Diabetes advice from Tenterfield educator Nicole Green

Tenterfield Hospital's diabetes educator Nicole Green urges everyone to go to their GP for a simple blood test, to avoid the consequences of this condition.
Tenterfield Hospital's diabetes educator Nicole Green urges everyone to go to their GP for a simple blood test, to avoid the consequences of this condition.

Did you know there's no such thing as a 'diabetic diet'? Tenterfield Hospital's diabetes education nurse Nicole Green (who doubles as a community nurse for most of her shifts) said the healthy diet she encourages her clients to adopt is the same one she and everyone should be eating.

This week is Diabetes Week, and Miss Green is urging everyone to go to their GP and get a simple blood test to see if they're at risk of this modern-day disease. There are some tell-tale signs that you may have it but some or none of them may be present.

For Type 1 diabetes it's the 4Ts: thirst, tiredness, thinner and toilet. Miss Green said being thirsty and constantly running to the toilet is the body's way of trying to flush out the glucose, resulting in a vicious cycle.

Symptoms for Type 1 are similar, but also include blurred vision and slow-healing wounds. Apparently bacteria is attracted to the sweeter body fluids!

Also, while being overweight predisposes you to the disease (as does genetics and ethnicity), being thin does not necessarily protect you and you still have to be tested.


GPs will often refer patients to Miss Green at the hospital on a Type 2 diabetes diagnosis but patients can also self-refer. Type 1 cases and more complex Type 2 cases instead see nurse-practitioner Louise Vaughan in Armidale, usually via teleconferencing from the local hospital.

Miss Green said she spends on average a day a week on her diabetes education role, supporting new and ongoing cases, but can always accommodate a need for consultation. She helps those starting out on insulin and is at the end of the phone for any follow-up questions.

"Through education I enable patients to feel comfortable to manage their condition," she said.

"If their readings are out of the ordinary I can help them identify was it a something in their diet? Did they have four beers the night before?

"We can also identify whether they need to see their GP. If their blood sugar's been elevated with no apparent cause for a day or more, they need to go to their GP or Emergency."

Ongoing elevation can cause serious complications, such stroke, blindness, kidney and cardiac problems as well as anxiety and depression. In Australia 4400 amputations a year are due to diabetes.

While she suggests everyone should be seeing their GP for regular blood tests (and the theme of this year's Diabetes Week is It's about time), being older, overweight and leading a sedentary lifestyle puts people at particular risk.

Miss Green said there is no 'cure' for diabetes, but it can be controlled by medication and/or by making lifestyle changes to include more movement and a healthy diet. The condition is a combination of the pancreas no longer working efficiently, and cells in the body becoming insulin-resistant.

While it may be a challenge for those with mobility issues to become more active there is information on using resistance training and other methods, although Miss Green said patients should always be cleared by their GP before embarking on an exercise program.

The bottom line is: there's no excuse.

"There are definitely ways," Miss Green said.

Clients can also be referred to an exercise physiologist to help them get moving.

She said it's also the client's choice as to whether they change their diet to less of the convenience food that's so readily available, but there's help available. Referrals are available to a dietitian in Inverell, again via a Telehealth hookup.

Miss Green said while there's lots of misleading advice out there, Diabetes NSW is a reliable reference point.

Finger pricks are a cost-effective way to monitor blood sugar levels, but there are new methods like an arm patch with a tiny needle which measure interstitial fluids (doesn't need to penetrate a vein). A monitor much like a smart phone is swiped over the patch to get a reading, but Miss Green still recommends regular finger pricks to double-check.

The monitor, however, costs around $95 with a similar price for each patch which has to be changed fortnightly, although some patients may be eligible for subsidies.

Managed well, diabetes patients can avoid consequences like limb amputation (due to a combination of poor circulation, nerve damage and the aforementioned attraction of sweet blood to bacteria). Meticulous wound care is obviously vital, and Miss Green sees a crossover to her community nursing work.

While she doesn't have Tenterfield statistics, Miss Green said there is an increase in diabetes Australia-wide with 300 new cases diagnosed every day.

Moreover it's estimated that half-a-million Australians have diabetes and don't know it. Statistically some of them will live in Tenterfield, so get a blood test to make sure it's not you.