Independence Archives - Page 2 of 2 - Diabetes Counselling Online

Too much sugar hey? On taxi drivers & molotov cocktails

September 3, 2014 by Helen-Edwards 10 Comments

the beautiful running venue for the weekend

I have gone to the national diabetes scientific conference, held every year, for the past 15 years. This year, I decided to take a break from all things diabetes and went to the ProBlogger 2014 conference instead, seeking inspiration and ideas for both this blog, and my other blog at Recycled Interiors. Ironically, after booking to go to this in May, I was later asked to be keynote speaker at 2 sessions of the diabetes conference, including the new consumer session – maybe next year. Did any of you go along?

I won’t bore those of you not interested in blogging with all the content, as I am sure lots of other people will be doing that sort of round up if you want to find out more in depth about content. Or you can hop on Twitter hashtag #pbevent or instagram, where we apparently blew the record out of the water for most instagram pics from one event, and were trending on twitter! I really think this blog has the power to make a difference to the lives of people with diabetes and no matter what else I do in life, will continue to offer ways for you all to connect with each others stories.

Instead I am talking about my experience of the event with 6 inspirational quotes today and a bit of a summary – some of which you may connect with. These are key messages that relate to life in general, not just blogging.

To begin with, here is something that happened on the way from the airport to the hotel. You might relate. So I am sitting in this taxi and the driver is a quiet talker – have you seen that Senifeld episode? He was talking about the weather as there was a huge wind that day, which we felt on the somewhat precarious descent into the airport, and how the beaches were shut. I mentioned how I was there when I was 12 and how different it was then, and that this was the trip after which I was diagnosed with type 1 diabetes. Are you guessing what comes next?

“Ah, too much sugar hey!”……….

At that point I nearly opened the door and jumped out. I wanted to let him have it. I didn’t. “Oh no it’s nothing to do with that” I said. Screaming inside “you DICKHEAD”. A few minutes later the brakes screamed to a halt as we nearly plowed into another car. Now I really wished I had jumped out. We kept driving. He kept quiet talking, explaining how he had been looking at someone and didn’t see the other car. Whatever. Maybe you had too much sugar, I thought.

Just after the molotov cocktail incident, waiting in traffic

On we went, into the back streets near the beach, him telling me this was the easiest way to the hotel, so close I could almost feel the soft pillow beds at the QT Hotel. And then bam. There was a police cordon. I kid you not – 20 police cars and people everywhere. I later found out some dude had threatened to have a molotov cocktail in his backpack. Welcome to the Gold Coast.

We doubled and tripled back and got stuck in traffic and an hour and 10 minutes after leaving the airport, I was finally at my hotel. You have never met a happier diabetic. Get me some sugar I shouted. Happily, this was the worst part of the weekend. The rest was amazing, awesome and inspiring. Despite my introvert tendencies.

Are you more of an introvert or an extrovert? I used to think I was an extrovert. People would call me that due to my LOUDNESS and my TALKINGNESS (not sure that is a word, well spellcheck didn’t think so but I like it). But then I got older. And I stopped drinking and going out. And through a pile of events and horrid things I was exposed to, I stopped feeling safe and started feeling scared. And anxious. And little by little I became so introverted I almost disappeared….

That was a tough time. But I went through it, and I climbed out, and I was me again. The same but different. I didn’t like drinking, or bars or clubs anymore. I didn’t like being crushed in the mosh pit at a concert. I didn’t really like going out to parties anymore, or noisy footy games. I was definitely here, but I was a more gentle version of myself. I DID still love loud music, at home, on my own terms.

Do you work from home? Lots of bloggers I know do. I spend most days from 9 am until 3 pm totally alone other than radio national. I do have a team who work with me for my diabetes work, and I do have meetings, conferences, workshops, client styling appointments, my studio and lots of reasons to be with people. But many hours are spent in solitude. It is then that I get most of my inspiration. I guess that is a true introvert.

I also need time alone to breathe. I become suffocated when there is too much noise, too much light, too many smells – I experience sensory overload and my creative brain starts to freak out a little. So you can imagine me at ProBlogger this weekend with over 500 excited, loud and fabulous people! Don’t get me wrong, I have been to HUGE events, I was even a speaker at two sessions of the 10,000+ International diabetes conference in Melbourne last December. I can get up in front of a huge crowd and deliver a presentation. And I love to talk. But I prefer intimate, 1-1 conversations and I find it hard to push myself into already established groups or conversations. Maybe that goes back to feeling like an outsider as a kid. Maybe.

My experience of being with 550 people was therefore one of being quite alone. Isn’t it funny how you can be alone, when you are in a room full of people? In fact sometimes you feel more alone than when you are actually alone – do you know what I mean? I wandered around the crowds a bit, trying to catch eyes and feeling a bit like a twit.

I did meet a few wonderful new friends who I am sure I will continue to connect with, such as Trudie from My Vintage Childhood, who I had a deep connection with, and some who I had followed or connected with online for a long time. I pushed myself to the cocktail party (but stayed only an hour!) and it was my chance to meet a bloggy idol of mine, Carly Findlay. That was cool.

I did feel the most alone however, when in the 45 minutes between sessions and the cocktail party, I had to change my pump, had high BGL’s, followed by a crashing low on arrival at the noisy party. The free orange juice was welcomed but there was no #itmakessenseifyouhavediabetes because I had no D-friends there- although there must have been some in a crowd of 550 people.

One of the highlights of the weekend was meeting Reservoir Dad and Edenland on the cab to the airport to fly home. Like the last hour of the disco, I hooked up with them as we staggered out of the hotel into the sunshine, to wing back home, Reservoir Dad sure he would die as his plane crashed and burned. This was one of the funniest 45 minutes of the weekend. These people blog it real and do social good with their words. Do yourself a favour and check out their blogs.

One of the downfalls of being an introvert is sometimes you leave it too late, and sometimes you have regrets. I have nothing to regret from this weekend however. I did it on my terms, retreating to my room when needed. On that I highly recommend staying in the hotel where a conference is being held,especially for those of us who are sugar challenged- I could go change my pump site, have a moment of grab some food when what was offered was not suitable. I had always stayed away at events, but it was a great little security blanket to have a room onsite.

ProBlogger is definitely one of the best things I have ever done. The organisation, communication, content, speakers venue, food and all aspects, were outstanding. There were no sessions where I did not take something away with me. And I did make some new friends. Also I got to run on the beach twice, see the ocean, the sky and the sand. I had a king size bed to myself for 3 nights. I ate what I wanted. It was good.

Here are some takeaway things I have which you might find useful as a blogger and a human being.

And here’s to the introverts and the extroverts and those in between,but not to ignorant taxi drivers. #itmakessenseifyouhavediabetes

Helen

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While we’re busy making other plans..

August 7, 2014 by helwild 2 Comments

A diagnosis of diabetes brings the ‘C’ word into everyday life: Control. We get bombarded with information, instructions, advice. We’re told to ‘test’, given pieces of paper to go to a clinic or hospital for a variety of even more ‘tests’. We’re monitored, measured, & judged. For some people, this becomes more important than anything else. They become hyper vigilant, testing, checking, measuring, exercising, dieting. Almost everyone diagnosed with diabetes begins their journey like this; driven by fear, anxiety, guilt, the notion of ‘control’ becomes all consuming. For some, this is relatively short lived, and things become all too hard. Those who ‘drop the ball’ early give up, bury their head in the sand, ignore advice, feel hopeless, helpless. Their diabetes remains ‘uncontrolled’. For others, the steady mantra of ‘control’ rules their lives. No matter what they achieve, no matter how ‘good’ their diabetic ‘control’ is, they strive to be ‘better’, to be ‘perfect’. To all intents and purposes, and according to most measures, their diabetes is ‘controlled’. Yet they still feel unsuccessful.

How do we find balance?

Ive been thinking a lot about this lately. Those who have a child diagnosed with diabetes come to this with a rather different perspective. For us, the worry, anxiety, need to achieve control are driven by the primal urge to protect our child. It can be harder for us to let go of the notion of ‘control’ than for the child themselves. After all, our main role in life is to care for our child, to make life the easiest, the best, it can be. We will access the best technology and resources available to us, whether thats a new insulin, a new way of measuring, a new test, an app, a new alarm or monitor, a hypo dog. It can be hard to relinquish that ‘control’ to our child. At what age do we ‘allow’ them to make their own decisions about management? For many of us, the decision is taken out of our hands. Our child will refuse to allow us to administer insulin, conduct tests, record results. They may lie to us, and we have the moral dilemma of respecting their autonomy, their right to privacy, and reconciling that with our parental role to manage their health. In some families, difficult topics are discussed. In others, they are not spoken of, they are ignored. Either way, the hard subjects, sex, death, religion, war, family secrets, unfairness, prejudice, injustice, and overnight hypos, all exist. Our children will learn about them. We do have the right to choose whether or not to speak of them.

We tend to judge ourselves very harshly around these changes in our ‘control’. Yet in the end, the vast majority of children with diabetes grow up to manage their diabetes well, to live good, productive lives, to participate fully in other aspects of life, work, socially, and also often with a strong social conscience, a sense of advocacy and participation in supporting others with diabetes. Through struggle & difficulty many are very compassionate human beings, people to be proud of. In managing our own diabetes, although some Health Care professionals may seem, or indeed be, somewhat judgemental, in the end we are all doing the best we can at the time. There may be ‘scope for improvement’, but judging and blaming have no part in our Mental Health, nor in our Physical Health. We need to find our motivation in self love and in our sense of our own worth. We deserve kindness, and the best we can do.

I think one of the key notions that helps to make this journey survivable is to accept that it is just that- a journey. We travel our road in life, and sure, for everyone, some more than others, there are rough patches, difficulties. The destination is known, we don’t know when, but we do know that ‘all things must pass’. Looking around us while were on that journey is what makes the difference. Taking that holiday in Japan, even though we can’t get an Insurance company to fully insure our insulin pump; walking to the shops in the sunshine, or the rain; playing with our child because it’s fun, not because the exercise will be good for his blood glucose control; taking time out from achieving, controlling, managing, to just simply be. This week I went back to my Yoga class. It’s been 5 years since I saw my teacher, Balbir. In that 5 years she has grown old, but she still has the mesmerising power to transport me during relaxation time to a place of calm and serenity; and the ability to lead me through physical practice which stretches and awakens my body to Life. Taking time to focus on the breath, on Balance, Serenity, and the practice of Mindfulness. Most of all, on Resilience. Building resilience in ourselves, and importantly in our children, helps us and them to live life fully: to achieve a level of mental health that will see our journey through life as a balanced one, a life to feel gratitude for, not a life of self doubt. Yesterday I saw an almond tree in full blossom. It was growing alongside a busy highway. Clearly it had stood there for decades before the road came along, before the construction that rose around it. Yet there it was, in full blossom, old, huge, bursting with optimism and life.

Life is what happens to you while you’re busy making other plans- remember to Notice your Life.

Its a Long Way to go, A Hard Row to Hoe

Helen Wilde

Helen has been the parent of someone with Type 1 diabetes since 1979. She has lived with the diagnosis of Type 2 diabetes herself since 2001. She is a Senior Counsellor with Diabetes Counselling Online. If you are struggling with Control or any aspect of your diabetes you may like to contact our team at

http://www.diabetescounselling.com.au/counselling-request/

carpe diem

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My d-holiday in Thailand

July 7, 2014 by Sally 2 Comments

Wow! I really needed that break! I had concerns about my diabetes and coeliac disease before I left, but other than a few minor hiccups, they were fine. I prepared well, and was mindful of my activities (as much as possible) so thought I’d share some of the highlights with you.

You probably all know how I feel about routine being so important for diabetes control. I really didn’t know how I’d go with a complete break from my usual routine. I was also concerned about the impact of the high-GI foods in Thailand, and from a coeliac perspective, the availability of low-GI gluten free foods. So, I decided to be organised and ensure I took with me what I needed:

10 measured packets of my low-GI GF cereal
2 loaves of my low-GI GF bread
A few juice poppers in case of night-time hypos
Mixed unsalted nuts for snacks

And I was glad I did that as it did make a big difference! Of course I also took a spare BGL meter and loads of extra fast acting and Lantus insulin and Glucagen but fortunately didn’t need them.

The Flights

I also had to think about the plane flights, as we flew with Jetstar and they don’t provide gluten free meals. For the way over I made a frittata with lots of veggies, sweet potato and cannellini beans (for low-GI carb) which was very tasty, and my Mum (who I was travelling with) was envious as her in-flight meal was not nearly as appealing. I also took a couple of pieces of my low-GI GF bread and a jar of peanut butter, an apple, a box of nuts and a juice popper for the flight. Worked out perfectly, but I didn’t need the popper (no hypos).

On the way back we slept most of the way, but I took a baby banana (provided every day in our room as part of a fruit platter) and boiled egg from the resort and had those with bread and peanut butter for my on-board breakfast. Very satisfying – a peanut butter and banana sandwich with an egg on the side!

The Resort Food

We had breakfast included in our package which was an enormous buffet of cereals, breads, pastries, European food and Thai food as well as the usual cooked breakfast options. I missed my coffee as, although they offered coffee, it was different to the coffee we have here. Of course, I had brought my own cereal, and I indulged in a freshly made omelette most days – most delicious. I also tried some Thai breakfast options including a clear broth with pork and cabbage with a fish sauce-based chilli seasoning. Very zingy and tasty!

I found that being coeliac wasn’t much of an issue there, but was glad to have my own cereal and bread. For lunch we took a selection from the European breakfast option of cold meats/cheeses and salad to make our own sandwiches in our room.

The night time meals were pretty easy to manage other than having a higher glycemic index/load than I’m used to. Most of the seasonings were based on fish sauce, tamarind, lime juice and coconut milk, so I really only had to watch out for soy sauce. And the noodles – some were wheat based, but they’re pretty easy to spot so I just avoided those, and of course there rice and mung bean/glass noodles always available.

When we ate at the buffets in the Resort, the staff were only too happy to have the chef prepare me special meals to my liking, so I felt very spoilt and had no accidental glutenings.

Food outside the Resort

We had only one day excursion from the hotel (other than local restaurants in the evenings) and although I checked 3 times with the hotel tour operator that there would be gluten free food available on the day, when we were on the bus on the way to lunch the guide asked if anyone had any special food requirements. When I advised I needed gluten free food, he really had no idea. There were ten Australians on our bus and everyone tried to explain on my behalf (how sweet), but when we got there they’d misunderstood ‘wheat’ as ‘sweet’ lol. Suited me too, but the 3 dishes offered, one was sweet & sour pork (too sweet for my taste), one was spring rolls (not gluten free) and the third was a chicken and eggplant green curry. The restaurant made me an extra serving of the green curry very kindly, so all was good including my BGLs as the coconut milk lowered the GI of the high-GI rice they served with it!

We also went to a market one day which was fascinating to see the various vegetables available as well as the meats and even insects. We didn’t eat anything there as it was very hot and didn’t look clean, but wished we could have tried some of the fruits and vegetables on offer. In the resort the only real green vegetable dish offered was called Morning Glory that was served stir fried. Vegetables were one of the foods I missed most on this holiday, and I normally eat about 6 serves every day of fresh veggies.

The local restaurants were fantastic and I had no issues with any of their meals, other than perhaps eating too much

My diabetes control

As mentioned at the top, I had concerns about how my diabetes would cope with a complete change of routine. With the weather being in the high 30s and very high humidity, it was really too hot to exercise. My usual exercise routine helps to keep my BGLs steady across the day, and that was reflected in higher BGLs than I would usually have. I had a few up around 16mmol/l, but these were easily corrected using my insulin pump. I used more insulin than usual, but not much more.

I spent hours relaxing in the pool, just sitting or sometimes chatting with other guests. With an insulin pump, you can take it off for up to two hours at a time, but I was often there for longer than that. The solution I found was to attach my pump to my cap, which also made for a good discussion topic I just couldn’t quite stand up straight as the tubing was slightly too short to reach from the cannula on my tummy up to my cap lol.

One day, I was zoned out after a massage and went for a swim in the pool, forgetting to take my pump off. Fortunately I remembered only about a minute into the swim and jumped out in a bit of a panic thinking I’d wrecked my pump (as I’d done to a phone before that never recovered). It was fine, but certainly shocked me out of my zoned out state of mind!

I only had one minor hypo after going for a walk on the beach one day without notice, but it was only 3.6mmol/l and the juice box was cool from the mini-bar fridge so very welcome. I carried my hypo treatments and my BGL meter everywhere with me.

I went there with the idea of running my BGLs slightly higher than usual, okay since it would only be ten days away. I didn’t actually do anything to achieve that but the lack of exercise and higher GI foods naturally did it for me, and everything’s fine.

I remember the story of 90 year old, Edna who was diagnosed aged 20, so 70 years of diabetes, who said “I don’t worry about my diabetes, I just say to myself to do my testing, to get rest every day and to enjoy life and stop wasting time worrying about my health. If you look after yourself you will have a long, happy life like I have.” Wise words methinks!

The language barrier

The Thai people are so lovely and helpful, but there were occasions when language caused confusion, such as the gluten free issue on the bus ride. Also, I had taken 2 loaves of my low-GI GF bread and when we got there I asked the kitchen to put one into the freezer for me to keep it fresh until I needed it later in the visit. Two days before the end I went to collect it and found they’d only kept it in the refrigerator, so it wasn’t as fresh as it could have been, but lasted the two days and the flight home so there was no drama.

I explained to the manager how asking for something to be kept in the freezer, meant the deep freeze where ice is made, not just the refrigerator, to ensure it is kept fresh. He seemed to understand so hopefully others won’t have this issue in future.

Happy Ending

The main goal of my holiday was to completely relax and switch off, which is exactly what I did. I didn’t even get around to reading any books. We just hung by or in the pool and the beach, had massages, ate yummy food, drank a few Mojitos (with little sugar and a big garden of fresh lime and mint in the glass) and lots of water, and chatted with other guests. I’m usually an adventure holiday type of girl, but to spend this relaxing time with my Mum was definitely what the doctor ordered.

We finished off with one day of adventure on rafting down a river on bamboo rafts, and trekking with elephants to make a perfect holiday. Wishing you all the opportunity to enjoy such a holiday yourselves one day. It was a once in a lifetime experience for me, but you never know what’s ahead!

Sally is the Social Media Dietitian with Diabetes Counselling Online, owner of her private practice (Marchini Nutrition), and has had type 1 diabetes for close to 40 years and coeliac disease for many years too.

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Your Feet

December 3, 2013 by Imagine_David 9 Comments

Not all people with diabetes will develop foot problems.

However, it is estimated that 10% of people with type 2 diabetes will have some nerve changes on diagnosis.

Reducing your risk of potential foot problems is the bottom line for all people with diabetes.

People with diabetes are more prone to infection, so even a tiny break in the skin – such as a blister or graze – can potentially lead to infection, gangrene and amputation.

Regardless of the type of diabetes you have, putting prevention into practice is an integral part of all diabetes self-care plans.

In my 15 years of practice in diabetes educator I have found that most people have no footcare plan – even after years of being diagnosed. Not knowing the things you can do each day to protect your feet puts you at risk.

Some examples of the things I have seen and heard:

JW: 54yr old, t2 diabetes, driver of heavy machinery – road building equipment / plant. Developed an ulcer where his foot was constantly in touch with the metal footrest in the vehicle. Did not take any action. Ulceration and lower leg amputation.

MC: 26yr old t1 diabetes, salesman. Cut foot at beach on rocks when surfing. Went stratight to local hospital. Antibiotics and stitches. Wound heal uneventfully.

TC: 62 yr old. History of heart disease. Smoker. Had a friend who had a foot ulcer for 4 years. Went walking on the beach in bare feet. Cut foot – infected. No treatment for 3 weeks. Foot ulcer. Healed 10 months later.

RF: active foot ulcer for 4 years. About to have surgery to foot for the 7^th time. Not amputated – yet.

AK: 23yr old t1 diabetes. At the end of a foot-care seminar said “so, I need to look after my feet like my wife looks after her face”

SE: 70 yr old man, t2 diabetes for 30 years. Checked his feet every day – sat on edge of bed and counted his toes. One day in the bathroom he heard a ‘tap tap tap’ on the bathroom floor. He had never looked at the bottom of his foot. Never. He had a drawing pin / thumb tack stuck in an infected wound. 6 months of hospitalisation before he finally had his leg amputated. Checking the bottom of his foot each day (as well as the top) would have saved his leg.

This foot care guide will help you identify some simple self-care strategies.

These strategies may help you prevent severe complications such as foot ulcer or leg amputation.

Diabetes has the potential to cause two problems that affect the health of your feet:

Loss of feeling (Peripheral Neuropathy) – this can happen if diabetes has damaged the nerves to your feet. Damaged nerves prevent pain and temperature sensations reaching your brain, therefore you may not be able to feel an injury to your foot when it occurs.

Poor blood flow (Peripheral Vascular Disease) – A reduction in blood flow to the feet will increase the risk of ulceration and amputation. Diabetes affects the elasticity of the blood vessels and can cause narrowing and blockage. This reduces the amount of blood that is supplied to the feet, meaning that there will be a delay in healing.

Smoking will damage your feet by reducing the blood supply.

I once saw a cardiologist present the following at a conference:

Diabetes + Smoking = Amputation

CHECK – EVERYDAY

Your feet for any redness, swelling, blisters or cuts. If you have difficulty reaching your feet, use a mirror or have someone look at them for you.
Before and after you wear your shoes, check them for objects that may have fallen into them. Objects such as small stones, gumnuts, twigs etc. Also, feel inside them for any material damage such as nails poking through the sole, rough or loose areas of material, which may injure your feet.
In between your toes to make sure they are not wet.

WEAR

Comfortable, well fitting enclosed shoes. They should fit well in the shop before you buy. Don’t depend on shoes stretching – they may not.
Good supportive footwear, which has a firm heel counter, flexible in the forefoot, and firm throughout the mid-foot. The shoe should also have a fastening device such as a buckle, velcro or laces.
With any new pair of shoes, wear the first time for no longer than 15 minutes. When you take them off after this time, check your feet for areas of redness or abrasion. If present return the shoe for a refund. If no redness or abrasion noticed, wear the shoes next time for up to 30 minutes, and check again. i.e. wear your new shoes in slowly.
Clean socks or stockings every day. Socks without tight elastic or seams are best. Try socks made specifically for people with Diabetes.
Bed socks or ugg boots if cold feet trouble you.

SELF FOOT CARE

DO’s:

Wash and dry your feet thoroughly, especially between your toes, every day.
Use a water-based cream such as sorbolene on your feet every day, but be sure not to apply cream between your toes.
Cut toe nails straight across and gently file rough edges. Never cut nails shorter than the end of your toe and don’t cut down the sides of the nail as this may leave jagged edges.
If you use a bath or foot spa check the water temperature with a bath thermometer. This will reduce your risk of causing a burn to your feet.

DON’T’S:

Don’t Soak your feet for long periods
Don’t use talcum powder on your feet
Don’t use any product that hasn’t been recommended by your podiatrist on corns, calluses or warts.
Don’t go bare-footed. The feet are at a greater risk of injury without shoes. Injury can lead to ulcers, infection, gangrene and possible amputation.
Don’t wear shoes without socks.
Don’t wear thongs or flip-flops or sandals.

WARNINGS

If you use hot water bottles, electric blankets or heaters, you may burn yourself and NOT FEEL it happening.
In winter do not put your feet near a fire or radiator. It is possible to burn your feet and NOT FEEL it happening.
If you find a break in the skin (cut, scratch, broken blister etc), you must clean it and keep it covered with a sterile dressing and see your doctor or a podiatrist as soon as possible.

FIRST AID

If you have a burn, cut, scratch, graze, broken blister, or any other area of broken skin, clean it and put a dry dressing on it to reduce the risk of getting it infected.
If it doesn’t seem to be getting better, or is deteriorating, see your Podiatrist or Doctor as soon as possible.

Hospital Plan:

Ask to see a podiatrist if you have a wound of any kind on your foot. My personal experience is having seen (on a number of occasions) a vascular surgeon with a plan to amputate a foot turn to the rescue of the same foot by the podiatrist.
Ask your family to check your feet for any signs of redness or broken skin (just as would have done yourself at home) if you are incapable of doing this yourself.
Ask your caring team (doctors and nurses) to refer you to the endocrine team if they have not done this. There is good evidence stating that your hospital recovery wil be less problematic if your BGL’s are well managed. Even for a few short days stay.
If you are capable, measure your own BGL pre and 2 hours post meals. The nurses looking after you are well meaning caring beings; but they are usually overworked and not in a position to measure your BGL as efficiently as you could yourself. This information can be invaluable in helping your recovery.

In your experience of hospitals, what would you be suggesting to include in a hospital admission plan?

Here is a self assessment tool that you can complete to see how your fare at present. I shall publish the scoring sheet next week.

This tool – the Nottingham Assessment of Functional Footcare – was developed by the team in Nottingham. Myself and a colleague podiatrist used it for the first time worldwide in clinical practice. We found that education based on this tool enhances the foot care of all participants. I hope that it can be a helpful guide for you as well.

NAFF unscored

If you would like some individual assistance to further your diabetes self care plan, simply complete one of our eConsul forms.

Safe travels,

David – Diabetes Educator @ Diabetes Counselling Online

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