Michele Garrett and Gemma Stott

Cultural Differences in Diabetes Podiatry and Diet

Traditional Maori and Pacific islanders often miss meals, typically breakfast and lunch with a large meal in the evening. Larger people are seen as healthy and prestigious and if a family member loses weight this can indicate the provider is not bringing home enough money for sufficient food for the family.  Takeaways are often consumed and healthy eating is seen as expensive; thus their diets are commonly high in fat, carbohydrate and low in non-starchy vegetables.
People from Indian and Asian cultures often seek advice from herbalists with regards to their diabetes management. 
Food plays a large part of many cultural festivals, e.g. Diwali, Ramadan, church gatherings or Marae Hui.  This may involve periods of fasting and or late meal feasting where large portion sizes are consumed.
It is important to enquire about your patients cultural practices and not assume.  Portion size of carbohydrate foods is key and using visual culturally appropriate resources paramount.

Biography:  Michele has been a podiatrist in private practise for more than 25years and 10years ago completed a post graduate Diploma in Podiatric Surgery. Her passion for saving soles has developed whilst working for the past 9 years in diabetes podiatry with Waitemata DHB. The secondary service role involves specialised wound care and management of active diabetic foot complications. This role with the DHB has lead to developing a community based podiatry programme for people with Diabetes related foot complications and the MOH in developing service specifications for podiatry and serving on the Diabetic Foot QIP committee.
A member of the Podiatrist Registration Board and currently chair of this and the AUT Podiatry Advisory committee.

Biography:  Gemma moved to New Zealand in December 2007 and has been working for Waitemata DHB diabetes centre.  She graduated from University of Newcastle with a degree in psychology in 2003, qualified as a dietitian in 2005 and has since completed an MSc in patient satisfaction comparing methods of education.  Gemma trained and worked in London before emigrating to New Zealand thus have experience working with a vast array of cultures.  She is passionate about providing patient centred education within a culturally appropriate environment and implemented the first Dose Adjusting For Normal Eating (DAFNE) course in New Zealand at Waitemata DHB.