ONLINE - International Diabetes Federation

Transcription

E
N
November 2015
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GLOBAL PERSPECTIVES ON DIABETES
ON
Diabetes Voice
WORLD DIABETES DAY 2015 - HEALTHY EATING
Diabetes Voice Online - November 2015
DIABETES VIEWS
For all types of diabetes, one common goal: healthy eating
Elizabeth Snouffer
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DIABETES VOICES
Healthy eating challenges for diabetes self-management
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THE GLOBAL CAMPAIGN
Fighting for ‘Good food’ (Mai Wiru)
John Tregenza
Revolution against sugar: Q&A with Jamie Oliver
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WORLD DIABETES DAY 2015
Diabetes advocates inspire action for WDD 2015
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AstraZeneca: addressing gaps in diabetes care
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Let’s make healthy eating a right, not a privilege
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International Diabetes Federation
Promoting diabetes care, prevention and a cure worldwide
Editor-in-Chief: Rhys Williams
Editor: Elizabeth Snouffer
Editorial Coordinator: Agnese Abolina
Design & Layout: Lorenzo Piemonte
All correspondence should be addressed to:
International Diabetes Federation
Chaussée de La Hulpe 166, 1170 Brussels, Belgium
Tel: +32-2-538 55 11 | Fax: +32-2-538 51 14
[email protected]
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 [email protected].
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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
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Diabetes Voice is about medical issues, it is not medical advice and should not
be construed as such.
Cover photo: © International Diabetes Federation
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DIABETES VIEWS
For all types of diabetes, one common goal:
healthy eating
Elizabeth 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 body’s ineffective use of
insulin. Type 2 diabetes affects children and adults.
Further confounding for the public’s 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 aren’t
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
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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
<6% to 7.5% and depend upon a personalised
treatment plan.
While the targets are similar, the therapeutic
pathways to achieving targets can be very different
for type 1 diabetes and type 2 diabetes. An adult
living with type 2 diabetes may be required to lose
a considerable amount of weight to reduce insulin
resistance. A young adult with type 1 diabetes
may be required to both test blood glucose and
inject insulin more than 12 times a day to achieve
blood glucose targets. Neither of these tasks
related to self-management are easy, but they are
different. Achieving targets takes a great deal of
individual initiative, discipline and support. No
type of diabetes is more or less serious; all types
of diabetes are difficult and equally weighted with
devastating complications if they are not treated.
There is, however, one very common objective
that people living with all types of diabetes share
and that is a commitment to healthy lifestyle
behaviours, including a commitment to healthy
eating. A commitment to healthy lifestyle
behaviours makes achieving targets possible.
(Although it is acknowledged that access to healthy
fresh foods is not always possible for people who
do not have the means to afford this privilege.) A
person living with type 1 diabetes who eats a diet
high in processed foods (which tend to be high
in sugar, fat and salt) without a healthy level of
physical activity is going to have a very difficult
time making their targeted HbA1c and avoiding
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complications. The same is true for a person living
with type 2 diabetes.
Recognising the differences between types of
diabetes is very important to maximize appropriate
awareness, diagnosis and treatment. It is important
that people at risk for type 2 diabetes understand
that, for the most part, the condition is preventable.
It is also important for people diagnosed with type
1 diabetes to understand that their disease requires
a life-long commitment to a 24/7 schedule of
insulin injections and blood glucose monitoring
for survival.
Perhaps the time has come for the type 1 diabetes
community and the type 2 diabetes community
to support each other by recognising equal but
different challenges in attaining normal glycaemia
with a united commitment to healthy eating
and other healthy lifestyle behaviours such as
physical activity. This year’s World Diabetes Day,
will focus on healthy eating as a key factor in
the fight to prevent type 2 diabetes and to treat
all types of diabetes. This issue of Diabetes Voice
is dedicated to discussions about healthy eating
and healthy foods access from people living with
type 1 diabetes and type 2 diabetes and
communities struggling to find sustainable
solutions. We also report on the latest news
for World Diabetes Day events and activities
worldwide.
To all people living with all types of diabetes, let’s
stand together and support each other, recognizing
our differences, yet united in action for healthy
eating as a cornerstone of wellness and sustainable
development. Let’s unite for a better tomorrow.
Elizabeth Snouffer is Editor of Diabetes Voice.
DIABETES VOICES
Healthy eating challenges for diabetes
self-management
Elizabeth Snouffer
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 Federation’s (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 (USA)
Celebrity chef, film maker and global diabetes advocate, diagnosed with type 2 diabetes in 2011
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.
don’t need.
As much as I help and share other people’s
stories about living with diabetes, I am now
becoming a story of my own. Let’s 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 don’t do what’s right for
our condition. It’s time to get back on course!
My first step is to lose the extra 15 pounds that I
© Charles Mattocks
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don’t need. I should be at my ideal weight and
that’s 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 can’t go wrong
with loads of vegetables and water. We can’t go
wrong with small portions of lean meat and limit
our total intake. Let’s 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 that’s
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. Don’t forget
if you live with diabetes, you need to make sure
what you do today, won’t hurt you tomorrow.
Fortunately, I got back to my healthy ways again
with a smile on my face and I’m down a few
pounds in only a few days and counting. I also
got my medical tests back and it’s all clear. I
must admit I was very nervous and I know those
test results were a wake-up call for me. I don’t
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.
HÉLÈNE 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
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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 host’s 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.
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 didn’t
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 couldn’t 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 didn’t 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. I’m choosing
to eat whole foods that I (mostly) cook myself as
opposed to processed meals or foods that contain
too much of what isn’t good for me.
I’m 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.
These may seem like sacrifices but I no longer feel
deprived. I’m happy to be eating in a way that has
made me healthier and will hopefully help prevent
complications down the road. I’m lucky to live
where I have choices.
Visit Kate’s blog on living with diabetes.
JOÃO VALENTE NABAIS (PORTUGAL)
President of IDF Europe, diagnosed with type 1 diabetes at 12 years
I have been living with diabetes for 35 years. On
my journey, I have witnessed several changes in
the way food was taught to be managed for insulin
therapy. Back to the beginning of my diabetes,
treatment was based on one insulin shot of slowacting insulin, and the advice was to base the
“diet” (yes it was a “diet”!) on vegetables, meat
and fish with only a small portion of carbohydrates.
Sweets and similar food were the devil and to be
used only for hypoglycaemia episodes (low blood
glucose events).
With the evolution of diabetes treatment options,
including new insulin and monitoring devices, a
new world opened up to me. This evolution was
extremely positive in all aspects and the freedom
to choose a variety of foods is only one of them.
But new challenges came along! How can I choose
© João Nabais
healthy food with all opportunities available?
Carbohydrate counting is like a game, in particular
when I am travelling abroad and the food is
unfamiliar. Adjusting the insulin dose correctly to
exercise and food can sometimes feel like a horror
movie.
There are apps for smart phones, devices to
evaluate the food content and a panoply of tools
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to help people with all types of diabetes. I use a
few of those to base my decisions, but most of the
time I use my experience and what I have learned
from other people with diabetes and healthcare
providers. Sometimes you make good choices,
sometimes not. But, this doesn’t make you a bad
person, only human!
I try to plan my meals as carefully as possible in
order to include healthy ingredients for both food
and drinks (water is the first choice along with red
wine or beer) but all have to be tasty and enjoyable.
When I travel I like to experience the local food,
which can be tricky because most of the time
you don’t know the fat or carbohydrate content.
For me, this is not a problem as I can always readjust my insulin dose afterwards or eat a sugary
supplement (that we must carry all the time) to
ensure my blood glucose doesn’t go too low.
SCOTT JOHNSON (USA)
Diabetes advocate, diagnosed with type 1 diabetes at 5 years
I believe that learning more about healthy eating
would be good for me. It would give me an
additional set of tools to manage my blood sugar,
and my overall health. Essentially, I’ve allowed
myself to look the other way when I eat something
unhealthy, especially if I can manage my blood
sugar by doing fancy tricks with my insulin. I tell
myself it’s OK because diabetes is all about blood
sugar management, right?
No. I’m justifying unhealthy eating behaviour
and using blood sugar as an excuse. Honestly, I’m
intimidated by the idea of learning about food. The
endeavour seems overwhelming, with conflicting
opinions and misinformation throughout the
journey. Where do I start? Who do I trust?
People living with type 2 diabetes successfully are
my heroes here. Their most influential tools are
often food and activity. They may not know how
much I admire them or look to them for inspiration
and leadership. Why?
Because I imagine, at diagnosis, they also had little
interest in learning about food. It may have even
been an emotional trigger evoking the diagnosis
experience all over again.
And now, here they are, the challenge overcome,
using the power of healthy eating to manage their
health. They are setting examples that can often
serve us all well, regardless of what type of diabetes
we have. I have much to learn from my friends in
the community living with type 2 diabetes. Thank
you for being brave, inspirational type 2 diabetes
leaders. I am ever grateful to you.
Visit Scott Johnson’s blog.
DICKY POON (HONG KONG)
Student, diagnosed with type 1 diabetes at 6 years
In 2014 I joined a Youth Diabetes Action bike
tour for 8 hours a day over a period of nine days.
The greatest challenge was managing continuous
and vigorous exercise on insulin. During the
latter part of the journey, my daily insulin usage
actually decreased by 40%! The greatest threat
was hypoglycaemia, and even delayed effects of
low blood glucose at night. Even with all these
challenges, I believe that regular exercise, insulin
therapy and managing food all go hand-in-hand.
One of my challenges related to eating with
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© Dicky Poon
diabetes is how to calculate the amount of
carbohydrates in food when eating out at a
restaurant or having take-away. In Hong Kong,
there are so many restaurants providing different
cuisines. One type of food, such as noodles, can
be cooked in so many ways with a huge variety
of sauces and seasonings, which usually contain
sugar. As a result, every time I visit a restaurant
where I have never been before, I can only guess
the amount of carbohydrates in those dishes, and
I often underestimate, which results in a higher
blood glucose value.
Overall, the food choices available and affordable
for students like me on a budget here in Hong Kong
are usually not healthy. What I can do is to eat “less
unhealthily” and choose dishes with enough meat,
vegetables with less salty or less sugary sauces
if possible, and avoid cold drinks which usually
contain a large amount of simple sugar.
Maybe this challenge can be overcome by bringing
packed lunch to school or workplace, which can
be prepared at home with the accurate number of
carbohydrate calculation for easy insulin dosing
at mealtime. Yet, having lunch with friends,
classmates or colleagues is a crucial part of my
social life, and everyone enjoys eating out. It’s
a hard decision to sacrifice my social life for a
healthier diet. It’s important to mention that most
people don’t care if I have diabetes or not, as it
is not the most important characteristic of myself.
Generally, I think most of the pressure comes from
ourselves.
© International Diabetes Federation
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THE GLOBAL CAMPAIGN
Fighting for ‘Good food’ (Mai Wiru)
John Tregenza
In the Western Desert nations of Central
Australia, the Pitjantjatjara, Ngaantyatjarra and
Yangkunytjatjara people reside on the Anangu
Pitjantjatjara Yankunytjatjata (APY) Lands, and refer
to themselves as the Anangu (people). Like so many
colonized indigenous peoples of the world, the
Anangu suffer from poor health, malnutrition and
now face epidemic proportions of type 2 diabetes.
According to the United Nations Economic and
Social Council, type 2 diabetes places the very
existence of indigenous communities at risk.
Improving food security and turning around the
long-standing poor health outcomes for indigenous
people in remote communities like the Anangu is a
priority for their survival. The Anangu people have
endured the loss of access to natural resources,
including access to traditional foods, and have
now come to rely on foods high in fat, sugar
and salt produced, delivered, and distributed by
commercial outlets servicing remote areas. Remote
communities like the Anangu have come to rely
on their local food stores for the vast percentage
of their daily food intake. These “convenience”
stores have historically failed to provide nutritional
and affordable food to the communities, for many
reasons including remoteness and transport costs,
lack of effective refrigeration and storage, and
maverick unqualified store managers.
In the same time frame, western style diseases
or non-communicable diseases (NCDs) have
increased and over the past two decades end
stage renal failure has become endemic in remote
communities. As a result, people on the APY Lands
are living in a society where type 2 diabetes, obesity,
renal failure and death from lifestyle diseases have
become a part of the modern community. The
most common social event on the APY Lands is a
funeral.
Evidence suggests that that improving the supply
and consumption of healthy food in remote
indigenous communities is mandatory to reduce
the high levels of preventable diet-related chronic
disease, including type 2 diabetes, suffered
by indigenous Australians in these locations.
In fact, it is estimated that up to nineteen
per cent of the national indigenous health
© That Sugar Film
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gap is attributable to diet related causes, including
low fruit and vegetable intake.
In remote communities, where the external
economy is limited to running some cattle and
art making, the need for government subsidies
for communities like the Anangu is unavoidable
to make food affordable for people living
below the poverty line, to provide nutrition and
health education programmes in the stores and
communities and to carry out maintenance and
renovations on Anangu houses to ensure residents
have functioning kitchens so they can prepare,
cook and store nutritious foods.
Mai Wiru (Good Food)
The cost of treatment and management of the
hundreds of people with diabetes is a constant
issue for the Anangu community controlled
Aboriginal Health Service that is responsible for
Primary Health Care on the APY Lands. The level
of government funding to the Health Service
precludes the necessary public health education
and promotion services. Approximately 20% of
regular healthcare participants (all ages included
in this statistic) of the Nganampa Health Council
have diagnosed type 2 diabetes and prevalence
increases with age. The majority of APY residents
on renal dialysis have type 2 diabetes. “The rates
of obesity and insulin resistance syndrome in our
communities are now so high that the majority of
the adult population over 35 will be affected. This
provides a situation in which we are not aiming to
target a subset or at risk group of the population
with a nutrition strategy but our whole population
is both at risk and suffering disease. This is why
an effective and sustainable stores service will be
an essential prerequisite for changing the health
profile in this region,” says Dr. Paul Torzillo, Medical
Director of the Nganampa Health Service.
Understanding their challenges, the people of the
Anangu took the issue of food security into their
own hands. Between 1998 and 2003, the regional
Anangu organisations Nganampa Health Council
and Ngaanyatjarra Pitjantjatjara Yankunytjatjara
© That Sugar Film
Women’s Council developed a Regional Stores
Policy, Mai Wiru, (Good Food), to take control
of the delivery of food and nutrition to Anangu
community stores in an effort to ensure access to
affordable healthy foods on a daily basis. Today, the
Mai Wiru Regional Stores Council has established
a commercially efficient and responsible business
model and operation for their local stores.
While the Mai Wiru Regional Stores Council, and
the people in the community, have benefitted from
hard work and success in bringing healthier, fresh
food to Central Australia, reduced government
support has become a barrier to the fulfilment
of goals. In sum, without support, development
and implementation of the Mai Wiru policy have
not been sustainable and, therefore, progress for
health and wellness and the push to reduce NCDs,
such as type 2 diabetes, has stalled.
Early on in the implementation of Mai Wiru the
organisers had a saying “It is not about money,
it is about health,” but commercial imperatives
have reduced the impact for the provision of
fresher and more nutritious food. Providing food
at an affordable price in these circumstances,
without government support and without outside
contributions, means the community has no
resources to fund the necessary health education
programmes required to help people make
informed choices about nutrition and pathways to
healthier lives.
The documentary That Sugar Film recognised the
efforts of Anangu taking control of their community
stores as a health initiative. The producers
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of that film set up the Mai Wiru Sugar Challenge
Foundation to support the Mai Wiru Regional
Stores to educate and employ Anangu to work in
the local stores to help residents make informed
decisions about their diet and nutrition, especially
in relation to the amount of hidden sugar in food.
All State and Federal Departments involved with
Aboriginal communities are aware of this situation.
Government Ministers and bureaucrats from
bottom to top have been lobbied regarding this.
Sadly, their response has been underwhelming.
Type 2 diabetes and the indigenous peoples of
Australia
Overall, type 2 diabetes is around three times more
common among indigenous people than among
other Australians. According to the Australian
Aboriginal and Torres Strait Islander Health Survey
(updated results, 2012-13) type 2 diabetes is
diagnosed in indigenous people at a younger age
than non-indigenous people: in the report 5% of
indigenous people aged 25-34 years had type 2
diabetes, and up to 39% of those aged over 55
years had the disease. (see Figure 1) It is also worth
pointing out that type 2 diabetes is more common
for indigenous people living in remote areas
than for those living in non-remote areas. Type 2
diabetes is the second leading cause of death for
indigenous people; ischemic heart disease is the
number one cause of death.
Individuals of the Anangu who reach the stage of
kidney failure have to leave their communities for
dialysis or die at home. The nearest dialysis facility,
located in Alice Springs, is anywhere from 450
kilometres (kms) to 800 kms. The Alice Springs
dialysis centre is reportedly always full, and many
Anangu now have to relocate even further away
to Adelaide to receive life-saving care – a distance
up to 1,800 kms from their homes. Many Anangu
families in this situation spend all year travelling
up and down the Stuart Highway just to maintain
family structure and security for survival.
Social dislocation caused by diabetes complications
such as kidney dialysis is profound. The patient
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Figure 1: Type 2 diabetes prevalence in indigenous and nonindigenous population (Source: Australian Bureau of Statistics, 2014)
experiences isolation and loneliness in a strange
and foreign environment far from family, language
and cultural events. Cultural identity suffers
from the loss of teaching and learning from one
generation to the next. If family members follow
their loved ones to the city, the social problems
of an impoverished, unemployed and uneducated
racial minority in a modern western city creates
problems and places significant pressure on family
members.
The distress for individuals, families and the
community contributes to the burden of trauma
and grief of a marginalised people. Recently, a
nephew informed me from Alice Springs that my
brother-in-law advised hospital staff that he does
not want dialysis, preferring to go to his family
to die in his homeland. Events and decisions like
this are a daily occurrence in remote Aboriginal
Australia.
For more information:
That Sugar Film
The Mai Wiru Sugar Challenge Foundation
About the Author
John Tregenza has over thirty years’ experience working
in community development in urban, rural and remote
settings. The great part of his work has been in very remote
Aboriginal communities throughout Central Australia,
from Yalata on the Great Australian Bight to Balgo in the
Kimberly. His work has focused on developing Aboriginal
community-controlled organisations to address primary
health and community social needs.
THE GLOBAL CAMPAIGN
Revolution against sugar: Q&A with Jamie Oliver
Earlier this year, Jamie Oliver got fired up about sugar consumption in the United Kingdom. This led
him to produce “SugarRush”, a TV documentary that shows just how devastating the effects of
consuming too much sugar can be for millions of people worldwide. Jamie’s determination to put an
end to the obesity and type 2 diabetes crisis in the UK has driven him to petition the UK government
and parliament for a tax on sugary drinks. If the tax gets passed, it could provide GBP 1 billion (USD
1.5 billion) per year to support much needed preventive strategies relevant to childhood obesity and
type 2 diabetes in the UK’s National Health Service and schools.
But it’s not just the UK where Jamie is pushing for action! #FoodRevolutionDay is a global campaign to
put compulsory practical food education on the school curriculum. Jamie passionately believes that
by educating children about food in a fun and engaging way, we can equip them with the basic skills
they need to lead healthier, happier lives for themselves and their future families. The International
Diabetes Federation (IDF), the Food Revolution Team and of course, Jamie Oliver are collaborating to
Act today to change tomorrow and create healthier eating habits, better access to food education
and to bring about greater awareness of type 2 diabetes. We had an opportunity to speak to Jamie
about his mission and his work with IDF to see what’s cooking!
When was the tipping point for you in deciding
to take action against sugar consumption both
in the UK and worldwide?
I’ve been campaigning for better food education
for many years now and Food Revolution Day is
really the annual focus for that, but I’ve got teams
working on various campaigns every single day.
A couple of years ago I started talking to medical
experts, really clever people, and they all said
the same thing: sugar is a major, major problem,
putting many people, particularly kids, at great risk
for type 2 diabetes. As a reflection of the problem,
many children are being admitted to hospital for
multiple tooth extractions. Once I’d started to get
deeper into the subject, I uncovered this massive,
terrifying health crisis.
What has been the public reaction to your
campaign?
Incredible. I started a petition to get the British
government to bring in a sugar tax on sweetened
fizzy drinks. You need 100,000 signatures before
they will even consider a debate, and we hit that
within two days of the TV documentary being
screened. The British media has also been great,
by and large. Plus, since we started our own, selfimposed sugar levy in my restaurants, we’ve only
had one complaint as far as I know.
What has been the most riveting moment
for you in observing or seeing first-hand the
devastating effects of sugar consumption?
There have been many, but I think the most
difficult moment was watching six-year-old
Mario having his teeth extracted under general
anaesthetic because they had simply rotted away
due to his love of fizzy drinks. What’s a kid of six
doing drinking so many fizzy drinks? That’s my first
question, but then you find out that this happens
to 26,000 British children of primary school age
(four to 11) every year. It’s shocking.
Thousands of people have signed your
petition against sugary drinks calling for
a sugar tax on soft drinks with added
sugar in the UK and 1.6 million people
13
© 2015 Jamie Oliver Enterprises Limited; photography Cliff Evans
have signed the petition for Food Revolution
Day. What other initiatives are you planning
to raise awareness for obesity and diseases
related to obesity, such as type 2 diabetes?
Our Food Revolution campaign lives on long after
Food Revolution Day! My Food Revolution team
continues to raise awareness and provide people
with knowledge and resources across our social
media channels every day. Amazingly, we have
over 2,000 ambassadors in over 110 countries
who are our eyes and ears on the ground and help
us make noise all year round by working on local
initiatives – whether it’s tackling the food served
at home, at school or at work, or through passing
on their food skills and knowledge to others. From
Uruguay to the Netherlands and the USA to Jordan,
our ambassadors are out in their communities
doing really amazing things.
In the UK we are campaigning for our government
to announce a strong childhood obesity strategy
with clear initiatives aimed at reducing obesity
rates across the country. We are also working
closely with Brighton Council and the Brighton and
Hove Food Partnership (UK) to pilot a brand new
14
scheme called “Sugar Smart City”. It’s a city-wide
strategy with many different initiatives – involving
businesses, schools, restaurants and food outlets
– aimed at increasing awareness of the effect that
too much sugar can have on the body, and we are
hoping to have a real impact on the consumption
of sugary drinks. We will also be launching food
education programmes in every primary school
across the city, to give every child the knowledge
they need to grow up making healthier decisions
that will have a long-term impact on their lives.
We are hoping that the Sugar Smart City initiative
will be able to be replicated in other cities across
the UK.
Also, through the Jamie Oliver Food Foundation,
we have hands-on programmes in communities
and schools throughout the UK to empower and
teach people how to cook – these are year-round
programmes, and honestly, they bring the food
revolution to life every day.
Of course we’re also working on our plans for Food
Revolution Day 2016 and our global advocacy
strategy to help turn all those signatures into real
changes, so watch this space!
For World Diabetes Day 2015, what special
activities are planned to support IDF’s campaign
for “Healthy eating and diabetes?”
IDF’s focus on healthy eating, a key factor in the
fight against type 2 diabetes and a cornerstone
for health and sustainable development, is a really
good fit with my campaigns and the community
that we’ve built through the Food Revolution.
Last year, IDF’s theme was healthy breakfast, so
we shared my South American style brunch, and
encouraged people to get cooking from scratch.
We’ll be supporting World Diabetes Day on
14 November again this year across our social
media channels, sharing resources, recipes and
content from the World Diabetes Day team to
inspire people to use healthy eating as a way
to take control of their health. And in the leadup we’ll be encouraging our global community,
especially our ambassadors, to get involved.
Helping to prevent type 2 diabetes is something
that I am really passionate about, so it’s good to
get our community behind this initiative, too.
healthier cooking.
Ninety percent of diabetes cases are type 2,
which is largely preventable, and what we eat
and how we look after our bodies has a huge
impact. Implementing public health strategies and
support to tackle childhood obesity will also tackle
type 2 diabetes, as the two are so closely linked.
World Diabetes Day and the IDF call on national
governments to implement policies to reduce sugar
consumption and advocate specific measures
to increase access to healthy alternatives, such
as fresh fruit and vegetables and clean drinking
water in order to help prevent new cases of type
2 diabetes.
Essentially, we’re working towards the same
thing – a healthier world. It’s key that we arm
future generations with the life skills they urgently
need in order to lead healthier, happier, more
productive lives. I passionately believe this is every
child’s human right and I hope you agree.
400 million people live with diabetes today.
Act today to change tomorrow is a call-toaction campaign targeting G7 countries to
stop the serious rise in diabetes prevalence
worldwide by implementing public health
strategies and support. What is the link
between the #FoodRevolutionDay campaign
petition directed at G20 countries for nutrition
education in schools and IDF’s call to action?
I think better food education is key and our
research proves it. As you know, we have a Kitchen
Garden Project in the UK which helps schools to
grow food and use it in lessons. We know from
experience that this leads to healthier, happier kids
who concentrate better in the classroom.
In addition, Ministry of Food Centres in the UK and
Australia, and research done by Deakin University
in Melbourne reveal that if you teach people to
cook from scratch then their health improves,
their confidence improves and naturally they’re
also improving the health of their families with
For more information:
Healthy Eating and World Diabetes Day
SugarRush and the petition
Food Revolution Day
Jamie Oliver is a phenomenon in the world of food. He is
one of the world’s best-loved television personalities and
one of Britain’s most famous exports. Jamie has inspired
people to spend more time enjoying cooking delicious
food from fresh ingredients – and even start growing their
own food. His Jamie Oliver Food Foundation campaigns
globally for better food education for all. Jamie lives in
London and Essex with his wife, Jools and his kids, Poppy,
Daisy, Petal and Buddy.
15
Diabetes advocates inspire action for
WDD 2015
World Diabetes Day (WDD) is the world’s largest diabetes awareness campaign reaching a global audience
of over 1 billion people in more than 160 countries. Every year since 1991, WDD focuses on a new
campaign theme to address the most significant issues facing the global diabetes community. This year,
WDD has become a year-long campaign to reflect the realities of people living with diabetes and focuses
on healthy eating as a key factor in the fight against diabetes.
WDD 2015 primarily addresses key opinion leaders and stakeholders of the global diabetes community.
However, one thing is clear, World Diabetes Day would not be what it is today without the support of
IDF’s Members, volunteers and all people connected to diabetes – people living with all types of diabetes,
their families, healthcare professionals and more.
Diabetes Voice asked two members of our Young Leaders in Diabetes Programme (YLD) to tell us about
their activities for 2015. Hisako Saito (Japan) and Kayla Brown (Canada), like all participants in YLD,
work to raise awareness of diabetes and use their platform to advocate prevention, education, access
to quality care, and improved quality of life. Hisako has been involved in a national contest especially
tailored to the improved nutrition of people with diabetes, where fresh ingredients are the staple. Kayla
has dedicated her energy to finding a positive outlet for young women with type 1 diabetes.
Likewise, we called on two leading IDF Members to present their WDD events, past and present. The
Sociedade Brasileira de Diabetes (Brazil) lights up their nation in blue for diabetes awareness to an extent
unlike any other country in the world. The Chinese Taipei Diabetes Association has created a huge buzz
with its four-day diabetes cycling event.
We hope these contributors inspire you as much as they have inspired their national and local diabetes
communities!
16
Diabetes Voice Online - September 2015
CELEBRATING RECIPES WITH LOCAL, SEASONAL FOODS
Hisako Saito, IDF Young Leader in Diabetes (Japan)
In October 2015, the Japan Association for Diabetes
Education and Care conducted a Healthy Recipe
Contest aimed at students studying nutritional
science in keeping with the World Diabetes Day
theme for this year, “Healthy Eating and Diabetes.”
The contest was developed to encourage the
creation of a variety of healthy food recipes for
people with diabetes. There was a lot of enthusiasm
for this programme! We received 223 applications
from 64 universities and colleges in Japan.
What made the winning recipes so popular? They
were the most nutritious and tasty! Fresh seasonal
foods are available in food markets for a better
price than out-of-season produce and therefore
more cost effective for home budgeting. The
contest meals were all very colourful and reflected
wholesome nutrition in green, red, and yellow. It
has become well recognised that colourful plated
food signals a well-balanced and nutritious meal.
Plus, it is more appealing to the palate.
We divided the contest into recipes for breakfast,
lunch and dinner and contest participants were
asked to develop a menu for each meal. Recipes
were evaluated in part on their ease and simplicity
because we wanted to ensure people with diabetes
could learn how to prepare the recipe creations on
a daily basis. Common ingredients for a normal
Japanese diet were encouraged and items like
artificial sweeteners or non-fat dairy products
were not allowed.
After winning the best award, Keito Asanabe, told
the crowd, “It’s sad if a person with diabetes can’t
enjoy the same food for family meals. I made dishes
for the competition that can be happily shared by
everyone.”
Many of the participating students brought fresh
vegetables, soybeans and chicken from their home
regions to cook in the final round of the contest
in Tokyo. Participants were very proud of local
ingredients and participants wanted to share the
goodness of seasonal vegetables and fruits.
Do you think you eat differently from others
because you have diabetes? I live with type 1
diabetes and I don’t believe in this idea of “diabetic
foods.”A healthy diet is an important part of
preventing type 2 diabetes and effectively managing
all types of diabetes, but what people with diabetes
are asked to do is simply eat healthy foods and
this is the same advice given to everyone. A good
plan for sustainability, health and pleasure is to
eat locally grown foods in season, create colourful
dishes and enjoy them with your family and friends.
© Japan Association for Diabetes Education and Care
17
BRAZIL BRINGS DIABETES AWARENESS TO LIGHT
Maria Izabel Homem de Mello on behalf of the Sociedade Brasileira de Diabetes
The Sociedade Brasileira de Diabetes’s call to
action for 2015 leading to World Diabetes Day
is encouraging people with diabetes to practice
healthy habits which can result in better blood
glucose control for all!
A range of activities will be facilitated by Sociedade
Brasileira de Diabetes as a means to strengthen
this message and help people get into action for
diabetes. Recently we encouraged people with
diabetes to show results of their blood glucose
measurements on our association fan page, and
had a great response. We also promoted a healthy
cooking competition called “Sweetening without
Sugar” which was broadcast on major television
outlets, including a showcase on the “Program
Dia, Dia” show.
We are also excited to announce that we have
many iconic locations lit up in blue for diabetes
on November 14, 2015. In Rio de Janeiro, the
following will be brilliant blue: the Maracanã
Stadium with a diabetes screening campaign; the
30 metres (98 feet) Christ the Redeemer Statue
(Cristo Redentor) and Sugarloaf Mountain Peak
(Pão de Açúcar). In Sao Paulo, we will have the
Octávio Frias de Oliveira Bridge (a cable-stayed
bridge that is 138 metres tall (453 feet) as well as
other locations throughout Brazil.
To promote diabetes education and awareness
to the general public of Brazil, we will distribute
diabetes information packets at toll roads where
there is a large influx of vehicles. The information
packets will consist of four topics, one delivered for
each week of the month of November. The 1st week
will focus on food; the 2nd week of November will
look at oral medicines; the third week will focus
on insulin therapy; and the last and fourth week
will address “body care” issues for people living
with diabetes. On November 14, we will hold an
interactive flash mob with a symphonic orchestra
playing in public places. This World Diabetes Day
event will be recorded on video and published on
social networks. Look out for it!
Our supporters will also be excited to see that we
will distribute diabetes communication material
throughout Brazil. These promotional items always
get a great response from the public and include:
posters, t-shirts, headbands, pins and bracelets.
Many of these items are available for free and can
be downloaded from our website. Many of these
t-shirts and headbands will be worn with pride
during running and walking events for diabetes
awareness held at the 20th Brazilian Diabetes
Congress in November 2015 .
© Sociedade Brasileira de Diabetes
18
EMPOWERING TEENS WITH TYPE 1 DIABETES
Kayla Brown, IDF Young Leader in Diabetes (Canada)
WDD has always been an important date for me
since being diagnosed with type 1 diabetes in
March 2009. Over the past six years, I have created
and participated in various WDD events and
activities from scavenger hunts to encouraging
friends and family to wear blue. The importance
of celebrating the 14th of November has both
personal meaning, especially for people who live
with a type of diabetes, and public impact, by
generating greater awareness. For those of us who
live with the disease, we are incredibly thankful to
Sir Frederick Banting, born on the 14th November
1891, for his discovery of insulin (in 1922), and
we are also thankful that we have the knowledge
and tools to manage this disease, especially as the
number of people with diabetes rises every day.
This year for WDD, I plan to focus on the facts
and realities of living with type 1 diabetes as a
young person. Often people with diabetes are
misunderstood. However, people living with
diabetes can significantly improve general
understanding by sharing their stories.
Since July 2014, I have led open sessions, called
“T1 Empowerment”, with a small group of type 1
teen girls based where I live in London, Ontario,
Canada. T1 Empowerment gives teen girls living
with type 1 diabetes a positive outlet to express
feelings about their disease in a safe space. The
teens share ideas, vent challenges and create
incredibly strong bonds with each other. WDD
gives the group an added opportunity to speak to
the community about the importance of education,
communication and social support when dealing
with diabetes. For 2015, we are planning an open
T1 Empowerment event at the public library giving
participating teens an opportunity to share their
type 1 diabetes story in any creative form they
wish, whether that’s through public speaking, art,
or writing. Our hope is that visitors will gain a
greater understanding about type 1 diabetes.
Whether you decide to host a blue party or a
diabetes scavenger hunt in the park, remember that
change for diabetes begins with you. Celebrating
WDD, whether big or small, can easily help foster
diabetes empowerment for you and for those
around you.
© Kayla Brown
19
HELPING PEOPLE BREAK THROUGH PHYSICAL LIMITATIONS
Kang-Ning Hsu on behalf of the Chinese Taipei Diabetes Association (CTDA)
The Chinese Taipei Diabetes Association (CTDA)
has provided regional and international diabetes
events with great enthusiasm every year for World
Diabetes Day. With great preparation and followthrough, the association holds different activities
to raise public awareness of diabetes together with
other diabetes-related associations, patient groups,
government representatives and more. With all
these participants, we deliver diabetes awareness
with a great impact to a large population.
Currently, we are planning to celebrate World
Diabetes Day 2015 with many Taiwanese events,
including: a cycling event, garden festival, global
diabetes walk, monument lighting ceremony and a
photo competition.
For World Diabetes Day 2014, we had many
successful events and activities. They are so
popular that the people of Taiwan expect to see a
lot from us every year!
We boosted diabetes awareness in 2014 and
people were inspired to do their best. For the past
three years, we have promoted and managed
a very popular cycling for diabetes awareness
event which gives participants the opportunity to
learn about diabetes. People with diabetes and
people without diabetes all ride together. Many
participants help people who are cycling with
diabetes break through any physical limitations by
making their cycling dreams come true. In 2015, a
group of people with diabetes cycled a distance of
242 kilometres in a four-day tour in late October
accompanied with a professional medical-care
team. The support and encouragement they
received was key for their success!
By bringing together professional teams,
government representatives, people living with
diabetes, and the general public, all Taiwanese
people can better understand the importance
of nutrition and management for diabetes care.
We hope Taiwan’s educational activities are a
significant and fun way to promote action for
diabetes change.
© Chinese Taipei Diabetes Association
20
AstraZeneca: addressing gaps in diabetes
care
How do you tackle a disease that impacts nearly 400 million people1 across the globe? “It all starts
with the science,” according to Mark Mallon, Executive Vice President of the International Region for
AstraZeneca.
For AstraZeneca, a global pharmaceutical company, delivering novel treatment options for people
with diabetes is a top priority. Mallon and his colleagues work to achieve this goal through sharply
focused clinical and early-stage research efforts, patient-centric programmes, strategic collaborations
and a diverse portfolio of medicines.
Driven by science, AstraZeneca is helping effect change in the treatment paradigm for people with
diabetes. Diabetes Voice had an opportunity to learn more about AstraZeneca’s role in improving
outcomes for people dealing with the daily challenges of diabetes in a brief chat with Mark Mallon.
Currently, there are approximately 400 million
people living with diabetes worldwide, and the
greatest percentage live in low- and middleincome countries.1 What is AstraZeneca’s
commitment to people living with non
communicable disease, especially type 2
diabetes, in the developing world?
to better understand how diabetes treatment
patterns evolve globally. The study is unique in
its true global nature and coverage of “data blind
spots,” and will enable the establishment of longterm registries for the first time in many countries.
From the staggering number of people living with
diabetes in developing countries, it’s clear that any
efforts to address the global burden of the disease
must place a special emphasis on reaching lowerincome populations.
AstraZeneca is focused on the concept of
“treating the whole patient” which speaks
to the heart of both the systemic nature of
diabetes complications and person-centred
care. Can you talk a little about AstraZeneca’s
commitment to care for people living with
diabetes in this regard?
Here at AstraZeneca, we believe that real progress
in improving diabetes outcomes globally is rooted in
ensuring that patients have access to the medicines
they need. We are taking action by delivering
patient support and access programmes within
emerging markets. For example, in the Middle
East, our “By Your Side” and “Home Injection
Program” initiatives help patients understand how
to correctly take their medicines via educational
tools and medical services. Approximately 2,000
people have participated in the programme to
date.
Our approach of “treating the whole patient”
stems from our commitment – in diabetes and
across the company – to putting patients at the
centre of everything we do. One of the biggest
challenges in treating diabetes is the fact that so
many people with diabetes face serious, sometimes
life-threatening comorbidities. We can only
improve outcomes for these individuals by looking
beyond glycaemic control to better understand an
individual’s overall health, with a particular focus
on areas such as weight, renal and cardiovascular
effects.
We are also addressing gaps in data commonly seen
in emerging markets, where clinical studies may
not be as readily available. By conducting a large,
real-world observational study, we are aiming
AstraZeneca currently has medicines in the fastestgrowing classes of anti-diabetic products. Through
our clinical research programme, we’re continuing
to build the body of evidence to support our
21
medicines’ benefits in treating both diabetes
and its associated comorbidities. For example,
we are conducting several large cardiovascular
outcomes trials, which should further advance our
understanding of these outcomes in patients with
type 2 diabetes.2,3
IDFs dedication to professional healthcare
education is best reflected in D-NET, the
first international forum aimed at enhancing
diabetes education and management around the
globe. How does AstraZeneca help healthcare
professionals worldwide understand the
concept of “one patient, multiple strategies?
Disease education is important to us at AstraZeneca,
as supporting healthcare providers in their efforts
to learn more about managing diabetes ultimately
helps their patients. We provide numerous tools
and resources for healthcare professionals to help
them understand and act upon the benefits of
treating people with diabetes proactively.
For example, through the launch of the “EVOLVE
for Diabetes” programme this year, we are
connecting with specialists, primary care and allied
health to offer comprehensive resources for the
healthcare community on all aspects of diabetes.
We also recently partnered with Project Hope on
a community-based programme in China that will
encourage diabetes education among healthcare
professionals at regional primary health facilities.
We are now looking for ways in which the synergies
between D-NET and EVOLVE can be harnessed to
create the best possible learning environment for
HCPs working in diabetes prevention and care.
Through these efforts, we aim to empower
healthcare providers to more effectively treat
people with diabetes earlier in their disease
progression and achieve control sooner.
The traditional stepwise approach can leave
patients uncontrolled and at risk of developing
complications due to hyperglycaemia. We intend
to help change this paradigm through education.
AstraZeneca collaborates with a wide variety
of academic, scientific and patient advocacy
organisations committed to diabetes, including
IDF. How do collaborations focused on diabetes
research, care and advocacy foster innovation?
Collaboration brings together the best thinking
across industry professionals, academia, advocacy
organisations and policymakers – exactly what we
need to solve the growing world health issue that
diabetes presents. At AstraZeneca, we are working
closely with the diabetes community to cocreate solutions that support disease prevention,
encourage professional education and advance
care for patients at all stages of their disease.
From a research perspective, approximately
70% of our current pipeline projects are run in
collaboration. These initiatives allow us to explore
important new directions in clinical research and
increase our understanding of the underlying
mechanisms of diabetes. With our partners, we’re
investigating methods for restoring the function of
pancreatic beta cells, reversing kidney damage in
diabetic nephropathy and addressing comorbidities
such as obesity and cardiovascular disease.
Our collaborations also go beyond the portfolio,
enabling us to reach the diabetes community in
unique ways to foster awareness and advocacy.
Through our longstanding relationship with the
IDF, we participate in programmes such as World
Diabetes Day to help raise the global profile of the
disease and encourage ongoing action to address
its burden.
Mark Mallon is responsible for the growth and
performance of AstraZeneca’s International region,
which predominantly includes AstraZeneca’s commercial
businesses in Asia Pacific, Russia, Latin America, the Middle
East and Africa. He is based in Shanghai, China.
References
1. IDF Diabetes Atlas, 6th edn. Poster Update 2014, International Diabetes
Federation Accessed September 2015.
2. Multicenter trial to evaluate the effect of Dapagliflozin on the incidence
of cardiovascular events (DECLARE-TIMI 58). AstraZeneca, 2015. Last
accessed October 2015.
3. Does Saxagliptin reduce the risk of cardiovascular events when
used alone or added to other diabetes medications (SAVOR- TIMI 53);
ClinicalTrials.gov. Accessed October 2015.
22
Let’s make healthy eating a right, not a
privilege
This year, the World Diabetes Day (WDD) campaign represents the rights of all people worldwide to
have access to healthy food which if prioritized will save lives, reduce the global burden of diabetes
and save billions in lost productivity and healthcare costs.
The International Diabetes Federation (IDF) believes the right to access healthy food is a critical
preventive strategy for type 2 diabetes. IDF also recognizes that healthy eating is a critical tool
to promote effective self-management of all types of diabetes. Healthy eating is a cornerstone of
successful diabetes management along with a comprehensive healthcare strategy and medicine, such
as insulin.
No matter how you choose to get involved in the WDD campaign for 2015, here are a few key facts
that will help you take a stand for diabetes in your community:
• Diabetes is a huge and growing burden: whilst some 387 million adults were living with diabetes
in 2014, this number is expected to skyrocket to around 600 million people by 2035.
• A healthy lifestyle could prevent up to 70% of type 2 diabetes, and healthy eating can help reduce
risks.
• A healthy diet containing leafy vegetables, fresh fruit, whole grains, lean meat, unsweetened
yogurt and nuts can help reduce a person’s risk of type 2 diabetes and reduce complications in
people with diabetes.
• More of us will develop and live with type 1 diabetes. While type 1 diabetes cannot yet be
prevented, a healthy lifestyle is an important part of effective management of the disease.
• Encouraging healthy eating habits in young children is key to halting the rise of the diabetes
epidemic. By ensuring the health of future generations, we take a step toward ensuring sustainable
development.
WDD 2015 around the world
WDD is the world’s largest diabetes awareness campaign with around 500 events organised for 2014
in more than 100 countries. The list that follows represents a regional variety of IDF Members and
other organisations with activities for 2015!
23
AFRICA
In Sudan, the National Childhood Diabetes center, in collaboration with Jabir Abuelizz Diabetes
Center, Eldaw Hajog Mini Diabetes Clinic and Elzubair Musa Charity Diabetes Clinic have planned a
variety of activities throughout the country from 12 to 18 November. These include diabetes health
day campaigns at various clinics, the annual WDD Charity Night, diabetes educators courses, and prescheduled meetings with Federal and State Ministries of Health.
EUROPE
In Belgium, the International Diabetes Federation (IDF) will hold an exclusive and interactive roundtable discussion in Brussels on November 12 to promote the importance of acting together to promote
healthy eating and ensure access to healthy food. The event will also mark the release of the diabetes
prevalence, mortality and expenditure figures from the IDF Diabetes Atlas Seventh Edition.
In Denmark, Danish pharmacies and healthcare centres in collaboration with the Danish Diabetes
Association invite the public to test their risk of developing diabetes and have their blood glucose level
measured at a large number of locations around the country. Several iconic buildings around Denmark
will be lit in blue, among them the castle of Kronborg in Helsinore. Hamlet will not attend the event
though.
In France, the International Diabetes Federation Europe Region (IDF Europe) is organising a lunch debate
on “Diabetes: Youth and Sport” on Tuesday 27 October at the European Parliament in Strasbourg.
Therese Comodini Cachia MEP (Malta) and Nicola Caputo MEP (Italy) will host a debate addressing the
many challenges faced by young people with diabetes. The role of physical activity and sport in the
management of type 1 and type 2 diabetes and the prevention of type 2 diabetes will be a key focus.
Other awareness raising activities at the European Parliament during the week include: promotion of
healthy lunches, an informational exhibition area and opportunity for people to take a blood glucose
(BG) test, reflecting the importance of regular BG testing and early diagnosis. The purpose of bringing
the WDD campaign into the heart of the EU Parliament is to encourage policy makers to implement
effective strategies and policies for the prevention and management of diabetes.
In the United Kingdom, Diabetes UK will launch a new campaign - Taking Control - in the week leading
up to World Diabetes Day to make sure more people get access to diabetes education to help them
manage their condition well. For the campaign, people who have taken diabetes education courses
will discuss how it has changed their life. While finding better ways to support healthcare teams to
encourage people with diabetes to sign up for a diabetes education course, the campaign will also
assess if people with diabetes are receiving the necessary opportunities through the healthcare system
to learn about their diabetes, and therefore become better skilled to manage the condition.
MIDDLE EAST AND NORTH AFRICA
In Qatar, the Qatar Diabetes Association (QDA) celebrates WDD in conjunction with the rest of the
world. On 13 November, the QDA will hold an awareness walkathon around the lake of Aspire Park
in Doha that will also feature blood glucose tests and nutrition counselling. The length of the walk
is approximately 1 kilometre and participants will be provided with free t-shirts, caps, healthy snacks
and water at the event.
In the United Arab Emirates, International Diabetes Federation (IDF) leadership will participate in
a Global NCD Alliance Forum convening in Sharjah on November, 13-15 entitled “NCD Advocacy
and Accountability in the Post-2015 era.” IDF will lead a lunchtime session, Uniting to Meet the
24
Challenges of Diabetes, on November 14th. The goal of the session is to foster full participation from
NCD leaders for strategizing, and together choose one new unifying idea to fight diabetes and advocate
change for a healthier world today.
NORTH AMERICA AND CARIBBEAN
In Canada, November is Diabetes Awareness Month, and to celebrate, the Canadian Diabetes
Association (CDA), Manitoba & Nunavut Region, is hosting a special evening in support of Manitoba
Diabetes camps and their “Youth in Action” Programme on November 14. The 7th annual Best Banting
Evening 2015 will provide guests with the opportunity to mix and mingle with friends, colleagues and
distinct members of the community. Live and Silent Auctions will be featured with a fantastic array of
prizes. The event will be hosted by Canadian Broadcasting Corporation (CBC) top news anchor, Janet
Stewart, and also feature world renowned hypnotist Sailesh Jiawan.
In Trinidad and Tobago, the Diabetes Association of Trinidad and Tobago is holding a day-long Diabetes
in the Limelight Jamboree. This festival will include diabetes education, foot examinations, screenings
of blood glucose and other diagnostic tests, a weight clinic, vision testing, storytelling for children,
artwork displays, a diabetes education poster competition, and several education booths including
information on nutrition and much more!
In the USA, the American Diabetes Association is organising a Luncheon Symposium and Expo in
North Texas on November 12 that will feature distinguished speakers from the local community who
will give their perspective on the health and welfare of the region and provide updates on health and
wellness programmes that are working. Among the speakers will be the Mayor of Fort Worth, Betsy
Price who spearheaded the city’s initiative to become one of the nation’s first Blue Zone major cities,
helping people live long and better lives.
SOUTH AND CENTRAL AMERICA
In Brazil, the Sociedade Brasileira de Diabetes will light up the following locations in Rio de Janeiro in
brilliant blue along with complementary celebrations: the Maracanã Stadium with a diabetes screening
campaign; the 30 metres (98 feet) Christ the Redeemer Statue (Cristo Redentor) and Sugarloaf Mountain
Peak (Pão de Açúcar). In Sao Paulo, the Octávio Frias de Oliveira Bridge (a cable-stayed bridge that is
138 metres tall (453 feet)) will be lit, as well as other locations throughout Brazil.
In Costa Rica, the Asociación Salvadoreña de Diabéticos is holding a “Stop Diabetes In El Salvador”
walk and will attract more than 2,000 people with banners, balloons, musical bands, all dressed up on
blue, and creating awareness on diabetes, culminating with a Health Fair.
SOUTH EAST ASIA
In Bangladesh, a World Diabetes Day flash mob will be organised in the Shahbagh neigbourhood of
the capital city Dhaka. Hundreds of people are expected to participate and create awareness about
diabetes.
WESTERN PACIFIC
In Australia, Diabetes South Australia (Diabetes SA) will be celebrating World Diabetes Day with a
seminar for people living with type 1 diabetes. The seminar will be held at the Adelaide Convention
Centre, on November 11, and will focus on Innovations in Diabetes Management. The seminar provides
25
a unique opportunity to learn about the latest studies and technological advancements in the field
of diabetes. Diabetes SA will also be heading to the city’s Rundle Mall on November 13 to help raise
the community’s awareness of the prevention of type 2 diabetes by handing out the Australian Type 2
Diabetes Risk (AusDrisk) Assessment Tool for people to calculate their own risk.
In New Zealand, throughout November, Diabetes New Zealand will put the Mobile Diabetes Awareness
Service on a roadshow visiting 30 towns and cities across the country. On WDD, it will stop in Porirua,
a city 25 minutes north of the capital city Wellington. Porirua is home to a significant number of Maori
and Pacific people who are at higher risk of diabetes.
In Taiwan, the Chinese Taipei Diabetes Association (CTDA) will celebrate WDD 2015 with many
Taiwanese events, including: a national marathon cycling event, a garden festival at Sun Moon Lake,
CTDA’s annual diabetes walk, a monument lighting ceremony at Wenwu Temple and much more.
See how WDD 2015 is being marked all over the world and share your own event information at
www.idf.org/wdd-events
For more information about IDF networks and participation online:
• Participate in WDD events and share your photos with the diabetes online community. You can also
take a blue circle selfie and share it on social media channels.
• Or join social media to be part of the conversation around WDD! Follow us IDF on Twitter and create
your own #WDD Tweet or share one of our suggested tweets.
Twitter @WDD: https://twitter.com/WDD
Facebook: www.facebook.com/worlddiabetesday
LinkedIn: https://www.linkedin.com/company/international-diabetes-federation
YouTube: https://www.youtube.com/user/IntDiabetesFed
26
Make HEALTHY EATING
a RIGHT, not a privilege
CONSISTENTLY
HIGH blood
DIABETES
SUGAR LEVELS
If left unmanaged can result
in serious health complications
DIABETES
1. CHINA
World’s
is the
rd most populous
country
3
2. INDIA
3. DIABETES
4. USA
Global healthcare
expenditure
1
US
9
IS SPENT ON
in
DIABETES CARE
HEALTHY EATING
and physical
activity
DIABETES poses
a THREAT to
GLOBAL
SUSTAINABLE
DEVELOPMENT
COULD
PREVENT
IS AN
IMPORTANT
UP TO
PART OF
70%
of type 2
DIABETES
EFFECTIVELY
M A N AG I N G
type 1
DIABETES
All figures from the IDF Diabetes Atlas Update 2014
HALT the diabetes EPIDEMIC
www.worlddiabetesday.org
#WDD
ONSI
TE
AS OF REGISTAT
IO
30 NO
VEMB N
ER
DAY R
ATE
€330
STUD
ENTS
€110
30 November – 4 December
Learn.
Discover.
Connect.
SCIENTIFIC PROGRAMME
Chair: Bernard Zinman
Deputy Chair: Nam Cho
Basic & Clinical Science
Diabetes in Indigenous Peoples
Education & Integrated Care
Global Challenges in Health
Living with Diabetes
Public Health & Epidemiology
Steven Kahn
Malcolm King
Unn-Britt Johansson
Gojka Roglic
Gordon Bunyan
Edward Boyko
www.wdc2015.org #WDC2015

ONLINE - International Diabetes Federation

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