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					Spring Newsletter
Department of Endocrinology and Diabetes

September 2009

Eye Screening Now Available at PMH Diabetes Clinics!                    Inside this issue:

PMH Diabetes Services can           Pictures are taken before and       Eye Screening at PMH        1
now offer eye photographs for       after eye drops are put in. The     Feedback from Regional
diabetic eye disease screening      pictures will then be examined      Satisfaction Survey         2
using the Canon CR-1 camera         by a paediatric eye specialist to
                                                                        Cooking Demos at
at your next clinic visit. This     see if there is any evidence of     Diabetes WA                 3
camera can take extremely           eye disease.
detailed, high-resolution images                                        Do Energy Drinks Really
                                                                        Give You Wings?             4
of the back of the eye to enable    This study is run by Dr. Trang
diagnosis of early diabetic eye     Ly, who is a recipient of a DRF     New and Improved Flexible
disease.                            Fellowship, and is currently        Lifestyle Program         5
                                    available for PMH clinics only.     Research Update             6
The Canon CR-1 was kindly           Children and adolescents with
donated by Bosch, through their     type 1 and type 2 diabetes who      JDRF Youth Ambassador
corporate program with PMH          are due to have eye screening       Program               7
Foundation. Bosch raised this       are invited to have their eye       Recipe                      8
generous sponsorship through        photographs taken. If you are
the sale of Bosch Hot Water         interested in attending PMH         Donated Pumps               8
Systems with temperature            just to have eye photographs
regulation, an added safety         taken, this can be arranged.
feature to prevent hot water        For more information about this
burns in children.                  study, please contact Dr. Ly at
We are currently running an eye     on 9340 8680.
screening study with another
camera, the EyeScan. This was                                           Contact Details:
developed at the Lion’s Eye
Institute and is a portable                                             Princess Margaret Hospital
camera. We are comparing                                                for Children
pictures from the EyeScan to the
CR-1 to see if the images are as                                        Department of
good as the CR-1.                                                       Endocrinology and
                                                     Canon CR-1         Diabetes

                                                                        Phone: (08) 9340 8090

                   Normal Eye      Diabetic Retinopathy

                                                                                 -1-    -1-       -1-   -
                                                                        Delivering a Healthy WA
Your Feedback from the Regional Satisfaction Survey

The PMH Diabetes and Endocrinology            A total of 65% of respondents had made
team recently surveyed families attending     contact with PMH between clinic visits.
four of our regional diabetes clinics to      Some comments from those who had not
evaluate the diabetes (type 1) outpatient     made contact were:
service in regional centres. We wanted to
identify ways to improve services to meet            the need for longer contact hours,
the needs of these families attending PMH            that it may be helpful for PMH to
regional clinics.                                    contact them and
                                                     that phone contact is often rushed.
We are very grateful to those who
participated and would like to share some     Ongoing education group sessions have
of the results and suggestions we received    also been run in each of the regional
and highlight the areas we are working on     clinics surveyed. The majority of those
to improve service satisfaction.              who attended found it beneficial. Common
                                              themes from those who did not attend
Ninety-five percent of respondents were       included:
happy with PMH current service delivery.
Less than 1% of respondents from each                unaware that it took place
clinic were dissatisfied.                            could not make the time due to
                                                     other commitments or
Suggestions to improve satisfaction with             were currently happy with the
PMH services included:                               services already provided.

      more time at appointments,              Suggestions for improvement of these
      more support between clinics,           group sessions included:
      privacy during consultation,
      child only sessions,                          holding them more frequently,
      having more control over which                holding them at different
      team members you see at your                  times/days,
      appointments, and reducing the                increased promotion of group
      number of different people seen,              services to increase attendance,
      unless requested or required.                 inviting school staff to attend,
                                                    gender specific groups and
In response to current appointment times            holding them out of the usual clinic
and rescheduling, 93% of respondents                building/setting.
were happy with appointment times.
Suggestions for improvement included:         We have taken all these valid suggestions
                                              on board and individual clinic teams will
       appointments later in the day, e.g.    accommodate as many suggestions as
       early evening,                         possible.
       no appointments in the first week
       back at school, and                    To improve our service we will be making
       more flexibility in appointment days   a conscious effort to minimise any
       and times.                             discussion in open waiting areas, and will
                                              provide you with the opportunity to request
                                              specific areas of your diabetes care that
                                              you would like to focus on.

                                                                               -2-    -2-   -2-   -
Your Feedback from the Regional Satisfaction Survey (cont.)

If you require a longer appointment time or     Common themes surrounding online help
feel that you may benefit from additional       and easier ways to record blood glucose
support between clinics, please talk with       levels arose. The majority of blood glucose
one of your team members to arrange the         meters and insulin pumps allow for
details.                                        computer downloads which can be looked
                                                at as a family and emailed through to your
Unfortunately due to flights and other work     PMH team. If you are interested in
commitments we are not always able to           obtaining the software to download your
accommodate all time/day requests for           meter or pump, call your blood glucose
appointments and ongoing education              meter/pump representative, check out their
group sessions, however you are more            website, or ask a member of your PMH
than welcome to ask your team and they          diabetes team.
will do what they can to accommodate.
                                                Thank you again to everyone who
PMH triage (nurse) contact has been             participated in the survey. Your clinic
extended to 5pm; we understand that             team strives to make your clinic visits as
during busy times, our phone service may        useful and efficient as possible. If you
be more rushed. If you require more             have any further suggestions on ways to
assistance make it known to the nurse on        improve our services, be sure to chat to a
the other end of the phone and a phone          member of your diabetes team.
call at a later time can be arranged.

Cooking Demos at Diabetes WA!

Are you looking for some inspiration in the       When: Tuesday 29th September OR
kitchen? Do you want to get some                      Friday 2nd October 2009
practical tips on cooking healthy meals for             from 10.00 – 11.30am
the whole family?                                   Where: Diabetes WA, Level 3,
                                                         322 Hay St Subiaco
The PMH Diabetes Dietitians have been                       Cost: FREE!
working with Diabetes WA to organise two
interactive cooking sessions during the         The session will be run by the PMH
school holidays. We will be cooking             Diabetes Dietitians and places are limited
healthy and tasty meals that are suitable       so book early. To reserve your place
for people with diabetes (all meals will also   contact Kirilee Lennerts, Diabetes WA
be gluten free) and you will get to taste       on 9436 6239 by Monday Sept 21st with
your creations afterwards!                      your preferred day and the number of
                                                people attending. Please also advise of
There will also be a tasting table for you to   any additional dietary requirements at the
try new and exciting products that are          time of booking.

The sessions are available to all families
whose children attend PMH Diabetes
clinics. Children welcome!

                                                                                  -3-   -3-   -3-   -
Do Energy Drinks Really Give You Wings?

Energy drinks have become increasingly         blood pressure, alter mood and sleeping
popular in recent years, especially with       patterns, affect the growing brain and may
children. A recent Australian study found      cause a decline in the body’s immune
that 27% of 8–12-year-old boys, 12% of         system. Currently, due to limited research
8–12-year-old girls, 24% of 12–18-year-old     surrounding energy drinks, it is
boys and 20% of 12–18-year-old girls had       recommended that caution is needed in
had at least one energy drink in the two       certain groups in the population. The main
weeks prior to the survey (CHOICE, 2005).      concern is that consumers are drinking
In recent weeks energy drinks have made        energy drinks as if they were soft drinks or
media headlines with the collapse of a         water. Manufacturers recommend
teenage boy who drank an energy drink on       consumers don’t have more than 2 -5 cans
an empty stomach. In addition, a number        per day. However many consumers find
of schools around the country are working      the information on labels confusing and
towards banning energy drinks at school        may feel they have to drink the maximum
due to subsequent unruly behaviours. The       amount to get the full benefit of these
question then is do these drinks really give   drinks.
you wings or do they do more harm than
good?                                          Below is the caffeine content of some
                                               popular drinks (per 250 ml):
What are they?
                                                   Energy drink                  Caffeine content
Energy drinks are soft drinks containing
carbohydrates, amino acids, vitamins, and                 Impulse                        88 mg
so called ‘energy enhancing’ ingredients                 Red Bull                        80 mg
such as caffeine or guarana, a natural
plant substance that is naturally high in                    "V"                         78 mg
caffeine. They are marketed to the                      Coca-Cola                        49 mg
general community to be “energy boosting,
and to increase physical performance and                Diet Coke                        48 mg
stamina”. Within Australia there is a                 Diet Coke                           2 mg
range of energy drinks avaliable on the              Caffeine-Free
market, they include: Red Bull, V, Mother,               Pepsi                           40 mg
Impulse etc.
                                                        Diet Pepsi                       44 mg
Do they do as they claim?                               Pepsi Max                        44 mg
The producers of energy drinks claim that           Instant coffee                    60-80 mg
these drinks enhance mental and physical             (1 teaspoon)
performance. The truth - not enough is             Percolated or drip                60-120 mg
known about the health risk of these                     coffee
drinks. We do know that one of their main                 Tea                         10-50 mg
ingredients is caffeine (in the form of
                                                     Chocolate bar                    20-60 mg
Guarana), and in small amounts it can
                                                       (30g bar)
enhance mental and physical
performance. However, large amounts of          Source: Australian Drug Foundation's Druginfo Clearinghouse
caffeine can cause dehydration,
restlessness, nervousness, increased

                                                                                            -4-      -4-      -4-   -
Do Energy Drinks Really Give You Wings? (cont.)

The Regulations                                The Verdict

The ANZFA (Australian and New Zealand          The effect of caffeine on children remains
Food Authority) standards for energy           unclear. There is however a general
drinks require the product to carry a          consensus that energy drinks are not
warning on the container stating that they     recommended for children. Energy drinks
are not recommended for children,              have double the caffeine content of soft
pregnant or lactating women and caffeine       drinks, are high in sugar and have limited
sensitive individuals. In addition the         nutritional value. Even a small amount of
caffeine level should be listed. The current   caffeine can make kids anxious and affect
caffeine level has a set minimum and           their sleeping patterns.
maximum level of 145mg/L and 320mg/L

New and Improved Flexible Lifestyle Program!
Carbohydrate counting and Insulin Adjustment Workshops

Do you have type 1 diabetes?                   We are able to offer the course to you and
Do you want to:                                2 other family members.
    Decide on your insulin dose
    Eat when you are hungry                    It is essential that you can attend each of
    Learn about a correction bolus             the 4 x 2 hour sessions held once a week.
    Adjust insulin to suit your lifestyle?
You can learn all this and more at our         You must commit to
Flexible Lifestyle Programme! In response         • completing a BGL monitoring diary
to your feedback we are now offering              • completing a food diary and
shorter workshops held after school hours.        • setting weekly goals.

            Next course dates:                 The course will be intensive, however your
                                               effort will be rewarded by a more flexible
October (Tues)          November (Mon)         lifestyle and a greater control of your
13th                    16th                   diabetes.
20th           OR       23rd
27 &                    30th &                 Places are limited (5 families per course).
Nov 3rd                 Dec 7th                To reserve your place please phone us on
                                               9340 8090.
            Time: 3:30–5:30pm

                                                                                -5-    -5-   -5-   -
Research Update - HypoMon

Do you ever have hypos?                                    Oh No!
                                                        My BGL is low
Go low while you’re sleeping?                         & I’m fast asleep!

Or maybe not???

The HypoMon research team is pleased to
announce that the next stage of the
HypoMon studies is on! HypoMon is a
needle-free alarm system being developed
by AiMedics. The alarm picks up changes
in your heart rate, heart rhythm and
changes in your skin responses when you
go low.
                                                 There have been several stages of the
We need to test the HypoMon on both              HypoMon studies over the last four years:
people who may have a hypo at night and          a big ‘Thank you’ to all who have
on those who don’t. The HypoMon is worn          participated.
on a belt that fits around your chest. The
belt is now more comfortable and user-           To find out more or if you think you might
friendly.                                        like to help us out, please call either Julie
                                                 Dart (9340 7856) or Niru Paramalingam
For this ‘Clinical Evaluation’ stage, starting   (9340 8671). We’d love to talk to you and
mid-September, we need people with type          tell you all about the study. ☺
1 diabetes who are aged 10 – 25 years
old, and are willing to come and stay for
one night (Fri, Sat or Sun) in the Sleep Lab
at PMH. This study will collect information
which will be used to develop the
HypoMon for home use.

For this study you will come to the Sleep
Lab in the evening, and will be monitored
continuously by the HypoMon overnight.
You will also have your blood glucose
tested regularly overnight. Then in the
morning, we’ll give you breakfast before
you go home.

If you do go low, we will wake you for a
hypo treatment. If you don’t go low, that’s
fine too. Just think . . . it’s something
different to do on a weekend night!

                                                                                    -6-    -6-   -6-   -
Research Update (cont.)

Type 1 Diabetes Prevention Trial                Microvascular Study
This study is to determine whether              This is a study about to be undertaken by
intranasal insulin administration to children   the Department of Endocrinology and
and young adults at risk for type 1             Diabetes, and the School of Sports
diabetes will reduce their rate of              Science, Exercise and Health, UWA. The
developing diabetes. It is a multi-site study   project is:
that is being conducted in Australia and
New Zealand.                                    “Does ambient blood glucose influence
                                                skin blood flow and microvascular function
You are eligible to have a test for the         in adolescents with type 1 diabetes?:
antibodies (free of charge) if you are aged     A validation study”.
between 4 and 30 years, and have a blood
relative with type 1 diabetes. Screening for    This study will provide important
this study can be at Princess Margaret          information about the reliability and
Hospital, or at a Pathology Centre.             relevance of a new technique to assess
                                                the health of small blood vessels. It may
At Princess Margaret Hospital there are 9       provide useful information on the potential
people participating in the study, who have     for this technique to be used to assess the
all completed the 12 month treatment            early stages of small vessel disease in
period. Across all sites there are 40 people    type 1 diabetes.
who have completed the 12 month
treatment period.                               The people who are eligible for this study
                                                are adolescents who have been diagnosed
If you wish to have further information         with type 1 diabetes for more than one
about this study, please contact Julie          year, aged between 13-18 years without
Kendall, Intranasal Insulin Study Co-           established microvascular disease or
ordinator on 9340 8486.                         peripheral vascular disease.

                                                If you wish to hear more about this study,
                                                please contact Dr Louise Naylor on
                                                6488 3887.

JDRF Diabetes Youth Ambassador Program

JDRF are looking for young people with          If you would like to play a part in helping
type 1 diabetes to join their Youth             JDRF to continue their research to find a
Ambassador Program.                             cure for diabetes, check out:

 A Youth Ambassador can help increase 
diabetes awareness and funding                  youth-ambassadors
by speaking at public events, organising
fund raising activities, or writing to local    to find out more.
businesses and Parliament.

                                                                                  -7-    -7-   -7-   -

Red Lentil Burgers with                    Zesty Yoghurt Topping
Zesty Yoghurt Topping
                                           Serves 5
Preparation time: 1 hour                   Ingredients:
Serves 5
Ingredients:                               1 cup Yoghurt
                                           1/2 cup Mint
2 tsp (chopped) almonds                    1 tablespoon lemon (juice and 2 teaspoon
2 slices (crumbled) bread                  of rind)
1 tsp ground coriander
1 tsp cumin
1 (beaten) egg
1 tbsp lemon rind
1 cup dry red lentils
1 tbsp Marsala
1 tbsp olive oil
½ medium onion finely chopped
1 tsp paprika
1 1/3 cups of vegetable stock
                                           Donated Pumps

                                           The Diabetes Department has received
                                           some donated insulin pumps from the
   1. In a saucepan heat stock and add
                                           Variety Club which we need to find homes
      lentils. Cook for 20 mins over
                                           for. If you and your child have considered
      medium heat, stirring to prevent
                                           using an insulin pump but have not been
      lentils from sticking.
                                           able to arrange health funding, speak with
   2. Meanwhile, prepare remaining
                                           your clinic team about whether a donated
      ingredients. In a bowl combine
                                           pump would be suitable for you. To ensure
      burger ingredients. Mix well and
                                           everyone is considered equally we ask
      refrigerate for 30 mins.
                                           you to be prepared to answer some
   3. Shape into burgers and pan fry for
                                           questions with your team, and do some
      a few minutes on each side.
                                           fact finding yourself about insulin pumps.
   4. Prepare Zesty Yoghurt Topping. In
                                           Good luck - hoping to hear from you soon!
      a bowl combine ingredients and
   5. Serve Red Lentil Burgers with a
      dollop of Zesty Yoghurt Topping
      and a mixed salad of tomato,
      lettuce, cucumber, capsicum and
      mushrooms with pita or turkish

                                                                            -8-   -8-   -8-   -

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Description: newsletter spring 09