Transcript:

Hi my name's Alison Johnston, I'm a gp in Ulverston and i'm also a clinical lead for Mid-Furness Integrated Care Community. So i'd like to welcome you all today to our online diabetes awareness event, we would have loved to have done this in person but unfortunately because of COVID we can't but we will hope to do this again in the future and look forward to meeting you all in person then. So we're going to break it down into little chunks of video so you don't have to watch it all at once if you're busy, you can always come back to it. We're going to have some really interesting demonstrations and talkers today so we have Diabetes UK, Slimming World, we're going to have some stories of really inspiring stories of patient successes of losing weight, we've also got University Hospitals of Morecambe Bay where you're doing a cooking demonstration and we've got some ideas for low carb menus and that should be really interesting. We also have active cumbria who are doing some videos for us with some exciting exercises that you can do, so I hope you enjoy this today and if you have any questions then please do get in touch or any feedback for us we're going to be doing a question and answer session at the end too so hopefully any questions that you would have asked, we'll be able to answer them for You, I hope you enjoy it thank you

Hi, there I’m just going to explain to you today about how to measure your bmi. First of all what is bmi? So it stands for body mass index and it just gives you an indicator of whether you're a healthy weight or not, so it's not entirely accurate so for example if you're a six foot ten, 20 stone rugby player you probably have a bmi which comes up to be in the obese range however Your all muscle so it's got to be taken in context really. So how do we calculate bmi? So first of all you're going to need to know your height and your weight, so if you don't know you height you could just get a tape measure and just stand against the door frame or wall with the pencil and just pop your mark on the door and then you can just use a tape measure to measure how tall you are, then you need to stand on the scales and find out how much you weigh. So to calculate your bmi what you need to do is to go on to a bmi calculator site, the nhs has a very good one so if you just type into google bmi, it comes up as the first hit. With the nhs website and so that will come up with some different readings, so you need to first of all say um if you're an adult or a child because it's not um they need to know your age, your sex and your height and weight and also your ethnicity so you just put all those entries into the calculator and you'll calculate the bmi. So for example my height is five foot four and weight is ten stone three which gives me a bmi of 24.4 and that is in the healthy range although it does say that it's the top end of normal so we need to keep an eye on that, so if you have a look that's a good way of calculating it. The other thing you can do is measure your waist circumference so you might have a normal bmi but you might have a bit of a stomach and that say could show that you're actually overweight, so I’ve got a tape measure here so basically what we're going to do is to measure around this part of your waist (demonstration of measuring) so the middle where your tummy button is, so not, so some people have like a big belly like that and the waist they feel is there but actually it's it'll be in the middle. So you just pop the tape around the middle part your stomach and mine's got colour coded on it so it shows you I’m in the green section for my waist measurement, so which is fine that's normal, so for women your waist measurement should be less than 78 centimetres um and for males; I’ll just check the other side of this tape measure, so it should be less than 94 is in the green range. So this tape measure tells you sort of whether you're, so if you're in the red which is over 102 centimetres then you definitely need to do something about your weight but that's explained it to you, but um you say if you haven't read on the nhs website there's some interesting information on there.

Good morning my name is Christine and I’m a diet chef at Furness General catering department in Barrow in Furness. This morning I’ll be making a lentil soup dish and a tuna and mushroom baked dish. The ingredients for the lentil dish is two ounces of dried lentils, some large tinned tomatoes, water and seasoning; and for the tuna mushroom bake, a small tin of tuna, a dried soup mix – mushroom, small tin of sweet corn, instant mashed potato and an ounce of grated cheese. So I’m going to demonstrate making the following, (demonstration of cooking on screen) first of all I’ll put the dried lentils in a pan of water with a little bit of salt and pepper and I chose a little bit of vegetable stock just a pinch and then I’ll just cover the lentils in the pan about maybe a pint you can always chop up after and some chopped in tomatoes and then that will be on to simmer for around 20 minutes.

I’m just going to make a tuna and mushroom bake, right in a small oven proof dish, I’ve put a small can of tuna, this is going to be mixed with the dried soup mix or the condensed soup mix, which I’m going to make now, so I’ve got the condensed soup I’ll just put that in the pan, um, it'll thicken like a sauce but when that starts to do that that means it's ready. Then I will add this to the tuna to make a sauce. The soup was ready so I’ve just added it to the tuna to make a bit of a sauce and I’ve pre-cooked some sweet corn and you can always buy tin sweet corn and drain it and add it to it. Then I’m going to add the cheese to the potato to give it a little bit of extra flavour, because mashed potato on its own can be a bit bland. That's our mashed potato it's got a little bit of cheese in; and then I’m just going to top the tuna bake with the mash. This is our tune bake, this will go in the oven about gas mark 5 for about 15 to 20 minutes to crisp the stuff up and cook the tuna a little bit. You can always finish these and decorate them with a few fresh herbs which would probably be nice on the top of both.

Hi there thanks for watching, so far I’m just going to go through the question and answer section. So I’ve got two pre-submitted questions which I’ll answer and then I’ll pass over to Marie who's gonna answer some other questions. So first question we've got is from Caroline and she's asked what are the common signs of diabetes? So hopefully this presentation has already answered your questions Caroline but just to recap so the most common symptoms of diabetes are probably feeling thirsty, so are you getting up in the night drinking loads of water, other thing is passing a lot a lot of urine so you're having to start getting up for a wee a few, three or four times in the night or you're drinking gallons of water, sometimes you can get blurred vision as well and also you can feel a bit tired. Now obviously you can feel tired anyway because you're busy at work or whatever, so that's not always a sign. So what would you do if you had those symptoms? So probably the first part of call is to ring your gp practice and book a blood test and then that will tell you if you have got diabetes, and then they would book you in with the diabetic nurse to explain to you what the next steps are. So the next question we have is from Avril Wray and she was wondering that her blood tests have been borderline every time she's checked them, so she's not a big person, she's trying everything she can personally but every time she comes for a blood test it's still borderline; she's wondering you know how come she changes what can she do? So I’ve already I mean first thing to say is that you've done really well it hasn't gone up so you're doing something right, the main thing that you could probably do is look at your diet. So it doesn't sound like you're overweight but maybe you're eating too many carbohydrates, you could look at a low carbohydrate diet. It's worth looking at some good books that you can look at Michael Mosley’s blood sugar diet, there's also, if you're on twitter you could follow Dr David Donwyn he's a gp in Southport and he's got the lowest prescribing of diabetes drugs in the northwest because he's put all his patients on the low carbohydrate diet and it is possible to reverse diabetes. So I would say don't give up, keep trying and take some advice from the diabetes specialist nursing at your practice do some reading and hopefully you'll have success. Okay thank you.

Transcript:

(Graphic on screen representing the narrative) There are two main types of Diabetes Type 1 and Type 2, they're different conditions but they're both serious. There are some other rarer types of diabetes too, what all types of diabetes have in common is that they cause people to have too much glucose in their blood but we all need some glucose, it's what gives us our energy. We get glucose when our bodies break down the carbohydrates that we eat or drink and that glucose is released into our blood. We also need a hormone called Insulin it's made by our pancreas and it's Insulin that allows the glucose in our blood to enter our cells and fuel our bodies. If you don't have diabetes your pancreas senses when glucose has entered your bloodstream and releases the right amount of insulin so the glucose can get into your cells, but if you have diabetes this system doesn't work. When you've got type 1 diabetes you can't make any insulin at all if you've got type 2 diabetes it's a bit different the insulin you make either can't work effectively or you can't produce enough of it. In both types of diabetes because glucose can't get into your cells it begins to build up in your blood and too much glucose in your blood causes a lot of different problems. To begin with it leads to diabetes symptoms like having to wee a lot, being incredibly thirsty and feeling very tired, you may also lose weight get infections like thrush or suffer from slow healing wounds. Over a long period of time high glucose levels in your blood can seriously damage your heart, your eyes, your feet and your kidneys, these are known as the complications of diabetes but with the right treatment and care people can live a healthy life and there's much less risk that someone will experience these complications. If you've got diabetes you can find lots of information and support about living with it using our website and helpline. As well as campaigning for everyone with diabetes to get the right care Diabetes UK fund research into all types of diabetes so we can develop new treatments and one day find a cure.
 
You can find out more about type 1 and type 2 diabetes and how they're treated in our next videos.

Hello my name is Sarah Callahan, and I’m 53. 14 years ago when I was pregnant with my second daughter I was diagnosed with gestational diabetes, this went away as soon as she was born but unfortunately when she was 12 months old it came back. I was type 2, I was incredibly overweight and my diet was not the best, this is me, I didn't like seeing myself in photographs, I was lethargic and I had quite bad sleep apnea. I suffer from limb girdle muscular dystrophy and have been wheelchair bound for 18 years, I was convinced I was overweight because of my inability to exercise. I’ve been on every diet going but never really saw any significant improvement or weight loss, a friend of mine had been to slimming world and had noticed how well she had done but despite her encouragement I felt that I didn't want to go and waste money as I couldn't exercise thinking it wouldn't work. My type 2 diabetes was not controlled at all by what I was eating and my hb a1c test result was way over the recommended level it should be. The practice nurse told me that if the next time my levels were checked they were still as high I would have to go on metformin which would probably be for life. The doctor suggested that she gave me a referral to slimming world which gave me 12 weeks for free to see if it would work. As you can see it did from the minute I walked through the door, Claire the consultant gave so much encouragement support and all the tools I needed to change my life including a booklet on diabetes and diet. The great thing about slimming world is nothing is out of bounds, within reason just making wise choices and changing what I ate made a huge difference, I started to see the weight coming down instead of using jars of sauces which have hidden sugars I started to make my own with fresh ingredients I’ve lost five and a half stone up till now ,with slimming world and I can honestly say my life has changed I feel good about myself I feel more confident and more in control, my bmi has come down and my hba1c is now within the parameters

(Graphic displaying visual representation) Top tips around menu planning, let's keep it simple. Why? why menu planning? I suggest four reasons why, it helps with shopping, a plan done on an evening makes the shopping the next day so much easier and prevents having to go again to the shops numerous times in the week. Maybe it even helps to prevent arguments, the often-repeated question what should we have for dinner? “I want this”, “no I want that”, it encourages variety in meals. When you're writing it down you try not to put similar meals together and that helps with the vitamin content of our meals, and it's easier to manage after a busy day. It does help to know what can be done in the morning before work and not just grabbing something quick and easy from the freezer, those foods can be high in fat and carbohydrate and really not so helpful for us. When? When is a good time for menu planning? I suggest each week, it doesn't have to take long to write and after you've done three or four weeks you have a good pool of meals to utilize in future menus. I suggest at the start of the week whenever your week starts but the same day each week helps. It's best not done when you're feeling hungry. we don't always think quite so well at those times and maybe it helps to write it with others in the family to enlist their ideas and if family aren't available maybe you could team up with a friend, possibly even make meals for each other. And how? How do we write a menu plan? THINK that is my suggestion t h I n k. T is for think about colour on your plate, imagine the meal with lots of colour in it making meals like that helps them to be more appetizing and when we have lots of colour it tends to mean that we've also got lots of vitamins and minerals which are hidden in colourful foods and they're essential to our good health. H, have smaller portions, oh it's so tempting to eat more than we really need it's better not to skip meals but to have smaller meals rather than one large one. I, include fruit and or vegetables at each meal we all know the maxim of having five a day and if we have fruit or vegetable at each meal that means without even really thinking about it we've had sixty percent of that five a day, and it doesn't make it such a daunting proposition. N - no added sugar drinks that can be cordials with no added sugar or it can be just plain refreshing water or tea or coffee without sugar added. K - keep carbohydrates cupped hand size this refers to the starchy carbohydrate foods such as bread, cereals, potato, rice, pasta anything made with flour. All carbohydrate foods break down to glucose and having diabetes means that your body struggles to manage glucose effectively. The more carbohydrate we eat the harder it is for the body to cope, keeping to smaller portions is really what we need, with plenty of vegetables to fill the plate. Some easy meal ideas which can easily be made with foods you have in the cupboard and padded out with vegetables and frozen vegetables are as good as fresh. Some ideas of these meals pasta with ham and tomato an easy risotto lentil soup and we've already seen that demonstrated on our kitchen video. So top tips for menu planning, THINK, think colour, have smaller portions, include fruit and or vegetables at each meal, no added sugar drinks, keep carbohydrates cupped hand.

Hello my name is Pete, I just wanted to tell you what the NHS diabetes prevention program has done for me. When I was invited onto the program I was a bit sceptical of how an online program could possibly help, but I was wrong. This will not stop you getting type 2 on its own, you must follow it for it to be successful but the program does give you the tools to make it work. Firstly I better understand the link between exercise and well-being, and also the way that certain foods can help and others cause problems. The way that burning more calories than you eat will help you lose weight, I know what to look for on food labels and I know about fats. I thought I did know about fats but everyone can learn something. In health terms you're the one to gain most so sticking with the course will pay dividends, it's all about how we can help ourselves and not end up a burden on our families or the NHS. It's for our benefit, it's not hard and the people that run the courses are there to help. Our tutor Henna is patient and understanding, the information is clear and easy to follow, the online documentation is useful but most of all if you do not understand something she will explain it for you. For me the program has meant education, it's meant looking at exercise in a different way not as an all-out session but as something that can be done in handy bite-sized chunks of 10 minutes or so, so what are you waiting for? in the words of a famous sports manufacturer just do it!

Transcript:
Hi there my name is Jennifer Shaw i'm part of the volunteering team for Diabetes UK in the north of England today I'm going to do a really quick run-through of our online know your risk tool and this is a tool to find out your risk of type 2 diabetes, so i'm just going to start sharing my screen.
(screen changes to display of the tool) Okay so this online know your risk tool, you can find it through our website or you can enter know your risk into the search engine and it should be the first result that comes up, and so this is a really quick seven step as you can see process to find out your risk of type 2 diabetes. It will go through the risk factors for type 2 diabetes so before you start you will need a tape measure and some scales, as you'll need your height weight and waist measurement; and if you are in england um and you come out at risk of type 2 diabetes at the end of of the process there'll be a link to self-refer into the NHS diabetes prevention program as well and which i'll show you when we get to the end. Okay so to start finding out your risk you simply click here (find out your risk)
So as you can see the seven questions um related to your risk of type two diabetes and underneath each question there's a little information bracket here on why we're asking so the first question is around gender and here we're looking at gender at birth um as we know that men are slightly at higher risk of developing type 2 diabetes/ So for today's I'm going to click female okay question two was around age we ask this because we know the older you are the higher your risk for type 2 diabetes, so today i'm going to put in 66. Okay the third question is around ethnicity and we have blocked it out and to make it as simple as possible into you know wider ethnic groups and we're asking this because we know that some ethnic groups are more likely to develop type 2 diabetes than others so for today say i'm going to select white
Okay question 4 is around that close relation with diabetes so do you have a parent a sibling or a child who has diabetes and we ask this because we know that that close relative with diabetes does increase your risk of developing type 2 diabetes, so for today I'm going to select yes.
Okay question five is around your waist measurements we asked this because we know that a larger waist measurement increases your risk for type 2 diabetes, there's a little diagram here as to where you can find your waist and so it's just below where you feel your bottom rib and the top of your hip bone and you can enter in inches or in centimeters, today i'm going to put in 110 centimeters.
Okay question six is around your body mass index, your bmi, you don't have to calculate this yourself and we just need your height and your weight and the the calculator will do it for you, we ask this because we know those who are overweight or obese and they do have a greater risk of type 2 diabetes so for today i'm going to put in 5 foot 7 inches and we'll go with 13 stone 8 pounds.
Okay see so there is your bmi just calculated below. okay and we'll click next, okay and the last question is around blood pressure and have you been told that you have high blood pressure or ever given medication for it again we asked this because we know that those who have been treated for high blood pressure, it will contribute to the overall risk of type 2 diabetes and so today i'm going to select yes.
Okay just before you get your results and there's a page here where you'd be prompted to put in a contact email address, now this is optional so um this is for those who want the information sent directly to them and but if they don't want to put their information at this stage there's a skip link here and you can you will be prompted again on the next screen and in case you change your mind but again it's entirely optional. Okay and this is the last um final page where you get your results and so here you can see at the top um it's quite nice and clear and so here it says your risk is high um and underneath is this color-coded system, so low would come out green increased would come out yellow moderate would come out red and high comes out oh sorry moderate would come out orange and high would come out red, and so trying to keep it as clear as possible for our online users. So here it talks about my risk score so this is broken uh down further down the page my risks are 31 and as you can see it falls within this high bracket and what does that mean for me, so that means that one in four people with this risk score will get type 2 diabetes in the next 10 years. So that puts it into context and and the importance of what that means for me. Okay as i mentioned at the start people are in england they can self-refer to the nhs diabetes prevention program and here's the link for it but for everyone um who takes part and we do advise that they they contact their gp practice as soon as possible be tested for type 2 diabetes and have that chat as well around um what is type 2 diabetes and their risk for it.
Okay this is um the risk score explained so that number of 31 how did we get there so on the left you can see the things that you can't change so the age gender ethnicity and those close relations with diabetes and this breaks down where that risk score has come from um as you can see we did mention as you get older, excuse me, as you get older your risk for type 2 diabetes increases and men are slightly more at risk and those certain ethnic groups are more at risk of type 2 diabetes and if you've got a close relation with diabetes whether it's type 1 type 2 or another type that does increase your risk as well; and those things on the right here are things that we can influence we can change and they're really important to have a look at when you get your risk score. So you can see um waist measurement here I entered 110 centimeters you can see that's the highest bracket so actually if i want to reduce my risk of type 2 diabetes then losing some a few centimeters to my waist would actually make a big difference and to my risk score so to my overall risk of type 2 diabetes. The same goes with my BMI so you can see here actually I'm about to move into the next bracket um so it's looking at those numbers and and where those um key changes could be made to reduce your risk of type 2 diabetes. And everyone will get a personalized risk score like that. Okay this is where you get prompted again to put your email address in and so those who have come out moderate and high risk for type 2 diabetes and they will um get a letter that they can direct straight to their gp and you know print and post or send over email and this will let your gp know that you've taken part in the Diabetes UK know your risk tool that you've come out moderate or high risk for type 2 diabetes and to book you in for a diabetes test and a consultation around your risk for the condition. So that's why we prompt again in case anyone changes their mind it will also send some useful links and um kind of where you can get support as well; but again it is optional it's it's entirely up to the user. There's a keeping in touch with diabetes uk section in case you wanted to hear more from us and let's spread the word right at the bottom as well so if you think you know close relations or anyone you know might want to take part and and use the tool that's how you can easily share it there.
(Back to speaker) Okay well I hope that's been helpful and as i said it should be nice and easy um to follow through and to use and but if you do have any questions then you can get in touch with our north of England team and by email on n.west@diabetes.org uk and or you can get through to our uh national helpline on 0345 123 2399  and thanks again for for listening today thanks.

Hi my name's Michaela, I’ve been asked if I’ll share my weight loss journey with you all and hopefully it may inspire some of you. Um yeah I’m a different story really, you know I didn't do it for me I did it for my son, uh I’m um 40 years old single mum to a 16 year old boy and back in 2017 my son was 13 at the time and turned to me and told me he was unhappy and he wanted to lose weight and could help him. At that point you do everything that you want, you know you do everything support your kids. Um so the minute he said that I knew things had to change, that was on a Sunday, by the Thursday we joined our local slimming world group and you know I’d never have ever had an issue with my weight and never felt the need to lose weight. Uh I was happy I felt fit I felt healthy albeit I have been big all my life, um but it didn't bother me that that was just me. Um you know it never stopped me, my weight never held me back from doing anything. Now I look back I’m glad I have done something about it and I know health reasons. You know I’ll have changed everything because there is diabetes and heart disease runs down both sides of my family, so I know you know I’ve possibly added years onto my life by losing the weight. um so the reason you know we did decide to join as I say was to support my son and the local slimming world group was amazing. The minute we walked through the door the consultant was fantastic, um very welcoming, very warm it's very important that you find a group uh that you're happy with, that you can really click with, that consultant because that's the most important. My son idolized her, uh really took to her you know within two the first two weeks we had both lost half a stone uh and within a month we'd lost a stone each; as well you know when I first stepped on them scales I went in group, you know my son was 13 years old and he wanted to lose around about four stone which he did within the year. For myself I never set a target um I just wanted to do it to support my son, when I stepped on them scales I was 24 stone, that was kind of a shock. I never ever imagined, I hadn't weighed myself for years um as I said never had an issue never felt the need to so, that was an eye opener when I did finally step on them scales and I was 24 stone at the age of 37. Um you know I lost my dad, my dad was 60 years old and 25 stone double amputee due to heart disease, uh angina, uh diabetes and he ended up with gangrene and he lost both his legs and you know with illnesses there is also diabetes and heart disease runs in my mum's side of the family as well, so it is a kind of eye opener of my future what what could be. Um you know so from that point I knew then things had to change I never set a target um you know and I just wanted to see where my body took me and when I was happy that is when uh I would stop. So over the two years you know and go to group every week and the group are like a family and you know everyone supports each other. I am now part of the social team where I help and support other people as well and giving advice. You know everybody's journey is different, everybody's an individual and everybody's body's working different ways you've got to find what's right for you. Both me and my son work in different ways and we both lose weight in different ways and but it's worked. Slimming world has helped um I never did any exercise for the first year um and then after about a year I used to go out walking the dog, within my first year I lost eight stone, um as I say no exercise so that was just by changing the 38 and how I actually it's really you know cutting out, um I used to use jazz and convenience foods whereas then I started making everything from scratch to be honest it tastes a lot better and it's so much nicer as well and a lot more fruits and veggies with my meals, not just afterwards or anything like that. You don't have to do without you can still have the takeaways, the chocolates you know the crisps but just with you know um more of a healthy choice of it. Um I never find slimming world is a diet it's just kind of a lifetime lifestyle change and I’ve never struggled, I’ve really enjoyed it to be honest I’ve won quite a lot of awards within our group of woman of the year, greatest loser my final goal was after two years I decided my body started staying around the way it was at that time and at that point I had lost 11 and a half stone that was over a year ago now and so at that point, that is when I decided that that's where I’d be um and that was me. Um so yeah the um really I’ll show you a picture saw a before picture of me so this is a picture of me before (Picture on screen)

to what I am now this is me with my son, so yeah as you see you know I’ve gone down oh one two three four five six seven dress sizes, um and my body sits around about 11 to 11 and a half stone loss um within where I am really um as I say I feel a lot fitter, a lot healthier I do go out walking more and yeah, my as I say my clothes it's so much easier for shopping um it does cost me a lot more uh in buying clothes really um but yeah my main thing is I am proud of what I’ve done, but I’m more proud of my son for making that first move and uh inspiring me. He is throughout of all this my inspiration and you know so many people come to me and tell me that I inspire them and if I can inspire one person to change their life and be healthier and happier then you know that's all it takes um and I’m willing to help and advise to anybody if anybody wants any help or advice at all um I’ll assist. You know my journey is my journey and it's not the same as everybody else's um you know I’ve never found it hard I’ve enjoyed it and I continue to enjoy it and you know this is for the rest of my life now so yeah this is me and as I say I hope I have inspired somebody and I hope all of you enjoy your journeys in getting fitter and healthier, take care.

Hi I’m Kelly from the activecumbria team and today I’d like to talk to you about physical activity, you won't need any equipment just a chair. First of all why physical activity? Well being physically active on a regular basis can bring about many benefits for both your mental and physical well-being, when we talk about physical activity this comes in all shapes and sizes, it's not just about team sports gym classes or going for a run but more on that in a little while. So in terms of the benefits first of all from a mental well-being we know that when we do physical activity our bodies release endorphins i.e our happy hormones, which in turn help us to feel better in mood reducing our stress and anxiety levels, whilst also giving us more energy; physical activity can also help us to sleep better. Studies have shown that regular physical activity can reduce the likelihood of experiencing a period of depression; from a physical perspective it can help us strengthen your heart and lungs improve your balance and muscular strength and also increase your flexibility and mobility, all of which help to reduce the risk of many long-term conditions including type 2 diabetes, coronary heart disease and stroke, and even some cancers.

But thinking a bit more specifically about diabetes physical activity has been shown to improve hb a1c levels and also reduce the risk of diabetes complications by managing blood pressure levels, these are just a few examples. Now I don't just want you to take my word for it I’d like you to listen to one of the stars from the sport England we are undefeatable campaign here's his story. (voice of Zahur Bukhari) I love dancing, I’m sorry I got to, I am I’m old people tell me oh my god you are no I’m not my name is Zahur, they call me Hari because Bukhari is my surname and I had the type 2 diabetes, I was diagnosed about around about 24 years ago, I used to play cricket, I used to play volleyball, I was very good in volleyball as well and basketball but when you go into the office and sit on your chair and computer in front of you and then you sit and say all right we have a good day let's go out and have a really slap up dinner, I was eating you know whatever comes in front of me and tasty food things like that and there I put my guard down, now this is the time that I got to think and I got to do something very very very serious. You educate yourself you got to broaden your mind and learn about the condition, the exercise being active are very good for my condition. I have seen so many video on the YouTube I go on the google and see that I learn from that and I adopt that in my life and take control of diabetes. I switch on my music and I let myself go if you're lying down watching your tv you know, switch off tv and then start raising your hand and your legs and you're you know stretching yourself and that can be done inside the house. Walk is the other thing take a walk of course, you will have a little bit of tiredness but I do bear in mind what are my capabilities and how far I can go. You should do what you love to do, you know that will give you the energy inside because you like it and the kids, you know involve them, they are the people they are the people around me, so I decided to take control and I had decided that I will do everything which I could to live bit longer and have that happiness and give them the company as well as a granddad.

(back to Kelly’s voice) So how can you make a change? Well here's a few tips to get you started try to get up and move more during the day, why not get up on the hour every hour stretch your legs move regularly around the house, even try going for a walk we should all try to minimize the amount of time we spend sitting, try small bursts of activity even 10 minutes of activity, that gets you warm and slightly out of breath can make a difference. Build those 10 minute blocks up over the course of the day because before you know it you could be doing 30 minutes a day. Think about the ways to get your heart pumping and your body moving whilst at home, try marching on the spot while watching tv, play some of your favourite tunes and dance around the house or try an online class if you fancy a little bit of company. You don't have to take part in structured sports or activities, physical activity is about all those ways to build activity into your day-to-day lifestyle think gardening think walking anything that just gets your body moving.

Also it doesn't matter what you do it's just about doing something, the most important thing is to find something you enjoy, start slowly and work your way up so that you gradually increase the amount of activity that you do and finally use whatever you have to hand you don't need any equipment to stay active. You can use your own body weight for squats or press-ups or go and find a couple of tins of beans. If you want to follow an online workout now after listening to all that, if you're feeling ready to try some activity for yourself, here we have a short seated Pilates session courtesy off Togetherly. (voice of instructor) Hey everybody, so today we're going to be doing a Pilates chair session, all you need to get is a chair that's got no sides on it ideally and it's secure. We're going to start off with a warm-up and then we're going to be doing two sequences of movement and then we're going to finish off with a cool down on the stretch all on the chair you don't need any equipment but your chair.

Okay so to start off with we need to make sure that we're sitting in the active chair position, what that means is that we are seated with four legs against the chair and bums firmly back completely against the chair, we've got a nice strong back, our shoulder blades are down and our scapula is tucked in. We're going to hold on to the sides of the chair if we need to and we're going to make sure that our legs are hip-wide apart. Okay at this point if we focus on our centrum, which is one of our class principles, so if you imagine bringing our abdominals in towards our spine, keeping our back nice and straight, core nice and tight. First movements that we're going to do is a knee lift, okay so a knee lift up, so what I want you to do is the leg goes up then comes back down, what I’m going to try and imagine is that the ankle joint is in line with the knee joint so you're just going straight up and back down again. Okay we'll repeat about eight times on each leg, so we'll do each leg of them but then we're going to go fly into our next movement which is our leg out and coming back again, leg coming out and back again, so we come up into that knee lift the leg goes straight out I’m making sure that it stays in line with my hip joint as I lift it off and then come down and come back again. Okay third movement in this sequence of movement is hip abduction so I’m going to breathe out and bring it straight and then I’m going to add dough to the side and I’m going to come back again my hips stay facing forward I still maintain active seated position, hold onto the chair if you need some extra security and then go straight out I always keep my leg in line with my hip joint. Okay let's get started on those movements, get yourself in that active seating position we'll do eight of everything starting off with the leg lift firstly, so we'll do one leg and then we'll repeat to the other leg, okay ready? one two three four five six seven eight; changing legs one two three four five six seven eight. Okay this time we're going to go our leg up and out back and down two three four five six seven eight. Changing legs one two three four five six seven eight. Okay abduction, getting back in the active chair position leg goes up straight one two three four five six seven eight, change one two three four five six seven eight. Okay I’m gonna put a reminder.

Okay so our second cycle of movements is that we're going to be doing rotation of the hip joint okay, which is circulation of the hip joint. I’m going to do that in a few different ways we're still in the active seating position so you'll notice that my back isn't against the chair, about halfway onto the chair that my legs are held in the hip apart, I’m sitting evenly on my sitting bones, I’ve got my shoulders back and down and you can hold on to the chair if you want to, personally I prefer my hands out to the front. So the first movement that we're going to do is a rotation of the leg okay so it's a very small rotation and you'll notice that I’m going a very small circle and I’ve pointed my toes slightly, if you imagine that you're painting a picture with your foot and you're doing small circles it makes it a little bit easier. So that's the first one, which is a small rotational circle, we're going to do five on each leg, we're then going to change directions and go five on the opposite side and then our third movement will be a wider circle. Okay we'll stay in one direction this time and then we'll do it on the other side of the same direction. Okay ready, so get yourself into an active seated position please remember that when you're lifting your legs, you want it to be up to hip height if you can, if you need to drop it down that's absolutely fine, but it will not be in alignment and it might be that you haven't got the strength to be able to keep it up which is fine. Okay ready, hands out leg up - one two three four five, change sides one two three four five, big circle one two three four five and change your legs go one two three four five; change directions two three four five, big circle two three four five leg goes down. I’m gonna pause the video then I want you to repeat these up to three times in total. What I want you to do is bring one of your legs out, reaching down to the back of your legs so you can feel it along your hamstrings holding for seven to fifteen seconds to maintain our flexibility or up to 30 seconds to increase flexibility. Remember Pilates is a strength and conditional workout but we can also work on our flexibility and sometimes some of the moves intertwine as well. Okay if you can you're going to turn to the side bring your leg up behind, you  want to have your leg out or if you need to you can hold on to your shoe, hold on to your trouser leg whatever's best and you're going to pull it up behind you so you can feel it in the front of your leg. We're going to change side so you can see it on the other side so the leg is behind you and pulling up on the other leg we're going to stretch the legs with purpose here, which is all of our lower body rather than upper body. Okay what I want you to do bring your feet up if you can bring your soles together and push them down on your knees cause nice and tight. So this is a really great exercises to do so you can do blasts on a chair if you don't have much room at home, and yeah it can be done anywhere. You can also do run a sofa but sometimes it can be difficult on certain movements, okay legs are going down what I want you to do is bring your leg up and we're going to hold it towards the ankle, lift it up if you struggle to hold it in there you can bring it up towards and underneath the knee joint but I want you to be aware that you're not pulling the knee joint and you're not going to put much pressure on it or straightening it out, change the sides and you're going to go for the same thing on the opposite side and pull down hold on to the ankle and hold.

(Kelly’s Voice again) So I hope you enjoyed the taster session and if you'd like more information and ideas on how to stay active please visit one of the websites mentioned below for inspiration.