Innholdsfortegnelse for November - December 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 has a child with type 1, and 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…

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. *That's People With Diabetes 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…

My diabetes nurse told me to watch my blood sugars when I drink alcohol. Why? Sultan says: Drinking alcohol when you have diabetes can cause a few problems. Firstly, it contains calories (even if low carb), which is not helpful for losing weight. Secondly, it can affect BGLs. So let's discuss why this happens. The liver stores glucose as glycogen, so when BGLs are low it can deliver glucose back into the bloodstream. Alcohol, which is processed in the liver, prevents stored glucose from entering the bloodstream when you need it. Most of the liver’s glucose releases in the night, so heading to bed after a big night out can be dangerous. Alcohol can cause hypos for up to 12 hours. It's really important you do not drink on an…

Some medications, including insulin, do need to be stored below a certain temperature, so it’s always a good idea to ask your pharmacist if in doubt. Also remember that blood glucose control can be affected by temperature, while testing strips can be damaged by temperature extremes, either hot or cold. So, whether you have type 1 or type 2 diabetes, if you’re taking medication to help manage it and need to test your blood glucose levels regularly, ask your pharmacist before you travel for their advice. It’s also a good opportunity to make sure you have enough medication to take with you, to cover you for the entire time you’ll be away from home. You might also like to ask your TerryWhite Chemmart pharmacist about the Dose Administration Aid, which…

MONDAY BBQ STEAK WITH CHICKPEA & TOMATO SALAD The classic combo of meat and veg gets a tasty, colourful update. see recipe, page 25 NUTRITION INFO PER SERVE 1630kJ, protein 39g, total fat 11g (sat. fat 4g), carbs 26g, fibre 11g, sodium 171mg • Carb exchanges 1½ • GI estimate low • Gluten free • Lower carb TUESDAY RICOTTA, ASPARAGUS AND PROSCIUTTO PASTA Soy bean spaghetti helps boost the health factor. see recipe, page 25 A few tweaks turn a familiar favourite into a summer stunner How our food works for you see page 90 NUTRITION INFO PER SERVE 992kJ, protein 21g, total fat 12g (sat. fat 5g), carbs 7g, fibre 9g, sodium 356mg • Carb exchanges ½ • GI estimate low • Gluten free • Lower carb WEDNESDAY INDIAN-STYLE…

TURKEY CORIANDER BURGERS WITH GUACAMOLE Homemade guac is the perfect partner for turkey mince. see recipe, page 37 How our food works for you see page 90 NUTRITION INFO PER SERVE 2170kJ, protein 34g, total fat 17g (sat. fat 4g), carbs 53g, fibre 8g, sodium 790mg • Carb exchanges 3½• GI estimate medium TURKEY BÁNH MÌ Dazzle allcomers with your version of this zesty Vietnamese filled roll. see recipe, page 38 NUTRITION INFO PER SERVE 1130kJ, protein 19g, total fat 6g (sat. fat 2g), carbs 32g, fibre 5g, sodium 541mg • Carb exchanges 2• GI estimate medium Cook’s Tip If you can’t buy small baguettes, simply cut a large one into pieces of the same weight. TURKEY CORIANDER BURGERS WITH GUACAMOLE PREP TIME: 15 MINS COOK TIME: 15 MINS SERVES…

SPINACH Rich in the B vitamins and folate, which plays an important role in managing homocysteine, an amino acid that narrows the arteries. DRESSING Loaded with protective vitamin C and anticoagulant garlic. RED ONION Rich in quercetin, which has antioxidant and anti-inflammatory properties and may help lower blood pressure. PUMPKIN SEEDS Help to maintain healthy blood vessels and top up your calcium, magnesium and zinc intake. AVOCADO A great source of potassium, making it good for blood pressure. Peel carefully, as many of the beneficial nutrients are found in the darker green flesh next to the peel. ORANGE Don’t forget the zest, which is rich in protective compounds such as hesperidin, which helps to balance blood pressure and protect arteries. SALMON Great source of omega-3 fatty acids, which have cholesterol…

RICOTTA, SPINACH, BASIL AND LEMON DIP A great make-ahead starter that’s perfect for a warm Christmas Day. see recipe, page 65 How our food works for you see page 90 NUTRITION INFO PER SERVE 497kJ, protein 6g, total fat 6g (sat. fat 1g), carbs 6g, fibre 5g, sodium 109mg • Carb exchanges ½• GI estimate low• Gluten free• Lower carb ORANGE AND ROSEMARY PORK Love the pork rub, which pairs perfectly with the salsa. see recipe, page 65 NUTRITION INFO PER SERVE 1030kJ, protein 41g, total fat 6g (sat. fat 2g), carbs 4g, fibre 4g, sodium 78mg • Carb exchanges ½• GI estimate low• Gluten free• Lower carb APPLE, CELERY, WALNUT AND ROCKET SALAD A light tangy side that won’t weigh you down. see recipe, page 66 NUTRITION INFO PER…

HOMEMADE CHIPS Cut any of the wraps listed below into triangles. Bake in an oven preheated to 180°C (fan-forced) for 8-10 minutes or until crisp. For something a little different, spray triangles with a little olive oil cooking spray. Sprinkle with a little smoked paprika and oregano leaves or a combination of sesame seeds and some chilli flakes or a pinch of dried chilli. You can play around with spice combinations. Just be mindful of the flavoured dip you’ll be serving chips with. WRAPS • Mission Low Carb Wraps• Woolworths Wholegrain Wraps• Freedom Foods Barley+ Whole Grain Barley Wraps• Simson’s Pantry Activated Charcoal Wraps• Helga’s Lower Carb Wholemeal Wraps BREAD TOASTS Thinly slice a wholemeal sourdough baguette or cut slices of wholemeal sourdough bread into small pieces. Spray with olive…

Prebiotic power The importance of ensuring you have a good balance of healthy gut bacteria (probiotics) to promote a healthy immune and digestive system is well known and spoken about these days. However new research suggests that it is equally important to ensure you are feeding your healthy gut bacteria the right fuel to help you reap the full health benefits. Prebiotics are a type of fibre and resistant starch that, when eaten, make their way to the large intestine undigested, where they then act as fuel to stimulate the growth or activity of our healthy gut bacteria. Research suggests a diet high in prebiotics may not only help to promote a healthy immune and digestive system, but may also improve your mood, increase insulin sensitivity and improve blood glucose…

I decided to try out the keto diet to see what all the hype was about. People claim it is the ultimate fat-loss diet, others say it can reverse type 2 diabetes. I had to put it to the test to see if it would help me manage my type 1 diabetes. My keto experience The thing that makes this experiment so eye-opening is, as someone living with type 1, I get to see objective insights every day into my BGLs and insulin requirements. I also have two university degrees. First, I completed a Bachelor of Science (exercise and sport) and went on to become an accredited exercise physiologist. Then, after being diagnosed with type 1 diabetes at age 22, I went back to university and completed a post-grad certificate…

Diabetes Australia suggests moderate weight loss should be part of a treatment plan for people with diabetes who have a high body mass index. But advice for weight loss may convey shame and blame – and can even be dangerous. “I was sick for three years before my diabetes diagnosis. I knew I was sick, but since I passed my fasting blood [glucose] check, the diabetes was not caught by doctors. Instead, the doctor told me I wasn’t dieting and exercising hard enough,” says Lenza. “I injured my knee pursuing this doctor’s orders, and developed full-on eating disorder behaviour, desperately trying to starve myself [into being healthier].” “We’ve come to have this societal expectation that losing weight should be easy,” says Puhl. “We see so many messages from the diet…

OUR NEW PODCAST! GO ON A TASTY ADVENTURE AROUND THE WORLD! Join your hosts, Julia and Ben, as they visit a different travel destination in each episode, hitting tourist hotspots and hidden gems. Each week you’ll hear about where to stay, what to see and what to eat and drink with fabulous guests who have all the tips you need for your next trip! Let’s go on a gourmet globe trot! FIVE-STAR REVIEWS WANDERLUST It’s like foodie wanderlust in audio form! I can’t wait to see where we go next! DELICIOUS Nice concept, great hosts! This is a nice change from the stuff I normally listen to. LOVE IT! Fun episodes, lots of knowledge gained. Big fan of Lamberto! MEET THE HOSTS Julia Zaetta BHG editor-in-chief Ben Alcock Travel blogger…

There’s an awful lot of information out there about what we should, and shouldn’t, be eating. We know, it can get confusing. Last issue DL dietitian and diabetes educator Dr Kate Marsh (who also has type 1) wrote about the keto diet – a very low-carb approach that is gaining in popularity. In this issue, we have a follow-up, with a piece from exercise physiologist, sports scientist and diabetes educator Drew Harrisberg (who was diagnosed with type 1 at the age of 22) about life, and diabetes, on the keto diet – and why he ultimately quit it. Turn to page 96 for a fascinating read. Although you might not be taking the keto approach, chances are you’re watching your carbohydrate intake. We know that’s an area of discussion for…

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've had pain in my heel for many months. I have been resting it, but it is not getting better. What should I do? Danielle says: It is important to know what is causing the pain in your heel. One of the most common problems is plantar fasciitis, but there are other reasons that should be excluded during your assessment with a podiatrist. It may be recommended that you have further investigations, such as an x-ray or ultrasound, to see what else may be going on. Heel pain can develop suddenly or gradually. In the case of plantar fasciitis, it is a musculoskeletal injury that results in inflammation and pain under the heel as it involves overstretching of the thick fibrous tissue that forms your arch. As it is difficult…

I can’t find a script for one of my meds and, being such a busy time, I’d prefer not to visit my GP if I don’t have to. Is there anything I can do? Unfortunately, without a script, a pharmacist will be unable to give you the medication, so if you can’t find your original script, you will need to visit your doctor to get a new one. To avoid this happening again, one solution is to manage scripts using the TerryWhite Chemmart Health App. This not only lets you leave your script with your TerryWhite Chemmart pharmacist for safekeeping, it also makes remembering to fill any recurring scripts a breeze. As well as reminding you to fill a script, and chasing you if you forget, by using the ‘tap…

CHEESE & GARLIC ROLLS The crunchy cheese and garlic top always makes these a favourite. see recipe, page 32 NUTRITION INFO PER SERVE 577kJ, protein 5g, total fat 5g (sat. fat 2g), carbs 18g, fibre 1g, sodium 63mg • Carb exchanges 1• GI estimate high SWEET POTATOES WITH CAPSICUM AND HALOUMI A yummy alternative to meat on the barbie. see recipe, page 32 How our food works for you see page 90 NUTRITION INFO PER SERVE 1630kJ, protein 12g, total fat 18g (sat. fat 8g), carbs 41g, fibre 8g, sodium 474mg • Carb exchanges 2½• GI estimate low• Gluten free PINEAPPLE & PORK SKEWERS Bring tropical and Asian flavours to your next barbecue. see recipe, page 33 NUTRITION INFO PER SERVE 1600kJ, protein 30g, total fat 3g (sat. fat 1g),…

Discover how to fight those unhealthy grazing and snacking habits If you have diabetes, healthy eating is vital. Healthy eating manages your blood glucose, cholesterol and blood pressure levels better. Healthy eating helps you maintain a healthy body weight, boosts your energy and improves your wellbeing. This is why an Australian dietician developed low GI BodyCare Nutrition Revitalise. It is a delicious multi-vitamin and mineral health shake. Revitalise also contains essential amino acids and fibre and has a low glycemic load. Healthy eating can be challenging. Reaching for a biscuit, chocolate bar, cake or soft drink can be very tempting at times. Consuming too many of these foods can play havoc with your blood sugar levels. You may even experience weight gain. If any of this sounds familiar you should…

CAJUN PRAWN PIZZA Spice and all things nice give this seafood pizza some extra bite. see recipe, page 55 NUTRITION INFO PER SERVE 1310kJ, protein 17g, total fat 7g (sat. fat 1g), carbs 37g, fibre 9g, sodium 228mg • Carb exchanges 2½• GI estimate medium CARAMELISED ONION & GOAT’S CHEESE PIZZA This meat-free treat is low on tradition but high on tasty, healthy ingredients. see recipe, page 55 How our food works for you see page 90 NUTRITION INFO PER SERVE 1840kJ, protein 17g, total fat 16g (sat. fat 5g), carbs 49g, fibre 15g, sodium 235mg • Carb exchanges 3½• GI estimate medium Cook’s Tip This pizza is made without tomatoes, but if you like them, serve it with a tomato and cucumber salad on the side. BARBECUE CHICKEN PIZZA…

BERRY FRO-YO Creamy yoghurt, colourful berries and crunchy granola make for an epic conclusion to any meal. see recipe, page 80 How our food works for you see page 90 NUTRITION INFO PER SERVE 538kJ, protein 3g, total fat 3g (sat. fat 1g), carbs 22g, fibre 3g, sodium 18mg • Carb exchanges 1½• GI estimate low GF EASY KIWI SORBET With a tart edge, this sorbet is easy to make, and even easier to eat! see recipe, page 80 NUTRITION INFO PER SERVE 307kJ, protein 1g, total fat 0g (sat. fat 0g), carbs 16g, fibre 1g, sodium 3mg • Carb exchanges 1• GI estimate medium• Gluten free BERRY FRO-YO PREP TIME: 5 MINS (+ OVERNIGHT FREEZING) SERVES 6 (AS A DESSERT) 4 ripe bananas, chopped80g (1/2 cup) frozen berries130g (1/2…

How our food works for you see page 90 NUTRITION INFO PER SERVE 1810kJ, protein 40g, total fat 12g (sat. fat 3g), carbs 35g, fibre 8g, sodium 575mg • Carb exchanges 2½• GI estimate medium HEALTHY ‘FRIED’ CHICKEN WITH CHIPS AND SLAW PREP TIME: 10 MINS COOK TIME: 40 MINS SERVES 4 (AS A MAIN) 75g (1/2 cup) dried breadcrumbs2 tsp smoked paprika1/2 tsp ground turmeric1/2 tsp garlic powder1 tsp dried oregano2 Tbsp wholemeal plain flourFreshly ground black pepper60g egg4 large (700g) skinless chickenthigh fillets, halved, trimmed of all fat400g Spud Lite potatoes, peeled, cut into thin chips2 Tbsp Sriracha (hot chilli sauce), to serve Slaw 1 small red onion, very thinly sliced¼ red cabbage, shredded2 carrots, shredded or coarsely grated2 Tbsp 97% fat-free mayonnaise1 Tbsp white wine vinegarFreshly ground…

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. BAKED BEETROOT FALAFELS see recipe, page 41 NUTRITION INFO PER SERVE 1150kJ, protein 12g, total fat 5g (sat. fat 1g), carbs 39g, fibre 10g, sodium 265mg • Carb exchanges 2½• GI estimate medium Brand names We often use product names to make it…

Plan your plot Keep soil well-groomed and clear of tripping hazards, such as hoses. Consider incorporating functional hardscapes, like benches and paved paths. They’ll take up space – less bare earth reduces maintenance – while making your grounds easier to navigate, advises retired physical therapist and certified master gardener Patricia Kolling. Protect your skin Well-fitting garden gloves protect your skin from pricks and cuts without adding pressure to joints. Look for a pair that doesn’t strain across your knuckles when you make a fist, but also has minimal excess fabric, says Kolling. Wear sunscreen, long sleeves and pants, and solid, closed-toed shoes. Position properly While digging, bend at the knees, keep your back mostly straight, and make small, controlled motions instead of stretching your arms far. This technique may reduce…

When did you learn you had type 2? My wife, Lorraine, had been on my case for years, saying that I needed to go and get checked for diabetes. Deep down I knew there was something wrong, but I kept avoiding it. When I had a big feed or a lot of sugar, I’d get a sickly feeling and I was always thirsty. Eventually I went to my doctor and he did tests and said, yep, your wife is right. However, he said that rather than going on medication, I should work on my diet and lose some weight. That was about 15 years ago. Were you very overweight? I’m not a big bloke, really; I’m about 1.75m tall and I was about 95kg, so not huge. But I’ve always…

It’s easy to get caught up in life – working, cooking, cleaning, watching TV – but you also need to remember to take time for you. The best way to do this is by adding at least 30 minutes of exercise to each day. You don’t need to join a gym or attend fitness classes to do so. Start by creating your own personalised Move-More Plan (opposite) and get started with these simple exercises. Pick your MOVES STANDING SIDE CRUNCH 10 crunches on each side Stand tall with your feet hip-width apart and knees soft. Gently rest your hands on the back of your head, elbows out (A). To begin, shift your weight to your left foot. Simultaneously raise your right knee and lower your right elbow with the intention…

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…

Should I be checking my blood glucose levels every time I want to drive somewhere? Rachel says: If you are taking a type of glucose lowering medication that can cause hypoglycaemia (hypos), low BGLs, or if you are using insulin to manage your diabetes, then yes, the recommendation is to ensure your glucose level is above 5mmol/L before you drive. If you are at risk of having a hypo due to the medication you take to manage your diabetes, test your BGLs and ensure it is above 5 before driving. Check it every 2 hours on long journeys, ensuring it is above 5, and carry a quick-acting carbohydrate food or drink with you in the vehicle. If you do not regularly use a blood glucose monitor to check your BGLs,…

INDIAN NACHOS PREP TIME: 15 MINS COOK TIME: 40 MINS SERVES 6 (AS A LIGHT MEAL) 420g can no-added-salt chickpeas, rinsed and drained1 Tbsp olive oil½ tsp cumin seeds½ tsp mild curry powder2 naan breads, cut into triangles1 Tbsp margarine, melted150g grated reduced-fat cheddar1 green chilli, finely chopped Salsa 250g punnet cherry tomatoes, chopped1 red onion, finely chopped1/2 cup coriander leaves, chopped Yoghurt sauce 150g reduced-fat natural yoghurt1 clove garlic, crushed1 tsp mint sauce 1 To make the salsa, toss all ingredients in a bowl and then set aside. 2 To make yoghurt sauce, whisk all ingredients in a small bowl. 3 Preheat oven to 180°C (fan forced). Line a baking tray with baking paper. Rinse chickpeas in a sieve under running water. Drain well and then pat dry with…

ROASTED VEG AND FETA QUINOA SALAD There’s plenty of variety for vegie lovers in this dish. see recipe, page 46 NUTRITION INFO PER SERVE 1060kJ, protein 15g, total fat 5g (sat. fat 2g), carbs 31g, fibre 11g, sodium 191mg • Carb exchanges 2• GI estimate low• Gluten free BAKED BEETROOT FALAFELS No meat but there is lots of flavour in this spin on a Mediterranean classic. see recipe, page 46 How our food works for you see page 90 NUTRITION INFO PER SERVE 1150kJ, protein 12g, total fat 5g (sat. fat 1g), carbs 39g, fibre 10g, sodium 265mg • Carb exchanges 2½• GI estimate medium THAI RED CURRY PUMPKIN SOUP Traditional soup with a spicy Asian twist, yum! see recipe, page 46 NUTRITION INFO PER SERVE 623kJ, protein 6g, total…

While food choices clearly play a key role in weight loss, they aren’t the only thing that matters. Regardless of the type of eating plan you choose to follow, there are a number of other factors that can impact your ability to lose weight. Addressing these, alongside a healthy eating plan, will give you the best chance of achieving long-term weight-loss success. So, what are these factors? 1 Perfect your portion sizes Even if you follow a healthy eating plan, if you eat more than you need to, it will be difficult to manage your weight. Yet the increasing portion sizes of packaged foods, fast foods and restaurant meals, alongside bigger bowls, plates and glasses, makes it easy to eat more than we need. Research has shown if we are…

Doctors handed Claire Bickel a diabetes diagnosis the day before her fifth birthday. Her mum, Francesca, learned to stick Claire’s finger to check her BGLs, and began monitoring her levels eight to 10 times daily. As a newly diagnosed kindergartener, Claire headed to school each day with a juice box in her backpack, just in case her BGLs dropped at school. That was more than a decade ago; Claire is now a high school student. “In 2007, there was no way [for me] to know what her levels were [at school], nothing that could tell [me] she was trending down. I had to put all my faith into a five-year-old recognising she didn’t feel right and knowing she could sip on some juice if she didn’t feel well,” says Francesca.…