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Amputated limbs, blindness, erectile dysfunction, stroke, kidney and heart disease are just a few complications of a condition suffered by over 200,000 New Zealanders.
Diabetes is a sometimes life-threatening disease that affects three times as many Māori and Pacific Islanders as it does other cultures.
And Ministry of Health figures suggest that another 100,000 New Zealanders could have the condition without realising it.
Te Korowai Hauora o Hauraki dietictian Claire Cannon says once a person gets over the initial shock of a diabetes diagnosis they can focus on implementing positive changes to improve their health.
“I have seen people make a real positive difference to their health by improving their diet, becoming more active and reducing stress,” she says.
Diabetes occurs when the hormone insulin, produced by the pancreas, doesn’t do its job properly. Insulin is needed to balance our blood sugars, which increase when we consume carbohydrates and sugary foods.
There are three types of diabetes.
Type 1 diabetes is an auto-immune condition where the body attacks the cells that produce insulin. Without insulin blood levels in the body remain high resulting in damage to the vessels that supply blood to vital organs. Type 1 Diabetes cannot be prevented but it can be managed through a combination of medication, healthy food choices and exercise. People with Type 1 diabetes need to manage their blood sugar levels with insulin.
Type 2 diabetes is the most common form of diabetes and can be helped by maintaining a healthy weight and through making dietary changes and lifestyle changes.
Gestational Diabetes affects some women during pregnancy when they can’t produce enough insulin to meet the demands of a growing foetus – sometimes up to three times that of normal needs. Gestational diabetes usually disappears after pregnancy, however the woman’s risk of developing risk of developing type 2 diabetes increases by 50-60% in the future, so Diabetes NZ advises yearly blood tests.
The main symptoms of diabetes are frequent urination, excessive thirst, extreme hunger, abnormal weight loss, increased fatigue, irritability, recurrent infections, blurry vision and erectile dysfunction in men.
Claire says some people may not be aware they have diabetes, so if they recognise any or all of the symptoms above, they should see their GP, who can arrange blood tests.
World Diabetes Day is November 14.
Referring to Thames as the ‘big smoke’ brought hails of laughter from Te Korowai Hauora o Hauraki kaimahi (staff) who warmly welcomed Prime Minister Jacinda Ardern to their Wharehui on Monday.
The Prime Minister was relaxed and friendly on her whistlestop visit to the Hauraki health provider on Monday.
CEO Riana Manuel and about 80 of the organisation’s 250 kaimahi were able to share their invaluable contribution to the health of the Hauraki community, while Prime Minister Ardern acknowledged that organisations such as Te Korowai were at the core of New Zealand’s wellbeing and always had been.
Riana says Te Korowai Hauora o Hauraki came from very humble beginnings with an aim to support whānau struggling with mental health diagnosis and finding support for them.
“Through the support of many of our kaumātua throughout Hauraki we were able to come together and create an organisation that would support our people toward wellness,” she says.
Prime Minister Adern shared her “small personal connection” to Te Korowai because of the work Te Korowai has done on behalf of her own family, in particular her grandparents, under its Ohu Kāinga Home Assist umbrella.
“My grandparents and parents were born in Te Aroha and if we asked my grandfather what he wanted to do on a day out when we visited on a Sunday afternoon, he would always want to come here – Thames was the big smoke - because you had a shopping centre and fast food,” she says.
“But, of course, your catchment area covers my grandparents and you have been part of providing them with care later in their life, as you are for many.”
Te Korowai Hauora o Hauraki services span across three district health board areas, with four whānau health centres in Thames, Paeroa, Te Aroha and Coromandel, while their Home Assist and a multitude of other services reach into the wider rural communities.
The logistics of accessing clients throughout such a wide and sometimes isolated catchment were not lost on the Prime Minister, who grew up in the rural town of Morrinsville.
Compounding those logistics, she says, is the fact that the area sit alongside Otaki in terms of age profile.
“You have a high proportion of older citizens and that means you are providing really critical care,” she says.
Elaborating on a quote from former Labour Prime Minister Norman Kirk, Prime Minister Ardern stressed the importance of supporting the nation’s health and wellbeing.
“He had this saying that all anyone ever needs is something to do, somewhere to live, someone to love and something to hope for. Nothing could be truer, but he is taking something for granted there and that is that we need our health, because if we don’t have our health, that something to do is that much harder, and that somewhere to live is what contributes to whether we are often well or not and that affects those people around us who love us.”
“I see this as being absolutely critical to the wellbeing of Aotearoa and health sits at the core of that - be it our physical wellbeing, or, increasingly, a focus on our mental wellbeing as well.”
Prime Minister Adern says that while the last budget had a particular focus on mental health and wellbeing, the health system and the professionals that work within it have for a long time been plugging a gap where it hasn’t been provided for by central government leadership.
“So many of the places I visit are already making sure they are integrating mental health services into their primary care practice, so I would love to hear more from you (Te Korowai) as to how you see us rolling out what is now a half billion dollar programme for primary mental health care in every medical centre, iwi provider, GP practice - rural or urban across the country - as a way of trying to grab that missing group not getting the care they need.”
Specific funding for kaupapa Māori services is within that package, she says.
“We will be reaching out and asking what will work for your community best. Let’s not design this in Wellington - you’re already here working on the ground. Tell us what primary mental health care for your community would look like and how best to offer that.”
The Government recognised that it needed to build care, focusing from maternal mental health right through to those who may require more intensive tertiary services, she says.
“We actually have need at every single part of that mental health and wellbeing spectrum. Our mental health has so many contributing factors - we often don’t put enough emphasis on the connection for instance between family violence and mental health, between financial insecurity and mental health, between trauma and all the origins of that trauma and mental health.
“So, acknowledging that when we built that wellbeing budget, the work that we did on Oranga Tamariki and the investment there and trying to put in extra support into early intervention was about mental health.”
The rollout of nurse-based health services in schools was ongoing.
“We are now moving through decile 5 and we have already extended some free doctor visits for that kura but for our young people it will be again the rollout of that primary mental health service through youth health centres as well as through our kaupapa Māori providers and through our GPs. Absolutely every single place a person accesses primary health services are where we want those services to be.”
Prime Minister Adern says the Dunedin study had provided the Government with many insights into the life experience of Aotearoa’s young people and the impact that then had on their mental health further down the track.
“There’s a really interesting linkage there that tells me that really investing in the work we do through early childhood education and through parenting support will make a longterm impact that I won’t see until I’m old and grey, but if I know now that if I invest now, then my grandchildren will benefit from that - and that is an investment worth making. So, we need to use that evidence base that we have.”
Riana agreed, citing a report written 33 years previously by Māori leader John Rangihau.
“He was outlining the very same things you have just done now,” she says. “If we leave it too long, we will not see the differences that we envisage for. Now that you are a mother and I am a grandmother of eight, I am determined above all to make sure that those babies don’t have the same problems that we have.”
Riana says Te Korowai Hauora o Hauraki’s vision had always been “Hauraki as a healthy nation”.
“We hope that one day it will no longer be the vision and we can replace it with something else. It won’t be needed anymore because we would be a healthy nation”.
Caption: Prime Minister Jacinda Adern has a chat with clinic kaimahi. From left: Riana Manuel, Nurse Practitioners Jane Jeffcoat and Esme Moloney and Registered Nurse Nadia Molloy. Photo Credit: Jo Belworthy
Prime Minister Jacinda Adern made a whistlestop visit to Te Korowai Hauora o Hauraki yesterday, spending time with kaimahi and management in the wharehui, before heading off around the complex for a meet and greet. Super relaxed and friendly, the Prime Minister happily chatted and posed for photos with kaimahi before being whizzed away to her next appointment armed with a kete full of goodies, including a wee gift for daughter Neve.
Ko Moehau ki waho, Ko Te Aroha ki uta.
Ko Waihou, ko Piako me ko Ohinemuri ngā awa.
Ko Tīkapakapa te moana
Ko Ngāti Maru, ko Ngāti Tamaterā ngā iwi.
Ko Matai Whetu, ko Te Pai o Hauraki ngā marae. Ko Tainui te waka.
Ko Hoturoa te tangata.
Ko Jo Shelford tōku ingoa.
Ngā mihi mahana ki a koutou katoa e te whānau whānui o Hauraki.
Nō reira e te whānau Turou Hawaiki
nā Io ki a koutou katoa
Call and make an appointment. Freephone 0508 835 676