Diabetes Voice Digital Issue November 2015

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The November 2015 digital issue of Diabetes Voice is dedicated to World Diabetes Day and the 2015 theme - Healthy Eating.


  • Diabetes VoiceONLINE



  • Diabetes Voice Online - November 2015


    International Diabetes Federation

    Promoting diabetes care, prevention and a cure worldwide

    Editor-in-Chief: Rhys WilliamsEditor: Elizabeth SnoufferEditorial Coordinator: Agnese AbolinaDesign & Layout: Lorenzo Piemonte

    All correspondence should be addressed to:

    International Diabetes Federation Chausse de La Hulpe 166, 1170 Brussels, Belgium Tel: +32-2-538 55 11 | Fax: +32-2-538 51 14diabetesvoice@idf.org

    Diabetes Voice is available online at www.diabetesvoice.org

    International Diabetes Federation, 2015 - All rights reserved. No part of this publication may be reproduced or transmitted in any form or by any means without the written prior permission of the International Diabetes Federation (IDF). Requests to reproduce or translate IDF publications should be addressed to communications@idf.org.

    The information in this document is for information purposes only. IDF makes no representation or warrantires about the accuracy and reliability of any content in the document. Any opinions expressed are those of their authors, and do not necessarily represent the views of IDF. IDF shall not be liable for any loss or damage in connection with your use of this document. Through this document, you may link to third-party websites, which are not under IDFs control. The inclusion of such links does not imply a recommendation or endorsement by IDF of any material, information, products and services advertised on third-party websites, and IDF disclaims any liability with regard to your access of such linked websites and use of any products or services advertised there. While some information in Diabetes Voice is about medical issues, it is not medical advice and should not be construed as such.

    Cover photo: International Diabetes Federation


    For all types of diabetes, one common goal: healthy eating 3 Elizabeth Snouffer


    Healthy eating challenges for diabetes self-management 5


    Fighting for Good food (Mai Wiru) 10John Tregenza

    Revolution against sugar: Q&A with Jamie Oliver 13


    Diabetes advocates inspire action for WDD 2015 16

    AstraZeneca: addressing gaps in diabetes care 21

    Lets make healthy eating a right, not a privilege 23

  • Diabetes Voice Online - November 2015

    For all types of diabetes, one common goal: healthy eatingElizabeth Snouffer


    In the following headlines, diabetes is mentioned, but what type is being discussed exactly? Given that there are different types of diabetes, how does the general public understand the difference when no distinction is made?

    Five million adults in England at risk of diabetes

    One third of diabetes in the US is undiagnosed

    Blood pressure, diabetes, smoking among biggest killers in India: Study

    The media has a knack for using one word, diabetes, without distinction, to represent type 2 diabetes, and it is hard to blame them. Because the healthcare cost of diabetes worldwide is estimated to be USD 548 billion and because 90%-95% of the 400 million people with diabetes has type 2 diabetes, type 2 diabetes has become the leading global healthcare crisis of the 21st century, and therefore, important news to report. The general public should be aware by now that type 2 diabetes is caused by a genetic predisposition and, in the majority of cases, excess body weight and physical inactivity leading to the bodys ineffective use of insulin. Type 2 diabetes affects children and adults.

    Further confounding for the publics understanding of the diabetes health crisis is the fact that type 2 diabetes is largely preventable for the millions of people at greatest risk with rather inexpensive measures such as education and behaviour modification, but it can be hugely expensive to treat with monitoring supplies, medicines, doctor visits, annual eye exams and other routine costs to keep complications at bay. The economic burden of type 2 diabetes is crushing and people feel angry and helpless. Type 2 diabetes is a medical illness, but it is also a social and economic condition with many variables at play. Unfortunately, news reports about type 2

    diabetes and the obesity epidemic have become so prevalent that many outlets, in an effort to get the news out as fast as possible, supply poor or unclear information, giving rise to a timeworn effect.News reports about the type 2 diabetes crisis have nearly lost their power to inform or influence.

    That other 5%-10% of the 400 million with diabetes mainly constitutes children and adults living with type 1 diabetes, formerly known as juvenile diabetes. While exact numbers are hard to determine, in 2014 it was estimated that 500,000 children under the age of 15 years live with this this incurable disease. Type 1 diabetes is not yet preventable. It is an autoimmune disease that occurs when T cells attack and destroy most of the beta cells in the pancreas that are needed to produce insulin. Since the body no longer produces insulin (or produces insufficient amounts), children and adults diagnosed with type 1 diabetes must inject insulin for survival, for life.

    Many people living with type 1 diabetes arent happy that there has became one catch word to represent two diseases for the very simple reason that it confuses the public and reduces important factors related to type 1 diabetes awareness, research and funding. If the diagnosis of a child suffering from type 1 diabetes is delayed, it takes only weeks for severe consequences to set in such as cognitive impairment or ketoacidotic coma which can be fatal. The consequences of high blood glucose for a child or adult with undiagnosed type 2 diabetes are demonstrably less severe, although serious complications can form within years.

    The differences are important, but there are many common goals for people living with all


  • Diabetes Voice Online - November 2015


    types of diabetes. The most important goal for people living with all types of diabetes is to achieve an individualised and safe target as close to normal glycaemia, which for people who do not have diabetes is 4.0 to 5.9 mmol/L (72 mg/dL to 106.2 mg/dL). HbA1c targets can range from


    Diabetes Voice Online - November 2015


    Healthy eating challenges for diabetes self-managementElizabeth Snouffer

    I was recently at the doctor for a follow up visit. We discovered that my HbA1c was higher than it normally would be and that I had protein in my urine which can be an early sign of kidney disease. Needless to say, I was worried.

    As much as I help and share other peoples stories about living with diabetes, I am now becoming a story of my own. Lets be honest here, I know what I should be doing for my type 2 diabetes and at times, like many other people with diabetes, we just dont do whats right for our condition. Its time to get back on course!

    My first step is to lose the extra 15 pounds that I

    dont need.

    CHARLES MATTOCKS (USA)Celebrity chef, film maker and global diabetes advocate, diagnosed with type 2 diabetes in 2011

    What is healthy eating? A healthy lifestyle involves many choices and for all people in our modern world today choosing balanced nutrition is a priority to live a long healthy life. Generally, it is recognized that a healthy eating strategy emphasizes vegetables, fruit, whole grains, lean meat and foods low in salt and added sugar.

    For people living with all types of diabetes, a healthy eating plan is extremely important to meet blood glucose targets and avoid complications related to untreated or poorly managed diabetes. When a person is first diagnosed with diabetes, this is one of the most significant self-care messages from healthcare providers worldwide, and much of what is said in the healthcare setting about nutrition and diabetes is delivered as common sense. However, it is also commonly appreciated that it can be a challenge to put healthy eating, which sounds so simple - even easy, into practice. Add insulin therapy into the mix, required for people living with type 1 diabetes, and matters become much more complex. Careful coordination of carbohydrate intake with medication, physical activity, and other variables including stress must be prioritized to manage blood glucose levels, and for many, survival.

    In support of the International Diabetes Federations (IDF) World Diabetes Day 2015 campaign, which recognizes healthy eating as an important part of the effective management of all types of diabetes, we asked individuals living with diabetes to discuss their greatest challenges related to making the right food choices and sticking to a strategy. In the following contributions, we hear from people who are making a total effort to self-manage diabetes successfully, which for so many millions requires

    24/7 vigilance and discipline.

    Charles Mattocks

  • 6

    Diabetes Voice Online - November 2015

    dont need. I should be at my ideal weight and thats that. So I need to start with a plan that allows me to lose 15 pounds and then maybe I can shed more. What works for me is a low carbohydrate, low sugar, and low starch meal plan. A few months back I recently lost 12 pounds and it was primarily from lots of walking! In order to achieve that, I was walking about three times a day for about forty minutes per walk. I drank nothing but water and was eating lean meat and vegetables. As a celebrity chef, it can be hard staying away from the food - heck it can be hard for anyone to stay away from the table. Food is truly a drug that can be used for good and for bad. When society accepts that healthy eating and an active lifestyle can make a positive change then we will be in a much better place.

    I always go back to what a healthy food choice is for me and my type 2 diabetes. I start with what God gave us and go from there. We cant go wrong with loads of vegetables and water. We cant go wrong with small portions of lean meat and limit our total intake. Lets face it, when I am back in my home country of Jamaica, I go crazy at times. I love curried goat and ackee and salt-fish, the national Jamaican dish! I know some Jamaican foods are the cause for many people suffering in the Caribbean

    islands with high cases of type 2 diabetes. But in reality, when I get there I actually slim down a bit because I go on a fresh food diet. If I need to eat on the go, I will make a small meal, like some egg whites or some curried chicken. Now thats mostly protein and vegetables, low in calories, but these choices still have that great taste.

    When I am out with friends or family, that can also be an issue that haunts us. I always suggest sticking to quality vegetables and protein. I suggest that people with diabetes grab a steak or some lean chicken, because these options can be tasty but still healthy. Also, grab some steamed veggies instead of the rice, and always make sure your portions are small. Dont forget if you live with diabetes, you need to make sure what you do today, wont hurt you tomorrow.

    Fortunately, I got back to my healthy ways again with a smile on my face and Im down a few pounds in only a few days and counting. I also got my medical tests back and its all clear. I must admit I was very nervous and I know those test results were a wake-up call for me. I dont miss some of the bad choices I make from time to time and with the holidays coming up, I want to make sure I am heading in the right direction.

    HLNE COLON-RAPHAEL (USA)Grandmother, diagnosed with type 1 diabetes at 23 years

    There are many challenges in having diabetes, but I faced one big hurdle when it comes to healthy eating and being social. I declined invitations to friends homes because I was afraid of what I was going to be challenged to eat and how it was going to affect my blood glucose. Now, I accept social invitations, with the caveat that I am allowed to bring a dish or a beverage.

    Bringing something for myself to eat is reassuring knowing that there is something I will feel comfortable eating or drinking. It is important for me to know how certain food or drink will impact my blood glucose and when I do know the number of carbohydrates in my food, I am able to

    properly dose my insulin. Sometimes I will bring an appetizer, side dish or a beverage, and I make sure I know how many carbohydrates are in each. Otherwise, it is very difficult. I will have to guess, or ask the host what exactly is in each dish which can lead me to take either too much insulin or too little insulin. When deciding on an item to bring to a hosts party, I typically bring homemade hummus, shrimp cocktail, white bean stew or low calorie/no sugar added margaritas. With my strategy, going out socially means I have lower stress, and I can enjoy visiting friends and family at their home.

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    Diabetes Voice Online - November 2015

    KATE CORNELL (USA)Writer, diagnosed with type 2 diabetes at 50 years

    My diagnosis of type 2 diabetes changed a lot of things for me, but the biggest change related to food. Everything revolves around food in our society, which makes eating with type 2 diabetes more challenging. Challenging, but not impossible.

    The way I eat now is dramatically different than the way I ate ten years ago but those changes didnt happen overnight. Type 2 diabetes is a progressive condition and, therefore, I have made progressive changes to the way I eat. One change at a time.

    As luck would have it, most of my favourite foods became difficult for me. I couldnt keep my blood glucose levels where they needed to be if I ate bread, pasta, cereals and potatoes. Some fruits also became off-limits. It was necessary for me to remove those things from my food plan because I do not use insulin to manage my diabetes. Finding alternatives made living with these food changes much more bearable. Alternative flours, such as almond and coconut, allowed me to make breads, cookies and cakes that didnt spike my blood glucose. Replacing pasta with spaghetti squash or

    zucchini made a huge difference! Some might say that I am now following a low carb diet, but I prefer to call it a no processed carb diet. Im choosing to eat whole foods that I (mostly) cook myself as opposed to processed meals or foods that contain too much of what isnt good for me.

    Im fairly successful at home, but eating out, travelling or attending social functions add a layer of difficulty to my food choices. I choose to eat a sandwich with a fork and knife, avoiding the bread. I order cottage cheese or sliced tomatoes instead of potatoes. I travel with my own snacks so that I can avoid fast and convenient foods. Attending a celebration means loading up on salad and having only a taste of that birthday cake....