1. Our vision: Healthier communities, Excellence in healthcare Our values: Teamwork, Honesty, Respect, Ethics, Excellence, Caring, Commitment, Courage Diabetes Mellitus on the Lower Mid North Coast-watch this space… Prepared by Diabetes Dietitian Lower Mid North Coast Cluster November 2009

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3. 3 Who do I see?  Anyone in the LMNC cluster with a blood glucose disorder…. –Type 1 DM Paediatrics, young adults and Adults –Type 2 DM Paediatrics, young adults and Adults –Gestational Diabetes Mellitus –Polycystic Ovarian Syndrome –Impaired Glucose Tolerance, Impaired Fasting Glycaemia

4. 4 What are those kids up to?

5. 5 I’ve noticed with Paediatrics…..  Increasing waist circumferences  Kids dictating what’s being eaten for dinner  Not many kids involved in food preparation- from menu planning, peeling vegetables to stirring and baking.  They love screens!

6. 6 Things to Investigate….  Sedentary Behaviour  Exercise and Activity  Meal preparation skills

7. 7 Sedentary Behaviour  Think in terms of screens –How many are in your house? –Is there a TV and/or computer in your bedroom?  How many hours per day is spent watching TV? – Include videos, DVDs, pay TV?  How much time is spent on the Playstation/X-Box/ Wii?  Who turns the TV on and off?  What time does the TV go on?  Do you ever have Technology blackout?  How much time is spent on the computer? –Home –School/Work

8. 8 Activity and Exercise  How do you get to and from school/ bus stop?  What activities do you do at lunchtime/after school/work?  Are you involved in any organised sport?  Do you avoid situations where exercise is required? e.g. sports carnivals, PE  Do you do any exercise/activity as a family?

9. 9 Food  How many days per week do you eat breakfast?  What types of snacks do you have?  What fluids do you drink?  How often does your family eat at the table? –Is the TV on?  How often do you eat takeaway or eat at fast food restaurants?

10. 10 Skills of parents Would they like education in -time management -meal planning -budget -shopping list -making vegetables edible -how to give your children cooking skills -behavioural eating- they’ve had insulin, but won’t eat dinner…

11. 11 Is food preparation too hard?  Changes in insulin delivery such as multiple daily injections and insulin pump therapy mean it’s even more important to understand dietary sources of carbohydrate and be able to estimate the carbohydrate content.  Is it easier to look at the packet?

12. 12 How do I find this out?  Quality Activity vs. Research  Survey/ Focus group –Face to face interviews –Phone surveys –Posted surveys –SMS on mobile phone  2 nd yr student recommendations and pitfalls of mail outs

13. 13 What about the Type 2 groups???

14. 14 Type 2 Education group  Last surveyed 2004  Wanting to know –Do they like current format –Do they remember key messages –What about coaching post group education? –http://www.gethealthynsw.com.auhttp://www.gethealthynsw.com.au The Get Healthy Service provides information on how to Get Healthy in relation to: Healthy eating, Being active, Achieving and maintaining a healthy weight. Participants of the Get Healthy Service will receive up to 10 telephone based coaching calls over six months.

15. 15 Come and visit sometime….

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