The right choices Recipe for improving quality of life with Type 2 - Sign up for Type 1 diabetes summer events - Diabetes Ireland
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The right choices
Recipe for improving
www.diabetes.ie
quality of life with Type 2
Diabetes Helpline Lo-call 1850 909 909
Sign up for Type 1 diabetes
summer events
New Cork Care Centre open
Styling a new life after diagnosis
Volume 14 Issue 2 Summer 16 e5
CONTENTS
news 6 cover story 10 life story 22
NEWS & VIEWS COVER STORIES REGULARS
5 EDITORIAL 10 SPRING MEETING: With Type 22 LIFE STORY
50 years of education, fun and 2 diabetes it is important to live Hairdresser Kevin Staunton has
advocacy a healthy lifestyle, have regular lost five stone since he was
health checks and take the diagnosed with Type 2 diabetes
6 NEWS appropriate medication in April 2015, and he feels much
New Diabetes Ireland Care better now than he did before
12 SPRING MEETING: Picture spread
Centre for Cork… Progress at his diagnosis
last in North West services… 12 SPRING MEETING: A healthy
Promised 36 HSE posts remain diet is vital in Type 2 diabetes, 25 NUTRITION
unfilled… National Spring writes Sheila O’Kelly Keeping up to date with Type 2
Meeting workshops packed… dietary guidelines
DCU research may aid reversing
blindness… Integrated diabetes
tracker app… Thriveabetes
FEATURES 28 RECIPES
Chicken avocado salad and fruit
conference 1 October in Naas… flan
18 COMMUNITY EDUCATION
Summertime Ball Saturday 20
There is a huge appetite 30 SUPPORTING DI
August… Cork Golf Classic 25
for diabetes education Christmas day dip… Swim For A
August...
among carers of people with Mile Challenge… City to Seafield
intellectual disabilities, writes Cycle...
DIABETES IRELAND
32 BRANCH NEWS
Sheila O’Kelly
WEST: Sligo Rovers score with
36 SWEETPEA
kids in Sligo/Leitrim… Nutrition 20 HEALTHY EATING Sweetpea kids get ready for the
talk goes down well in Limerick… Owen Petticrew showed his summer holidays
Families rock on while hill classmates that despite his Type
walking in Limerick… Pauline 1 diabetes, he was not that 46 DIARY
Cooney Golf Classic raises different to his other classmates, F ree CODE education and other
€2,000 for Diabetes Ireland... writes Sheila O’Kelly events. See www.diabetes.ie
SUMMER 2016
The contents in full of Diabetes Ireland are Copyright© of MedMedia Ltd. The views expressed in this publication are not necessarily those of the Diabetes Federation
of Ireland. Subscription to Diabetes Ireland is an automatic benefit of membership with the Diabetes Federation of Ireland.
Editorial Statement: Diabetes Ireland is produced by professional medical journalists working closely with and on behalf of the
Diabetes Federation of Ireland. Advertisements in this magazine does not imply endorsement by the Diabetes
Federation of Ireland or benefit for people with diabetes from any product.
3
EDITORIAL
50 years of education,
fun and advocacy
M ore than 130 people attended the
Diabetes Ireland annual National
Spring Meeting in Sligo recently where
experts ran workshops for adults with
Type 1 diabetes, children with Type 1 dia-
betes and their parents, and for people
with Type 2 diabetes. See our picture
pages in this issue; and reports on two
of the speakers, Ms Marie Boyce and
Editor Sheila O’Kelly
Publisher Geraldine Meagan Dr Aonghus O’Loughlin.
Production & Design Sonja Storm In the coming months Diabetes Ireland This prompted Pauline Dunne,
Diabetes Ireland is published by events are very much focused on children Dietitian and Regional Development
MedMedia Publications
with Type 1 diabetes and their families. Officer, Diabetes Ireland, Western area,
17 Adelaide Street,
Dun Laoghaire, Co Dublin •• In June there is an action-packed to initiate diabetes education sessions for
Tel 01 280 3967 family day in Tayto Park these carers last year.
Email sheila@medmedia.ie
•• In July, there is the National Teen The sessions were so successful that
Diabetes Ireland editor Activity Day, which takes place all over Pauline with Sinead Hanley, Dietitian and
Kieran O’Leary the country Regional Development Officer, Diabetes
Editorial Board •• In August the National Diabetes Cup Ireland, North East, expanded the pro-
Dr Anna Clarke, Kieran O’Leary and
is on in Dublin gramme to provide day-long sessions
Sinead Hanley
President of Diabetes Ireland •• In September, the family weekend will this year. There is now a waiting list of
Professor Gerald Tomkin be held at Avon Rí in Wicklow. people anxious to take part.
Chairperson of Diabetes Ireland
Register now to make sure you secure Keeping up with all the latest health
Professor Hilary Hoey
a place by going to www.diabetes.ie or information takes some doing and in this
Diabetes Ireland correspondence to: phone 1850 909 909. See more details issue’s Nutrition article Pauline Dunne
Diabetes Ireland, in our full page ads in this issue and on gives us a helping hand in her piece
19 Northwood House, Northwood
the Diary page. ‘Keeping up to date with Type 2 dietary
Business Campus, Santry, Dublin 9,
D09 DH30. These events help parents to look guidelines’.
Tel 1850 909 909 / 01 842 8118 after their children with diabetes, and Kevin Staunton, who has Type 2 dia-
Fax 01 842 8178 Diabetes Ireland is now looking to see betes, took his own education on board
Email info@diabetes.ie
Website www.diabetes.ie what other groups could do with a help- when he was diagnosed in 2015. Kevin
Western Regional Office ing hand. has lost five stone since then through a
DIABETES IRELAND
1 Wine Street, Sligo, F91 RFK1. They found that one of the gaps in combination of diet and exercise – and a
Tel 071 91 46001 Fax 071 914 6001
diabetes education was where people fitness regime designed by his son. You
Email wro@diabetes.ie
Southern Regional Office were caring for people with intellectual can read Kevin’s strategy in this issue’s
32 Grand Parade, Cork, T12X H5F. disabilities who also have diabetes. Life Story.
Tel 021 427 4229 Fax 021 427 0009 Developing awareness and educa-
Email sro@diabetes.ie
tion have always been key strategies for
Printing W&G Baird Ltd
Diabetes Ireland since it was founded
Diabetes Ireland is published four times a year
(March, June, September and December). It 50 years ago. And to launch its 50-year
is registered at the GPO as a periodical and is
anniversary celebrations, Diabetes Ireland
distributed by direct mail to all members of
SUMMER 2016
Diabetes Ireland. It is also distributed by Easons. will be holding a ‘Health and Wellbeing
Exhibition’ on Sunday 13 November
2016 in the Chartered Accountants
Ireland, Pearse Street, Dublin 2. Put it in
your diary now.
5
NEWS
New Diabetes Ireland Care Centre for Cork
Diabetes Ireland has opened its second
Subsidised Cork fees
Diabetes Care Centre, this time in Cork.
The opening is part of its strategy to The healthcare professional-led
make sure that comprehensive diabe- services in the Cork Diabetes Care
tes healthcare services are available to Centre are offered at a subsidised rate
people with diabetes all over Ireland. First Follow-up
The Dublin Centre opened in 2013 to appointment appointments
make it easier to access diabetes health-
Podiatrist €45* €35
care and it has been hugely successful.
Dietitian €80* €35
Members from other parts of the coun-
try started asking for their own Care *First appointment fee includes free
The new Diabetes Ireland Care Centre on
Centre and Diabetes Ireland plans to annual membership of Diabetes Ireland
Mary Street in Cork, phone 021 427 4229
open four centres by 2020. The cost of
opening a Care Centre is approximately has begun by offering podiatry services with professional shoe fitting where
€250,000 and with the support of its and eye screening and will expand later necessary,” said Pauline Lynch, Regional
branch network and kind donations, to offer the other services. Development Officer, Diabetes Ireland.
Diabetes Ireland is confident it will reach “Our podiatry service provides cli- “A choice of diabetes friendly foot-
its goal. ents with a full diabetes foot screen and wear (orthotics, shoes and socks) is
The Dublin Diabetes Ireland Care assessment, foot and nail care treat- available at extremely competitive prices.
Centre already offers podiatry (footcare), ment and education plus callus and Our orthotics and footwear services are
eye screening, a dietitian, counselling corn removal where necessary. A foot- only recommended if warranted, after a
and hearing test service. The Cork Centre wear assessment is also carried out, full podiatry assessment,”she added.
Progress at last in North West services
Letterkenny Gate Lodge Dietitian who works with both adults Paediatric consultant, Sligo
There is good news in Donegal where and children. Meanwhile, the appointment of
Gate Lodge, a new diabetes centre for Sligo Day Centre Paediatric Endocrinologist, Dr Orla
adults and children with diabetes has Funding to build a new Diabetes Day Neylon, last year means that families
opened in Letterkenny Hospital. The Gate Centre for both paediatrics and adults in the North West no longer have to
Lodge has five rooms, which replace the in Sligo General Hospital has been travel to Dublin for insulin pump ther-
previous one single room. It means that approved by the Department of Finance. apy and other diabetes services. This
there is now privacy to see patients and a The centre will be a combined paedi- appointment came about as part of the
child-friendly room for children. atric and adult diabetes centre, purpose Paediatric Diabetes Model of Care.
“The rooms are places where the built to provide nursing, dietetic, podia- There are already 60 children in
nurses can quietly see people with dia- try and medical reviews. Donegal using pump therapy out of the
DIABETES IRELAND
betes and help them out with things In time, all future diabetes outpatient 143 children with Type 1 diabetes.
like using an insulin pump,” says Avril services attached to Sligo Hospital will “It is fantastic for people with diabe-
McCloskey, Paediatric Diabetes Nurse be based in the new centre. It is antici- tes in Donegal. Before Dr Neylon was
Specialist, Letterkenny Hospital. pated that it will take about 12 months appointed if a child was suitable for pump
The paediatric consultant from Sligo to complete the work. The Sligo branch therapy, we had to refer them to Dublin
holds a clinic in Letterkenny once a has being advocating since 1988 for a and all their appointments were there.
month. In between, the nurses in dedicated diabetes centre in the hospi- This meant an overnight stay and could
Letterkenny can download information tal. So it’s great news for the community be very expensive, and parents could
to Sligo and vice versa. and especially for all those who worked require childcare for their other children.
SUMMER 2016
The Gate Lodge has two adult towards this over many years. “Now, if they are starting pump ther-
Diabetes Nurse Specialists working “We are delighted to see the local apy, they can begin it in Sligo. They will
alongside Avril McCloskey. In addi- diabetes community and local branches then attend Sligo for six months, and
tion, a podiatrist is starting at the Gate supporting these developments,” said then they get referred back to us in
Lodge soon. Fiona Hegarty is the Senior Kieran O’Leary, CEO, Diabetes Ireland. Letterkenny,” says Avril McCloskey.
6
NEWS
Promised 36 HSE posts remain unfilled
Diabetes Ireland is extremely concerned As a direct result of these unfilled In answer to a parliamentary question
that the key 36 posts sanctioned in the posts, GPs delivering the Cycle of Care put to the Minister for Health in the Dail
2016 HSE Service Plan may not be filled initiative cannot refer high risk patients about this issue, John Hennessy, HSE
this year. to the specialised services such as podia- National Director, Primary Care said:
The posts are needed to support the try and dietetics. This continues to put “Primary Care and the Clinical
implementation of the Type 2 Diabetes patients at increased risk of develop- Programme for Diabetes are working to
Cycle of Care initiative which com- ing problems requiring in/outpatient progress the clinical posts identified in
menced in October 2015. These posts are hospitalisation. the 2016 HSE services plan.
a mixture of Community based Diabetes This negates the aims of the initiative “Job descriptions are at final stage of
Nurse Specialists, Senior Dietitians and and the HSE policy to move Type 2 dia- drafting and discussions are progress-
Senior Podiatrists. betes care into the community. To date, ing regarding the exact locations of the
Kieran O’Leary, Diabetes Ireland CEO nationally almost 80,000 patients with identified posts. Once these have been
said: “We recently contacted TDs around Type 2 diabetes have registered for the agreed, recruitment will proceed and the
the country asking them for their sup- initiative. timeframe identified in the Primary Care
port in seeing these posts filled as quickly About 90% of GPs have signed up to Operational plan for commencement is
as possible. A huge number of TDs put support implementation of the initiative, quarter four, 2016.”
down parliamentary questions to the which involves two diabetes reviews per “We will continue to monitor the pro-
Minister for Health on the issue.” year for eligible patients. cess in the coming months,” said Kieran.
National Spring Meeting workshops packed
There was a great attendance at the
recent Diabetes Ireland National Spring
Meeting held in the Clarion Hotel, Sligo
Town recently.
The theme of the meeting was ‘Let’s
Focus On’, to provide people with diabe-
tes with an opportunity to focus on the
relevant management issues you may
face on a daily basis.
On the day, there were themed
patient education streams for people
with Type 1 diabetes, Type 2 diabetes
and for parents of children with Type 1
diabetes. Each stream had three pres- Anne Ferguson and Majella Toomey, Diabetes Nurse Specialists Sligo University Hospital, at
entations from a range of healthcare the Diabetes Ireland National Spring Meeting. Photo Philip McCaffrey
DIABETES IRELAND
professionals.
The overall purpose of the meeting
was to inform people with diabetes how
to:
•• Cope with feelings at and from diag-
nosis onwards
•• Manage the condition from day to day
•• Allay concerns on the future devel-
opment of complications through
SUMMER 2016
action.
You can see reports of the presenta-
tions by Dr Aonghus O’Loughlin and Ms
Marie Boyce in this issue on page 10 and
15 respectively. Grace Brennan and Tommy Gallagher at the Diabetes Ireland National Spring Meeting
7
NEWS
Save the date – DCU research may aid
Annual exhibition
on 13 November
reversing blindness
Diabetes Ireland will be holding a Research is taking place at Dublin The research team will:
‘Health and Wellbeing Exhibition’
City University (DCU) which may have •• Develop improved gene therapy based
on Sunday 13 November 2016 in
life-changing results for people with dia- on a modified form of human angi-
Chartered Accountants Ireland,
Pearse Street, Dublin 2, to launch its betes who have lost their sight through opoietin to potentially reverse blood
50-year anniversary celebrations. diabetic retinopathy. The research study, vessel damage during diabetes and
It will feature a large array of attrac- is a three way partnership between ultimately restore visual function
tions like free diabetes screening, A1c Ireland, Northern Ireland and the US. •• Investigate how the drug can prevent
testing, foot and eye checks, BMI -The research programme is five years in inflammation and improve the func-
measurements, product promotions, length and the team hopes to combat tion of the cells within the retina.
both family and children’s attractions
blindness caused by diabetes. DCU aims to identify, manipulate
and patient education workshops.
Some 285 million people have dia- and utilise AAV serotypes that will sig-
It will also give attendees the
chance to put questions to health betes mellitus, a figure expected to rise nificantly improve COMP-Ang-1 delivery
professionals on specific areas relat- in the next 15-20 years. Diabetic retin- into retinal cells in order to combat dia-
ing to diabetes on what promises to opathy (DR) is caused by chronically betic retinopathy.
be a very interactive and informative elevated blood glucose levels which can The Queen’s University partners will
day. damage the blood vessels at the back model diabetes in stem cells and test the
Diabetes Ireland will be undertak- of the eye. Existing DR therapies have effect of the drug.
ing a media campaign to promote
significant limitations. At the University of Utah, research-
the exhibition and to create further
A US-Ireland partnership has brought ers will ascertain how the drug prevents
awareness of diabetes in Ireland. This
will target members of the public together a unique team of scientists and inflammation in DR using the smallest
keen to learn more about diabetes as clinicians led by Dr Phil Cummins and possible drug dose to achieve optimal
well as those diagnosed with diabetes Dr Niall Barron of Dublin City University long-term effect while minimising side-
who want to keep up to date on how School of Biotechnology. effects of toxicity.
to proactively manage their condition. They are working with colleagues Research funding of €2.25m was
Diabetes Ireland expects to see 2,000 from: the University of Utah Moran received through the US-Ireland R&D
people attend the exhibition, which
Eye Centre, Professor Bala Ambati; Partnership Programme, jointly funded
will be free of charge.
a n d Q u e e n ’s U n i v e r s i t y B e l f a s t by the National Institutes of Health
Centre for Experimental Medicine, (NIH) in the US, Science Foundation
RIP – Jim Byrne Dr Tim Curtis, Professor Alan Stitt and Ireland (SFI) and HSC R&D in Northern
Diabetes Ireland Dr Reinheld Medina. Ireland.
extends its deep-
Integrated diabetes tracker app
est sympathies
to the family of
Jim Byrne who
DIABETES IRELAND
recently passed For those using Apple devices, a CareKit
away. medical app development tool, One
Jim was an
Drop, is now available.
active volun-
teer in Kilkenny It is a diabetes tracker that enables
for many years and represented his you to track glucose levels, food intake,
region on the National Council before medicines and activity in one place, all
becoming Chairperson of Diabetes integrated with whatever other plat-
Ireland. He stepped down from that forms you use to understand your
role due to ill health, but still contin- condition.
ued to volunteer locally in Kilkenny.
SUMMER 2016
The food intake reference library
He recently helped to find volun-
and medications used on the app are
teers for the Tour De Kilkenny in aid of
American.
the charity. He will be fondly remem-
bered by all in Diabetes Ireland. See https://www.apple.com/uk/
researchkit/
8
NEWS
Thriveabetes conference 1 October in Naas
World famous author, Gary Scheiner, Information” to people living with runner and International Diabetes
who wrote ‘Think Like A Pancreas’ is the diabetes. Federation Youth Leader.
keynote speaker at Thriveabetes, a Type “It’s the second Thriveabetes event. •• Dr Anna Clarke, Health Promotion
1 diabetes one-day conference which In 2015, we had 190 attendees, and and Research Manager at Diabetes
takes place on Saturday 1 October 2016 that was adults only. This year, we have Ireland.
in Naas, Co. Kildare. developed a programme for children and •• Penny Robinson, Mum of a teenager
Gary is a certified diabetes educator, teens with diabetes, and we are expect- with Type 1 diabetes and parent repre-
Clinical Director of Integrated Diabetes ing 300 attendees,” says Gráinne Flynn, sentative on the Families with Diabetes
Services in Pennsylvania, and has had co-founder and event organiser, who has Network in the UK.
Type 1 diabetes for over 30 years. been living with diabetes herself for 23 Registration for the conference costs
‘Thriveabetes’ will be held at The years. €35 per adult and €60 for two adult tick-
Killashee House Hotel, Naas, Co Kildare, Additional speakers are internationally ets. Children are €15 each or a family
and it is being organised completely by and nationally renowned in the diabetes ticket is €100. Advance registration is
volunteers from the diabetes commu- community and include: required.
nity, and with the support of Diabetes •• Joe Solowiejczyk, who has had Type 1 Register for Thriveabetes at: http://
Ireland. diabetes for more than 50 years and is thriveabetes.ie/
The conference focuses on the psy- a certified diabetes educator, and clini- For further information about
chological impact of living with a cal family and adult therapist. Thriveabetes contact: Gráinne Flynn,
lifelong, chronic illness. It aims to pro- •• Gavin Griffiths, who has Type 1 diabe- event organiser. Mobile 087 6548320 or
vide “Inspiration, Motivation and tes and is a di-athlete, ultra-marathon Email Grainne@thriveabetes.ie
Summertime Ball Saturday 20 August Cork Golf Classic 25 Aug
The Cork Branch Committee will hold its
Following schoolgirl Ciara Carew’s annual Golf Classic once again this year,
success at raising awareness about in the Mallow Golf Club on 25 August
diabetes at the Junk Kouture fashion 2016. Tee time is 12 noon to 4pm. The
design finale, she is going on to organ- format on the day is ‘Three ball better
ise a Summertime Ball in aid of Diabetes ball’ with great prizes to be won. For
Ireland and scoliosis. more information contact Charlotte on
The ball takes place in The Hub, 021 4274229/1850 909 909 or sro@dia-
Kilkenny on the 20 August, so spread betes.ie.
the word and help raise awareness about This long-running much anticipated
diabetes and funds for Diabetes Ireland. event is a great day out for the expe-
Ciara made and designed a dress titled ‘You’re not my type’ that won the Junk rienced or inexperienced golfer and
Kouture Southern Regional award at the places are of a premium early booking
Ciara Grand Finale. advisable.
DIABETES IRELAND
Carew’s “The dress was inspired by my 12-year-
winning old brother who was diagnosed with Direct debit winners
entry in Type 1 diabetes at the age of six. • March: Deirdre Williams, Tipperary
the Junk
“Seeing how little people understood • April: Batt Horan, Kerry
Kouture
about the condition, my aim was to raise • May: Kate Hurst, Donegal
fashion
awareness for Type 1 diabetes, and to
design
finale transform something that would usually
Spring raffle
been seen as ugly and a nuisance into • First: Bernadette Costello, Co Kerry
something spectacular. •S econd: Flora Blackmore, Co
Kilkenny
SUMMER 2016
“Ellen McDonald modelled the dress
• Third: Amy Sully, Co Kildare
and Paul Roche was also part of the
•F ourth: Liam Blackmore, Co
team,” says Ciara.
Kilkenny
For more information contact Ciara • Fifth: B Hannin, Dublin 6
Carew ciaracarew99@gmail.com
9
COVER STORY/SPRING MEETING
How to avoid
complications in Type 2
Live a healthy lifestyle, have regular health checks and take the
appropriate medication, writes Sheila O’Kelly
T ype 2 diabetes is a complex condition
with many possible complications,
but they can be significantly reduced
advise people to get out and do what
they like doing for 20 minutes every
second day. Do it until you feel a little bit
•• HbA1c levels (average control of blood
glucose over the past two to three
months)
by following the recommended health sweaty or your heart rate goes up a little •• Cholesterol
guidelines, Dr Aonghus O’Loughlin, bit, and try to build that up from there,” •• Blood pressure
Consultant Physician/Endocrinologist said Dr O’Loughlin. •• Kidney function
Roscommon University Hospital/ If you have any heart condition, you •• Foot screening
Saolta Healthcare Group, told the should get advice from your doctor •• Retinal (eye) screening
recent Diabetes Ireland National Spring before starting any exercise regime. •• Weight
Meeting, in the Clayton Hotel, Sligo. First-line treatment for Type 2 •• Not smoking.
For people newly diagnosed with After diet and exercise, the first-line “We want to make sure that the
Type 2 diabetes the cornerstone of man- treatment for Type 2 diabetes is met- younger person newly diagnosed with
agement is diet and exercise. If your BMI formin for controlling blood glucose. Type 2 diabetes has the same life expec-
(body mass index) is more than 30kg/m2 “It is a good tablet that has been tancy as someone without diabetes.
you need to get your weight down. around for 40-50 years and goes some Really you are looking at strict glycae-
“Ideally people with Type 2 diabe- way towards helping control weight. mic control (blood glucose) and to keep
tes would be enrolled in an education “If someone has a very high HbA1c that person well, without complications
programme like CODE (Community and they are obese, then often diet and for the next 40 or 50 years,” said Dr
Oriented Diabetes Education) or exercise alone is not enough. It is proba- O’Loughlin.
DESMOND (Diabetes Education and Self bly unwise to wait and see how they get If you meet the recommended health
Management for Ongoing and Newly on, but to go ahead and start metformin, targets, it will reduce your risk of devel-
Diagnosed) or X-PERT. This gives them because the sooner blood glucose is oping complications like:
the tools to self-manage and empower under control, the better chance there is •• Heart attacks
themselves to make healthy lifestyle of limiting Type 2 diabetes-related com- •• Strokes
choices,” said Dr O’Loughlin. plications,” said Dr O’Loughlin. •• Kidney failure
“There are now courses all around The guidelines recommend: •• Blindness
the country and some are available in •• Healthy eating •• Neuropathy – nerve damage leading
DIABETES IRELAND
the evening. These courses work. In the •• Weight control to foot amputation.
clinic we do what we can to advise about •• Physical activity HbA1c levels
diet and exercise, if there is a dietitian on •• Diabetes education. HbA1c shows what your average con-
board, we will ask them to provide fur- “If the A1c target is not achieved trol of blood glucose has been over the
ther dietary advice,” said Dr O’Loughlin. after three months of this along with past two to three months. Unlike the
Typically this advice would include: metformin, then you can increase the finger prick blood glucose test that you
•• Eat three meals a day dose or move on to another diabetes may do every day, the HbA1c is done
•• Do not eat big portions medication. Metformin can cause some only periodically and shows the average
•• Do not eat late at night irritation of the stomach or gastrointes- blood glucose levels in your body over
SUMMER 2016
•• Avoid snacking tinal problems, and we always advise the longer period.
•• Avoid foods with high amounts of people about that,” said Dr O’Loughlin. The way these numbers are described
carbs or sugars. Know your numbers has changed. You may be used to your
“The recommendations for exercise Apart from diet and exercise, the medical team telling you that you should
are about 150 minutes per week. We health guidelines cover: have an A1c of under 7%. Now they
10
COVER STORY/ SPRING MEETING
call this 53mmol/mol – see Table 1 for Dr Aongus
the conversion figures. The glucose tar-
Table 1: Conversion table O’Loughlin
gets are the same, just how they are addressed the
From old HbA1c % figures
recent Diabetes
described has changed. To up-to-date mmol/mol
Ireland National
“It is important that people with Type Spring Meeting
Old % figure New mmol figure
2 diabetes get to know these new num-
bers. The 53mmol target is the most 6.0 42
common one you will hear. But there 6.5 48
are other things that need to be taken
7.0 53
into account. For example, if you have
previously had episodes of hypoglycae- 7.5 59
mia (hypos – extremely low blood sugar), 8.0 64 see is that when someone doesn’t do,
you will need to make sure to avoid that this they can develop an ulcer without
8.5 69
happening again,” said Dr O’Loughlin. them knowing, as they cannot feel the
Hypos are not as much of a prob- 9.0 75 ulcer. ,” said Dr O’Loughlin.
lem for people with Type 2 diabetes as Cholesterol
people with Type 1 diabetes. However, collapse and could cause problems with, LDL cholesterol is known as the ‘bad’
people with Type 2 diabetes who are on for example, driving. cholesterol. If you have Type 2 diabetes,
specific tablets or medication like insulin Danger of high blood glucose ideally your LDL cholesterol should be
or sulphonylureas, are more at risk of a Damage to your eyes less than 2.6mmol per litre.
hypo. Some people with Type 2 diabetes If your blood glucose levels are poorly This is because studies show that
would therefore need to test their blood controlled it causes hyperglycaemia – this will significantly reduce your risk of
sugars four times a day. blood glucose that is too high. This can developing a heart attack or stroke.
Low blood sugar and the elderly damage the small blood vessels. One If your cholesterol is higher than this,
There is some evidence that your of the complications this can lead to is your medical team or GP will prob-
memory can deteriorate after a hypogly- retinopathy – eye damage. Everyone ably recommend that you take a statin
caemic event. with diabetes should have retinal screen- – medication that will control your cho-
“It can be very serious if an elderly ing once a year, and you can do this free lesterol levels.
person develops hypoglycaemia by making sure you are registered with Blood pressure
because, for example, they may become the retinopathy screening programme at Good blood pressure control is also
dizzy, fall and break their hip. If some- www.diabeticretinascreen.ie very important to help avoid cardiovas-
one is living alone and is elderly and The Diabetes Ireland Care Centre in cular disease. Ideally your blood pressure
frail, the risk is significant. So we try to Santry, Dublin, is one of the places where should be less than 140/90mmHg. If
avoid that. you can avail of this free eye screening. your blood pressure is too high, there
“In the elderly, we use medication Damage to your kidneys is medication called ace-inhibitors or
that is less likely to cause hypoglycaemic High sugar levels also puts your kid- angiotensin receptor blockers (ARBs)
events,” said Dr O’Loughlin. neys at risk. This risk of damage to your that are especially suited for people with
Blood glucose levels kidneys is even higher if you also have diabetes.
People with Type 2 diabetes should nor- high blood pressure. Smoking
DIABETES IRELAND
mally check their blood glucose before Every time you go to your GP you It is really important that people with
breakfast and before the evening meal. should ask them to check your kidney Type 2 diabetes do not smoke as this
This and your A1c, will help to show you function. They can do this by checking would increase their risk of cardiovascu-
how well controlled your diabetes is. On your urine for protein and by measuring lar disease.
a daily basis, you should be looking for your creatinine levels. Aspirin
an average glucose of about 8 – which Damage to your nervous system If your 10-year risk of a cardiovascu-
should lead to an A1c of about 53mmol/ In addition high blood sugar over time lar event (heart attack or stroke) is more
mol (7%). can cause neuropathy, which leads to than 10%, you will probably also be
Of course you have to balance that loss of sensation in the feet. advised to take aspirin.
SUMMER 2016
with avoiding your blood glucose going “This can lead to someone not being “Typically a man of 50, who has Type
too low. Your blood glucose should not able to appreciate that they have an 2 diabetes and another risk factor, for
go lower than 4. Less than 4 is a hypo- injury on their foot. So it is very impor- example high blood pressure or smok-
glycaemic event (where your blood sugar tant for people to look at their feet and ing, would benefit from aspirin,” said Dr
goes too low). This could cause you to report any ulcers or blisters. What we do O’Loughlin.
11
NATIONAL SPRING MEETING/SLIGO
Prof Hilary Hoey, Chairperson Diabetes Ireland, and Nuala Sharkey at the recent Diabetes
Ireland National Spring Meeting, held recently in Sligo
Dr Aoife Egan Specialist Registrar, University
Hospital, Galway, addressed the Diabetes
Ireland National Spring Meeting on ‘Diabetes
Management targets to reduce/prevent
Type 1 diabetes complications
Tom Killoran and Sean Moylan Lorcan O’Donnell and Gillian Griffen
Michael, Aodhan and Thomas Sharkey
Donal Gilroy, Diabetes Ireland West; Mary Forde, who has had Type 1 diabetes for 63 years;
and Kieran O’Leary, Diabetes Ireland CEO
DIABETES IRELAND
Sheila Bourke and Barbara Muldoon
SUMMER 2016
Ann Roper, Rosaleen and Andrew Lang at the Diabetes Ireland National Spring Meeting, held
recently in Sligo
12NATIONAL SPRING MEETING/SLIGO
Grace Brennan and Tommy Gallagher at the
Diabetes Ireland National Spring Meeting,
held recently in Sligo
Avril McCloskey, Paediatric Diabetes Nurse Specialist, Letterkenny General Hospital, who
addressed the Diabetes Ireland National Spring Meeting on ‘Protecting my child’; Fiona
Hegarty, Senior Dietitan in Diabetes, Letterkenny General Hospital, who spoke on ‘Staying
healthy with diabetes’; Patricia Murray, Diabetes Nurse Specialist, Sligo University Hospital; and
Vincent McDarby, Senior Clinical Psychologist, Our Ladys Hospital for Sick Children, Dublin,
who spoke on ‘Getting my head around diabetes’
Linda Flanagan and Eileen Cullinan
Catriona Coleman, Donal Gilroy, Sligo branch Pauline Dunne, Dietitian and Diabetes
Diabetes Ireland; and Patricia Murray at the Ireland Regional Co-ordiantor, West and
Dr Rodger Graham, Consultant Clinical
Diabetes Ireland National Spring Meeting Regina Patton, Diabetes Ireland West
Psychologist in Diabetes, Ulster Hospital
Belfast, at the Diabetes Ireland National
Spring Meeting
DIABETES IRELAND
Picture above: Geraldine O’Donnell, Michael
Tarmey and Anne King at the Diabetes
Ireland National Spring Meeting, held
SUMMER 2016
recently in Sligo
Anne Moran and Margaret Finn
Killian and Mel McShane Photos: Philip McCaffrey
13COVER STORY/SPRING MEETING
A healthy diet is vital
in Type 2 diabetes
that different individuals can tolerate
Eat a variety of food; different amounts of fat around their
look at labels; and if abdomen and organs. This may explain
why not everyone who is overweight
dieting lose weight gets diabetes,” said Ms Boyce.
slowly, writes Sheila Apple or pear shape?
Where your body stores fat is impor-
O’Kelly tant. If you store fat around your waist
it puts you at higher risk of developing
diabetes and cardiovascular disease than
W e have to make a special effort
to be physically active now more
than ever because our lives have become
if you store it around your hips.
For women, a healthy waist size is
less than 32 inches (between 32 and 35
so automated, Marie Boyce, Senior inches is moderate risk, over 35 inches
Community Dietitian, Sligo, told the is high risk).
Marie Boyce, Senior Community Dietitian,
recent Diabetes Ireland National Spring For men, less than 37 inches is healthy
Sligo, addressed the recent Diabetes Ireland
Meeting. National Spring Meeting
(between 37 and 40 inches is moderate
DIABETES IRELAND
“We don’t run to pick up the tele- risk, over 40 inches is high risk).
phone anymore as it’s probably in our Slimming tips
pocket; we don’t have to get up to is stored in the body as fat in the liver, If you need to lose weight, set your-
change the channel on the television under the skin and around the middle of self a target of losing 10% of your body
anymore with remote controls. Cars are the body (abdomen). The fat around the weight at a rate of 1-2lb per week. To do
used for even the shortest journeys. So, middle of the body is known as ‘visceral this you will need to reduce how much
for our lives everyday, we are burning fat’ and this is linked to insulin resist- you eat a day by 500-600kcal.
less energy than ever before,” said Ms ance, which causes Type 2 diabetes. It helps to eat regular meals and avoid
Boyce, speaking at the meeting which Personal fat thresholds the feast or famine approach.
SUMMER 2016
was recently held in the Clayton Hotel, The fat that builds up in the liver can If you require support you can ask
Sligo town. also extend to the pancreas, which again your GP practice or diabetes clinic to
Energy stops insulin working effectively. refer you to a dietitian to help you
If we take in more calories (energy) “Personal fat thresholds are being draw up a personal plan to achieve this
than we need, we will gain weight. This researched, because there is a theory weight loss.
15COVER STORY/SPRING MEETING
Every little helps
Losing 10% of your body weight
could help:
•• Reduce your high blood pressure by
more than 10 blood pressure units
•• Reduce your high blood sugar levels
by 50%
•• Reduce your high blood cholesterol
by 10%.
The best diet
There is strong evidence that diets that
are the most compatible with health are
those that are higher in:
•• Vegetables
•• Fruits
•• Wholegrains
•• Dairy
•• Seafood
•• Legumes (pulses like lentils)
•• Nuts.
A healthy diet is lower in:
•• Red and processed meat
•• Low in sugar-sweetened foods, par-
ticularly low in sugar-sweetened
beverages
•• Low in refined grains (like white bread).
It is also important to drink only a
moderate level of alcohol.
High-fibre carbohydrates
It is useful to have higher fibre version
of starchy foods:
•• Brown rice
•• Wholemeal bread and pasta
•• Wholewheat noodles
•• High-fibre breakfast cereals.
Fibre in food slows down how quickly
you digest and absorb carbohydrates
and produces a gradual blood glucose
and insulin response.
DIABETES IRELAND
Know your portion sizes
Take care with starchy foods such as
rolls, scones, paninis, bracks and bagels
as they are available in various portions
sizes. Go for the smallest size as you
could end up eating five portions of
starchy food without realising it.
Low carbohydrate diets
“While low-carb diets are associated
SUMMER 2016
with a reduction in body weight and
improvement in glucose control in the longer term. People on low-carb diets
short term, there is little published evi- lose a similar amount of weight over 12 See also Nutrition on page 25 for
dence showing benefit for weight loss, months, when compared to those on a more information about diet and
compared to other approaches, over the low-fat diet,” said Ms Boyce. Type 2 diabetes
16COMMUNITY EDUCATION
Carers throng to
diabetes education
There is a huge appetite for diabetes education among carers of
people with intellectual disabilities, writes Sheila O’Kelly
A training programme for carers of
people with diabetes who have
intellectual disabilities has been devel-
would like the courses extended to one
day so that they could learn more about
the management and treatment of
process. During the full-day sessions
people’s knowledge about diabetes is
measured at the start and the end of
oped as part of the Diabetes Ireland diabetes. the day. Evaluation forms are completed
strategy of targeting specific groups in Diabetes Ireland then developed a after all sessions, and follow-up tele-
terms of education. full-day programme and submitted it for phone calls will be carried out after all
Some 61% of people with intellec- funding to the Dormant Accounts Fund sessions to discuss impact of the aware-
tual disability are at increased risk of and was successful. Some 320 support ness sessions at local level.
pre-diabetes and Type 2 diabetes, and workers for people with intellectual The full-day sessions update people
16% of people with intellectual disabil- disabilities are expected to complete on diabetes using current evidence, best
ity aged over 40 years have diabetes. the ‘Diabetes awareness, prevention practice guidelines and management
Research shows there is great potential and management in Adult Intellectual strategies. Nutrition-related topics such
to prevent Type 2 diabetes in high-risk Disability Services’ sessions by the end as healthy eating to aid in the manage-
individuals by lifestyle intervention, thus of 2016. ment and prevention of Type 2 and
delaying the onset of diabetes-related At the planning phase of the pro- pre-diabetes, portion sizes and physical
complications. ject, The Brothers of Charity services in activity are also included in the session.
In 2015, Pauline Dunne, Dietitian and Waterford and Roscommon came on Taking part in the community
Regional Development Officer, Diabetes board as partner organisations. Since The support workers are very involved
Ireland, Western Area, began the pro- then, additional Brothers of Charity ser- in helping people with intellectual dis-
cess of developing a three-hour training vice areas and other organisations that abilities to take a more active part in
DIABETES IRELAND
programme for carers of people with offer support services to people with the community. A common activity with
intellectual disabilities. Sinead Hanley, intellectual disabilities have been offered service users would be food-based, for
Dietitian and Regional Development sessions. These include COPE, Northwest example, to go to a coffee shop for
Officer, Diabetes Ireland, North East area, Parents and Friends Association and something to eat or drink. Part of the
then came on board to help deliver the St John of God. session looks at:
initiative. Interactive education sessions •• What could be a healthier option?
Diabetes Ireland applied for fund- The sessions are delivered in a simi- •• How can we adjust portion sizes?
ing for these training sessions from the lar way to CODE (Community Oriented •• How can we support the service user
National Lottery and was successful. Diabetes Education). The sessions work in making healthy choices regularly?
SUMMER 2016
Some 22 of these training sessions were best with no more than 16 per group The attendees get a participant pack
held in 2015. and are very interactive, which enables with relevant literature to support the
The sessions focused mainly on nutri- the session facilitators to meet the needs information they have learnt.
tion, pre-diabetes and Type 2 diabetes. of the group. The training sessions are facilitated by
The evaluations showed that participants The sessions have a strong evaluation Diabetes Ireland professionals.
18YOUNG PEOPLE
Leaflet focuses on
healthy eating for all
Owen Petticrew Kieran O’Leary, CEO
Diabetes Ireland, Owen
showed his Petticrew; and Donal
Gilroy, Sligo Branch
classmates how he Diabetes Ireland, with
Owen’s ‘pamphlet on
was not so different Nutrition tips for Kids’
after all,
writes Sheila O’Kelly
W hen sixth-class student, Owen
Petticrew from Mullingar, was
diagnosed with Type 1 diabetes two
Table’ display from the sixth class pupils
at a ‘Sugar and Fat’ information evening
in a local hotel.
beginning to take control. Although
myself and Colin do worry. It is stressful.
“It was a case of getting him to real-
years ago, he wasn’t too happy about Professor Donal O’Shea, endocri- ise he was going to have it forever. He
how the other children focused on him nologist, was the main speaker at the would have to take control and get on
as being different. information evening and he said it was with it as best as possible,” says Orlagh.
Owen’s mother, Orlagh, is head of the clear that Owen had put a considerable Owen himself said that if could give
parents’ council and the council came amount of thought, time and effort into any advice to another 10- or 11-year-old
up with the idea of focusing on healthy the quality of the information in the leaf- who was newly diagnosed, he would
eating for all the children by making let. Professor O’Shea suggested that all say: “It takes a while to get used to it,
posters. This would mean that Owen the attendees should make sure to take but once you are, it’s okay. It’s not so
would not stand out so much as being a leaflet home with them. bad. It’s a lot easier than you think. I do
different. They also encouraged healthy While Owen was unable to attend all my own injections and blood testing.
eating habits by asking the school chil- the event due to illness, his friend Niall “At school I do one injection at big
dren to include a vegetable and a fruit as Doonan filled in for him. Owen can be break. I do it at my desk. Originally the
part of their packed lunch. happy that his healthy choice message other children would stare at me when
DIABETES IRELAND
However, Owen was in hospital was well recognised. I was doing it, but not any more,” says
around that time and couldn’t take part Orlagh also has Type 1 diabetes and Owen.
in the poster making, but he could work was diagnosed 31 years’ ago. This meant Owen has taken part in the Diabetes
on his computer. He decided to design a that she and her husband Colin were Ireland Teen Activity Day for two years
nutrition leaflet for schoolchildren, that very aware of the possible symptoms and really enjoys it.
could include a lot more information of diabetes back when Owen was diag- “We did a lot of running and compar-
than would be possible on a poster. nosed. They spotted it straight away and ing blood sugars, and it was interesting
“Owen did all the research himself tested his bloods at home before bring- to see how different the readings were,”
and then came back to us with all the ing him to an emergency department. says Owen.
SUMMER 2016
information. Then he had to work out “He was diagnosed on the Monday Meanwhile, Owen loves doing project
what the most important information for night and was out of the hospital by work and we may well see some new
school children was,” says Orlagh. Friday without any need for IV interven- scheme from him to promote a healthy
The posters and Owen’s leaflet were tion,” says Orlagh. lifestyle for everyone – those with or
then both included at a ‘Healthy Food “We encouraged Owen from the without diabetes.
20LIFE STORY
Styling a
new life after
diagnosis
Hairdresser Kevin Staunton has lost
five stone since he was diagnosed with Type 2 diabetes
in April 2015, and he feels much better now than he
did before his diagnosis, he tells Sheila O’Kelly
F or Kevin Staunton, from Kilmallock,
Co Limerick, sugar was the big culprit
in piling on the pounds. As a hairdresser
felt so rotten for the first three months
after his diagnosis.
“The first two months I was in misery,
anything at home, but would buy a
breakfast roll on his way to work.
“Since my diagnosis I kicked that out
he was used to having coffee and bis- when I think back. I was thinking ‘should the window and switched to breakfast at
cuits with his clients through the day. I be eating this? Should I be eating home with porridge, or beans on brown
“I always used to get a packet of bis- that?’. toast. I religiously have a breakfast now,
cuits in the morning and by the end of “But I was determined I was going to I can’t survive without one,” says Kevin.
the evening they were gone. All that beat this thing. That was my goal. I have Lunch has changed too. Kevin used to
DIABETES IRELAND
went out the window when I was diag- got very strong willpower,” says Kevin. just keep on working as long as there
nosed. I kicked sugar big time and lost Kevin and his wife Catherine have three were clients, and try to fit lunch in some-
loads of weight. I went from 16 and children, two boys and a girl who are 21, time between 12 and 4. One time he
three quarter stone, to 11 and three 20 and 16. Kevin gives Catherine a lot of had no lunch, then went straight off to
quarter stone in a couple of months. the credit for his successful weight loss, a funeral after work.
I’ve looked at pictures and think ‘oh my as she has tweaked the diet of the whole “My wife had to drive me home where
god, is that me?’. I’ve tried on some of family to include more healthy food with I went straight to bed. So now I have my
my suits and I could fit two of me into lots of fruit and vegetables. lunch at the same time every day and will
them,” says Kevin. Kevin is now doing so well that his say to clients: ‘Can you wait 10 minutes
SUMMER 2016
It wasn’t easy to drastically reduce his medical team just tell him to keep on because I am having my lunch?’,” says
sugar consumption and Kevin had felt a doing what he is doing. Kevin.
bit like the ‘cold turkey’ he felt when he New breakfast regime Kevin has his evening meal at home
gave up smoking 23 years ago. He thinks One of the changes to his lifestyle with the family.
this sugar withdrawal was partly why he is breakfast. Kevin used to never have “Every food I pick up in the
22LIFE STORY
supermarket, I look at the label. We
make our own pasta sauces, we eat
brown bread and very few potatoes.
Even the children adapted well to a
fresher diet. Fruit, vegetables. I check
the ingredients on everything at the
supermarket.
“Maybe twice a week, I might have
a bit of cake or chocolate. I’ve adapted
to the new regime no problem. I have
a glass of wine occasionally with our
dinner,” says Kevin.
Checking blood glucose
At first Kevin was obsessed with
checking his blood glucose – maybe four
times a day. But now he checks it just in
the morning.
“I’ve got it to a fine art of being
between 5 and 7 maximum,” says Kevin.
“I had a Chinese one time and I went
up to 10. The next time I rang I asked
them did they put sugar in the food, she
said ‘yes’, and I said ‘is it possible, no
sugar?’ and they did the food without
Kevin Staunton: “Every food
sugar and my bloods were fine after it,”
I pick up in the supermarket,
says Kevin.
I look at the label. We make
The whole family have got involved in our own pasta sauces, we eat
the new lifestyle. brown bread and very few
“My eldest son is hurling mad and potatoes”
he put me on a regime. He thought my
muscles were fading away. He had me
doing major walking and major stretch- My wife just tweaked our whole diet to top of you. And you are thinking, now
ing and quads. My arms had gone a bit suit. The eldest lad is happy because it I can’t go anywhere, I have to keep this
weasly looking. He said ‘you’re going suits his training. The children love the on track. We like to go to Spain for our
to waste away if you don’t start doing wholegrain brown bread. Nothing in our holidays, and I was thinking ‘I can’t go
something’. diet is over the top. there now, what am I going to eat?’
“He adapted his own strengthening “I feel much better now than I did “I was very mopey for the first couple
and conditioning programme for me. It before I was diagnosed. Maybe it was a of months.
has been great. My legs are great. I walk blessing in disguise that I got this,” says “But now everything is fine. We can
DIABETES IRELAND
maybe five nights a week, about three Kevin. still go out for a drink. We can enjoy our-
miles each night. Kevin’s typical daily diet selves and we can go places.
“I have some sensitivity in my feet. But •• Breakfast: porridge, or brown bread “I was relieved at the diagnosis of Type
other than that healthwise, I am feeling and beans 2 diabetes because I was afraid it was
great,” says Kevin. •• 11-11:30, a banana something worse, like cancer. I felt Type 2
Kevin’s cholesterol and blood sugar •• 1 o’clock – no matter what: salad, diabetes was something I could control, it
levels are generally at the levels they pasta, or sometimes a sandwich was up to me. The first time I went back to
should be for him. •• 5 o’clock, a snack like a piece of fruit the doctor she said to me, ‘I’m so pleased
“I have come to the conclusion that •• 7 o’clock, dinner. with what you’ve done. People think that
SUMMER 2016
if you get rid of sugar, you are on a For dinner Kevin and his family once I give them the tablets they can carry
winner. I keep an eye on the fat, and have, fish, chicken or meat and fresh on as before. But you have to work with
I don’t have much. We don’t fry, we vegetables. the tablets’. She said: ‘Whatever you’re
always grill. We just make sure that we “At first when you are diagnosed, doing don’t change it, stay with what you
have a few carbohydrates and protein. you think the world has come down on are doing’,” says Kevin.
23NUTRITION
Keeping up to date with
Type 2 dietary guidelines
People with or dietitian or diabetes care team to see the ingredients list for other names for
how flexible you can be with your meal sugars such as:
without Type 2 plans. •• Honey
Starchy carbohydrates come first •• Glucose
diabetes need the Starchy carbohydrates include: •• Dextrose
same healthy diet, •• All types of breads and crackers •• Fructose
•• Cereals •• Syrups
writes Pauline Dunne •• Potatoes •• Lactose
•• Pasta •• Maltose
M edia messages on what to eat to
optimise health are confusing with
banner headlines promoting different
•• Rice
•• Noodles.
You should include these foods at each
•• Hydrolysed starch
•• Treacle.
Try not to add sugar or honey to
dietary ideas. There currently is no ideal meal, but the amount which each person coffee, tea or cereals. Use an artificial
dietary plan, but rather a dietary plan needs differs. For more information on sweetener instead if you feel you can’t
based on healthy eating that is individu- portion sizes, see the food pyramid on do without.
alised to meet your needs. www.healthpromotion.ie Choose: Fruits and vegetables
People should replace refined carbo- •• Wholegrain breads Most people know the 5-a-day message
hydrates such as sugary foods and drinks •• Wholegrain cereals for fruits and vegetables – we should all
and those with added sugars with whole •• Wholemeal or seeded pitta pockets/ eat a minimum of 5 portions daily of a
grains, legumes (peas, beans, pulses like wraps/bagels mixture of fruits and vegetables. Examples
lentils and chick peas), vegetables, and •• Oatcakes, wholegrain crackers of a portion of vegetables include:
fruits. Whether or not we have diabetes, •• ‘Kids’ size wraps. •• A couple of dessertspoons of cooked
we should all eat less saturated fat. We Choosing oat-based and wholegrain veg
should replace margarines and lard with varieties of starchy carbohydrates will help •• A small bowl of salad vegetables
mono and polyunsaturated fat sources increase the fibre content of your diet, •• A bowl of vegetable soup.
such as rapeseed and olive oils and which in turn can help towards maintain- Pack your sandwiches out with salad
spreads made from these. ing a healthy bowel. Foods based on oats vegetables – aside from being full of
We should also: and wholegrains can release more slowly fibre, vitamins and minerals, they will
•• Reduce our intake of sodium (salt) into our bloodstream, improving blood also keep you full for longer. Vegetables
DIABETES IRELAND
•• Avoid smoking glucose control. Talk to your diabetes care can be steamed, roasted or made into
•• Avoid drinking alcohol to excess. team if you are unsure how much carbo- salads – include a variety to keep your
A healthy diet contains a balance of hydrate is right for you. meals interesting.
the 3 main nutrients: Only very occasionally, choose baked A portion of fruit can be:
•• Proteins goods such as biscuits, cakes and tarts, •• A small whole fruit, like a fun-size
•• Fats desserts, ice-cream, sweets and chocolate. banana, pear, orange or peach
•• Carbohydrates. These foods are very high in sugars and •• Two small fruits such as mandarins
Eating regular meals will make it easier fats and cannot only cause our blood glu- •• A small handful of berries or grapes
for your body to control your blood glu- cose levels to rise, but also cause weight (usually 10-12 grapes).
SUMMER 2016
cose either to manage diabetes or to gain. Try to keep the portions very small, If it is fruit salad which takes your
prevent Type 2 diabetes. Some diabetes and have these foods on special occasions fancy, aim to have no more than 1 tea
treatments mean you need to pay atten- rather than as a regular part of your diet. cup full at one sitting. Remember that
tion to the timing of when you eat your If you are unsure if a food contains fruit contains natural sugars. Space your
meals. Others are less strict. Talk to your sugary carbohydrates, have a look at fruit intake out over the day.
25You can also read
