Innholdsfortegnelse for September - October 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…

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…

How can I cope with all these extra medications to help manage my diabetes – it’s getting to be a burden Gary says: Diabetes can feel more of a burden, especially for the sheer number of things to manage. Between monitoring glucose and seeing health professionals, it can seem like a lot. This is called diabetes distress. There are ways of reducing the medication burden. You can buy medication where two drugs are put together in the same tablet, or buy slow-release medications – meaning the number of tablets needed daily is less. There have been recent developments of weekly injectable medication for type 2 that may help offset the need for daily injections. For type 1, insulin pumps are sophisticated enough to help replace multiple daily injections as well.…

What’s the best way to work out whether I might need to lose some weight? Should I jump on the scales, calculate my BMI or take my waist measurement? There are a lot of helpful tools available, and it can be confusing knowing what they all mean and how they’re different. Your Body Mass Index, or BMI, is a calculation based on your weight and your height, and is one way to determine whether you’re at a healthy weight and, by extension, if you’re at a higher risk of certain diseases. But it doesn’t take age, ethnicity, gender or body composition into account, so on its own, doesn’t necessarily provide a complete picture of how your weight may be affecting your health. Waist circumference is a simple check you can…

GFO THAI PRAWN AND GINGER NOODLES You’ll be eating in no time with this quick, tasty dish see recipe, page 31 NUTRITION INFO PER SERVE 2000kJ, protein 29g, total fat 12g (sat. fat 2g), carbs 57g, fibre 10g, sodium 585mg • Carb exchanges 4 • GI estimate low • Gluten-free option GF MALAY CHICKEN CURRY WITH YELLOW RICE A family-sized dinner full of warming spices. see recipe, page 31 NUTRITION INFO PER SERVE 2440kJ, protein 54g, total fat 19g (sat. fat 5g), carbs 44g, fibre 8g, sodium 292mg • Carb exchanges 3 • GI estimate medium • Gluten free GF MASALA CHICKPEAS WITH SPINACH A perfect meat-free dish for two. see recipe, page 32 NUTRITION INFO PER SERVE 2020kJ, protein 17g, total fat 15g (sat. fat 2g), carbs 59g, fibre…

WARM KALE SALAD WITH ALMONDS & PROSCIUTTO PREP TIME: 15 MINS COOK TIME: 20 MINS SERVES 2 (AS A LIGHT MEAL) 2 eschalots, thinly sliced into rounds1 tsp olive oil2 Tbsp whole blanched almonds Good pinch sweet smoked paprika200g kale, large inner stalks removed, leaves roughly chopped4 sticks celery, thinly diagonally sliced 2 thin slices prosciutto, cut lengthways into strips15g shaved parmesan GFO LC NUTRITION INFO PER SERVE 1340kJ, protein 11g, total fat 18g (sat. fat 4g), carbs 18g, fibre 5g, sodium 563mg • Carb exchanges 1 • GI estimate low • Gluten-free option • Lower carb Dressing 2 Tbsp sherry vinegar2 tsp extra virgin olive oil2 tsp Dijon mustard or gluten-free mustard1 tsp caster sugar Freshly ground black pepper2 Tbsp raisins 1 Preheat oven to 180°C (fan-forced). Line a…

PEPPER The perfect flavour addition when trying to minimise salt intake. TURMERIC Is an antiinflammatory and may be useful for those suffering from excess wind. LIME Contains flavonoids that stimulate secretion of digestive juices. GINGER inger may help soothe the stomach and reduce nausea, and aid digestion by stimulating saliva and bile production. INDIAN SPICED CHICKEN WITH PUMPKIN & BEANS PREP TIME: 15 MINS (+ 30 MINS MARINATING) COOK TIME: 40 MINS SERVES 2 (AS A MAIN) 150ml Jalna Sweet & Creamy Greek Yoghourt1 Tbsp finely grated ginger1 tsp ground cumin½ tsp ground turmeric250g skinless chicken thigh fillets, trimmed of fat, cut into big chunks Freshly ground black pepper200g butternut pumpkin, unpeeled, seeds removed, cut into bite-sized chunks2 tsp olive oil2 red onions, halved, thickly sliced1 clove garlic, crushed4 sprigs…

Gut boosting FOODS There is now a wealth of scientific evidence linking a healthy gut with a huge array of positive health outcomes, such as improved mood and mental health, immunity, a healthy digestive system and reduced symptoms related to irritable bowel syndrome (just to name a few!). Our gut is home to trillions of good bacteria that play an integral part in digesting our food and promoting a healthy body. Sometimes due to illness, taking a course of antibiotics or eating poorly, our gut bacteria balance can be disturbed and can negatively impact other aspects of our health. Probiotics are live bacteria found naturally or added to some foods. By regularly eating probiotic-containing foods, you can help restore and balance your gut bacteria to keep your body working the…

The risk of developing diabetic kidney disease grows the longer you’ve been living with diabetes. So, while 10 per cent of people develop chronic kidney disease in the first 10 years after diagnosis, that number rises to between 20 and 30 per cent of those who’ve had diabetes for 20 years. You can’t change how long you’ve had diabetes for, but there are things you can do to avoid becoming a statistic, starting with the following three steps. CONTROL YOUR BLOOD GLUCOSE LEVELS “The biggest single factor that can increase your risk of developing diabetic kidney disease is poor diabetes management,” says Bancroft. “Keeping your blood glucose levels and HbA1c within target, together with eating healthily, doing some regular physical activity and taking your diabetes medications as prescribed, is vital…

From the 5:2 diet to 16:8 and alternate-day fasting to the Warrior Diet, intermittent fasting is quickly becoming the latest dietary trend. But is it really the answer to weight loss and improved health, or just another diet fad? What is intermittent fasting? While there are many different ways to fast, intermittent fasting essentially means fasting for certain periods of time during your day or week. This could be true fasting (consuming nothing but water) or consuming significantly less energy than usual (typically less than 25 per cent of your energy needs) during the fasting periods. Types of intermittent fasting There are three main types of fasting, all of which provide a different means to reducing energy intake. • Periodic fasting involves fasting or eating a very low energy intake…

Have you always been a keen walker? No, it started after my husband Leonard died of lung cancer in 1996. He told me “Now is the time to show your mettle” and I found that really galvanising and poignant. We were always two halves of a whole and both of us worried about what the other would do when one of us died. His death left me with a compulsion to walk. I felt better when I was walking, and the faster I walked the better I felt. It was fantastic therapy while I was grieving, being out in the fresh air. It’s so good for your mental health. Leonard was never a great walker; he was rather slow. I would always take off at a very different clip. Why…

Here at DL HQ we spend a lot of time talking to experts about the best ways to lose weight and also to maintain a healthy weight, which is beneficial in so many ways, whether you have diabetes or not. Two topics that have been much discussed lately are the ketogenic (or ‘keto’) diet and intermittent fasting (or IF). Both promise big results, and there are plenty of Facebook groups to educate and support people who want to make a change. However, instead of relying on social media, we asked Dr Kate Marsh, an Advanced Accredited Practising Dietitian and Credentialled Diabetes Educator, to take a hard look and provide readers with information you can trust. Dr Marsh, who also has type 1, puts IF under the microscope on page 116…

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, helpful…

Can I stop taking my Metformin as my BGLs are now normal and my doctor said at my last appointment they were no longer in the diabetic range? Sultan says: I am often asked this question in my clinics. Metformin belongs to a class of drugs called Biguanides, which work on the liver to release stored glucose more slowly and increase the body’s response to insulin to better control BGLs. It can be used in people with borderline diabetes and we know it prevents people progressing to diabetes. Metformin also has many other potential benefits to your health, including lowering cholesterol levels (LDL) and reducing blood pressure, and may even help prevent certain cancers. So I think you need to consider your goal: is it stopping your medication or having…

ROAST PUMPKIN, FETA AND SPINACH SPIRAL PIE PREP TIME: 20 MINS COOK TIME: 1 HOUR 30 MINS SERVES 6 (AS A MAIN) 1kg peeled and deseeded butternut pumpkin, cut into 3cm pieces3 Tbsp olive oil250g baby spinach leaves200g reduced-fat feta, finely choppedFreshly ground black pepper11 sheets chilled filo pastry50g light margarine, melted, cooled slightly1 egg yolk (from 60g egg)1 Tbsp skim milk1 tsp sesame seeds¾ tsp oregano leaves¾ tsp ground sumac2 cups green salad, per person, to serve 1 Preheat oven to 200°C (fanforced). Line a large baking tray or roasting pan with baking paper. Spread pumpkin over tray. Drizzle over olive oil and toss to coat. Roast at the top of the oven for 50-60 minutes (turning pumpkin after 30 minutes) or until pumpkin is light golden brown and…

GF LC CHICKEN CACCIATORE Skinless chicken is the key to flavours that are still bold, but better for you. see recipe, page 53 NUTRITION INFO PER SERVE 1340kJ, protein 39g, total fat 10g (sat. fat 2g), carbs 7g, fibre 8g, sodium 339mg • Carb exchanges ½ • GI estimate low • Gluten free • Lower carb Hearty dinners can be healthy too! LC LANCASHIRE HOTPOT Lean lamb and lashings of veg make this a perfect spring sensation. see recipe, page 53 How our food works for you see page 79 NUTRITION INFO PER SERVE 1840kJ, protein 34g, total fat 20g (sat. fat 7g), carbs 26g, fibre 9g, sodium 294mg • Carb exchanges 1½ • GI estimate medium • Lower carb SPAGHETTI AND MEATBALLS PREP TIME: 30 MINS COOK TIME: 25…

GFO LC THAI RED VEGIE CURRY Embrace the chillies, then mix and match your favourite vegies. see recipe, page 69 NUTRITION INFO PER SERVE 1280kJ, protein 14g, total fat 15g (sat. fat 6g), carbs 22g, fibre 12g, sodium 487mg • Carb exchanges 1½ • GI estimate low • Gluten-free option • Lower carb How our food works for you see page 79 JAPANESE TOFU NOODLE BOWL Edamame and other Asian ingredients pair perfectly with this meat-free dish. see recipe, page 69 NUTRITION INFO PER SERVE 1540kJ, protein 14g, total fat 16g (sat. fat 5g), carbs 36g, fibre 8g, sodium 410mg • Carb exchanges 2½ • GI estimate low CAPSICUM AND CHEESE QUESADILLA Pack a punch with bright Mexican flavours and chilli. see recipe, page 70 NUTRITION INFO PER SERVE 1340kJ,…

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! 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 to make it easier to find nutritionally suitable brands when shopping. Sugar or sugar substitute In some dishes, you can use either sugar or a sugar substitute. In these cases, we give you the nutrition analysis…

1 See your doctor to review your diabetes medications. If you’re taking insulin or some types of oral medications, a keto diet can increase the risk of hypos and your medication doses will need adjusting. If you have type 1 diabetes, cutting insulin and carbs too much can increase the risk of diabetic ketoacidosis (DKA), so medical supervision is important. Another type of diabetes medication, called sodium-glucose co-transporter-2 inhibitors, or SGLT2i, has also been found to cause DKA in some people, particularly when they restrict their food intake, so you will likely need to stop taking this medication if you adopt a keto diet. 2 Keep a check on your cholesterol levels. Keto diets have been shown to increase levels of the ‘bad’ LDL cholesterol in the blood in some…

1 SPRING FEVER The time has come once again to Marie Kondo your home. But a clean house doesn’t end with making your bed in the morning (although it doesn’t hurt!) – it also includes removing, or minimising, the clutter in your home. Research has found experiences make us happier than material goods. So, rather than keeping endless items you like around the home, only keep those that remind you of special memories, such as a holiday or milestone celebration. While you are decluttering, ensure you vacuum and wipe down rooms, furnishings and items as you go, to reduce pollutants (think dust, mildew and mould) that have built up, especially during the colder months. In doing so, cleaning improves your breathing, decreases your risk of heart disease (cleaning is a…

START HERE 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…

I always start the week with good intentions to eat well, but it all seems to fall apart when I get busy and tired by the end of the week. Do you have any tips to help? Kate says: You are definitely not alone – this is a problem I often see. The good news is, healthy eating doesn’t need to be difficult. Try these tips: • Plan your meals for the week – pick some healthy meals and snacks, and make sure you have all the ingredients by adding them to your shopping list. • If time is short, consider ordering your groceries online for home delivery – this will free up more time to plan and prepare meals, rather than spending it at the supermarket. • Plan for…

MONDAY MIDDLE EASTERN PIZZA Get your pizza fix by making it at home with a healthier base and toppings! see recipe, page 25 NUTRITION INFO PER SERVE 1580kJ, protein 28g, total fat 12g (sat. fat 4g), carbs 35g, fibre 8g, sodium 789mg • Carb exchanges 2½ • GI estimate medium TUESDAY VEGETABLE PESTO STIR-FRY WITH RICE A dish of vibrant vegies to paint your plate all the colours of the rainbow. see recipe, page 25 How our food works for you see page 79 NUTRITION INFO PER SERVE 2020kJ, protein 22g, total fat 21g (sat. fat 3g), carbs 44g, fibre 15g, sodium 233mg • Carb exchanges 3 • GI estimate low • Gluten-free option WEDNESDAY NUTRITION INFO PER SERVE 2040kJ, protein 37g, total fat 18g (sat. fat 3g), carbs 46g,…

GFO LC CHICKEN SATAY SALAD With the crunch of pomegranate, this is anything but just a salad. see recipe, page 60 NUTRITION INFO PER SERVE 1370kJ, protein 30g, total fat 12g (sat. fat 2g), carbs 20g, fibre 9g, sodium 370mg • Carb exchanges 1½ • GI estimate low • Gluten-free option • Lower carb GFO PRAWN, MANGO & PEANUT CRUNCH SALAD It’s the catch of the day as fruit meets fruits de mer. see recipe, page 60 How our food works for you see page 79 NUTRITION INFO PER SERVE 1780kJ, protein 32g, total fat 16g (sat. fat 3g), carbs 34g, fibre 13g, sodium 694mg • Carb exchanges 2½ • GI estimate low • Gluten-free option GFO LC NUTRITION INFO PER SERVE 1180kJ, protein 26g, total fat 13g (sat. fat…

GF CRANBERRY PANNA COTTA Nuts and berries give this creamy sensation extra colour and crunch. see recipe, page 75 How our food works for you see page 79 NUTRITION INFO PER SERVE 680kJ, protein 5g, total fat 6g (sat. fat 3g), carbs 22g, fibre 1g, sodium 40mg • Carb exchanges 1½ • GI estimate medium • Gluten free SPICED POMEGRANATE POACHED PEARS PREP TIME: 15 MINS COOK TIME: 40 MINS SERVES 8 (AS A DESSERT) 250ml (1 cup) dry red wine125ml (½ cup) pomegranate juice125ml (½ cup) water1 Tbsp caster sugar or granulated sugar substitute2 sticks cinnamon2 whole allspice4 x 150g firm ripe pears, peeled, halved lengthways, core removed (see Cook’s Tip)½ tsp vanilla extract35g (1⁄4 cup) chopped walnuts, toastedGround cinnamon (optional) 1 Put wine, pomegranate juice, water, sugar, cinnamon…

Soups can make the perfect light meal or entrée, providing a boost of nutrients when based on the right ingredients. Cooking from fresh ingredients at home will always be our No. 1 recommendation, as you can control everything that goes in your dish that way. But let’s face it, with our busy modern lifestyles, we are bound to need store-bought ready meals from time to time, and fortunately, there are actually some great products available! When choosing ready-made soups in your local supermarket, look for those that are primarily based on vegetables for a good hit of vitamins, minerals and fibre, and avoid those that are cream- or coconut-based as they tend to be high in total and saturated fat. When reading the nutrition information panel, we recommend choosing soups…

Spring has well and truly sprung and, for many of us, so too has the desire to lose a few kilos and head into summer feeling healthier. While there are many diets, detoxes and weight-loss programs out there, you can’t go past eating good-quality, fresh, unprocessed food and moving your body regularly when it comes to losing weight and keeping it off. To help make things easier, dietitian Susie Burrell has put together a 4 Week Spring Reset program. Each week you’ll focus on a specific area of your lifestyle to help reprogram your diet and exercise habits while supporting healthy weight loss. And, best of all, it’s easy to follow – turn the page and let’s get going! WEEK 1 Planning is the key to dietary success It may…

There’s no such thing as one size fits all Almost 80 per cent of people living with diagnosed diabetes in Australia take some type of medication to help manage it, so if you’re one of them, you’re not alone. But it’s likely the type of medication you need, and the dose, will change over time. So, while you might be familiar with your current prescription, you may need to come to grips with a different one in the future. Don’t panic. Our handy go-to medication guide can help you navigate the different diabetes treatment options. THE TABLETS There are six different classes or groups of diabetes tablets. While they all work slightly differently to lower BGLs, none are oral forms of insulin, and are only used to help manage type…

Don’t let diabetes interfere with your love life. You can keep the romance alive with these strategies from relationship experts. Establish expectations People with diabetes often feel more comfortable managing their condition independently, but that can worry loved ones. Be proactive. Identify and advocate for ways in which your partner can help, and discuss areas where they should not interfere. This may help to alleviate tension before it even starts. For example, says psychologist Mark Heyman, who also has type 1, he and his wife had to negotiate how to handle hypoglycaemic episodes. They have agreed on a strategy for times when Heyman’s wife worries he isn’t taking care of himself. Their plan: she can ask him to check his blood glucose and drink juice – without question – if…

Tell us about your diagnosis My doctor told me I had type 2 just before Christmas last year when I went in to get my cholesterol checked. I didn’t have any symptoms, but it didn’t come as a huge surprise. I was overweight and my cholesterol was off the charts. It felt like my health was going downhill, fast. I was upset and a bit freaked out with the diagnosis, because I was 59 and my dad, who had type 2, passed away at 76. I couldn’t get in to see the community diabetic health service my doctor referred me to because they were so busy, so I headed into Christmas with just some diabetes medication and a pamphlet that explained what foods I should avoid. I felt like I…