Diabetes Helpline Lo-call 1850 909 909 www.diabetes.ie Styling anewlife afterdiagnosis New Cork Care Centreopen summer events up forSign Type1 diabetes quality of life with Type 2 Recipe forimproving right choices The Volume 14Issue2Summer16 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 FEATURES 28 RECIPES tracker app… Thriveabetes 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... 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, Free CODE education and other DIABETES IRELAND €2,000 for Diabetes Ireland... writes Sheila O’Kelly events. See www.diabetes.ie
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 SUMMER 2016 Federation of Ireland or benefit for people with diabetes from any product. 3 EDITORIAL
50 years of education, fun and advocacy
ore than 130 people attended the MDiabetes 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 [email protected] •• 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 [email protected] 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 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 [email protected] 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 [email protected] tion have always been key strategies for Printing W&G Baird Ltd Diabetes Ireland since it was founded DIABETES IRELAND 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 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. SUMMER 2016
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. € € Members from other parts of the coun- Dietitian 80* 35 try started asking for their own Care *First appointment fee includes free The new Diabetes Ireland Care Centre on annual membership of Diabetes Ireland Centre and Diabetes Ireland plans to 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 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.
DIABETES IRELAND 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. 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
SUMMER 2016 Lodge soon. Fiona Hegarty is the Senior Kieran O’Leary, CEO, Diabetes Ireland. Letterkenny,” says Avril McCloskey.
6 NEWS 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 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 DIABETES IRELAND •• Allay concerns on the future devel- opment of complications through 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 SUMMER 2016
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. and Queen’s University Belfast 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- est sympathies to the family of Integrated diabetes tracker app Jim Byrne who 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 DIABETES IRELAND 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. 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/
SUMMER 2016 researchkit/
8 NEWS 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 [email protected]
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. 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 • May: Kate Hurst, Donegal fashion about the condition, my aim was to raise design awareness for Type 1 diabetes, and to finale transform something that would usually Spring raffle DIABETES IRELAND been seen as ugly and a nuisance into • First: Bernadette Costello, Co Kerry something spectacular. • Second: Flora Blackmore, Co “Ellen McDonald modelled the dress Kilkenny • Third: Amy Sully, Co Kildare and Paul Roche was also part of the • Fourth: Liam Blackmore, Co team,” says Ciara. Kilkenny For more information contact Ciara • Fifth: B Hannin, Dublin 6
Carew [email protected] SUMMER 2016
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
ype 2 diabetes is a complex condition advise people to get out and do what •• HbA1c levels (average control of blood Twith many possible complications, they like doing for 20 minutes every glucose over the past two to three but they can be significantly reduced second day. Do it until you feel a little bit 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 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
DIABETES IRELAND •• 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 •• 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
SUMMER 2016 are about 150 minutes per week. We health guidelines cover: have an A1c of under 7%. Now they
10 COVER STORY/SPRING MEETING COVER STORY/ SPRING MEETING
call this 53mmol/mol – see Table 1 for Dr Aongus Table 1: Conversion table the conversion figures. The glucose tar- O’Loughlin addressed the gets are the same, just how they are From old HbA1c % figures recent Diabetes described has changed. To up-to-date mmol/mol Ireland National “It is important that people with Type Old % figure New mmol figure Spring Meeting 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 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 DIABETES IRELAND 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. 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. SUMMER 2016
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
Sheila Bourke and Barbara Muldoon DIABETES IRELAND
Ann Roper, Rosaleen and Andrew Lang at the Diabetes Ireland National Spring Meeting, held
SUMMER 2016 recently in Sligo
12 NATIONAL 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 recently in Sligo
Anne Moran and Margaret Finn
Photos: Philip McCaffrey
Killian and Mel McShane SUMMER 2016
13 COVER STORY/SPRING MEETING
A healthy diet is vital in Type 2 diabetes
Eat a variety of food; that different individuals can tolerate 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 e have to make a special effort if you store it around your hips. Wto be physically active now more For women, a healthy waist size is than ever because our lives have become 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). recent Diabetes Ireland National Spring Marie Boyce, Senior Community Dietitian, For men, less than 37 inches is healthy Sligo, addressed the recent Diabetes Ireland Meeting. (between 37 and 40 inches is moderate National Spring Meeting “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. DIABETES IRELAND 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. 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. SUMMER 2016
15 COVER 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. 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
DIABETES IRELAND starchy food without realising it. Low carbohydrate diets “While low-carb diets are associated 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
SUMMER 2016 compared to other approaches, over the low-fat diet,” said Ms Boyce. Type 2 diabetes
16 COMMUNITY 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
training programme for carers of would like the courses extended to one process. During the full-day sessions A people with diabetes who have day so that they could learn more about people’s knowledge about diabetes is intellectual disabilities has been devel- the management and treatment of 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 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 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? 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
SUMMER 2016 The evaluations showed that participants The sessions have a strong evaluation Diabetes Ireland professionals.
18 YOUNG 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
hen sixth-class student, Owen Table’ display from the sixth class pupils beginning to take control. Although WPetticrew from Mullingar, was at a ‘Sugar and Fat’ information evening myself and Colin do worry. It is stressful. diagnosed with Type 1 diabetes two in a local hotel. “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 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-
DIABETES IRELAND 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. 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
SUMMER 2016 then both included at a ‘Healthy Food “We encouraged Owen from the without diabetes.
20 LIFE 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
or Kevin Staunton, from Kilmallock, felt so rotten for the first three months anything at home, but would buy a FCo Limerick, sugar was the big culprit after his diagnosis. breakfast roll on his way to work. in piling on the pounds. As a hairdresser “The first two months I was in misery, “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 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
DIABETES IRELAND 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 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.
SUMMER 2016 this sugar withdrawal was partly why he is breakfast. Kevin used to never have “Every food I pick up in the
22 LIFE STORY LIFE 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 sugar and my bloods were fine after it,” Kevin Staunton: “Every food 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 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 DIABETES IRELAND 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 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. SUMMER 2016
23 NUTRITION
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 diabetes need the Starchy carbohydrates come first •• Glucose Starchy carbohydrates include: •• Dextrose same healthy diet, •• All types of breads and crackers •• Fructose •• Cereals •• Syrups writes Pauline Dunne •• Potatoes •• Lactose •• Pasta •• Maltose edia messages on what to eat to •• Rice •• Hydrolysed starch Moptimise health are confusing with •• Noodles. •• Treacle. banner headlines promoting different You should include these foods at each 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 •• 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 DIABETES IRELAND 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). 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. SUMMER 2016
25 NUTRITION
Protein •• Eating less processed meats such as gravy/sauces all tend to be high in salt. Meat, poultry, fish, eggs, nuts and chicken kiev, sausages and puddings Try to use less often, and when possible pulses are protein foods, and don’t gen- •• Keeping baked goods such as pastries, make your own instead. erally affect blood glucose. Choose lean cakes and tarts for special occasions. Can I have alcohol? cuts of meats to reduce saturated fat At home, why not try making your Like everything else, it is fine to enjoy intake. Ask your butcher to trim excess own salad dressings with low fat natu- alcohol in moderation. But remember, fat and skin off your meat and poultry. ral yoghurt, lemon juice and herbs, or alcohol is high in calories, yet doesn’t pro- Cheaper cuts of meat are ideal for soups, French vinaigrette made with olive or vide any nourishment. Drinking more than stews and casseroles. rapeseed oil and vinegar. the weekly limit can increase your weight, Sausages and puddings have a high fat Stay hydrated and your blood pressure and put you at content – even when grilled, so only have To stay well hydrated we should drink increased risk of heart disease and stroke. these foods occasionally. Remember that up to 8 glasses of water per day. If we It can also damage your liver and increase stuffing or sauce will have a lot of salt, don’t have enough fluids, we can feel your chances of certain types of cancer. and usually some carbohydrate too. sluggish, have a mild headache and Ask your diabetes care team how alcohol Find a place for fish suffer from constipation. We can also may affect your blood glucose levels. Fish is low in fat, so enjoy it twice a often think that we are hungry when in Everyone should have at least 3 alco- week. Cod, hake, plaice are all healthy actual fact it is thirst the body is trying hol free days per week. Try not to have options. And oily fish like salmon, trout to communicate. We tend to perspire more than 3 standard drinks at one time. and mackerel are rich in heart healthy more on warmer days or when physically Men are advised to have no more than 17 omega-3 fatty acids. People with Type 2 active, so make sure to drink more fluids standard drinks a week, and women no diabetes are recommended to have oily than usual on those days. more than 11 standard drinks a week. See fish twice a week. If you struggle to drink enough during www.diabetes.ie and www.drinkaware.ie Many supermarkets now stock plain the day, try keeping a jug of water in for more information on alcohol intake. uncoated frozen fish too – look for fish the fridge so it is cool and refreshing; Weight management fillets without breadcrumb or batter or add a slice of lemon, lime or orange Modest weight loss (5-10% body coatings. See recipe ideas at www.diabe- to jazz up the water glass. Other fluids weight over 6 months) benefits over- tes.ie if you need help with meal ideas. also count – try sparkling water, herbal weight or obese adults with type 2 And, store-cupboard staples of tinned teas and no-added-sugar drinks that you diabetes and also those at risk for diabe- salmon, tuna, mackerel or sardines can dilute, to vary your fluid intake. tes. The ideal approach to weight loss is be the basis of a quick and tasty healthy What about salt? to reduce energy intake (calories) and to meal. When choosing tinned fish choose Too much salt can contribute to high increase physical activity. those tinned in water, brine or tomato blood pressure and heart disease. On Many people find it of benefit to join sauce instead of oil or mayonnaise. average Irish people eat at least 10g salt a group programme to assist in weight Fat in our diets per day which is almost double the rec- loss. Examples of commonly available A cornerstone of dietary advice for car- ommended 6g per day. Whether is it rock programmes include Unislim, Weight diovascular health has been to reduce: salt, sea salt, or table salt it will have the Watchers and Slimming World. •• The intake of total fat to less than same effect, so most of us should reduce Your local sports partnership is also 35% of total energy intake our salt intake. Easy ways to do this are: worth looking up. There are many differ- •• Saturated fat (SFA) intake to under •• Reduce your intake of processed ent activities on offer around the country 11% of total energy intake. foods especially ready-prepared meals, – why not take up a new class or join an We can do this by choosing olive sauces and takeaways outing? See www.getirelandactive.ie for oil or rapeseed oil for cooking and •• Choose fresh foods (fruit, vegetables, the full list of events. salad dressings and using olive or sun- meats, fish) more often Eating well can improve your blood flower oil-based spreads on our breads. •• Use less salt when cooking and at the glucose control, and reduce your long Choosing low-fat dairy can also help table term risk of cardiovascular disease
DIABETES IRELAND lower our intake of saturated fats and •• Flavour with alternatives – pepper, and diabetes-related complications. they include: garlic, herbs, spices, vinegar, lemon Have a look at the recipes section of •• Low-fat milk juice are all flavoursome www.diabetes.ie for ideas on how to •• Reduced-fat cheese •• Recognise salty food descriptors – food shake up your dietary intake! •• Natural or diet yoghurts. labelled as ‘smoked’, ‘pickled’, ‘mari- We should also reduce our intake of nated in soya sauce’ will be high in salt Pauline Dunne, is a dietitian and hydrogenated and trans fats – this can •• Choose unsalted nuts and snacks. Diabetes Ireland Regional Develop-
SUMMER 2016 be achieved by: Stock cubes, packet soups and instant ment Officer (Western Area)
26 RECIPES
Chicken avocado salad
Avocado is high in monunsaturated fats which can help to protect your heart and Nutrition per portion it also count towards 1 of your 5 a day. Typical Per adult Per child por- Try to include, as here, at least 2-3 por- values portion tion (115g) tions of your 5-a-day at lunchtime. (173g) With diabetes you should include a Energy 268 calories 178 calories source of carbohydrate with this recipe. value If you were to have 2 slices of wholegrain Protein 23.1g 15.4g bread it would provide an additional 30g Carbs 1.3g 0.9g of carbohydrate. (of which 0.4g 0.26g Ingredients – Serves 4 Adults or 6 sugars) children Fat 10.9g 7.25g •• 2 ripe avocados, peeled and stones This recipe is intended to serve 4 adults, removed or 6 average child size portions depend- •• 390g/14 oz of skinless and boneless •• While that’s cooking, chop the avoca- ing on the age and activity levels of the chicken fillets, around 3 fillets dos into small cubes child. Talk to your dietitian or diabetes •• 1 tablespoon of olive oil •• Mix the olive oil and pepper together care team about your child’s individual •• 1 handful of chopped fresh parsley with a fork nutritional needs. •• Freshly ground pepper to taste. •• Remove the chicken and cut into strips NB – bread or potatoes will add to the Method •• Serve in a salad bowl with the avocado total carbohydrate of your meal and so •• Cook the chicken under a grill or non- •• Drizzle the oil on top and garnish with will affect blood glucose readings. stick pan the parsley according to taste. Source: safefood www.safefood.eu
Fruit flan
This fruit flan is a nice dessert to share as Filling a treat with family and friends at a get •• 1 x 227g/8 oz tin of fruit cocktail – Nutrition per portion together or meal. canned in juice not syrup Typical Per adult Per child Carbohydrate: This recipe uses caster •• 1 x 23g/1 oz sachet of quick-set jelly values portion portion sugar, remember a small amount of crystals (133g) (88.6g) sugar is fine as part of a healthy bal- •• 1 x 170g/6 oz carton of single cream Energy 186 calories 124 anced diet for people with diabetes. •• Water for jelly, around 425ml/¾ pint value Ingredients – serves 8 adults or 12 Method Protein 4.9g 3.2g children •• Preheat the oven to 200°C/400°F/Gas Flan case mark 6 Carbs 27.3g 18.2g
•• 85g/3 oz of plain, white flour •• Place sugar in a bowl and whisk (of which 20g 13.3g •• 85g/3 oz of caster sugar together with eggs over a pan of hot sugars) •• 3 medium eggs water for 10 minutes. Remove and Fat 6.2g 4.1g continue whisking for 5 minutes. •• Gently fold in sieved flour, in about 4 This recipe is intended to serve 8 adults, lots or 12 average child size portions depend- •• Pour mixture into a greased and ing on the age and activity levels of the
DIABETES IRELAND floured flan tin child. Talk to your dietitian or diabetes care team about your child’s individual •• Bake in a preheated oven for around nutritional needs. 20 minutes •• Dissolve jelly and leave in a cool place. Do not allow to set •• Allow jelly to set, whip the cream and •• Drain the tin of fruit decorate the flan by piping the cream •• When flan case is cooled, arrange fruit around it.
SUMMER 2016 on top and cover with jelly Source: safefood www.safefood.eu
28 SUPPORTING DIABETES IRELAND
Pictured above is Isabel Bennett, who recently undertook the Swim For A Mile Challenge and fundraised for Type 1 Research through her exploits. Pictured accepting the cheque for €507 is Pauline Dunne, our Western Regional Officer
Pictured above are the extended O’Shea family from Pictured left is John Butler, who Killorglin, Co Kerry along with Pauline Lynch, our undertook a 100km cycle in Southern Regional Officer, at the handover of a fun- the past couple of weeks and draising cheque for €10,752. The family organised a raised over €330 in aid of Type Christmas Day Dip in the Atlantic on Cromane Beach 1 research. John undertook in memory of family member Denis, who tragically this cycle as he had been reg- passed away last August at the young age of 27. istered for our City to Seafield The family were overwhelmed by the support of the Cycle which unfortunately had local community which saw over 100 locals take to be cancelled due to low the plunge in the icy ocean with equal numbers of registration numbers but still onlookers. They directed their fundraising towards wanted to show his support to Type 1 research and our Teen/Children’s activities the cause
TEAM Diabetes Ireland needs YOU this year!
Are you undertaking any challenges this summer such as Road Races, Cycle Sportifs, Triathlons, Mud Runs or even YOU choose which area a Skydive? Why not use your participation to fundraise your fundraising is to be for us and join the hundreds of people annually who do directed towards: likewise and become part of TEAM Diabetes Ireland... • Type 1 diabetes research • Type 2 diabetes research Or how about the big challenge of the Dublin Marathon • Education and support services 2016!!! As part of the Ireland 2016 Centenary Programme • Teen Activity Day and the 2016 SSE Airtricity Dublin Marathon will present all Sweetpea Kidz Club finishers with a special commemorative medal while • 2015/16 Type 2 Online the marathon course route will take in many iconic sites Education Programme associated with the 1916 Rising including Kilmainham • 2015/16 Type 1 GP Awareness Gaol. DIABETES IRELAND Initiative • Cork Care Centre Contact Gary on Tel: 01 842 8118 or Email: [email protected] to receive your fundraising pack today! SUMMER 2016
30 BRANCH NEWS: WEST
Sligo Rovers score with kids in Sligo/Leitrim Sligo/Leitrim children and teenagers with Everyone was made to feel very wel- the children and teenagers. The event Type 1 diabetes were very excited to train come by the players and staff at Sligo was organised by Sligo/Leitrim Parents with Sligo Rovers footballers on Tuesday Rovers, who gave up their time to Support Group and supported by the 26 April at the showgrounds. share their skills and knowledge with Diabetes team at Sligo General Hospital.
Nutrition talk goes down well in Limerick
The Limerick Type 1 Diabetes Support content of food products. All who
DIABETES IRELAND Group recently invited Sinead Delaney, attended found the talk very helpful Dietitian, to give a talk to parents and and informative. Our sincere thanks children about healthy eating habits to Sinead Delaney and the Limerick and healthy lunches to balance blood Diocesan Centre for making this glucose levels. The talk was extremely event worthwhile. The Limerick Type 1 helpful and highlighted hidden facts Diabetes Support Group can be con- to the parents and children about the tacted at [email protected]. SUMMER 2016
32 BRANCH NEWS: WEST
Families rock on while hill walking in Leitrim The Sligo/Leitrim parents support group held a very successful day out at Eagles Rock North Leitrim, recently
Pauline Cooney Golf Classic raises €2,000 for Diabetes Ireland
The family of the late Pauline Cooney Sixmilebridge. (nee O’Grady) of Shannon, Co Clare The cheque for and Mungret, Co Limerick recently pre- €2,000 was pre- sented a cheque to Diabetes Ireland sented by Pauline’s (Clare Branch). Pauline, who had dia- son Thomas to Gerry betes, passed away on St Patrick’s Day Cooney (who also has 2014. diabetes) on behalf
DIABETES IRELAND This is the second year the family has of the Clare Branch made a donation to Diabetes Ireland in of Diabetes Ireland. her memory. The Clare branch are The money was raised by holding a hugely appreciative
Golf Classic with her family and friends of this large donation Michael O’Grady, PJ Phelan and Mike O’Grady who were on and from some donations. The Golf from the Cooney and the winning team at the Pauline Cooney Memorial Golf Classic Classic was held in Walton Lodge, O’Grady families. held recently SUMMER 2016
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Hello everyone! Summer is almost here and we bet he has bright coloured patches on all you are all looking forward to your the parts of his body he has to test summer holidays! and inject himself. We would love to We had a great time with lots of know how Rufus is settling into his the Sweetpea families at our annual new homes – please do share your weekend trip to Trabolgan in April. stories and photos with us! Well done to everyone for taking A BIG thanks to all the SweetPea part in the activities and workshops. Volunteers for coming along once We hope you all enjoyed it as much again and helping out with the as we did. activities and workshops. We didn’t get much sunshine this We’ll be in touch soon with details year but there was lots of fun plant- of our next event, the summer ing sweetpea seeds and decorating picnic! If you are not a member and the plant pots, face painting, arts would like to find out more about MEET THE and crafts, playing games in the the Sweetpea Kidz Club please con- SWEETPEA! sports hall, bouncing on trampolines tact the Diabetes Ireland office on and up in the jungle gym. Tel: 1850 909 909. We took a moment to get to know a We were delighted to have a If have any suggestions for future couple of our Sweetpea’s a little better special gift from JDRF for all the chil- events, or have a story or joke you over the weekend in Trabolgan with a dren with diabetes – Rufus the Bear. would like to share on this page you quick fire question round. We’ll intro- Rufus the bear also has Type 1 diabe- can email the committee at Email: duce you to a few each issue. tes. He’s a very special bear because [email protected]
James is 9 years old and is in 3rd class at school in Co. Laois. He has had Type 1 diabetes for 6 years, uses an insulin pump and a dexcom continuous glu- cose monitor. James what do you want to be when you’re older? A goalkeeper What’s your favourite hobby? Football. Favourite snack? Crisps and diet coke What’s your favourite subject at school? I’m best in my class at maths and I’m good at Irish Name a country you have visited? Belgium, Portugal, Majorca and Spain Tell me a joke
DIABETES IRELAND Why did the cow go the cinema? He wanted to go to the mooooovies! SUMMER 2016
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MEET THE SWEETPEA!
Darragh is 8 years old, he is in 1st class and comes from Abbeyfeale in Co Limerick. He was diagnosed with Type 1 diabetes about 1 and a half years ago. Darragh takes insulin injections and uses a dexcom continuous glucose monitor. Darragh what would you like be when you’re older? A barber What’s your favourite sports? Soccer, Gaelic football and basketball Do you have a favourite snack? Maltesers What’s your favourite subject at school? Maths What are the best and worst things about having diabetes? I like that I get sweets and Lucozade when I’m low. Tell me a joke Why didn’t the lamp work? It had no bulb.
PHONE: 1850 909 909 EMAIL:
[email protected] DIABETES IRELAND SUMMER 2016
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