Guest Blog: Foot care, diabetic #neuropathy

Family Feet

One of our Closed groups on the Social Media platform of Facebook is called ‘Diabetes Education and Management’. This group is supported by Diabetes Educators and a Midwife, a Dietitian, and a Pharmacist, as well as Mental Health Counsellors.

Recently one of our Diabetes Educators posted a link to a blog about complications and Foot Care in diabetes management, a fairly regular topic of discussion. Footcare form edited July 09

A very heartfelt and powerful response came from a member of the group, Zac. Zac has very strong views on the importance of seeking truth, accurate information, and developing informed knowledge about foot care and diabetic neuropathy in particular. He warns about the high risks associated with poor diabetic control, and not being proactive in our own health care, risks that he believes were not made clear to him before it was too late. Here are Zac’s powerful words:

This topic is very interesting to me, being a Diabetic T2 for a few years now. I visit my Clinic only once a year. They make my appointments, not me. BUT I just wish I had’ve been told about the seriousness of COMPLICATIONS of Diabetes as so far as Peripheral Neuropathy is concerned, as I now have it.

Not once was I referred to a Podiatrist, so I asked to make an appointment, only to be told they are not taking any more patients as they are over loaded. Well, I didn’t bother too much about it at the time, as I didn’t have Peripheral Neuropathy, and thought nothing of it. Until, that is, for another 2 yrs. By then, my feet felt like they were in a bucket of bull ants.

Not realising this was nerve damage, I put up with it, until, on one of my visits to my Clinic the nurse did a small test on my feet. She looked at them and said, “Oh, your feet are fine.” So I asked, “What would be making my feet feel like they are being bitten by bull ants?” She looked at them again, said she didn’t know, and again, said she thought my feet were fine, so home I went, feeling disappointed.

On the next visit, I demanded. I said, “Something is SERIOUSLY WRONG with my feet, please help me.” So the nurse called in some guy, whom I wasn’t introduced to, and he put a name to it, called it ‘Peripheral Neuropathy’. Well, I was just over the moon that someone had finally worked out what was wrong with them!

But then he said, “Go to your chemist buy some Phanalgon Cream. This helps some people.” my reply was, “But I want something that will definitely help my feet!”

He said, “There is no cure for Peripheral Neuropathy.”

So I said, “You’re kidding me, in this day and age there is no cure for it?”

He said, “Yes, no cure.”

So home I went, with Phanalgon Cream in hand, only to have a bad reaction to it. My skin started to peel off from my feet, as it has chilli in it. So I tried again when my feet healed, but used less of the cream. Still I had a reaction to it, so I gave that the flick…..

I’m ANGRY at myself. First of all, for being so flippant about Diabetes; and not educating myself about complications which I never knew existed. And I’m ANGRY at my Clinic for not pointing these matters out to me in the first place. After all, isn’t this why we attend clinics? When the nurse used to test my feet, I was never given an explanation as to why. It’s the same with my eye tests. I was never told that Diabetes can affect your eyes. I just thought it was a normal eye test…Sorry this is long winded but if I can help just ONE person to realise the seriousness of Diabetes Complications then it will have been worth while typing all of this.

I just wish I had been warned. Peripheral Neuropathy is the pits, and I don’t have a normal life now. I am practically house bound because of it…..If you have read this far I Thank You and I Thank you David Mapletoft and Sally Marchini and for everything I have learned through your expertise and knowledge, even though it’s too late. Well, not too late as far as Diet is concerned, but it’s too late for my suffering feet. Thank you Zac

Zac has kindly shared his experience here. Do you have a similar experience? Can you give Zac any suggestions on how to manage his foot discomfort and pain?

 

Helen Wilde

Senior Counsellor

Helen has been a Counsellor with the service since 2003. She has been the parent of someone living with Type 1 diabetes since 1979, and has lived with type 2 diabetes herself since 2001.

 

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Guest Blog:Thanks Teacher

Our guest poet, Maureen Campey, has written another great poem about Parenting a child with diabetes. This time, Maureen has written about her teenage son starting a new year of High School, one of those momentous hurdles that we all face as parents.

DSCN2553

 

Here are Maureen’s wise words.

Sending our kids back to school always brings its own set of worries and frustrations. My T1 14yr old has gone back to a new set of teachers. He seems pretty cool with it all. My ‘coping mechanism’ seems to have become, Writing Poetry! Weird, I know but it helps me get it out of my system. I hope you don’t mind if I share!

Dear Teacher

Hi, hello, it’s me again.
Please don’t roll your eyes!
I’m not a helicopter parent,
I come in peace!

I need to explain
That my child will be carrying an invisible pancreas.
You won’t even know it’s there.
He will carry it with him wherever he goes.
He will do its job and look after it
But sometimes he may grow a little weary.
Your help may be needed as he mustn’t let go of this tiresome load.

Scared? Don’t be!
Imagine how he feels all day, every day
Yet he keeps on going.
Your job is small and help is at hand for you.

My child must calculate many things at the same time.
He must think like a pancreas.
Can you imagine?
As well as trying to learn,
He must anticipate the effect of every action and piece of food
Whilst travelling from class to class, and teacher to teacher.
No mean feat!

I will make sure you are given the knowledge you need.
I ask that you are willing to accept your role.
Let him be and don’t become a helicopter teacher.
He is not perfect.
Do not expect gratitude,
There will be no immediate reward for what you do
But know that he will go on to live a full life
Having learnt from you that this burden can be shared.

You will never know the gift you have given my child
But please know that I will be forever in your debt.

Maureen Campey

giving love
The gift of the Future..
 

 

 

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Research: why does it matter? The Endia study

pregnant happy couple
As the parent of someone with Type 1 diabetes, it can seem that the only organisation in the world doing research into diabetes is the International Charity, Juvenile Diabetes Research Foundation, or as it is more usually known nowadays, the JDRF. For many years, I have ‘walked for the cure’ hoping that one day it would happen. And of course many people connected by Type 1 diabetes, all over the world, are supporting JDRF, working, hoping for the day ‘the cure’ will come.
However, it is good to know that there are many other wonderful organisations undertaking vital research to assist people managing Living with diabetes, and researching possible ‘triggers’, causes, and even treatments, including some that are based right here in Australia.
One of these is a very interesting Australian study known as ENDIA, or “environmental determinants of islet autoimmunity”
We have posted information about this wonderful Australian Study before, but we have many new members who may be unaware of it. One of our Facebook Closed Group ‘Pregnancy and Parenting’ members has asked if we can ‘share’ the links here, hoping to get some more people to commit to the study. Note it is Australia only.
“Hello Helen, I am a member of one of your diabetes closed groups on FB. I have a son who is T1 and has been so since he was 18 months old (he is now 9). Here is a link about the ENDIA study that is being conducted around Australia. We are part of this study and it is about Type 1 diabetes in children. For example, studying what the ‘trigger’ could be for the onset of T1; studying using cord blood to prevent or delay the onset of T1; and studying whether cord blood can be used in assisting T1 children to ‘kick start’ the pancreas. One positive is that being part of this study the storage of cord blood is very cheap. Here is the link, and I hope you do post it, thank you so much”
Thanks to our group member for her story.
Helen
Helen Wilde
Senior Counsellor
Helen has been the parent of someone with diabetes since 1979. She has lived with Type 2 diabetes herself since 2001, and has been a Counsellor with the service since 2002.
www.endia.org.au/about/the-endia-study
The ENDIA study | ENDIA
www.endia.org.au
We are asking women who are pregnant and have Type 1 Diabetes themselves or have a family member with Type 1 Diabetes who would be a first-degree relative of the baby, i.e. the baby’s father or the baby’s older sibling, to consider participating.
The ENDIA study | ENDIAendia.org.auThere is also a Facebook group which you may like to visit, here is the link: https://www.facebook.com/endiastudy?fref=ts

The ENDIA study | ENDIA
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Fancy a beautiful Lunch in a Vineyard winery?

LDV 2014 email invitation.pdf - Adobe Reader

LDV 2014 email invitation.pdf - Adobe Reader

Hello.

You already know that www.diabetescounselling.com.au is an Australian Charity, providing free education, support, and counselling to people with diabetes and their families. This means that there are also Volunteers who spend time fund raising throughout the year.

In 2014 we are fortunate to be one of many charities generously supported by Channel 9 Telethon. In late October, we are one of only 6 charities being supported in running a Charity Luncheon, La Dolce Vita, in the beautiful Adelaide Hills.

La Dolce Vita

Celebrating our lives through good food, good company, good wine, in beautiful settings is one of the best aspects of life. This event is an outstanding one, with some of the best food, wine, and scenery that South Australia can offer. It is made extra special knowing that you are supporting 6 diverse charities directly through the opportunities to participate in auctions and raffles on the day, whilst enjoying a gentle ‘wind down’ as 2014 draws to a close.

“La Dolce Vita 2014
Proudly supported by Beyond Bank Australia
Sunday 26th October
It is our pleasure to invite you to La Dolce Vita which, again this year, is being held in the stunning setting of Longview Vineyard.

With fine Italian cuisine and specially selected wines from Longview Vineyard’s cellars being served, you will be treated to a range of mouth-watering taste sensations.
Inspired by the wonderful Italian lifestyle La Dolce Vita promises a lovely relaxing afternoon for you to enjoy with family and friends.

La Dolce Vita is being held:
At: Longview Vineyard, Macclesfield
On: Sunday 26 October 2014
From: 12.30pm to 5pm

(Entrees on the piazza followed by main course, dessert and an auction presented by Michael Pratt … his distinctive style … in the padiglione.)

This year La Dolce Vita is supporting Asthma SA, Blind Sporting Council, Diabetes Counselling Online, The Mary Potter Foundation, PARAQUAD SA, and 5RPH Vision Australia Radio.”

Tickets at $135 per person, or $1300 for a table of 10 are available next to the Diabetes Counselling Online table if you’d like to sit with us! Just email Helen Wilde at [email protected] to purchase tickets from us!

Tickets to La Dolce Vita are limited, but we do have a few remaining at our own table for sale.

Please read the info below from the Channel 9 Telethon office for other booking details. Contact me on [email protected] for more information.

Tickets at $135 per person or $1,300 per table of 10 can also be booked via the Telethon website or by contacting 8267 0206. Bus transport, which will leave vantage points close to the city, can be booked by contacting Channel 9 Telethon on 8267 0206.
Tickets are strictly limited to 270 guests.”

We look forward to sharing La Dolce Vita 2014 with you.

See you there!

Invitation to La Dolce Vita
Invitation to La Dolce Vita

Regards

Helen Wilde

Senior Counsellor

Helen has been a Counsellor with the service since 2003. She has been the parent of someone living with Type 1 diabetes since 1979, and has had type 2 diabetes herself since 2002.

 

 

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Healthy d-baking with guest Joan Bailey

Joan uncooked

One of our wonderful Diabetes Counselling Online volunteers, Joan Bailey, has type 2 diabetes. She also has two young daughters who both have coeliac disease. Joan loves to bake them yummy, homemade meals and treats for their lunchboxes. She also works hard to control her blood glucose levels and remain fit so that she’ll be healthy to look after her family in years to come. And she also enjoys the food that she creates for the rest of the family. This means that she needs to consider all the diabetes factors in recipes as well as making them gluten free and delicious.

In today’s blog Joan demonstrates how she does this and explains that often these healthier options are even more delicious than the original recipes. If you’re not gluten free, don’t worry as Joan has included gluten containing options too in her tips for healthier swaps :)

Over to you Joan:

Thanks Sally. I hope this blog highlights that for those of us who enjoy baking that it is still possible!

Today many low glycemic index (GI) recipes are available but sometimes a family favourite is hard to give up and obviously we still want to enjoy them at the end of the day.

So the only option is to identify the potentially high GI, high fat and high sodium elements within the recipe and swap them for diabetes friendly ingredients.

I personally think that taste-wise the healthier versions can taste even nicer and be more filling and satisfying!

Making the conversion

As we’ve learned through listening to Sally and other dietitians, when converting a recipe for diabetes the main components that should be addressed are the carbohydrate components (the sugars and the flours) as well as the total and saturated fat levels and the salt (sodium) content.

Once you get the proportions correct and the correct substitutions it is easy to do.

It does take a bit of trial and error, so it’s a top idea to write things down as you go. And just like anything you do, the more practice you get, the better you’ll be at making your original ‘guesstimations’ for the substitutions.

Beginning with a Brownie recipe

Let’s start with a basic brownie recipe and look at converting each component. This table shows what a difference the changes can make!

Original recipe Amount of Nutrient Substituted with Amount of nutrient % Difference
1.5 cups self-raising flour (337g) Carb = 246g 1.5 cups chickpea (besan flour) plus a teaspoon of baking powder (225g) Carb = 104.4g -57.6%
½ cup sugar (225g) Carb = 224.5g ½ cup Stevia Carb = 0g -100%
1 cup water   1 cup water    
¼ cup cacao   ¼ cup cacao    
1 tblspn vinegar   1 tblspn vinegar    
60mL full cream milk Per 100gFat Total = 4.4gSaturated = 2.9 60 mL low fat milk Per 100gFat Total – 1.2gSaturated 0.8 -73%-72%
1 tsp vanilla essence   1 tsp vanilla essence    
6 tblspns sunflower oil Per 100gFat Total = 100gSaturated = 11g 6 tblspns low fat yogurt Per 100gFat Total = 0.3gSaturated 0.2g -99.7%-98%

Now, this table took me a little while to put together, but I think it’s quite an eye opener as to the enormous differences we can make to help our health and wellbeing, just by making a few minor changes to the original recipe. Still looks and tastes as good as the original!

Joan finished product2

And just to further make the point, I put both recipes through the FSANZ Nutritional Panel calculator (following the directions in a past blog that Sally posted for Diabetes Counselling Online).

First is the original brownie recipe The original brownie NIP

And here’s my healthier version The new brownie NIP

Which would you rather have, especially when you know that this one tastes just as good as the original??

Are you amazed at the differences these changes have made?

And the taste also lived up to expections! My girls certainly enjoyed them – they didn’t last long!

Joan after kids had finished

Some other helpful ideas for your recipe conversions

  • Instead of icing sugar try low fat Philadelphia cream cheese thinned out with milk and sweetened with Stevia (cocoa – optional)
  • For pizza bases/pancakes/crumpets/muffins try swapping the plain white flour with chickpea flour, quinoa flour, buckwheat flour and spelt flour (for those who aren’t gluten intolerant). Coconut flour is also low carb, but I find its flavour spoils the flavour of the finished product.
  • Use low fat yoghurt! It makes a great alternative for mayonnaise, sourcream, ordinary cream and can directly replace oil in baking. Here is the link to an article that talks more about it.
  • Rolled outs and ground seeds also make an excellent substitution for flours. The calorie content does needs to be considered when using ground nuts and seeds. If one cannot have oats rolled quinoa could also be used. Love this Teresa Cutter recipe for Oatmeal Scones for when a special treat is in order.
  • I have not found a good replacement for syrups. I have tried dissolving Stevia in hot water and letting it cool down. (2tsp stevia to 1 cup water) this can be used in baking but the texture is not the same as syrup.
  • Sushi can be made with cauliflower rice or even quinoa if you wanted the low GI carbs
  • Quinoa can be substituted for cous cous to provide a lower carb amount (due more protein in the grain).

And now back to our Diabetes Counselling Online social media dietitian, Sally!

Wow Joan! Thanks so much for making such an effort to demonstrate just what a difference a little bit of thinking in your cooking can achieve. Those girls of yours are certainly fortunate to have a Mum who looks after them with good food for their wellbeing too!

Please add your comments below if you have other suggestions/tips that you’ve discovered that might interest some of our readers.

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. You can access a list of all Sally’s Diabetes Counselling Online blogs here.

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