaving. It had been such a fun
    week we didn’t want it to end.
    Anna Marshall

    Going to diabetes camp was an awesome experience for me. It
    was great to be able to make lots of new friends and meet other
    diabetic children and know that they have to do blood tests and
    have insulin just like I do. All the activities were really fun but my
    favourite was definitely stackum, where you have to stack milk
    creates and climb onto them as high as you can go until they fall. I
    can’t wait to go to camp next year.
    Katie Marshall

    It was my first time at camp and I made friends fast. I managed
    my diabetes well, same with my celiac disease. I liked the game
    stack’em because you have to concentrate on not wobbling or
    you’ll fall, lucky I had a harness. I‘m definitely coming back next
    Reece Waters

    What a great time I had. My team leaders
    were Neil and Richie (who has diabetes) who
    were both really cool. Our group had 2 nurses,
    Michelle and Jo and they were fun as well. I was
    in the Green team for the week and we had an
    awesome team. One of my favourite activities
    was snorkelling because we saw lots of little
    fish and a big snapper and a baby stingray.
    We climbed this huge tree with 5 of us tied
    together - that was so much fun. We also did
    archery which was actually quite hard but the
    boys were better at it than the girls. The food
    was really nice, we had yummy things like fish
    fingers and roast beef and Thursday night we
    had ice-cream cake for dessert because it was
    Zoe’s birthday. There was a disco for the final
    night and got to stay up really late. I had so
    much fun I’m going to go back to camp next
    Nick Keenan

                     Living Gluten-Free
Katherine Cave describes the impact of the                             (savouries, sweets, Xmas etc). I soon had a handy supply of my own
diagnosis of coeliac disease in her two sons, one of                   favourite recipes and became adept at baking them with speed and
whom has type 1 diabetes.
                                                                       Then 2 years on, I was advised to test Pascal’s 2 asymptomatic
I admit I had to laugh when ‘my’ son was diagnosed with coeliac
                                                                       siblings I thought, alright, lets satisfy the specialists and get them
disease! Me! Of all people! I was the most “un-baking” mother
                                                                       cleared. His younger brother Zander was diagnosed coeliac too at
you could get. Had almost never made a cake in my life, never
                                                                       7 years old. Now this one was a little harder. With no symptoms he
muffins,	bikkies.	Pies?	No	way.	Make	my	own	pastry!?	Doubt	it.	
                                                                       didn’t have the same motivation to remain gluten free. It wasn’t
Pizza?	Never...	well	maybe	if	I	had	the	pre-made	bases.	How	could	
                                                                       going to cure nasty tummy aches. All it meant was giving up foods
this have happened! On top of this, my attitude since my son
                                                                       that he – up until then – could eat that his brother was not allowed.
was diagnosed with diabetes was to ignore anything to do with
                                                                       He didn’t find it easy to accept.
coeliac disease. I knew about it, I knew a family with a child who
had coeliac disease, and I chose to ignore any mention of it, any      Now some years down the track the 2 of them cope okay. There
literature that would pop up alongside diabetes info, put it in the    are good and bad days but on the whole they manage. The tricky
too hard basket. Other mothers can cope with that, but not me. I’ll    times are social gatherings, school shared lunches, sports events,
just do diabetes, thank you. That’s enough.                            trips away, sleepovers. School events and gatherings you find
                                                                       out what’s being provided and mimic it as close as possible with
But 2 years on from Pascal’s diabetes diagnosis at 4 years old, he
                                                                       the gluten free variety. At least most items can now be bought
started having numerous lows and was needing less and less insulin
                                                                       from health food shops and most supermarkets so if you must you
which got a diabetes specialist’s mention of “further tests.” I
                                                                       can resort to a bought option, but this is a costly exercise, so it’s
asked for what, and pricked up my ears at the mention of coeliac
                                                                       worthwhile taking the time to bake and be prepared. (Trouble is,
disease. I knew my son had always complained of tummy aches,
                                                                       you provide a yummy plate of home baking alongside the bought
were	we	really	going	to	head	down	this	track????
                                                                       varieties and your son’s plate gets devoured so none left for your
I wasted no time and had the antibodies blood test ordered. They       child!) Taking time to explain to other parents for sleepovers that
came back positive. Then a gastroscopy to confirm the diagnosis. It    a simple meal of meat and vege will suffice and to avoid, sausages,
all took time but after a few months of waiting it was confirmed. I    soya sauce, milo, bread, pasta, gravy, chicken stock, to name a few.
now had to bake cakes!
                                                                       It is a chore but they lead a ‘normal’ life. Their condition is
Well, that was a steep learning curve! Not just baking, but            treatable, they look the same as their classmate and are fit and
gluten-free baking. Luckily the gastro-enterology department at        healthy. They just need a little more managing, and a little more
the hospital were helpful in providing advice and recipes. It was      organising, and much the same as diabetes - the life that they
basically a lot of trial and error, to work out what works and how.    know becomes their norm, and they just truck along concentrating
The Coeliac Society were also very helpful, providing a quarterly      on the important things.... ipods, facebook, guitars, pimples,
magazine packed with advice, articles and recipes and running          skateboards and homework (not!)
morning teas, with special themes of different baking ideas,

  Coeliac Disease
  A disease resulting from the abnormal reaction by the body’s
  immune system to gluten, a protein found in many grains, such as
  wheat, rye, and barley and other foods. In people who have coeliac
  disease (sometimes written celiac), the immune system causes
  damage to the small intestine and prevents the proper absorption
  of nutrients from food. Typical symptoms include diarrhea,
  stomach pain, anemia, chronic fatigue, bone pain, muscle cramps,
  weight loss, bloating and less insulin needs (despite large food
  The only known treatment is avoidance of foods containing gluten,
  which means cutting out many foods that are considered staples
  of our modern diet – bread, cereal, pasta, cakes and biscuits
  all contain processed grains that cause problems to those with
  To test for coeliac disease a blood test is given that screens for
  antibodies found in the majority of people with the disease. A
  biopsy of the intestine may be used to confirm the diagnosis.
  Coeliac disease is more common in people with type 1 diabetes
  than in the normal population.                                        Pascal, who is type 1 and his younger brother, Zander both have
                                                                                                coeliac disease.
         Youth Press
     This page is for and about our diabetic youth. It has a regular
     column and a ‘spotlight’ article. Young people are encouraged
     to contribute. If you would like to write an article, make any
     comments, or be involved in writing this page, please email

      my view
     As I write this the holidays are upon us, as is the burning sun,         own and freezes it) and some assorted veg – I love zucchini and
     which seems to affect my diabetes much more that we might have           mushrooms – ham or bacon and a bit of cheese, bung in it the oven
     thought. Heat often makes me go low, sleep-ins make me go high,          for no more than 10 minutes, and you have one delicious pizza, at
     sleepovers are more common, I’m in and out of the water, and             approximately 18CHO and no nasty pizza highs later in the night.
     meal-times aren’t as punctual. Summer holidays are meant to be
                                                                              Other foods full of carbohydrates, such as pasta, can be quite
     a fun, relaxing time, and with some careful management diabetic
                                                                              hard to manage, especially at night. Having pasta at lunch instead
     youths can relax safely.
                                                                              of dinner can be an easier way of managing it because not only
     Our meals in the holidays are far more laid-back than those term         are you busier during the day – therefore using carbohydrates to
     times where dinner is slotted carefully between after-school             counter-balance your activity – but you can keep an eye on your
     activities and early bedtimes, so it makes it more difficult to          blood sugars as the day grows old, instead of sleeping innocently
     control.                                                                 through horrific numbers.
     There are many different ways we adjust our meals to make it             I guess when you read this the holidays will be well over - I hope
     easier to manage blood-sugars, for instance we have pizzas every         you all had safe and happy holidays, filled with lots of beach-trips
     Friday (it is our ‘easy meal’) but instead of the carby, thick pizza     and perfect numbers, and are enjoying a great start to your new
     crusts, we use a tortilla as the base. We cover it with a thin layer     school year.
     of tomato pasta sauce (you can buy a jar or my mum makes her

        SPOTLIGHT ON...

                                                                              adventures and learning how to kayak and surf.

                                                                              Martin: I really enjoy swimming, playing guitar, being with
                                                                              friends and playing video games. But hanging out with my
                                                                              sister is what I like the most.

                                                                              What are your main memories of when you were first

                                                                              Kelsey: I don’t really have any, it was a while ago.

                                                                              Martin: I remember having the doctor putting the syringe in my

                                                                              Do you have supportive friends? How are they or are they not
       Kelsey Porter is a 16 year old who has had diabetes since she was
       4. Last year her 10 year old brother, Martin was also diagnosed.       Kelsey: My friends are very supportive. They ask if I need food
       We find out what’s the same and different for them.                    every time I test. They also love watching me take shots.

       Insulins used: Humalog and Lantus                                      Martin: In my classroom friends or not, everyone was
                                                                              interested and supportive of my diabetes.
       Is there a family history of T1? No, just T2
                                                                              What do you do differently than usual when you are at friends’
       What are your hobbies?	How	do	you	spend	your	free	time?
                                                                              houses for sleepovers?
       Kelsey: I like baking and doing art. I also like playing video games
                                                                              Kelsey: I don’t do anything. I’m very open with my diabetes
       thanks to my Dad and brother. I also love cars and photography.
                                                                              and all my friends support me.
       In my free time I like to hang out with my friends and playing
       volleyball. I also love going to the beach. I’m looking forward to     Martin: I don’t do anything differently.
                                                                                                                          Continued on Page 11...

Continued...                                                                    Kelsey: Move your shots. Shots get easier as you go, I could go
                                                                                on but I think the best thing to tell them is it only gets easier.
What is your favourite kind of holiday? Why?
                                                                                Martin: Don’t ever be scared and always be confident.
Kelsey: I’m from the States so my favourite holiday is the Fourth
of July because of the fireworks and the party we have with my                  What advice would you give to the parents of someone who was
family and friends.                                                             just diagnosed with T1 diabetes?

Martin: Thanksgiving because you spend time with your family.                   Kelsey: I would advise letting your child be independent. The
                                                                                last thing we want is not to do something because you have to
Thinking about your parents, what are the most wonderful
                                                                                be there to supervise everything.
things about them and what are the most annoying?
                                                                                Martin: Never panic about your child, they’re fine. But
Kelsey: Most wonderful thing is they let me go out and
                                                                                encourage them to tell people about his or hers diabetes.
be a teenager. The worst…how do I answer that without
consequences…uhm…there is nothing that even comes to mind.                      What is it like having a diabetic sibling?

Martin: My parents know that I’m on top of my blood sugar but                   Kelsey: It’s really no different from when I just had it, but it’s fun
they still tell me what to do.                                                  to have competitions over whose numbers are in range.

What advice would you give to someone who was just diagnosed                    Martin: It’s good to have a diabetic sister because you can help
with T1 diabetes?                                                               each other out.

                       UPCOMING EVENTS
Family Camp 2010!
 A fantastic weekend for families living with diabetes to get together,
 meet new friends and have loads of fun. Fully catered. Bunk-rooms
 sleep 8 (so you’ll probably share with another family)
 When:      26 – 28 March 2010 (weekend before Easter)
 Where:     Chosen Valley, Ararimu (near the Ramarama exit of the southern motorway)
 Ages:      The whole family. Ideal for primary and intermediate school age kids but
            pre-schoolers and teenagers will also have fun.
 Cost:      Final costs confirmed in March. It is unlikely to exceed $100 per family
            because we receive grants to keep the costs down.

   This highly popular weekend includes:
   •	 Water	activities;	kayaking,	rafting	and	a	monster	waterslide	with	a		
      flying fox right across the top of the lake
   •	 BMX	bikes	and	down	hill	trolleys	on	their	own	specially	built	tracks
   •	 Archery	
   •	 A	multi-level	confidence	course	
   This event is always popular so it’s first in first served.

To register, or for further information contact: Sara-Maria Broekhoff
Phone: 623 2508
Mail:     Sara-Maria Broekhoff, Diabetes Auckland, PO Box 67 041,
          Mt Eden, Auckland.
Please provide the following details when you contact Sara-Maria;
First & last names of all family members, ages of children, postal address,
contact phone numbers, email address, any special diet instructions
(i.e. allergies, coeliac)
•	 A	$50	deposit	is	required	with	all	registrations	to	secure	your	place	on	a
   first come, first served basis.
•		Make	cheques	payable	to	Diabetes	Auckland-Youth,	or	deposit	with
   surname and Family Camp as references into ASB 12-3048-0283381-02

        WEB GUIDE
         AUTUMN 2010
                                                   P W G
     To access some of the following articles you might                        nearly 5000 people in Finland.
     need to register a password. This is free, and easy                       Potential for regeneration as a possible cure for
     to do. Just follow the instructions on the webpage.                       type 1 diabetes
                                                                               A hormone responsible for the body’s stress response is also linked
     (Some of these links lead to the abstracts only, and
                                                                               to the growth of insulin-producing cells in the pancreas, according
     require payment for the full study)
                                                                               to JDRF- funded researchers at the Salk Institute for Biological
     Should we all be taking vitamin D?                                        Studies in California.
     Researchers in Finland tracking a group of people born in the             When to worry – and when not to – about your child’s
     Sixties turned up evidence suggesting a link between low levels of        increased risk for diabetes.
     vitamin D and Type 1 diabetes later in life. This is only one of a long   The first in a three part series Handing Down the Genes discusses
     line of studies suggesting that there is far more to this vitamin than    how to balance concern over children’s increased risk for the
     its traditional role in helping to maintain healthy bones.                disease with a desire not to cause undue alarm.                                   
     Brainstorming diabetes solutions – open innovation                        Timing the bolus
     An exciting and innovative challenge has been made which will tap         Researchers evaluated the most effective timing of a pump-
     the intellectual power of the entire Harvard University community         delivered, before-meal bolus in children with type 1 diabetes, and
     of more than 55,000 faculty members, students, and staff                  found results that support giving the bolus before, rather than
     members, in all of the University’s schools and affiliated hospitals.     after, eating, even if the patient is hypoglycemic before meals.
     The challenge is to define new hypotheses and unaddressed       
     questions concerning type 1 diabetes - identifying problems or
                                                                               Low carbohydrate meals after exercise may
     areas requiring further exploration and research. The best new
                                                                               benefit diabetics
     ideas will receive prizes ranging from $2,500 to $10,000. Looking
                                                                               This new study suggests that eating meals with a relatively low
     forward to seeing what comes out of this.
                                                                               carbohydrate content after exercise (but not low in calories)
                                                                               improved the control of blood sugar into the next day.
     Artificial Pancreas Project                                     
     On January 13th, the Juvenile Diabetes Research Foundation (JDRF)
                                                                               Diamyd Vaccine trials
     announced a non-exclusive partnership with Animas Corporation
                                                                               The US Food and Drug Administration (FDA) has approved the
     to develop an automated, partially closed-loop system to help
                                                                               experimental use of the diabetes vaccine Diamyd in children as
     control blood sugars Read about the closed loop system here – an
                                                                               young as three years of age. The TrialNet GAD study has previously
     interview with Aaron Kawalski from JDRF explains how this new
                                                                               enrolled new onset type 1 diabetes patients aged 16-45.
     system might work.
     Follow the Artificial Pancreas Project here
                                                                               Recent studies suggest benefits of continuous glucose
                                                                               monitoring (CGM)
     Closed-loop insulin delivery continues to show promise                    Six key studies suggesting the benefits of Personal CGM are
     The latest study using manual closed loop insulin delivery involving
                                                                               described in this article.
     the nocturnal monitoring of 19 type 1 diabetes patients aged 5 to
                                                                               Useful posters to illustrate high and low blood sugar
     19 years showed very promising results. A logarithm was used to
     respond to blood sugar levels, and a nurse manually adjusted the
                                                                               These illustrations could be useful to give to relatives, schools,
     delivery. 60% of tests were within the desired range and no lows
                                                                               baby sitters etc. They can be saved by right-clicking on the image
     under 3.0, compared with 40% and 9 lows for standard continuous
                                                                               and selecting the ‘save picture as’ option.
     infusion. News report:
     Read the abstract of the study here:                                             Educational animation illustrating diabetes and the body
                                                                               An excellent animation which can help those with little or no
     GAD antibodies linked to increased risk of diabetes
                                                                               knowledge of diabetes to understand what it is about. Aimed at
     Individuals are more likely to develop diabetes if they produce
                                                                               adults and older students – could be useful as a school staff info
     high levels of glutamic acid decarboxylase antibodies (GADAs),
                                                                               video, or for relatives and caregivers - check it out yourself first as
     regardless of a family history of diabetes, according to a study of
12                                                                             it spares no detail!
   Having a life with diabetes
This is a new page aimed at diabetics in their late                       I used to avoid telling people I was T1
teens and early twenties. Nic Reade is a 31 year old                      when I was out drinking because I didn’t
                                                                          want them to judge me. However, I nearly
who was 16 when she was diagnosed with type 1.
                                                                          always had my best mate by my side who
Her style is deliberately frank and light-hearted but                     was well-versed in what to do if I went low.
also offers up some practical advice. For medical                         It wouldn’t have been a bad idea to tell a
queries please ask your diabetes team.                                    couple more people though, in retrospect,
                                                                          given that being hypo and being drunk can
I was 16 when I was diagnosed with type 1, so was still a bit of a        sometimes look like the same thing.
newbie by the time I got to university age, the time in many young
peoples’ lives when alcohol becomes a bit more of a key player in         I recently read a book written by a 23 year old English guy who got
your social life.                                                         T1 at 13. It’s called “Joe’s Rough Guide to Diabetes”. At 23, he’s
                                                                          had a bit of hands-on experience with parties, and does a whole
I’d read that alcohol could make your blood sugars plummet, so            chapter on alcohol (and a bit on cigarettes and illegal drugs). He
my usual routine on a Saturday night would be to sneak into the           approaches each situation well – not as a kill-joy, but with some
kitchen and wolf down a couple of chocolate biscuits. I was still         degree of sensibility. I’d highly recommend.
living at home so I needed to be a bit covert about this or there
would be questions asked about why the chocolate biscuit supplies         Overall – it’s gonna be hard to avoid alcohol, and all of us (diabetic
were declining!                                                           or not) make a mess of it at least once in our lives. Just try to keep
                                                                          safe, and overall, make sure you keep taking your injections and
So – basically, that’s how I used to handle T1 and drinking. Get          always carry glucose with you. Party on!
the sugars nice and high, get drunk, eat food at the party/on the
way home, but always take my night time injection. Somehow                For more stories from Nic visit her blog at
this vaguely worked for me all the way through my late teens    
and early twenties. I’ve got lots of friends who weren’t so lucky
though, most of whom have had to go to the A&E once or twice
with ketoacidosis (never normally hypos). I say ‘vaguely’ worked,
because my HbA1cs were always around 9 or 10.

So	–	if	I	were	to	live	my	uni	days	again,	what	would	I	do	differently?	
First of all I’d chuck the biscuits and high BGs routine. Combined
with drinking fattening alcohol, this lead to me putting on quite a
few kilos. I still reckon it’s probably a good idea to have your BGs
at around 10 though while drinking, to be on the safe side.

Secondly, I’d definitely make sure I took my BG meter out with me.
They’re much smaller and cooler-looking nowadays and you can fit
them even in the smallest of handbags with a few test strips and
the rest of your stuff. I’d also take glucose tablets. I always used to
rely on being able to get a lemonade, but if you’re at a bar it can be
a bit of a wait to get a drink and that’s not cool when you’re hypo.

I’d also drink less beer. Because beer’s full of carbs it’s not only
fattening, but it’s hellish on your BGs. Wine is better; clear spirits
even better still. It’s easy to drink vodka and diet coke at a bar,
but I still wish they had diet lemonade so you can have a bit more
variety in drinks. I got into drinking vodka, lime and soda for a bit
but got sick of checking if it was lime cordial (bad) or Roses lime
(good). The annoying thing about parties (as opposed to bars) is
if you leave your diet mixers in the kitchen with everyone else’s,
there’s always someone who fancies using it for their drink. When
the diet stuff runs out, you can’t move onto sugary stuff – they can
switch between the two. Annoying.

     BE prepared for winter 2010!
     Starship Diabetes Service recommends the active immunisation of all children with
     type 1 diabetes – it’s FREE!
     Have your child immunised against influenza! This year the flu vaccine includes the
     H1N1 (swine flu) vaccine and is available from March.

     A school’s perspective on care
     Starship Children’s Health Diabetes Service are hosting a monthly seminar to provide school teachers, office
     staff and school nurses with an overview of knowledge and skills related directly to the care of school children
     and young people with type 1 diabetes.

     Parents and caregivers:
     If your child is starting school, changing schools or newly diagnosed please pass on these details to your school
     and encourage them to register.

                                                                                Where: Conference Room 541, Level 5,
                                                                                Greenlane Clinical Centre, Greenlane West Rd,

                                                                                Wilsons Parking in Greenlane site at cost – or 2
                                                                                hr parking available on Claude Rd free.
                                                                                THE SEMINAR IS AT NO COST!

                                                                                Dates: 17 March, 28 April, 26 May, 23 June,
                                                                                28 July, 25 Aug, 15 Sept, 20 Oct, 17 Nov

                                                                                Time: 1.30 pm – 3 pm

                                                                                RSVP: To with name,
                                                                                school and ph no.

     Starship Diabetes Team                                                      AUCKLAND STARSHIP PATIENTS ONLY
     For all queries telephone 09 631 0790
     Press 1 to be connected to the doctors for diabetes emergencies or if your child has ketones, diarrhoea or vomiting (24 hour service)
     Press 2 to be connected to the Diabetes Nurses (between the hours of 1pm-4pm) for non urgent advice and insulin adjustment
     Press 3 to be connected to the booking clerk for all enquiries related to clinic appointments

      CONSULTANT ENDOCRINOLOGISTS                                          NURSE SPECIALIST TEAM
      Dr Craig Jefferies - Clinical Director                               Grace Harris - Toddlers and Pumps
      Dr Fran Mouat                                                        Jean Ann Holt - Insulin Pump Programme
      Dr Paul Hofman                                                       Rosalie Hornung - Adolescent Transition & Quality
      Dr Wayne Cutfield                                                    Ann Faherty - School Age
      Dr Alistair Gunn                                                     Laura Bird - School Age and Type 2
                                                                           Sheryl Tregurtha - Endocrine
      Senior doctors who are very close to finishing their training        DIETITIAN
      in the field of Paediatric Endocrinology and will soon be at         Caroline Adamson
      Consultant level.                                                    Amy Kostrzewski
      Martin De Bock
      Tim Savage

                     UPCOMING EVENTS
DYA Annual General Meeting
GUEST SPEAKER: Catherine de Vos, NZ representative in Rhythmic Gymnastics
Diagnosed with type 1 when she was 11, Catherine will share her experiences of living
with diabetes for the last seven years through school, work and representing New Zealand
overseas competing in Rhythmic Gymnastics with the top gymnasts of the world.
Drinks and nibbles will be provided. Come along to meet and talk with
other families living with diabetes.

  When:    Wednesday 24 March
  Time:    7pm
  Where: Diabetes NZ Auckland, Nesfield House, 62 – 64 Valley Road, Mt Eden
  Everyone’s welcome – we look forward to seeing you there.

  Annual Parent/Care-Giver
  Education Evening 2010
   Thursday April 29, 6.00pm – 10.00pm
   Alexandra Park Function Centre, The Rutherford Room,
   Entrance - Gate B, Greenlane West

    Topics                                                               Current Insulin Regimens
                                                                         There are many types of insulin on the market these days
    Advances in Diabetes Technology and Research                         being used in a variety of ways for a variety of reasons.
    Dr Paul Hofman will share information gathered at recent             Dr Fran Mouat will provide an overview of the types of
    International Scientific Meetings regarding treatment options,       insulin currently available and discuss a range of blood
    approaches to care and research outcomes in Paediatric Diabetes      glucose profiles most suited to certain insulin regimes.
                                                                         RSVP: By Wednesday 14 April
    Psychological Aspects of Compliance                                  Contact: Sara-Maria Broekhoff
    How do you deal with your toddler who runs away when they                      Youth Administrator, Diabetes Auckland
    see their injection coming? How do you deal with your 8 year         Email:
    old who doesn’t want to be “different”? How do you deal with         Phone:    09 623 2508
    your young teen stealing food from the pantry at night? How
    do you deal with your adolescent wanting to “party” all night?       This evening is specifically focussed at an adult level and
    John Cowan from Parents Inc will talk about the developmental        there will be no provision for care of children.
    stages, the difficulties these stages pose for parents in managing   Light supper will be provided at the end of the evening.
    diabetes and the kinds of approaches that may be used to make
                                                                         Free parking available on site.
    the transition through childhood and adolescence a little easier.

    Sponsored by Medica Pacifica with the support of other companies:

  Wider Choice of Diabetes Management
    Products Available on Prescription
           From July 1st, 2009

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1. Data on file. *Prescription conditions apply. Always read the label and follow the manufacturer’s instruction.           TAPS No: NA 3424

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