Articles

Diabetes Epidemic: Part 2

December 30, 2019


We live in a toxic environment so whatever the guidelines tell us,
whether they are right or wrong the reality is that our food
environment is setting us up to fail. Why should we be setting up society to make it so hard for people
to choose healthy food? At some point governments
are going to realize that effectively the food manufacturers
are bankrupting us. The only good thing from
their point of view is you are going to die younger, which means they won’t have
to pay your pension. (Alarm sounds) (Narrator) Christina Muaiava loves food but having Type Two Diabetes means she has to be very careful
about what she eats. I eat lots of fruit and vegetables
but then I eat lots of the other foods. I have to seriously maintain
what I should be doing. Otherwise I hate feeling unwell,
I hate feeling sick. (Narrator) Christina injects
insulin twice a day to help her body manage blood glucose. Last night she had a sugar blow out so she’s not expected good news
from her daily blood test. A reading over 6 is high. Phew… 8.1 But I didn’t take my insulin
and tablets last night. And I had Koko Samoa so thankfully
it is alright this morning. Anything over 20 she faints, she drops and you have
to pick her up. (Narrator) Left untreated a
diabetic coma is fatal. I had one Koko Samoa last night
but I usually have six or seven. It has to have a lot of sugar
so it is not good for you. Damn it… because I love Koko Samoa. (Narrator) We can control blood
sugar through diet. Many people don’t realize a
lot of carbohydrates will raise blood sugar levels. I refrain from telling too many
people that I am diabetic. Because they are quite judgemental They will say, “Should
you be eating that?” “I thought diabetes people
don’t eat that kind of food.” I get annoyed because I don’t point the
finger and look at what you’re eating, and what you put into your body.
Because this is my body. You get people who will come up to you, “Don’t eat that!”
“Aren’t you diabetic?” Yes I do know. You never tell an alcoholic,
“Don’t have that drink.” Don’t point the finger at other people. I don’t tell other people what they
should and shouldn’t eat. We know what foods we’re supposed to
eat and what’s nutritious for us. And we encourage each
other to eat healthy. Tony really cares about me
and what I eat. Because he is the one that has
to look after me (laughs), when I get sick. (Narrator) For 16 hours a week
Brian Kairau’s blood is filtered through a dialysis machine. (Brian) It’s weird when you think that
your life depends on this machine and how well it keeps you
cleansed of all your toxins. This is me – this is my real
system right there. (Nurse) There you go some calcium. This bug kicks my immune
system in the butt. If they can’t bring this
infection under control and it continues to waste my limbs. They have no option but to remove
my legs from below the knee. (Narrator) Brian worries about his kids. His daughter Sharmayne once
played Softball for New Zealand, but that was before she became a mum. I’m not really healthy at the moment, I’m being naughty eating bad foods,
and not doing sports anymore. I’m being a bit lazy at the moment. It’s hard for me to stay healthy,
just paying your way and it’s hard. I just want to live a better life. Being a mum you’re
always on your toes and you have to do all these things. You don’t always find the time
to cook a healthy meal. So it’s easy to go and get takeaways. (Sharmayne) Hi Dad.
(Brian) Hello honey. (Brian) Missed you. (Sharmayne) Missed you too.
I got you some oranges. (Brian) Oh cool. Arrghh! Sorry I’m in pain right now. (Narrator) An infection in Brian’s
heel is eating the flesh. His body is struggling to fight it
because he has poor circulation. Typical of excess blood sugar
clogging up the veins. (Brian) It’s been so painful all night. They had to keep giving me
lots of medication. I’ve got no feeling in my foot. But even digging it in there
like that and twisting it around. I can’t feel any of that. I could stand on a nail and it
could go right through my foot, and I wouldn’t feel it or know
that I had done it. (Sharmayne) There is not much
that they can do for it anymore. I know he’s struggling with it,
going from a fit and healthy man, to downhill straight away, I think maybe
he was a bit shameful about it. He told my brother that he
doesn’t think he’ll make it, and I broke down because
that was so sad to hear. (Brian) I was ready to give up.
I’ve been fighting for eight years. I’d had enough to be honest. And then I called all my son’s
in and I told them. They said, “Come on dad!” And I apologized that I wasn’t as
strong as they thought I was. They told me that I was strong,
but I said nah. I said I can’t do this anymore
it’s just too hard. It’s just too damn hard I can’t do it. In the end they all accepted my decision, I mean here’s me thinking… I’m just going to lay back down
and see glory, you know, just let it go and come what may. Then my daughter heard what I
was telling her brothers, and she came in and that was it,
I didn’t have a chance after that. I can’t see my daughter weep. I’m just putty in her hands
when she does that. But I tried to resist and I argued
with her and I told her, and tried to make her
understand where I was at. And she didn’t want
anything to do with that. She said, “No I’m not
ready to let you go dad.” And she squeezed me so tight
and wouldn’t let me go. I told dad, “Please don’t go,
I don’t want you to go.” And he said, “He can’t do it.” I kept asking him and when my
brothers left he said, “Okay daughter.” I’m the Archive Resources Co-ordinator for the Archive of Maori
and Pacific Music at the University of Auckland. (Narrator) Christina’s family
depends on her income. She’s determined to keep
working and avoid dialysis. She must be vigilant
with her blood sugar. (Christina) When I feel unwell,
I probably haven’t eaten so I will go and get something. To me the telling point is,
“Oh it’s coffee break.” My father was a diabetic and he was on dialysis four years
before he passed away. My aunties and uncles, cousins,
three brothers and one sister, we all have some kind of diabetes. I’m always checking labels. I look at the labels and see
how high the sugar is. There’s sugar content in
everything you eat. I now know which ones have
the highest sugar, so I try and get the ones that are low. People don’t really know
where sugar’s coming from. It’s really easy to look at a fizzy
drink and a bag of lollies, and say, “I don’t eat that,
I don’t eat a lot of sugar.” “My diet doesn’t contain a lot
of sugar, I eat healthily.” But what they don’t realize is that all
the packaged processed foods that they might have in their
diet contain sugar. And because reading labels
is so incredibly difficult. And we’re constantly coming up with
different ways of trying to guide people, the reality is that it’s hard work and
people are getting a lot of sugar from a lot of places that
they would have no idea. My health is better than it
was 15 to 20 years ago. I use to be really bad. I use to eat everything and anything. And I use to drink heaps of fizzies. It was about 2005 when
I collapsed at home. And that was my first wake up call. Then I would go really well
and then after a while when I think I’m eating really
healthy and I’m exercising, then I get slack and
think that I’m alright. I use to be ashamed to do my insulin, and because I was ashamed
I wouldn’t do it. I don’t want people to feel
sorry for me either. One of the nurses said to me,
“You do know that with your condition,” “…your diabetes that you have
kidney failure and you’re dying.” “It’s a slow killing disease so we just
give you meds to prolong your life.” And I said, “Thank you very much,” I picked my bag up, went out the
door and I didn’t go back. It felt like to me that I was a
waste of time and money. I bet there are a lot of other
diabetes people who the medical staff that probably
just roll their eyes and go, “Oh.” There’s immense amount of stigma
that’s attached to Type Two Diabetes. The reason is because we get
bombarded with messages about what the cause is people being overweight and overeating. And so when someone is
diagnosed with diabetes it can be very shameful
and embarrassing. Which has a lot of consequence
in terms of that person then being
able to manage or deal with the Type Two Diabetes. (James) Hi Brian I got
you some biscuits. (Brian) Mean bro. (Narrator) James is Brian’s
diabetes buddy. They’ve been doing dialysis
next to each other for years. I would much rather enjoy
what time I have left eating something I enjoy
than bland food all the time. When you know you’ve only got
five years you don’t stuff around. There are lots of things that I
have to learn to live with now. Getting around with half
a foot is nothing compared to some of the other
people I’ve seen on dialysis. I sit there and think I’m lucky I don’t
have no legs like that guy. Lucky I still have got my hands. I was in a room once with
a guy that went blind and he was on dialysis for 17 years. Then I heard he died and
I thought far out! Man they seem to be dropping
like flies at times. Last time I saw that happen was a
young guy maybe 20 years old. And he’s just had both
of his legs amputated. And ‘Triple Eight’ happened
right on the bed next to me. His mother was hard out screaming. We’re sitting there trying to
pretend we’re use to it. But it makes you think about how
long before it happens to me? (James) I get like that as well. In saying that I’m looking at these
biscuits and I want to eat one. If you can afford to eat
healthy then eat healthy. All the good kai is so cheap
that’s what we can afford. So we feed that to ourselves
and our kids. You seldom see anyone that went to
Kings College etc., on dialysis eh bro? All the ones that are coming
through are guys like you and I. (Narrator) At 47 years old Jame’s
is already a dialysis veteran. The average life expectancy
on dialysis is five years. (James) I’ve been doing dialysis
almost seven years now. Both my parents are diabetic but I’m
the only one who’s doing dialysis. I was working for Alert Taxis
but I was getting blackouts. So that is when I started dialysis. I’m really careful with what I eat and
I haven’t had takeaways in ages. I might buy one can of Coke or Fanta
but I mainly drink water. I stopped drinking alcohol but I’ll
probably have a drink when I turn 50. If I can make it that far. The sugar has been there all my life. I know a lot of people that
can live without sugar. Those same people find it
hard to stop smoking. Or stop drinking alcohol. I can stop those two things quite easily. It’s not saying that one’s more
powerful than the other. It’s just that when you’ve been
raised with something that’s freely available it’s
really hard to kick it. I’m perpetuating the cycle by letting
my grandchildren have treats because I have that mindset that’s
what grandparents are for. You spoil your grandchildren. I can’t remember my grandparents, so I hope I can do a good job to
make my grandchildren happy. And sadly, I think that’s also
giving them treats. How’s your diabetes going? Up and down, but it’s alright
and this morning it was 8. If you have diabetes there’s a risk you
may have diabetic retinopathy at the back of your eye and it
needs to be looked out for. And we need to find this
before you’re aware of it. I can see where your cataract
surgery has been done. And you have a little bit of
cataract on your left eye. This is the sort of cataract that we see more frequently in patients
with diabetes. I can see changes at the back of
your eye typical of diabetes. There are are little dot
and blot hemorrhages. And some exudates where your vessels
are leaking at the back of your eye. The biggest issue that we have in
New Zealand right now is diabetes and the secondary effects
that has with respect to the eye. When we look at the back of the eye we can see changes before the
patients are aware of any symptoms. The most important thing about
diabetic retinopathy is that it’s related to blood
glucose control. If you have routinely poor blood glucose
control then you’re more likely to have a worsening of the diabetic
retinopathy at the back of the eye and lifelong treatment is required. In the worst case scenario people will have bleeding into the vitreous, which is the gel inside the eye. They’ll then develop retinal detachments and if they’re not picked up early enough they’ll end up losing their sight. My biggest concern is the vision in your left eye is reduced because of cataract, but more importantly the
cataract that you have stops us from seeing into
the back of your eye just like it stops you from seeing out. I’m going to suggest that we
should look at removing the cataract from your left eye as well. (Narrator) Brian’s doctors
have decided there’s nothing more they can do. They’re going to cut is foot off. I now understand why people
want their legs amputated because the pain… is not nice. I’m a pretty tough guy and
that keeps kicking my butt. I haven’t been able to
sleep for three days. It feels like the raw meat on my leg has
been scraped against a rasping file all night long and all day
it just doesn’t stop. (Dance music) Right now I’m getting
a health check done. They check your blood sugar,
your blood pressure and you have to weigh in. And after this we do Zumba. We try to keep healthy and they watch
for people who have diabetes. When they have these health checks
I know exactly what mine’s going to be. I can tell her now that it’s high. I’ve weighed myself and I’m 109kgs. Your blood pressure is very high,
we need to double check. That’s a dangerous blood pressure. Did you know you can
have a heart attack with this type of blood pressure
and blood sugar level? Too high… you can’t exercise
with that blood pressure. Yeah I will be fine. It’s fine with you but now fine with me. If anything happens to you then
they might take us to court. It’s way to dangerous it’s way too high. We need to refer her to the GP or if it’s after hours we can take
her straight to hospital. She might have a heart attack
or stroke any minute. So it’s very dangerous. My dear now it’s above 200. It’s dangerous. I will be fine don’t worry. It’s not fine. (Dance music) (Narrator) Christina went straight
to the Emergency Ward. I’m guessing tonight is
going to be painful. (Narrator) Brian is
about to lose his foot. But he’s worried it won’t stop there. Can I brazenly ask what my possibility is of me keeping my legs
in the next ten years or so? (Doctor) You know
we’re up against it. Most of the work that’s been done
has been to do with getting dressings right,
getting the podiatrist in, getting your diabetes under control,
making sure your dialysis is good, and my role has been to come
in here and tell you if we don’t do something
you’ll lose your leg. And then try and
make sure you don’t. (Brian) You’ve done that quite
well at the moment. (Doctor) So far so good. I feel like it’s too little too late
and that’s where I’m at. I need to get on your wavelength where
with a lot of hard work we can get there. I’m not there or sold on that yet. Thank you doctor see you. Bye. I’m at the bottom of the cliff here
and he’s already fallen off. There are a large number of patients
with Type Two Diabetes and infection within their feet
and they’re coming here. So a lot of patients get admitted
and need operations on their foot and toes chopping
off because of diabetes. It’s pretty common. (Brian) I’ve had over 20 operations done
that are diabetic related. They want to do what they can with the problematic issues that we’re having. It’s really cool that we’re given hope. So thumbs up. I’m resting at home today. I’ve been in hospital for two nights. The doctor said that my kidneys
are functioning at 50%. And it’s deteriorated in the last
three months at a fast rate. I know that I want to live longer
for my kids and my husband. And be happy. Food makes me happy. Everything in my life is around food. Our meals together are important
that’s when we talk about our day. I don’t know if I eat more
when I’m depressed but I know I eat more when I’m happy. So I’m happy all the time. We’ve been together 34 years. She’s my soul mate. She’s the mother of my two boys. I’ve never smoked in my life and
I’ve never drunk alcohol. I’ve never taken illicit drugs. But I have this slow killing
disease called Diabetes. Hi Brian? Hello Patricia. You’re going to take my dressing down? Yes so that doctor can have a look. (Narrator) Brian’s about to see the
remains of his foot for the first time. And it’s uncomfortable viewing. (Brian) One post amputated foot. I’ve just got to hope that this all heals
nicely and then I can keep my foot. Thank you. No worries. This is all a consequence of not listening
to the doctors 15 years ago when I was first diagnosed
with diabetes. Yeah… unfortunately this is one
of the things that can happen you can very slowly start
getting amputations. I’ve got all these things showing
up on my hands. If they can’t find out what’s causing that
and they start to get infected then I’ll start losing fingers as well. I can’t turn the clock back and say I should have done this and I
should have done that. I just have to accept that 15 years ago I made a choice not to
listen to the doctors and the consequence of that choice
is what I’m facing today now. (Brian) Hello my moko! Are you going to climb up here? Hang on Pappa will lower the bed. Watch out for Pappa’s leg. Hugs? Hi honey. Hi dad. Pappa miss you. You want to have a look at my leg? Are you ready? What does it look like? Blood and meat. My toe gone. I’m looking forward to finally
being discharged. I’ve spent the last eight years
in and out of hospital. And I’m looking forward to
being around my family. (Narrator) In our next program we learn that the dangers of getting diabetes
can start in the womb. And Brian is worried about how
much more he can take.

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