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Oats for d-health

June 9, 2014 by Sally Leave a Comment

Oats are an awesome topic for a d-blog as they bring together so many aspects of food in our lives with diabetes including the glycemic index of carbohydrates, the importance of whole grains in our diets, soluble and insoluble fibre, heart health and the chance to talk about more delicious recipes. Not to mention with winter on our doorstep, oats are a wonderful comfort food breakfast for the coming cold mornings – Yes! And this idea follows on well from a recent blog about healthy eating on a budget as oats are definitely a bargain food!

Of course, like with all foods that I talk about individually, I need to make clear that they should be consumed as part of a varied and balanced diet as is demonstrated in the Australian Dietary Guidelines.

I’ll also talk about oats and coeliac disease, since around 10% of us with type 1 get coeliac disease, and I know I was devastated to find out that oats were off my diet when I was diagnosed. Now they’re back, so I’ll speak more of that further down

Glycemic Index

Oats come in various states – groats (the whole oat, just with husk removed), steel cut (the next ‘least’ processed version), oat bran, rolled oats, traditional oats and quick oats – just to name a few. As we often discuss, the less processing that the grain goes through, the lower it’s glycemic index should be as our body has to do the processing itself to break the whole grains down into glucose that our bodies need for fuel. So, when you’re choosing oats try to avoid the ‘quick oats’ which have been chopped smaller for faster cooking, when whole oats actually don’t need much (if any) cooking anyway.

It is also interesting to note that oats are lower in carbohydrates than many other grains. According to Calorie King, they come in at only 58% carbohydrate compared with rice at 79%, wheat at 71%, and quinoa at 64%.

Our D-health

We’ve probably all heard of the cholesterol lowering and glucose ‘slowering’ (I know, I made it up, but you get what I mean lol) abilities of beta-glucans that are found in oats, but oats are packed with a huge range of nutrients that are essential for maintaining health including B-vitamins, minerals (including iron, magnesium, and zinc) plus a whole lot more as well both soluble and insoluble fibre to keep our gut healthy too.

They also contain a plant nutrient that is unique to oats called Avenanthrades which have been demonstrated by research to possess anti-histamine and anti-inflammatory properties, as well as being shown to reduce a process involved in atherosclerosis. All good evidence for us with diabetes to include them in our diet on a regular basis as part of our 3-6 grain serves per day where one serve is a quarter cup of raw oats (17g carb = 1 serve/exchange).

There’s a lot of evidence to demonstrate the heart health benefits of oats, and I’m sure there’ll be more to come!

Oats and coeliac disease

Coeliac Australia says on their website that “FSANZ defines wheat, rye, barley and oats as gluten containing grains, as all four grains have been shown to trigger a reaction in those with coeliac disease.

“Many gluten free or pure oat products are now being imported to Australia. It is important to note that this means that the product is only free of contamination from wheat, rye or barley crops during the harvesting, processing or packaging of the product. The product has not had the gluten extracted or been genetically modified to be gluten free.

“It is recommended by the Medical Advisory Committee (MAC) for Coeliac Australia that despite the extensive medical research done in relation to oats and coeliac disease, oats should be excluded from a gluten free diet until the research is more conclusive and definitive.”

However, if you’ve been strictly gluten free for over a year and have fully recovered any previous damage, then it’s possible to do an ‘oat challenge’ using uncontaminated oats including 50g oats a day for 3 months with a pre- and post- biopsy to determine if oats are likely to cause you villi damage/inflammation.

Having diabetes, my doctor encouraged me to do this to help with the inclusion of more low-GI grains in my diet, and I would encourage the same of other people with diabetes who miss oats in their diet.

Notice I said ‘uncontaminated’ oats? From a coeliac perspective it’s important with all ‘gluten free’ grains to ensure they’ve been processed/packaged in a gluten free facility. Two I know of here in Australia are Freedom Foods and Carman’s Fine Foods. If you know of any others, please comment in the space below, thanks

Recipes

The obvious way to eat oats is to include them in your breakfast as porridge, muesli or in a smoothie, but there are so many other delicious ways to use them.

One of my favourite snacks used to be this Lowan recipe for oatbran and apple muffins as they were so easy to make and turned out perfectly every time, remembering I’m not a baker lol With both oat bran and apple, the GI of these would definitely be low. I just used a little less sugar – if you like it sweet you could use some sweetener in place of some of the sugar. I also choose to use light olive oil rather than vegetable oil (from an inflammation perspective).

I also like the look of this oat crumble topped pears with yogurt recipe which is likely to have a low-GI, but go easy on the sugar/maple syrup. Perhaps try some Agave syrup with its low GI instead?

And as far as savoury goes, they’re ideal to add to casseroles and soups. And how delicious does this recipe for lamb rissoles with tabouli and hummus sound? Yummo!

This roasted pumpkin crumble also looks like a top low-GI idea, especially good for those vegetarians amongst us!

And if you’re after more info on oats, Accredited Practising Dietitian/Nutritionist Catherine Saxelby wrote a blog on oats with more detail on the types of oats and her own favourite recipes that you can read here. And here’s a website that has a listing of all the nutrients if you’re interested.

Please share your favourite oaty recipes in the comments below! Sally

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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#shortcuts or the #longwayround? Which is best? Making decisions & weighing up #choices

May 17, 2014 by helwild 2 Comments

Yesterday I had an appointment at the Dentist. Groan. Yes, it was just a checkup & clean, but I did end up with a new filling as well. My dental appointment had been delayed by about 6 weeks, due to a month long virus that had also resulted in the cancelling of appointments with my optometrist, chiropractor, my flu shot, my mammogram, and my podiatrist. I’m still catching up! So it’s been a bit of a marathon of the rounds of all my health checks, most of which are diabetes related. But all (most) is well, my HbA1c results are good, as was my random bgl fasting test & my urine tests for kidney health, my feet are doing well, my eyes are unchanged. My blood pressure was up on the day I finally got my flu shot, maybe I’ll have to change medication for that. Sigh. My chiropractor has previously worked miracles on my back, shoulders, hips and is now focussed on my knees. I know I need his help to keep mobile for the sake of my diabetes management as well as heart, lungs etc. My dentist is also important in terms of my oral health, as being able to eat & enjoy the fibrous & ‘healthy’ foods also helps my diabetes management.

Largely because I have diabetes, this is a never ending journey of health checks. I feel fortunate to live in Australia with its great universal healthcare system and affordable health insurance, compared to some countries. I do feel sometimes as though I’ve been going ‘the long way round’ to arrive back where I was before all these checkups. It all seems so hard to fit in, & I’m not always motivated nor sure that my results will be positive. I know I’m lucky: some people are following up these same health care checks and getting not so good news. Sometimes it’s tempting to delay or postpone or ignore the need for getting tests done. It all gets so complicated, fitting appointments into our regular life. It’s tempting to take the ‘short cut’ & ignore it all, relying on the bgl meter & how we ‘feel’. Sometimes we’re scared of getting ‘bad news’. But at the same time we know that by getting the tests it means that we can get proper advice, and at least know the best path to take to improve or maintain our health.

So in the afternoon, feeling fine after my filling, I decided to take some exercise. Normally that’s a walk in my suburban neighbourhood, which does have some pleasant options & is something I can do easily, as everywhere I go is relatively flat. I can also do some local shopping, with all staple needs & some luxury items being walkable, even the post office & my pharmacy are walkable. Some days I will do several short walks. Yesterday was another glorious warm day in Adelaide, & I decided to pop up to the local Conservation Park, at Morialta.

I parked my car under some tall gum trees, & hopped out. Usually I walk on the flat, a slow steady imperceptible incline takes me on a delightful walk, crossing the creek several times, then to the waterfall at the end. Usually I see lots of birds, butterflies, and koalas.

Most of the time I am out of mobile phone range, because of the walls of the Gorge, which is quite nice. My husband often tags along, but he climbs, heading for the Tops & walking a circular route around the ridges, crossing over the waterfall at the top, and meeting me back at the car. Yesterday he was feeling a little unwell, so I was alone.

As I hopped out of the car, ready to walk down to the creek trail, I glanced over my shoulder. I saw the beginning of the track my husband usually takes. I used to walk that track with him, but now I am too slow to keep up. I thought, ‘Oh, I might just walk partway up Hogan’s Track today’. So I started. The track is wide, & has been improved since I last walked it, but it’s still a physically demanding trail. The slope is quite steep in parts, and the sunny afternoon made me hot very quickly. I was intending to go partway, then head back for my usual flat walk. Somehow I just kept finding the motivation to keep going, with frequent stops, until I found myself at the top of the ridge. Here there are several options. I could head straight back down the broad track I had just come up. I could go to one of two lookouts. I could head up higher, to the next ridge, which provides good views of the city. I looked at the sky, and at the time on my mobile phone. I had about 30-45 minutes until the sun set. I knew I did not want to be heading down in the dark. So I took an option which was not the shortest, but which was manageable in the conditions and in the time frame. I headed along another ridge for Hogan’s Lookout, and a mad scramble down a ‘shortcut’, which would shave off about 300 metres of climbing, but I knew would be a more challenging descent. As I took the path leading to the lookout, I heard a soft grunt & a rustle. I felt a little surge of fear, you never know what creature might be about, and I’d seen no humans on my ascent. I looked off the narrow path, and there was a large echidna! Poor thing was clearly more afraid than I, and was trying to bury herself, face first, all fluffed up with her spines. I took a photo, spoke to her quietly, & headed on to the Lookout.

As I neared the Lookout, I could see there was a great view, and the sun was starting to head to the horizon.

Another decision: which way down? I could retrace the Lookout trail, & head back down the wide track I’d come up. Or I could take the scramble trail, much steeper & narrower: shorter by about 300 meters, but would probably take longer, as I would need to be more cautious. I found the start of the trail, not easy, as it is infrequently travelled and the start is steep and somewhat overgrown. I could see the track of a bicycle, muddy wheeltracks. I thought, if someone has recently gone down on a bicycle, I should be able to make it on foot. So over the edge I plunged.

I was rewarded with great views, birds, butterflies, & an ankle & knee threatening descent. The sun was going down, & the level of difficulty was every bit as challenging as I’d thought it would be. There were so many traverses of this steep descent that I lost count. The rains had gouged out little gullies in the centre of the narrow track, which of course was littered with stones & rocks. Most of the way I had fantastic views, into the Gorge & over the plains, with the low sun casting long shadows, with Adelaide spread out before me. There were feral olive trees scattered amongst the eucalypts, & animal droppings indicating wallabies or kangaroos. I started to worry about how long it was taking, but then I recognised that I was almost on the final traverse, & popped around a corner to glimpse my own car, parked below me amongst trees.

By this time I was covered in a fine film of sweat. My knees were somewhat tender, but they always are, even if all I do is sit. I’m pretty sure that the exercise endorphins & the mindfulness practice were kicking in, because what I felt was elation. I’d challenged myself, both physically & mentally. I’d made good decisions. I’d achieved something that I’d though was no longer possible for me to do. I reached the last little slippery slope, popped back down onto the road, crossed over & followed the creek back to the car. As the sun set, I drove slowly home, feeling quietly happy, and very blessed. I had done something that I thought might be too hard, but by thinking & strategising I’d achieved it.

Helen Wilde

Helen is a Senior Counsellor with Diabetes Counselling Online. She has been the parent of someone with Type 1 diabetes since 1979, and has lived with type 2 diabetes herself since 2001.

Diabetes can't stop me! — Diabetes can’t stop me!

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Nuts and D-health

April 28, 2014 by Sally Leave a Comment

Nuts are a fascinating food, and for us with diabetes they tick so many of our healthy eating boxes – fibre, nutrients, good fats, satiety and more! Today we’ll take a closer look at the reasons behind all those good stories with a focus on our D-health (remembering to choose unsalted ones). It’s important to remember with blogs like this that focus on one food type, that foods should be incorporated into a healthy varied diet. I like these words of David L. Katz to illustrate this point: “Eat a diet of wholesome foods reliably associated with good health across a vast and stunningly consistent literature.”

First up I’d like to introduce the photo at the top of this blog, as it is the new logo for the ‘Nuts for Life’ campaign and we’re fortunate to show it here as they launch their new campaign to help educate Australians on the health benefits of regular tree nut consumption #healthyhandful.

Last week I was chatting with Nuts for Life Accredited Practising Dietitian, Lisa Yates, who suggested the key messages for us with diabetes are:

People with diabetes can and should eat nuts (unless you’re allergic of course!)
Nuts are a healthy snack that will help control BGLs as they have a GI lowering effect when eaten with carbs due to their healthy fat content
Cashews and chestnuts are the only nuts that contain enough carbs to be GI tested (needs a minimum 10g carbs per serve) and they have a low GI. Cashews average GI 25 and chestnut meal has been GI tested and was 54. Since GI is related to particle size it makes sense that whole chestnuts not grounded will also be low GI
Nuts also help with improving insulin sensitivity
People with diabetes have an increased risk of heart disease and eating a daily handful of nuts will help reduce the risk of heart disease while managing weight and cholesterol
People who are overweight can eat nuts they will not cause weight gain and if eaten in a calorie controlled diet will help with weight loss. This is because we don’t absorb all the fat in nuts about 20% is excreted as trapped in the fibrous structure of chewed nuts. Nuts eaters have more fat in their stools than non nut eaters. Nuts also contain fibre, protein and fat which all work on various aspects of appetite control. 30g per day is the recommended daily amount = #healthyhandful

I’ll look closer at some of these claims and the evidence behind them, as well as explaining how nuts fit within the Australian Dietary Guidelines (hereafter called ‘the guidelines’) and provide you with some recipe ideas to help include nuts on a daily basis.

According to the guidelines nuts fit into the protein foods section and 30g (a healthy handful) is one serve. If you’d like to read more about Protein and diabetes you can check out a previous blog here.

In terms of definition of a nut the guidelines offers this one: “A nut is a simple dry fruit with one or two seeds in which the ovary wall becomes very hard (stony or woody) at maturity, and where the seed remains attached or fused with the ovary wall. Most nuts are indehiscent (not opening at maturity). Any large, oily kernel found within a shell and used in food may be regarded as a nut. Examples include almonds, pecans, walnuts, brazil nuts, cashew nuts, chestnuts, hazelnuts, macadamia nuts, pine nuts and pistachio nuts. The term ‘nut’ is applied to many seeds that are not botanically true nuts. These may include cape seed, caraway, chia, flaxseed, linseed, passionfruit, poppy seed, pepita or pumpkin seed, sesame seed and sunflower seed.” Lots of choices here then!

The guidelines tell us: “There is evidence to suggest that consuming nuts (65–110g per day) is not related to risk of weight gain in the short term”, and that “consumption of nuts and seeds may help reduce the risk of heart disease and is not associated with weight gain if total energy (kilojoule) intake is controlled.”

It goes on to explain a key point that I was keen to make in this blog, that: “Nuts and seeds are rich in energy (kilojoules) and nutrients, reflective of their biological role in nourishing plant embryos to develop into plants. In addition to protein and dietary fibre, they contain significant levels of unsaturated fatty acids and are rich in polyphenols, phytosterols and micronutrients including folate, several valuable forms of vitamin E, selenium, magnesium and other minerals. They are nutritious alternatives to meat, fish and eggs, and play an important role in plant-based, vegetarian and vegan meals and diets.” There’s an awesome ready reckoner for nuts available from Nuts for Life that lists all the different nuts and the levels of nutrients each of them contains per 100g. It’s one of my favourite resources that I give to clients to help them understand more about the food they’re eating.

Further on the topic of helping with cholesterol, the guidelines say, “Nut consumption provides benefits by enhancing anti-inflammatory processes and lowering serum cholesterol possibly due to the presence of phytosterols, which reduce cholesterol re-absorption and/or the effects of shifting dietary fat quality, notably replacing saturated with unsaturated fat. Nut consumption is also associated with increased levels of adiponectin, which has anti-inflammatory and anti-atherogenic properties. Early work suggests that the delivery of components such as tocopherols and phenolic acids may help to reduce lipid peroxidation and oxidative DNA damage, and there is some indication that walnuts with a relatively high content of the amino acid L-arginine may have an effect on vasodilation through nitrous oxide pathways. Other nuts are also significant sources of arginine. Proposed mechanisms for effects on weight control include increased satiety, increased faecal fat excretion, increased thermogenesis and increased fat oxidation.” Pretty impressive facts to encourage nut consumption I’d say!

The guidelines advice for pregnant women and young children

It’s also important to note that “Nuts are a problem for small children as their size and consistency increases the risk of inhalation and choking. For this reason, they should not be given to children aged less than 3 years.” And that, “Pregnant and breastfeeding women do not need to avoid consuming nuts for fear of causing an allergic reaction in their babies. Only women who are allergic to these foods themselves need to avoid them.”

On the topic of improving insulin sensitivity, it’s a little complicated to explain in depth at this point other than to say it’s related to evidence about increased amounts of the anti-inflammatory mono-unsaturated fats in nuts that reduce inflammatory processes in the body, thereby allowing improved insulin sensitivity combined with lowering the GI of other carbs and increased satiety leading to weight loss. I have lots of research papers on the topic if you’d like to learn more – perhaps improving insulin sensitivity could be the topic of a whole blog one day? Please let me know if you’re interested and I’ll add it to my list!

Specifically related to Lisa Yates’ points about how they related to us with diabetes, Nuts for Life offers a free downloadable fact sheet entitled, ‘Nuts and Diabetes’ where you can read more at your leisure. They also have many other fact sheets and resources, as well as some delicious recipes. It’s definitely a site worth bookmarking as Lisa advised me this week that there are some great additions to it on their way in the near future.

Other good nut recipes sites include the Australian Healthy Food Guide and Taste.com.au but please remember that not all the recipes will be suitable for us with diabetes, so choose carefully.

There’s a FAQ page on the Nutrition Australia site that you may also like to view that includes some other interesting points that I haven’t gone into here.

Remember that it’s a good idea to check with your Accredited Practising Dietitian before making changes to your diet and to learn what the right amount of nuts for you personally is, and it’s good to go armed with some factual information. You can find an APD near you via the Dietitian’s Association of Australia website, or you can book in for an e-consult with our e-dietitian via our Diabetes Counselling Online website.

Wishing you improved D-health! Please let me know if you have any questions as usual, and I would love to hear how you include nuts in your day! Sally

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#sick day #plan with #diabetes- the best laid plans

April 11, 2014 by helwild 3 Comments

without the noodles- for T2diabetic! LOL

I didn’t get my blogpost written for the group blog this week. Nor last week. In fact, I haven’t had my head up out of the sheets much since dinnertime on April 1st, when I went out to dinner to celebrate my son in laws’ 50th. With frog cakes..

That’s because I’m sick. I don’t mean with a metabolic disorder (Type 2 diabetes); nor an auto immune disease-my asthma; nor chronic pain; nor reflux; nor blood pressure; nor cholesterol; nor neuralgia; nor neuropathy; nor arthritis. I have a virus. A drag me down, unrelenting, constantly mutating virus. First it was probably the odd sneeze, next the extreme sore throat + a crushing, debilitating headache. Sweating of course, a cough. I slept. For 3 days. Because I take panadol constantly anyway, some symptoms were dealt with. What was I to do about my diabetes? I knew I should eat some carbs, I should try to exercise. On two days I staggered around the block, feeling dizzy & unsafe. On the other days I briefly wandered in my back yard, in my nightie. Eating was of no interest. Nor was checking my blood glucose levels. But I did keep taking all of my oral medications as prescribed, at the usual times. I cancelled all appointments. I stopped reading & working. I couldnt scroll on my mobile, as that was dizzying, so no Facebooking either. I couldn’t care for my grandchildren. I couldn’t visit my poor, demented elderly mother.

I didn't test my bgl.. — I didn’t test my bgl..

On the 8th day, the mutation was sudden. By now my sore throat had eased, the sneezing was still intermittent, & I’d developed what medicos call ‘a productive cough’. I’m a grandma, I know the lingo. But on this day, I actually felt a little better. I did 2 hours of paperwork. Then I stood up. The world swam around me. I felt nauseous, faint. I nearly passed out. I had other symptoms too. The worst was the severe vertigo. I tested my bgl. Steady at 6.2. So it wasn’t low blood glucose. I tested my BP. That was pretty ‘normal’. I rang the Dr’s rooms for advice, the Dr said come here straightaway, or go to Hospital. Now I have never been to an Emergency Department for myself. But I have been many times with Family members. I know you do not want to be in a ‘walk in’ situation in Emergency. I couldn’t drive, I couldn’t even open my eyes for the vertigo, I could barely walk. So my husband drove me. I carried a blue bucket, & a green towel. I was in old ‘trackie dacks’, my hair was a mess. The journey was quick, the Dr terrific. I threw up in my bucket, conveniently, she could test it for blood. She gave me an injection, a prescription, instructions to my husband about blood pressure, & a letter for the Hospital, should certain indications occur. Instructions to “Come back to see me on Thursday”. We set off home. The injection helped very quickly. Although I kept my eyes closed in the car, I was able to walk with eyes open to get to the car, & to have a rational discussion about filling the prescription.

I now had a new regime. 2 hourly Blood pressure checks, to particularly note if the pulse rate climbed & the BP dropped. A new medication, 8 hourly, so unfortunately, to start with, alarms & early morning wakings. My vertigo eased, I slept some more, & suddenly it was Thursday. My husband rang to book me in, of course it had to be a ‘double booking’. My husband said I needed to find something ‘decent’ to wear, as he wasn’t going to take me in as ‘disheveled’ as I’d been on Tuesday. That made me laugh. When the Dr saw me, I was neat, tidy, walking steadily, I was wearing earrings. (Diabeadies by Vivi of course). But when the Dr. examined me, she found another ‘mutation’. Now I have a chest infection, I need an antibiotic. Sigh. My chest does hurt. But apparently it’s not asthma.

Now it’s the next day. The antibiotics are making me nauseous. The metformin is affecting my gut. The stemetil is helping with the vertigo & nausea, but apparently is only ‘masking’ those symptoms, I still have the virus. The family’s long made plans for the School Holidays are ‘on hold’.

Last night my daughter flew from Sydney to Adelaide. Her plane, like most of the traffic to & from the Eastern seaboard yesterday, was delayed by the massive Category 5 cyclone Ita, which is currently approaching North Queensland.

During the delay, she was texting, & suddenly about 40 minutes before boarding, she texted, “I’m low.” A message like that puts my virus into perspective. Managing my type 2 diabetes when I’m sick is not hard, & it’s not life threatening. I might go high, or low. I might have work to do when the virus passes. But when you are insulin dependent, day by day, hour by hour, minute by minute, intensive mathematical calculations have to be worked through, instant decisions made, not always with a fully functioning brain. In either case, systems & plans are crucial in getting through the situation. Knowing that I’d be worried, my daughter texted, “I’m eating lots of glucose, back up to 10 now. Have longer acting carbs on board. Will make sure I’m 14 before boarding”. What a lovely clear, reassuring plan. Mine is to take the medication as prescribed, rest as prescribed, watch for changes as prescribed. Eat when I can, exercise if I can. I have had somewhat of a ‘bonus’. Not eating much other than my obligatory bananas (for the leg & foot cramps, to get the potassium), I have lost around 4kg. So maybe my T2diabetes is cured? Or maybe the chicken soup will cure me. LOL….

Last night I made Chicken soup.

And today, as cyclone Ita bears down upon North Queensland, I am hoping that no lives are lost.

http://www.abc.net.au/news/2014-04-11/cyclone-ita-compared-to-tracy-larry-and-yasi/5383224

Helen Wilde

Helen is a long term Senior Counsellor with Diabetes Counselling Online. She is the parent of someone who has been living with Type 1 diabetes since 1979, & has had Type 2 diabetes herself since 2001.

If you feel you’d like to talk with Helen or another member of our team, please contact us on this link:

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

Or look out for the chatline on the front page of the site, you can chat live when a counsellor is ‘in’, or leave a message for later.

Please feel free to leave a comment after this post!

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#Parenting a child with #diabetes #struggles & #rewards: owning your own #lifetime

March 20, 2014 by helwild 10 Comments

This is a blog I have wanted to write for some time. As the parent of a now grown up child with diabetes, I feel a ‘special’ bond with other parents. Because of this, I am one of the moderators of the Facebook Closed group Parents of kids with diabetes. Almost every day I read & respond to heroic, wonderful, ordinary, or desperate stories of parents, ordinary people, most of them with no prior knowledge or experience of life with diabetes. Some are the parents of newly diagnosed infants. Those of us diagnosed as adults, no matter what type of diabetes, we know the emotional rollercoaster that diagnosis brings. Imagine that diagnosis being pronounced on your baby or your child.

The journey of acceptance of the diagnosis of diabetes is often described as the journey of loss, a journey through the stages of mourning. Some people diagnosed, or some partners of people who are diagnosed, get ‘stuck’ in one of the very earliest of stages, Disbelief & or Denial. They may delay or refuse the suggested treatment or advice for management. They may hide their diagnosis from those around them. That stage is bypassed in a Blink for the parent whose child is diagnosed. From lasting perhaps years, this stage is reduced to a few moments, a few hours, a day, a couple of days. From then on, ‘Disbelief’ & ‘Denial’ do not exist. We leap straight to fear, panic, guilt; into anger, blame, shame. We also leap straight into fierce Warrior protector mode. For most of us, our fear has to be submerged into Action, Compliance, & Learning, all embedded in a fierce protective mode that overrides everything else. Our own sadness, mourning, self blame must be submerged under the need to be the responsible Parent, the one who will manage the journey of our precious child into adulthood with lifelong chronic disease. I imagine the journey is similar to that of any parent whose child is diagnosed with a chronic disease or condition.

One of the differences lies in the management. Daily, a parent must monitor & restrict or ‘manage’ the food intake of their child. When birthday parties or celebratory occasions come up, the decisions about how to manage party food become an obsession. We handle insulin, a powerful hormone with great responsibilities attached, several times a day. We check glucose levels, ketones. We must ensure that we never run out of any supplies. We make & keep appointments with a range of HCP’s. We keep records, or trust our children to. We learn jargon. We FB, we Tweet, we SoMe. We must budget to afford all this, & although thankfully in Australia parents do receive some government assistance with costs whilst their children are under 16, in some countries this is a crushing, unsustainable burden. Our sleep is interrupted, sometimes many times a night, for the duration of the time our child with diabetes lives under our roof; and in the case of our daughters, possibly again when (if) (joyfully; & scarily) pregnancy occurs. We become master mathematicians & pseudo nurses & endocrinologists, calculating complex equations several times a day, carbs, insulin, bgl ratios.

Another difference between being diagnosed yourself & having your child diagnosed is the type & level of Guilt & Self Blame that occurs. For ourselves, it becomes tied up in not talking about our diabetes, in hiding it so that we check our bgl’s or inject our insulin or take our oral medication very privately. We may even not do these things at all if a social occasion comes up. When it’s your child, ‘compliance’ is not an issue. We follow our instructions to the letter, to the minute. We advocate, we speak out, we question, we seek knowledge, advice, support. We talk to teachers, schools, principals, classrooms full of children. For many parents, their Guilt & Self Blame becomes lifelong, but is submerged into supporting a search for a cure. This is absolutely normal. It gives Hope, which is so wonderful. However, for some people supporting a cause such as this can become obsessive, preventing Acceptance, & interfering with normal life, & just getting on with managing the diabetes as best as possible.

It can seem impossible to set aside time for managing to care for ourselves. We can feel as though we are too tired, too busy, too responsible to take some time out just to be ourselves, just to breathe & enjoy our lives. We feel driven to Act, to do. The younger the child, & the more young siblings there are, the more difficult this becomes. Many parents are fortunate in having the practical support of a partner, grandparents, their own siblings. Others have friends in the ‘real’ world as well as in the virtual world. You may have access to good Child Care, where people are already trained or are open to be trained in managing your child’s health condition. It is hard to accept that it is not selfish to use such practical help to simply ‘take a sanity break’. However, doing so can actually be a wise management strategy. By allowing someone else to take care of our child with diabetes for a half a day, a day, a ‘sleepover’, a weekend; we are teaching everyone concerned that if for some reason we are unavailable, they can manage, & manage well. We’re teaching our child that there are safe people & places in the world, & as they get older, that they are clever, brave, strong; and normal. They can be away from us, & we can be away from them. We will come back, & we will all be OK. And we’re teaching ourselves that our lives exist outside our Parenting role, a role which changes over time for everyone, regardless of any health condition of their child.

What activities do you currently do that are solely for yourself? Do you walk, run, climb, meet a friend, visit a library, play a sport, go to the gym, sew, go to the cinema, study, paint, garden, play with animals, swim, do yoga, ski, ride a motorbike or bicycle, box, write a diary or blog? What have you stopped doing that you would like to go back to? What have you always wanted to do or try that you have not yet tried? Do you know how to practice relaxation, controlled breathing, or any stress relief practices?

Always remember, you are a Parent of a child, & you are a Person. These roles do not exclude or preclude each other. Your life is yours, you own it. We have a short time on this earth, & our time is Now.

Remain in Light. Talking Heads

carpe diem

Helen Wilde

Helen is a Senior Counsellor with Diabetes Counselling online, a Teacher, & the Parent of a person living with Type 1 diabetes since 1979. She has lived with Type 2 diabetes herself since 2001.

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