Innholdsfortegnelse for July - August 2019 i Diabetic Living Australia

Dr Kate Marsh Dietition & diabetes educator Kate, who has type 1, is in private practice in Sydney: drkatemarsh.com.au Christine Armarego Exercise physiologist At her clinic, Christine focuses on exercise as a way to improve BGLs: theglucoseclub.com.au Dr Sultan Linjawi Endocrinologist A diabetes specialist, Sultan has a clinic in Coffs Harbour, NSW: drsultanlinjawi.com Dr Janine Clarke Psychologist Janine is in private practice at Mend Psychology and The Sydney ACT Centre: mendpsychology.com.au Rachel Freeman Diabetes educator Rachel also works at the Australian Diabetes Educators Association: adea.com.au. Dr Gary Deed General practitioner Gary, who has type 1, is devoted to helping people with diabetes. He is in practice in Brisbane. Danielle Veldhoen Podiatrist Danielle works at Flinders Medical Centre, South Australia. Dr Angus Turner Ophthalmologist Angus directs Lions Outback Vision, providing specialist…

DIABETES 101 Getting your head around "diabetes lingo"? Read on… • When should I test my blood glucose levels (BGLs)? This varies depending on the type of diabetes and your medication, but possible times include before meals, two hours after eating, before bed, before you exercise and if you’re feeling unwell. • What should my BGLs be? As a guide, if you have type 1 diabetes, a healthy target to aim for is 4-6mmol/L before you eat, and 4-8mmol/L two hours after starting a meal. If you have type 2 diabetes, aim for 6-8mmol/L before meals, and 6-10mmol/L two hours after starting a meal. Ask your doctor or Credentialled Diabetes Educator for more guidance. • What’s mmol/L? It stands for millimoles per litre of blood, and is how BGLs are…

My doctor says it is my heart he is most worried about, not just my glucose levels. Is this true? Gary says: Your doctor is acutely aware having all forms of diabetes can unfortunately lead to early onset heart disease, compared to people without diabetes. Heart disease and stroke are four times more likely with diabetes, but the important thing is it is not always inevitable and there is lots that can be done to prevent these things occurring. This is why many people are often prescribed cholesterol-lowering and blood-pressure medications to help reduce risks. Staying a healthy weight, and being physically active your whole life can only help and, of course, seek help if you are smoking, to stop. Keep your regular appointments with your GP or specialist and…

LC MONDAY TURKEY PATTIES WITH GREEK SALAD You don’t need bread for a good burger. see recipe, page 23 NUTRITION INFO PER SERVE 1990kJ, protein 40g, total fat 21g (sat. fat 6g), carbs 26g, fibre 8g, sodium 731mg• Carb exchanges 1½• GI estimate low• Lower carb GFO LC TUESDAY SOY ROASTED ASIAN GREENS AND SALMON Add vibrant new flavour to your favourite fish. see recipe, page 23 NUTRITION INFO PER SERVE 2080kJ, protein 46g, total fat 21g (sat. fat 6g), carbs 25g, fibre 14g, sodium 620mg• Carb exchanges 1½• GI estimate low • Gluten-free option• Lower carb How our food works for you see page 86 On a chilly night, warm up the family with a hearty serve of soup GFO LC WEDNESDAY CAULIFLOWER, LEEK AND CHEDDAR SOUP Spuds and other vegies…

GFO LC BEEF PHO For a healthy, warming dish, it’s hard to go past a tasty, spicy pho. see recipe, page 63 PER SERVE 1180kJ, protein 26g, total fat 7g (sat. fat 2g), carbs 26g, fibre 6g, sodium 713mg• Carb exchanges 1½• GI estimate low • Gluten-free option• Lower carb How our food works for you see page 86 GFO LC SWEET CORN AND CHICKEN SOUP There’s a good reason this is the grandmothers’ cure for what ails you. see recipe, page 63 NUTRITION INFO PER SERVE 1130kJ, protein 21g, total fat 7g (sat. fat 1g), carbs 27g, fibre 10g, sodium 274mg• Carb exchanges 2• GI estimate low • Gluten-free option• Lower carb GFO LC CREAMY CHICKPEA AND PUMPKIN SOUP PREP TIME: 20 MINS (+ OVERNIGHT SOAKING) COOK TIME: 1 HOUR SERVES…

Our skin, which is our largest organ, is at the mercy of numerous influences, from diet and lifestyle to dehydration and sun exposure. Luckily, there are several complexion-saving steps we can take to stave off premature ageing, boost elasticity and stay protected from UV damage. Base your diet on low-GI foods, healthier fats and plenty of brightly coloured fruit and veg, and you’ll be giving your skin plenty of nourishment. LEMON MARJORAM SARDINES WITH WALNUT & PEPPER DRESSING PREP TIME: 25 MINS (+ OVERNIGHT SOAKING) COOK TIME: 10 MINS SERVES 2 (AS A LIGHT MEAL) 6 walnut halvesJuice and zest 1 lemon2 cloves garlic6 butterflied sardines (ask your fish shop to do it for you), thawed if frozenFreshly ground black pepper2 tsp marjoram or oregano, plus a few extra leaves…

LC CREPES WITH YOGHURT, FRUIT AND MAPLE SYRUP Satisfy a pancake craving with this lighter option see recipe, page 77 NUTRITION INFO PER SERVE 956kJ, protein 10g, total fat 8g (sat. fat 1g), carbs 24g, fibre 6g, sodium 44mg• Carb exchanges 1½• GI estimate medium• Lower carb LC CAULIFLOWER AND PARMESAN FRITTERS WITH ROASTED TOMATOES Instead of hash browns, try this scrumptious version see recipe, page 78 NUTRITION INFO PER SERVE 1040kJ, protein 14g, total fat 11g (sat. fat 4g), carbs 18g, fibre 8g, sodium 243mg• Carb exchanges 1• GI estimate low• Lower carb How our food works for you see page 86 GF LC MUSHROOM, CORN AND PARMESAN OMELETTE It’s the go-to family favourite with a twist see recipe, page 78 NUTRITION INFO PER SERVE 1720kJ, protein 27g, total…

1 The number of Australians living with diabetes has tripled since 1990. That makes it the nation’s fastest-growing chronic condition and the biggest challenge facing Australia’s health system. 2 About 280 Australians develop diabetes every day. That’s roughly one person every five minutes. In total, 1.7 million Australians have diabetes. About 85-90 per cent of them have type 2, while 10 per cent have type 1. 3 Indigenous Australians are almost four times as likely to have diabetes. They’re also at a significantly greater risk of diabetes-related complications, with a 10-fold higher risk of kidney failure and an eight-fold higher risk of high blood pressure. 4 For every four adults in Australia who have been diagnosed with diabetes, there’s another person living with it, undiagnosed. Yet only 5 per cent of Australians…

Worried about winter weight gain? Colder temperatures and more time indoors can provide a good excuse to eat more and move less, with the potential to add a few kilos during the season. If you have a history of gaining weight at this time of year, the good news is there are things you can do to avoid it. Before we talk about how, though, it can help to understand the reasons why we might gain weight during the colder months. • We move less. Unless you’re an avid skier and migrate to the snow come winter, chances are you’ll be moving less once the temperature drops. Not only are the days shorter, colder weather also makes it easier to hit the snooze button in the morning, rather than heading…

It can be exciting, it can be daunting, it can turn your life around or possibly upside down. There are many ways a new job can affect you, but all of them will require you to pay close attention to your management of diabetes. In April I began co-hosting a breakfast radio show out of Gosford on radio station 107.7 2GO. It’s a heap of fun but has presented some time, diet and schedule-managing issues to which I have slowly adjusted but am yet to get close to perfect. Initially, I starved myself from 3.30am until show finish at 9am, with a couple of coffees to prop myself up. This was because I wasn’t sure how much time, if any, I would have to eat as needed. I avoided an…

Have you been hearing lots of people talking about eating a lower-carb diet? I know I have. It seems to be everywhere on Facebook and in various forums. But what does that actually mean? There’s no real definition of ‘low carb’, so the concept is open to interpretation. Australian Dietary Guidelines recommend getting 45-65 per cent of your daily energy from carbs, with a minimum of 130g per day to ensure healthy function of the energy and nervous systems. This issue we’ve pulled together recipes and menu plans that aim to hit that 130g mark while still providing loads of flavour and all the nutrition you need. Just remember, though, that everyone is different and a diet that works for one person might not be optimal for another. Our advice…

It's my sweet tooth! It’s not that simple. While type 1 is triggered by genetics and unknown factors, type 2 is caused by a mix of genetics and lifestyle factors. One of those is being overweight, but it’s not just sugar that causes that. Plus, if you are overweight, that’s only a risk factor, not a direct cause of type 2. No more chocolate! False. As long as chocolate, or other foods containing added or natural sugars, are eaten as part of a healthy meal plan or combined with exercise, people with diabetes can definitely still enjoy them in moderation. Talk to your GP or dietitian for more info. Ugh. A ‘special diet’ Not really. These days ‘healthy eating’ for people who have diabetes is no different to the ‘healthy…

I feel like diabetes is really hard work and I’m just not coping. It’s getting on top of me and I feel angry about it. Is this normal? Rachel says: This can be a normal part of dealing with the day-to-day management of diabetes. Because diabetes is a chronic condition, meaning it is long-term, it can feel like a burden. There is a common condition called ‘diabetes distress’ and health professionals are on the lookout for this with their patients who have diabetes. There is help available and it is highly encouraged that you speak to your health professional about how you are feeling. It is important to find a health professional who has the time to listen, so you can share your concerns and feelings and discuss ways to…

Is it really that important to take my pain medication exactly as it’s prescribed? Yes. When selecting a pain reliever, your GP or pharmacist will always consider whether it’s the safest and best choice for you, and whether it’ll work well for the type of pain you’re experiencing. However, ensuring you benefit as much as possible from that careful consideration relies on taking your pain medication according to the directions, regardless of whether it’s medication that’s available for purchase over the counter or on a prescription-only basis. This will ensure you get the most out of your pain relievers. Take your pain medication according to the directions Your TerryWhite Chemmart pharmacist will always provide you with specific advice and instructions, but if you don’t understand it or are confused about…

GFO LC INDIAN-STYLE FISH CURRY An all-time fave with lots of flavour and punch, this curry will surely warm your heart. see recipe, page 32 NUTRITION INFO PER SERVE 1610kJ, protein 39g, total fat 15g (sat. fat 7g), carbs 18g, fibre 11g, sodium 710mg• Carb exchanges 1• GI estimate low • Gluten-free option• Lower carb How our food works for you see page 86 GF LC ROASTED WINTER VEGIE SALAD Don’t banish salads to spring and summer; roast them up to enjoy all year round. see recipe, page 32 NUTRITION INFO PER SERVE 1640kJ, protein 15g, total fat 23g (sat. fat 7g), carbs 26g, fibre 9g, sodium 300mg• Carb exchanges 1½• GI estimate low• Gluten free• Lower carb LC CHICKEN WITH CREAMY CRANBERRY SAUCE AND ROASTED VEGIES Packed with lots of protein, this…

CHICKEN, SPINACH AND CAULIFLOWER PIES PREP TIME: 20 MINS COOK TIME: 1 HOUR 10 MINS SERVES 6 (AS A MAIN) 1 tsp olive oil1 large brown onion, finely chopped200g mushrooms, sliced2 cloves garlic, crushed500g chicken breast fillet mince2 Tbsp salt-reduced gravy powder400g can no-added-salt crushed tomatoes1 Tbsp Worcestershire sauce250ml (1 cup) water2 zucchinis, coarsely grated2 sticks celery, finely chopped120g baby spinach leaves750g cauliflower, cut into small florets500g Spud Lite Potatoes, chopped1 Tbsp light margarine60g (½ cup) grated reduced-fat cheddar30g (¼ cup) finely grated parmesanFreshly ground black pepper, to serveFinely chopped flat-leaf parsley, to serve 1 Heat the oil in a large non-stick frying pan over medium heat. Add the onion, mushrooms and garlic. Cook, stirring occasionally, for 7-8 minutes or until onion softens. Increase heat to high. Add mince and…

GFO LC SPINACH AND CREAM CHEESE DIP see recipe, page 64 NUTRITION INFO PER SERVE 385kJ, protein 7g, total fat 3g (sat. fat 1g), carbs 8g, fibre 4g, sodium 186mg• Carb exchanges ½• GI estimate medium • Gluten-free option• Lower carb How our food works for you see page 86 GF LC KALE CHIPS see recipe, page 64 GFO LC CURRIED TUNA AND CUCUMBER BITES see recipe, page 65 LC SALMON AND ROCKET MUFFINS see recipe, page 64 GF LC BEETROOT, ORANGE AND GINGER JUICE see recipe, page 65 GFO LC SPICY POPCORN see recipe, page 65 SPINACH AND CREAM CHEESE DIP PREP TIME: 20 MINS (+ 4 HOURS CHILLING) COOK TIME: 15 MINS SERVES 6 (AS A SNACK) ½ tsp olive oil1 small brown onion, finely chopped1 clove garlic,…

Wholegrains are an important component of a healthy diet as they provide a chunk of our daily fibre intake and a good mix of the vitamins and minerals required for good health. Bread and wraps are a great way to help you reach the daily recommended target of 48g wholegrains per day. If you are looking for a lower-carb bread or wrap, look for one that meets the following criteria, and check out our selection of favourites. LOWER-CARB BREAD • Less than 10g carbohydrate per slice• At least 7g fibre per 100g• No more than 400mg sodium per 100g LOWER-CARB WRAP • Less than 18g carbohydrate per wrap• At least 7g fibre per 100g• No more than 550mg sodium per 100g…

Amputation in Australia is the second-highest rate in the developed world. But why is it happening? What is the reality of life as an amputee? How can you avoid becoming another statistic? We’ve got the answers for you. “I used to think having diabetes was like having a cold – a bit annoying, a bit inconvenient, but nothing too serious,” says 53-year-old Rod Winton from his home in Perth. “That was until I had to have some toes amputated from my right foot four years ago. I was dumbfounded. I couldn’t believe it was all happening as a result of my diabetes.” Diagnosed 10 years ago with type 2, Rod suffered another blow at the start of 2018: now his left foot was under siege. “I went to bed one…

When you have diabetes, you may be focused on managing your BGLs. But it’s important to also think about keeping your heart healthy. Over time, high BGLs can damage blood vessels and the nerves that control them, so people living with diabetes have an increased risk of heart disease and stroke, explains Dr Clyde Yancy, chief of cardiology at Northwestern University and a spokesperson for the American Heart Association. But, even when you have diabetes, heart disease isn’t inevitable, and there’s a lot you can do to lower your odds, says Dr Yancy. Focus on these areas for a healthier heart. Heart-Healthy Numbers You probably already know your HbA1c and what your goal range should be. But keep an eye on blood pressure and cholesterol numbers, too. Diabetes Australia recommends…

Beginning in the serene and secluded Chinese Garden of Friendship on the edge of Darling Harbour, you will find yourself surrounded by waterfalls, lakes, exotic plants, stunning pavilions and hidden pathways. Symbolising the friendship between Sydney and Guangzhou in China, the garden holds the five elements: wood, fire, earth, metal and water. Focus on your breathing and rid yourself of any stress that may be building up, so you can enjoy the walk ahead of you. When you’re ready, turn right as you exit the garden and make your way through Darling Harbour towards Cockle Bay (when you hit the water make sure you go to the right of the bay to continue on this walk). You’ll find yourself walking under the heritage-listed swing bridge crossing Cockle Bay. Known as…

We’d love to hear from you! We want to hear your stories, answer your questions and share the love with other readers. Email us at diabeticliving@pacificmags.com.au READER ENQUIRIES diabeticliving@pacificmags.com.au OR (02) 9394 2350 SUBSCRIPTION ENQUIRIES subscriptions@pacificmags.com.au OR 1300 668 118 Diabetes Australia and JDRF are proud to support Diabetic Living. While all care has been taken in the preparation of the articles in this magazine, they should only be used as a guide, as neither Pacific Magazines nor Diabetes Australia is able to provide specific medical advice for people with diabetes or related conditions. Before following any health advice given in this magazine, please consult your healthcare professional. Recipes that are gluten free or have gluten-free options have been approved by Coeliac Australia.…

1 YOU’RE NOT ALONE About 280 Aussies develop diabetes every day – one person every five minutes. And for every four people diagnosed, someone else is living with diabetes but doesn’t know. The longer diabetes goes undiagnosed, the more it can impact your overall health. 2 IT'S YOUR MOVE Continuing or starting regular physical activity will help lower your short- and long-term BGLs and can also help certain diabetes medications work more effectively. Plus, along with a healthy diet, losing weight – as little as 5 per cent of your body weight – can also have a positive impact. 3 WE’RE HERE Wondering where to start? Combined with advice from your healthcare team, you’ve made a great first step. In this (and every!) issue of Diabetic Living, you’ll find practical,…

I have some hard lumps on my stomach from injecting insulin and I have been told not to inject there anymore. Will the lumps go away and when can I start using those areas again? Sultan says: The medical term for these fatty lumps is Lipohypertrophy and is something that, unfortunately, is pretty common, but is usually avoidable if you rotate injection sites and don’t repeatedly use one area to inject. The reason this condition is problematic is that if insulin is injected into a lumpy scarred area it may not be absorbed in the same way each time (either too slowly or too fast) and this can lead to real problems with blood sugars. The best treatment is to leave these areas completely until they have gone, which can…

Apart from pain medication, what else can I do to help manage or alleviate chronic pain? Many factors can contribute to the ‘pain experience’, such as stress, your environment or an injury. A multimodal approach to pain means addressing these factors, and this involves seeing a range of professionals who specialise in different aspects of pain care. For example, a psychologist can help support the way we think about pain, a pharmacist will assist with pain relief medications, and a physiotherapist can help plan an exercise program. Together, these methods can improve pain more efficiently and effectively than any one of them used on its own. As a first step, check out TerryWhite Chemmart’s Pain Information Hub (terrywhitechemmart.com.au/pain). You’ll find information and resources from our pharmacists and allied health professionals,…

GF LC TANDOORI CHICKEN Spice up dinner with this zesty dipping dish. see recipe, page 38 NUTRITION INFO PER SERVE 1920kJ, protein 61g, total fat 17g (sat. fat 5g), carbs 10g, fibre 8g, sodium 271mg• Carb exchanges ½• GI estimate low• Gluten free• Lower carb GF LC VEGIE MEATBALLS WITH TOMATO COURGETTI Boost your daily fibre requirements by more than 40 per cent. see recipe, page 39 NUTRITION INFO PER SERVE 1230kJ, protein 15g, total fat 11g (sat. fat 2g), carbs 27g, fibre 13g, sodium 106mg• Carb exchanges 2• GI estimate low• Gluten free• Lower carb How our food works for you see page 86 SIMPLE SEAFOOD STEW PREP TIME: 10 MINS COOK TIME: 25 MINS SERVES 2 (AS A MAIN) 1 Tbsp olive oil1 tsp fennel seeds2 carrots, finely chopped2 sticks…

LAMB CUTLETS WITH MINTY BROAD BEAN MASH Here is your meat and greens with a difference. see recipe, page 57 GF LC NUTRITION INFO PER SERVE 1290kJ, protein 25g, total fat 19g (sat. fat 5g), carbs 8g, fibre 6g, sodium 32mg• Carb exchanges ½• GI estimate medium• Gluten free• Lower carb How our food works for you see page 86 GF LC ITALIAN-STYLE SALAD WITH CRISP PANCETTA Summer on a plate, even in winter. see recipe, page 57 NUTRITION INFO PER SERVE 990kJ, protein 13g, total fat 16g (sat. fat 4g), carbs 6g, fibre 5g, sodium 642mg• Carb exchanges ½• GI estimate low• Gluten free• Lower carb Bocconcini is easy to prep and makes a tasty topper for salads GF LC SPINACH, CAPSICUM AND BOCCONCINI SALAD A quick dish with heaps of…

GF LC SOFT MERINGUES WITH POACHED STRAWBERRIES With very little fat, this is a yummy winner. see recipe, page 72 NUTRITION INFO PER SERVE 330kJ, protein 4g, total fat 1g (sat. fat 0g), carbs 14g, fibre 2g, sodium 55mg• Carb exchanges 1• GI estimate medium• Gluten free• Lower carb GFO LC CAPPUCCINO-STYLE JELLIES Offer your guests an intriguing twist on after-dinner coffee. see recipe, page 72 NUTRITION INFO PER SERVE (with sugar) 311kJ, protein 7g, total fat 0g (sat. fat 0g), carbs 12g, fibre 0g, sodium 69mg• Carb exchanges ½• GI estimate medium • Gluten-free option• Lower carb PER SERVE (with sugar substitute) 223kJ, protein 7g, total fat 0g (sat. fat 0g), carbs 7g, fibre 0g, sodium 69mg• Carb exchanges ½• GI estimate low • Gluten-free option• Lower carb How…

HERMAN BROT MISSION DL loves BAKERS LIFE SIMSON’S PANTRY DL loves BARLEY+ BURGEN ABBOTT’S VILLAGE BAKERY HELGA’S…

Our Nutrition Info boxes sit alongside each recipe. Use them to track your nutritional requirements, as well as count carbs, carb exchanges and find out whether a recipe is low-, medium- or high-GI, or gluten-free. Easy! BEEF PHO see recipe, page 47 GF LC NUTRITION INFO PER SERVE 1180kJ, protein 26g, total fat 7g (sat. fat 2g), carbs 26g, fibre 6g, sodium 713mg• Carb exchanges 1½• GI estimate low• Gluten-free• Lower carb Serves 2 (as a main) We show you whether a food is designed to be a between-meals snack, breakfast, lunch (a lighter main) or dinner (the main meal of the day). When we say, “as an occasional dish”, it should only be eaten as a treat, such as once a fortnight. Brand names We often use product names…

Living with diabetes isn’t always smooth sailing; it can be challenging and you may feel as though you are going off course at times. Here are some simple tips on how you can live a more balanced lifestyle. QUICK TIP PREPARATION IS KEY. DON’T GET CAUGHT OUT – CARRY A SNACK WITH YOU WHEREVER YOU GO! 1. GET MOVING Exercise plays an important role in managing diabetes. Don’t make exercise a chore, make it something you enjoy. Some ideas are taking a walk outside, or participating in dancing lessons or yoga. 2. SUPPORT NETWORK Surround yourself with like-minded individuals who will help you stay on track. They can help keep you motivated and provide new tips and advice when times get tough. 3. HEALTHY EATING A healthy diet is crucial…

“I was sick for what felt like forever, and I wasn’t getting better,” explains Kate. Her mum, Karan, first took her to the paediatrician, just after Christmas 2016, when the then 12-year-old was sent home with the flu. A second trip to the doctor led to a diagnosis of pneumonia and Kate was put on antibiotics. During this time, she missed a lot of school and dance, had zero energy, was constantly thirsty and went to the bathroom more than usual. However, it wasn’t until her vision blurred and she began vomiting that her parents really started to worry, insisting on blood tests after the third doctor’s visit. One hour after the test, they received the call to take Kate to the emergency room at their children’s hospital in Ottawa,…

BEFORE EXERCISE At rest, two hormones from your pancreas – insulin and glucagon – play opposing roles to keep your blood glucose stable: insulin moves sugar into your cells and glucagon shuttles sugar out of your cells. After you eat, sugar and other nutrients are released into your blood from your intestines. Insulin levels rise to move that sugar into your cells, including muscle and liver cells, to be used or stored. Between meals, glucagon levels rise to maintain your BGLs by releasing that stored glucose back into your bloodstream – preventing lows. DURING EXERCISE THE WARM-UP It’s time to get your heart pumping. As you start to move, your muscles use their own stored sugar as well as sugar from the bloodstream to make an energy compound (called ATP)…

Dancing is a way to break out of your daily rhythms and let loose. Many people dance because it feels good – it can boost your energy levels and improve your mood. But it’s also exercise in disguise. “Enjoy the movement for fun, and fitness will be your reward,” says Mary E. Sanders, a registered clinical exercise physiologist who helped create this dance series. Music to our ears! Dancing is a full-body workout that’s been shown to improve fitness and lower blood pressure and fasting triglyceride levels. Learning new movements can teach your body to respond faster to “surprises” such as trip hazards, by creating brain-muscle memories that enhance balance, adds Sanders. But what if you think you can’t dance? “Dancing isn’t about perfection, it’s about being true to yourself…