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
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
firstname.lastname@example.org 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 email@example.com
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 chocolate and the added bonus of a toy
inside. Craig Sumpton
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
COMMITTEE MEETINGS 2010
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
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
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
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
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.
HEALTHY FOOD 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 http://www.annies.co.nz/ 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 co.nz – 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 http://www.diabetes.org.nz/food_and_nutrition/healthy_food_choices__
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: http://www.glycemicindex.com/ 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.
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.
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
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
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,
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
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
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
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.
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
• 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
P W G
To access some of the following articles you might nearly 5000 people in Finland. http://tinyurl.com/DYAutumn06
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. http://tinyurl.com/DYAutumn07
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 http://tinyurl.com/DYAutumn09
questions concerning type 1 diabetes - identifying problems or
Low carbohydrate meals after exercise may
areas requiring further exploration and research. The best new
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 http://tinyurl.com/DYAutumn10
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. http://tinyurl.com/DYAutumn03
Follow the Artificial Pancreas Project here
Recent studies suggest benefits of continuous glucose
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. http://tinyurl.com/DYAutumn12
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:http://tinyurl.com/DYAutumn04
Read the abstract of the study here:
http://tinyurl.com/DYAutumn05 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! http://tinyurl.com/DYAutumn14
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 www.beingdiabetic.co.nz
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 email@example.com 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
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
Where: Diabetes NZ Auckland, Nesfield House, 62 – 64 Valley Road, Mt Eden
Everyone’s welcome – we look forward to seeing you there.
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: Sara-MariaB@diabetesauckland.org.nz
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.
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• New Zealand’s first ‘No Coding’ blood glucose meter
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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