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Understanding Diabetes

What is Diabetes?  
Diabetes is a serious chronic condition that can affect the entire body. According to the National Health Survey 2017-2018, 1.2 million people are affected by Diabetes in Australia. Approximately one in six Australians over the age of 25 have prediabetes.  

Diabetes requires daily self-care and can have a significant impact on the quality of life and reduce life expectancy. There is no current cure for diabetes but you can minimise impacts on your quality of life through early diagnosis and effective treatment.  

There are 3 Main Types of Diabetes 

  • Type 1 Diabetes – is an autoimmune condition in which the immune system is activated to destroy cells in the pancreas, resulting in decreased insulin production.  Type 1 diabetes is not linked to modifiable lifestyle factors, there is no cure and it cannot be prevented. This tends to be diagnosed during childhood.
  • Type 2 Diabetes – is a condition in which the body becomes resistant to normal effects of insulin. The pancreas gradually loses the capacity to produce enough insulin. Type 2 diabetes can be caused by a combination of genetic and lifestyle factors.
  • Gestational diabetes – it is diagnosed when higher than normal blood glucose levels first appear during pregnancy. This is the fastest growing type of diabetes in Australia. All pregnant women should be screened for gestational diabetes. 

If you have any of these symptoms do not hesitate to ask your GP

Prevention 

Type 1 diabetes cannot be prevented.  
People at risk of type 2 diabetes can delay or even prevent the condition by:  

  • Maintaining a healthy weight 
  • Regular physical activity 
  • Making healthy food choices 
  • Managing blood pressure 
  • Managing cholesterol levels 
  • Not smoking. 

Early diabetes often has no symptoms; therefore, screening is vital. Your GP can organise a diabetes risk assessment. Everyone over the age of 40 should be having a diabetes risk assessment at least every 3 years. Your GP will take a medical history and physical examination and may recommend a fasting blood test. Some people should have screening earlier in life or more often, your GP can advise if you fall in to a higher risk category.  

If diabetes, or pre-diabetes, is diagnosed, a dietitian and an exercise program are invaluable tools in diabetes management.  


Have you met our in-house Dietitian? 

The Lifestyle Dietitian are a team of compassionate Accredited Practising Dietitians here to help you at NUVO Health. They are dedicated to supporting you in managing your health conditions through food and nutrition. Each of our Dietitians work across a range of health areas (including Type 2 Diabetes, insulin resistance, heart disease, weight management, PCOS, gastrointestinal conditions and hypertension) and recognise that patients are all unique with their own health goals and challenges. They are dedicated to understanding your individual circumstances and empowering you to make sustainable health behaviour and lifestyle change.  

If you would benefit from individualised dietary advice and support from an Accredited Practising Dietitian, book an appointment with one of the Dietitians from The Lifestyle Dietitian online or in-house at your local NUVO Health clinic. If you have private health insurance cover or a Medicare plan you may be eligible for rebates on your appointment.  

For a limited time, the team at The Lifestyle Dietitian are offering $50 off for your first appointment. 

RECIPE:  

Are you looking for a simple diabetes-friendly recipe that isn’t just nutritious but also delicious? The team at The Lifestyle Dietitian have put together an easy recipe to help manage your blood sugar levels whilst still enjoying a satisfying meal. 

Healthy Burrito Bowl

This Mexican-inspired recipe is packed with legumes, corn and basmati rice which are low GI carbohydrates that break down slowly and prevent spikes in your blood sugar. This recipe also includes tinned beans and vegetables which are not only incredibly nutritious but also very cost effective and a great way to save money when shopping on a budget or the cost of fresh produce is high.

With plenty of flavour, zest and spice, this recipe will soon become a family favourite for “Friday Fiesta” nights at home! 

Ingredients: (Serves 6) 

  • 500g extra lean beef or pork mince 
  • 1 tbsp smoked paprika 
  • 1 tbsp garlic powder 
  • 1x 400g can black beans, drained and rinsed 
  • 1x 400g can corn, drained and rinsed 
  • 1 red onion, chopped 
  • 1 red capsicum, chopped 
  • 2 fresh tomato, chopped 
  • ½ bunch fresh coriander, chopped 
  • Extra virgin olive oil 
  • 1 avocado  
  • 1x lime  
  • Basmati rice, to serve 
  • Chilli flakes (optional) 

Method: 

  1. Cook the rice according to the instructions on the packet and set aside.  
  2. Heat a large fry pan over medium heat. Add 1 tbsp olive oil and cook mince for 1 to 2 minutes. Add the paprika and garlic powder and continue cooking until golden brown.  Add the black beans and stir for a further 1 to 2 minutes until heated.  
  3. Heat a second large frying pan. Add 1 tbsp olive oil with the red onion, capsicum and corn. Cook until slightly charred.  
  4. Make the guacamole in a separate bowl by smashing the avocado with the juice of half of the lime. Mix in chilli flakes if using. 
  5. To assemble, arrange the rice, vegetables and meat and bean mixture in individual bowls (see image). Top with fresh tomato, coriander and guacamole. Slice the remaining lime into wedges and add to the bowls. Enjoy! 

After more tips for controlling blood sugar levels through good food? Learn these simple swaps when cooking or try a new Dietitian-approved healthy snack this week. Click here to read more articles and recipes written by our team of Accredited Practising Dietitians from The Lifestyle Dietitian 

Kind Regards,
The team at Rozelle Medical Centre

Sources: 
https://www.diabetesaustralia.com.au/ 
https://www.abs.gov.au/statistics/health/health-conditions-and-risks/national-health-survey-first-results/latest-release 

Are You Travelling Overseas This Year?

By getting vaccinated, you are protecting yourself against infectious diseases while you’re traveling. It also helps to ensure that you don’t bring infectious diseases home to your family and friends. 
https://wwwnc.cdc.gov/travel/destinations/list

Different countries have different vaccination requirements

We recommend that you visit your GP to get your vaccination at least 6 to 12 weeks before you leave Australia. You may need several doses of a vaccine to achieve full immunity and your body will also need time to develop full immunity. 

Get medical advice from your GP 

Your personal situation can affect your health risks overseas. You need medical advice tailored to you, even if you’re usually fit and healthy. 

Your GP can advise what vaccinations and preventative health measures you should take.

References: 
https://www.health.gov.au/health-topics/immunisation/when-to-get-vaccinated/immunisation-for-travel 
https://www.smartraveller.gov.au/before-you-go/health/vaccinations?#vaccinations 
https://www1.health.gov.au/internet/main/publishing.nsf/Content/ohp-humanbiosecurity 
https://healthwaymedical.com/travel-vaccinations-why-is-it-important/ 
https://wwwnc.cdc.gov/travel/destinations/list 

Flu Season Has Arrived

Dear Patients, 

Hope you are well. Autumn has arrived so has the start of the flu season. Although we could get flu at any time of the year, the spread is more prevalent when the weather cools down. The peak of flu season in Australia is usually June to September.  

The last two flu seasons have been unusual in Australia due to the covid-19 pandemic; we have not seen many influenza cases and there has been lower uptake of the vaccine. Now that the borders are open and life is returning to normal, health experts are predicting a more severe flu season in 2022.  

What is the flu or Influenza? 
The Flu or Influenza is an acute viral illness. It is a highly contagious disease that mainly affects the respiratory system. It is caused by influenza viruses classified as type A, B or C. Only influenza A and B viruses are included in seasonal influenza vaccines as they cause the majority of disease in humans. 

How the virus spreads?  
Influenza spreads easily, mainly through large particle droplets produced by sneezing and coughing. Droplets containing the influenza virus also settle onto surfaces, and the virus can then pass from hands to the nose, mouth or eyes. People with influenza can be infectious to others from 24 hours before symptoms start until 1 week after the start of symptoms. In previously healthy individuals, symptoms typically subside within 5–8 days. 

Symptoms 
Influenza symptoms usually have a sudden onset. The most common symptoms are:  

  • fever  
  • dry non-productive cough  
  • nasal congestion  
  • headache  
  • sore throat  
  • body aches, fatigue and feeling generally unwell          

Older adults and young children can be more severely affected and develop atypical symptoms.  

Prevention 

  • Vaccination is the best protection against influenza and its complications 
  • Practising hand hygiene and cough etiquette (such as covering the nose and mouth when coughing or sneezing) can help reduce the chances of getting and passing on the influenza virus.  
  • People who are sick with influenza should stay home from work, school and social gatherings to prevent close contact with and transmission to other people. 

Why is it necessary to receive another dose of the influenza vaccine each year? 
The influenza virus changes frequently. Each year, the dominant strains differ and a new vaccine is created to target the current strains. The vaccine is most effective for the first 3-4 months after vaccination (though it is expected to continue to offer some protection after this period).  

Can influenza vaccines cause the influenza? 
There is no live virus in the influenza shot, so you cannot get influenza from the vaccine. The vaccine can cause some mild “flu-like” side effects such as body aches, fever and fatigue which may be mistakenly thought to be an influenza infection. 

Who should be vaccinated? 
Annual influenza vaccination is recommended for all people aged ≥6 months unless contraindicated (refer to link for Contraindications).  

Influenza vaccination is strongly recommended for anyone travelling overseas in 2022.  

Free vaccine 
There are a number of groups that are at increased risk of influenza and its complications. Influenza vaccination is strongly recommended and funded on the National Immunisation Program for the following groups:  

  • Children 6 months to 5 years of age 
  • Aboriginal and/or Torres Strait Islander people 
  • Pregnant women (during any stage of pregnancy) 
  • Adults ≥ 65 years of age – this age group receive different version of the vaccine which is designed to increase the immune response to the vaccine  
  • All individuals aged ≥ 5 years with medical risk conditions (Please refer to link)  

If you are not eligible for the free vaccine, the cost of one vaccine is $25.00. 

To book an appointment, please click the button below. 

Kind Regards, 

The Team from Rozelle Medical Centre

Sources:  

Vitamin D – The Sunshine Vitamin

Dear Patients,

With the change of seasons into Autumn, the team from Rozelle Medical Centre would like to share some information on Vitamin D to ensure you maintain your optimum health to live your best life.  

What is Vitamin D? 

Vitamin D is a nutrient you need for good health. It helps your body absorb calcium, one of the main building blocks for strong bones. Together with calcium, Vitamin D helps protect you from developing osteoporosis, a disease that thins and weakens the bones and makes them more likely to break. Your body needs Vitamin D for other functions too. Your muscles need it to move, and your nerves need it to carry messages between your brain and your body. Your immune system needs Vitamin D to fight off invading bacteria and viruses.  

Sources of Vitamin D 

Small amounts of the Vitamin D you need can be obtained through food (about 5 – 10 per cent).  

  • Vitamin D is added to many breakfast cereals and to some brands of orange juice, yogurt, margarine, and other food products. 
  • Fatty fish (like trout, salmon, tuna, and mackerel) and fish liver oils are among the best natural sources of Vitamin D. 
  • Beef liver, egg yolks, and cheese have small amounts of Vitamin D. 
  • Mushrooms provide a little Vitamin D. 
  • Ultraviolet (UV) radiation from the sun (90%). Your body makes Vitamin D when your bare skin is exposed to the sun. Most people get at least some Vitamin D this way. However, clouds, pollution, old age, and having dark-coloured skin reduce the amount of Vitamin D your skin makes. Also, your skin does not make Vitamin D from sunlight through a window.  

What happens if I don’t have enough Vitamin D? 

Factors such as lockdown, working from home, decrease in exercise and outdoor activities have may lead to Vitamin D deficiency.  

Vitamin D deficiency does not always have obvious symptoms but without treatment there can be significant health effects. These can include bone and muscle pain and softening of the bones – such as rickets (in children) and osteomalacia (in adults) which can make bones easy to fracture or break.

Which adult groups are at high risk of Vitamin D deficiency? 

  • Older or disabled people in low-level and high-level residential care, particularly those who are housebound, hospitalised community-dwelling geriatric patients. 
  • Dark-skinned people of either sex 
  • People with a disability or chronic disease (eg: multiple sclerosis) 
  • Fair-skinned people and those at risk of skin cancer and avoid sun exposure 
  • People working in an enclosed environment, such as office workers, factory or warehouse workers or night-shift workers. 

Do I need a Vitamin D Test? 

Vitamin D deficiency is done through a simple blood test by measuring a form of Vitamin D in your blood named 25-hydroxynitamin D (25-OHD).  

You may need a Vitamin D test if: 

  • you are at risk of Vitamin D deficiency or 
  • you have abnormal levels of calcium, phosphate or magnesium in your blood 
  • you have bone problems 
  • you have diseases that might result in, or be caused by, too much or too little Vitamin D  
  • you have problems with your parathyroid gland 

Please check with your doctor whether you need a Vitamin D test. 

Source: National Institutes of Health 
Source: Health Direct 
Source: The Medical Journal of Australia 

Best wishes,

The Team from Rozelle Medical Centre

Rapid Antigen Test (RAT) & New and Returning Doctors at Rozelle

Dear Patients,

The team from Rozelle Medical Centre hopes you are staying safe and well, especially for those who are going back to the office or school. With the wide adoption of Rapid Antigen Tests (‘RAT’), following are some basic information about RAT from the NSW Health Department. We hope this helps with any confusion and makes life a little easier.

Rapid Antigen Test (RAT) 

What happens if I get a positive RAT result? 

If you get a positive RAT result and unsure of the next step, you may follow the guideline below.

Test result Symptoms Exposure risk Next step 
  Known or unknown contact You are a confirmed case, follow the advice for people testing positive for COVID-19 
 Or  Known high risk or household contact You are a confirmed case, follow the advice for people testing positive for COVID-19 
  No known contact You may be a confirmed case. Take another rapid antigen test within 24 hours or have a PCR test 

What type of RAT should I use? 

The Therapeutic Goods Administration provides a full list of RAT kits approved in Australia and how to use each one correctly. Please refer to https://www.tga.gov.au/covid-19-rapid-antigen-self-tests-are-approved-australia 

How do I use a RAT kit? 

Each RAT differs slightly so please follow the instructions of the RAT you are using. NSW Health has provided a quick video on how to use a basic nasal test. Click Here to watch the video.  

Can I eat or drink before using a saliva sample RAT? 

The answer is, “No. NSW Health recommends you do not eat, drink or brush your teeth for at least 30 minutes before doing a saliva rapid antigen test. This will ensure a clean sample is taken.” 

For full information on RAT for Covid-19 from the NSW Health, please refer to: 

https://www.nsw.gov.au/covid-19/stay-safe/rapid-antigen-tests-for-covid-19

How do I register a positive RAT result? 

From 12 January 2022, people who test positive to a Covid-19 RAT at home must register with Service NSW. You do not need to register if you have had: 

  • A negative or invalid RAT result 
  • A positive PCR test in the 28 days before your positive RAT 

To understand your eligibility, what you need and how to register, please refer to: 

https://www.service.nsw.gov.au/transaction/register-positive-rapid-antigen-test-result

Booster Eligibility 

You are eligible for a booster vaccination if you: 

  • are fully vaccinated (have received 2 doses of a COVID-19 vaccine), 
  • are aged 16 and over, and 
  • have received your second dose of a COVID-19 vaccine at least 3 months ago. 

For further information please see the NSW Government website Here. 

Welcoming New Doctors at Our Practice 

Please join us to welcome our new doctor in the clinic. We attached her bio and area of special interest.  Please do not hesitate to contact us should you like to know more about our doctors or book an appointment Here.

We would also like to announce the return of two of our wonderful doctors from maternity leave. Dr Zoe Boyatzis and Dr Melissa De Sano, will be back working on Sundays initially, from 13th of March. Many patients have enquired as to their return. We are so happy to have them back! These new additions will, we hope, create much easier access to available appointments. 

Dr Maddison Kane

Background – Dr Maddison Kane completed her medical degree at The University of Sydney in 2019. She has gained experience in hospitals on NSW’s Central Coast prior to returning to Sydney.  
Special Interests – Dr Kane enjoys the wide variety of general practice and has particular interests in Adolescent Health, Mental Health, and Addiction Medicine.  
Personal Interests – Outside of medicine Dr Kane likes to spend time in the garden with her husband, and read classic novels. 
Availability – Monday-Friday: 9am-5pm; Alternate Saturday: 9am-1pm

Please take care and stay safe.

Best wishes,

The Team from Rozelle Medical Centre

What if I Test Positive to Covid-19?

Dear Patients,

First of all, on behalf of the team at Rozelle Medical Centre, we would like to wish you a Happy New Year and we hope 2022 brings you good health, peace and abundance of joy. 
 
With the rapid rising number of Covid-19 cases recently, we understand that you may be feeling anxious and unsure about how to manage if you test positive for Covid-19. This email provides some basic information and links to resources from NSW Health Department on the steps to take should you, a family member or a friend of yours be confirmed Covid-19 positive. We hope this information is helpful in assisting you to navigate through this unprecedented time.  

Am I a high or low-risk patient?   

There are a range of factors that increase the risk of serious illness should you contract Covid-19. Please refer to the link below for more information. 
https://www.health.gov.au/health-alerts/covid-19/advice-for-groups-at-risk 

Should I manage my illness at home once I have confirmed Covid-19 positive?  

NSW Health website states “If you are under 65 years of age, have had two doses of COVID-19 vaccine, do not suffer from any chronic health conditions and are not pregnant, you can safely manage COVID-19 at home”. Please refer to the fact sheet below for more information. 

https://www.health.nsw.gov.au/Infectious/factsheets/Pages/advice-for-confirmed.aspx

Please contact NSW Health COVID-19 Care at Home Support Line at 1800 960 933 or our clinic at (02) 9818 1355 to speak to one of the doctors if you are pregnant or have chronic conditions.  

When can I be released from isolation?  

The isolation period is 7 days from the day you test positive for COVID-19. AFTER 7 days, you can leave isolation if you have had no sore throat, runny nose, cough, or breathlessness in the last 24 hours of your isolation period. However, you should avoid visiting high risk settings such as healthcare, aged care, disability care or correctional facilities until more than 10 days and have no symptoms over the last 72 hours. Therefore, if it is less than 10 days from the day you test positive and you have any questions or feel unwell and need to talk to one of our doctors, please call our practice at (02) 9818 1355 and DO NOT attend the practice in person. Please refer to the link below for more information.  

https://www.health.nsw.gov.au/Infectious/factsheets/Pages/recovery.aspx

Who do I keep updated?  

For your safety, NSW Heath advises you to appoint a support person during the isolation period. Please nominate a family member or friend, inform them you have Covid-19 and request them to contact you daily at agreed times to obtain an update of your conditions. Please take note this support person is not allowed to visit you in person. 

Who do I call if I need assistance when isolating from home?  

If you are self-isolating at home, you may call the NSW Health Home Support Line at 1800 960 933 or call our clinic at (02) 9818 1355 and ask to speak to one of our doctors. If it is a medical emergency, call 000 immediately and notify the help line you have Covid-19.  

In addition to the above resource, here is the link to a useful resource from RACGP (Royal Australian College of General Practitioners).  

https://drive.google.com/file/d/1m2KEgdgKvLJQwedErpPH2KsKSGa_19i7/view?usp=drivesdk

Please check our website regularly for child vaccination and booster appointments. We encourage you to check our website and book online instead of calling the practice as we are experiencing staffing shortages and a high volume of phone calls. Your cooperation is much appreciation. 

Please take care and stay safe.  

Best wishes,  

The Team from Rozelle Medical Centre

Covid Booster Vaccination Program

Note: Covid booster vaccine is available for ages 16 +

Rozelle Medical Centre are offering a Covid-19 vaccine booster dose using the Pfizer Covid-19 vaccine.

A single booster dose is recommended for people aged 16 years or older, 3 months after the primary course.

 4th booster – Winter dose:

An additional booster dose (also known as a 4th dose) is recommended for people aged 50 years and older, 3 months after the first booster. People aged 30 to 49 years can receive a winter booster dose of a COVID-19 vaccine, however the benefit for people in this age group is less certain.

booster shot is important for strengthening protection against the virus and helping to protect you and your family.

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In Australia, vaccination is strongly recommended for the following groups:

  • people with occupational risk of exposure to SARS-CoV-2, such as frontline healthcare workers, quarantine and border workers, aged care and disability care staff, and critical and high-risk workers
  • residents of aged care and disability care facilities
  • older adults
  • Aboriginal and Torres Strait Islander people
  • people with underlying medical conditions that increase their risk of severe COVID-19
  • pregnant women

You can find the date of your 2nd and 3rd dose on your Covid-19 Digital Certificate in the NSW Services app or Medicare app and if you require assistance, please contact the practice.

You may find more information about booster vaccination at NSW Government Health: https://www.health.nsw.gov.au/Infectious/covid-19/vaccine/Pages/booster.aspx

To secure your future appointment, please book your Covid-19 Booster now by clicking on the Book Appointment button on our website. Thank you for doing your part to protect yourself and your community.

Meningococcal B Vaccines Available

‘4CMenB’ is a meningococcal group B vaccine.

This vaccine is given to individuals from 2 months of age and older to help protect against disease caused by bacteria called Neisseria Meningitidis group B.

The B-strain of meningococcal disease has caused the most cases of the infection in New South Wales this year but a vaccine for the illness still isn’t eligible under the Immunisation Schedule.

NSW Health has revealed 15 of the 21 cases to date this year were meningococcal B.

It comes after NSW Health issued a warning this week encouraging the public to be aware of symptoms.

Bookings can be made online via HotDocs:

Book Appointment

Congratulations on 1 million consultations

We celebrated our 1,000,000th consultation.
Thank you for your support and for being a part of this wonderful journey.
We look forward to further improving the health and well-being of all our patients and community with the next 1 million patient care consults!
Dr Ryan Vo & Dr Jonathan Phan

CALORIE COUNTING – SHOULD I BE DOING IT? – Jessica Peronne, Dietitian

If the new year has you setting resolutions around healthy eating and losing weight, you may have considered counting calories. At first glance, the idea makes perfect sense – eat less than your body needs and you will drop a few kilos. But in reality, counting calories is much more complicated. Here are 4 reasons why calorie counting may not work for weight loss.

CALORIE COUNTS ARE ONLY ESTIMATES

From calories listed on food packets to calorie counting apps, the numbers you read are at best estimates. Studies on Australian products have shown that food products may have anywhere from 13% less to 61% more than what is stated on the packet! When it comes to apps like MyFitnessPal, information is crowd-sourced from all over the world where food formulations significantly vary. Combined with normal error in weighing and measuring your food, the numbers churned out are likely poor reflections of what you’re truly consuming.

PSYCHOLOGICAL DEPRIVATION CAN TRIGGER OVEREATING

Going on a diet and choosing the “low calorie option” often leaves you feeling psychologically deprived. Simply thinking a food is “low calorie” even if it is not reduces how satisfied we feel and disrupts ghrelin, our appetite hormone responsible for increasing our hunger.  As deprivation builds up, we end up obsessively thinking about food and then overeat. Whether you return back to depriving foods or continue over consuming, this pattern of eating prevents achieving a healthy weight.

In order to not feel overwhelmed with this return to fuller schedules and for some a return to life and work outside home, there are some strategies you can use to help manage life after lockdown. Perhaps unsurprisingly, these aren’t actually so different to those recommended over the past several months.

NUTRIENT QUALITY ISN’T CONSIDERED

With a laser focus on just calories, we start to neglect the nutrients in foods that help with weight loss. For example, protein and fats provide long term satiety and fibre provides “bulk” for fullness whilst also supporting the growth of healthy gut bacteria that regulate our weight and appetite. You may also miss out on key micronutrients like iron which can cause fatigue, poor energy levels and impact your physical activity!

IT CAN MAKE SOCIAL EATING STRESSFUL

Trying to calculate the calories when eating out can become near impossible and may leave you feeling incredibly anxious. As a result, many people begin avoiding social occasions. Apart from missing out on enjoying time with friends and families, this is a slippery slope into an unrealistic and unsustainable method of losing weight long-term. Remember, in order to maintain long-term changes in weight, your approach must be something you can sustain lifelong.

THE BOTTOM LINE

Although calorie counting works for some, it often becomes an ineffective way to achieve and maintain weight loss. Healthy weight loss encompasses much more than the calories you consume – it should also consider the nutrients you eat and the relationship you have with food. The best way to achieve a healthy weight is to choose something you can maintain long-term, and this may look different for each of us as individuals. If you are struggling with your health goals and would like tailored support, book in with our accredited dietitian, Jessica Perone