Carolien Koreneff is a Credentialed Diabetes Educator with nearly 20 years experience. She can help you manage your diabetes and teach you more about all sorts of diabetes related topics, including:
- Types of diabetes, the signs and symptoms, treatment and prevention of high blood glucose levels and hypoglycaemia (low blood glucose levels)
- Self management strategies including strange situations such as: travelling with diabetes, sick day management, pregnancy in pre-existing diabetes or GDM, as well as prevention or management of diabetes complications
- Treatment targets and recommendations to help you and your doctor
- New medications and treatment options, the latest gadgets such as blood glucose meters, injection devices and insulin pumps
- And other related disease such as hypertension (high blood pressure), cholesterol, obesity and depression.
Carolien can also provide counselling, coaching and psychotherapy services.
Contact Carolien to arrange an appointment to discuss your specific needs
Email: email@example.com or call Mobile: 0402 126 212 to Make an appointment
Fees and charges
My fee schedule from 1st of April 2013 will be as follows:
- New Patient for Diabetes Education
- (1 hour appointment will be allocated) – $120
- Review for Diabetes Education
- (1 hour appointment) – $100
- Home visits within the Sutherland Shire (by negotiation)
- (1 hour appointment will be allocated) – $120
- Home visits outside the Sutherland Shire are available, please contact us for details
- Fees are payable at time of consultation, credit or debit card payments are accepted with a minor surcharge of 2% to cover bank and processing fees.
- Patients will be able to claim back around $50 from Medicare (Item number 10951 – Diabetes Educator) if they present with an EPC referral.
- Medibank Private provides rebates to clients with a “Package Bonus Entitlement”.
- I am registered HCF provider for their clients with “Multicover”.
- Bulk billing is unfortunately not available at this time.
- Some Health Funds may provide rebates.
- Reduction of fees can be negotiated – particularly for students, pensioners and other disadvantaged people; please contact me for individual pricing.
If you believe that your private health insurance covers you for the diabetes education services you have received but you experience difficulties when you go to claim a rebate from your health insurance fund, you can contact the Private Health Insurance Ombudsman. The role of the Private Health Insurance Ombudsman is to protect the interest of people covered by private health insurance and they have an independent complaints handling service available to all private health insurance clients.You should provide them with the following information:
• The name of your private health insurance fund
• What if any information you requested from the fund prior to making the claim?
• What information did the fund provide you when they rejected your claim?Details of how to contact the Private Health Insurance Ombudsman are listed below:Hotline: 1800 640 69
Telephone (02) 8235 8777
Facsimile (02) 8235 8778
What is diabetes?
Diabetes Mellitus (often referred to as simply “Diabetes”) is a condition where the body cannot maintain normal blood glucose levels. We need glucose to provide us with the energy and we need insulin to help the glucose enter the body cells. Insulin is a hormone that is produced in the beta cells of the pancreas, an organ that lies behind the stomach. When the body does not produce enough insulin, the blood glucose level rises and this can lead to problems.
Australians are mainly affected by the following three types of diabetes:
- Type 1 (previously known as insulin-dependent diabetes or juvenile diabetes)
- Type 2 (previously known as non-insulin-dependent diabetes or mature onset diabetes)
- Gestational diabetes mellitus (GDM)
Types of diabetes
Type 1 diabetes
If the body’s immune system destroys the insulin-producing beta cells in the pancreas one can get Type 1 diabetes; this is an auto-immune disease and this type of diabetes accounts for 10-15% of all people with the disease. It can appear at any age (although usually occurs in people under the age of 40), and it can be triggered by environmental factors such as viruses, diet or chemicals in people who have a genetic predisposition. People with type 1 diabetes must inject themselves with insulin, usually several times a day, and they are required to follow a careful diet and exercise regime.
Type 2 diabetes
Is the more common form of diabetes, affecting 85-90% of people with diabetes in the world. It is characterised by insulin resistance and insulin deficiency, and is strongly genetic in origin; although lifestyle factors such as excess weight, inactivity, high blood pressure and poor diet are also major risk factors for the development of type 2 diabetes. Not everyone develops symptoms, or these symptoms may not show for many years and hence regular screening for diabetes through your GP is strongly recommended, particularly for people over the age of 50 and of certain ethnic backgrounds (in particular Aboriginal or Torres Strait Islander, Middle Eastern, Asian). People with type 2 diabetes are at higher risk of cardiovascular disease, such as heart attacks and strokes, and in some cases these complications may even have formed before the diagnosis of diabetes has been made. People with type 2 diabetes are recommended to make the dietary changes in an effort to lose some of the excess weight, incorporate regular exercise into their life and most of the time tablets are needed to control the glucose levels. As the natural progression of the disease is an ongoing decline in beta cell function over time, most people with type 2 diabetes will require insulin treatment after 5-10 years.
Gestational Diabetes or GDM has been defined as “a carbohydrate intolerance of variable severity with the first onset or diagnosis during the current pregnancy” and is usually diagnosed through an oral glucose tolerance test. Risk factors for GDM include a family history of diabetes, increasing maternal age, obesity, poor obstetric history, polycystic ovarian syndrome (PCOS) and certain ethnic groups. Between 5.5 and 8.8% of pregnant women in Australia will develop GDM. Women with GDM will be prescribed a diet with restricted carbohydrate intake, which is spread out across the day in smaller portions to help maintain glucose levels. They are also asked to do regular physical activity, to help burn off excess sugar. Good glycaemic control is crucial for the foetus as high blood glucose levels can cause complications in the new born baby such as jaundice, hypoglycaemia, shoulder dystocia and macrosomia. Women with gestational diabetes are asked to check their blood glucose levels regularly so that their progress can be reviewed. In approximately one third of patients diet and exercise alone is not enough to maintain good glycaemic control and hence insulin treatment may be required. Tablets are generally not used in pregnancy as most would cross the placenta. Insulin is a much safer option as this will not cross the placenta and side-effects are minimal. While the carbohydrate intolerance mostly returns back to normal after the birth, the mother has a significant risk of developing type 2 diabetes, while the baby is more likely to develop obesity and impaired glucose tolerance and/or diabetes later in life. Self-care and dietary changes are essential in treatment.
Diabetes affects nearly 1 million Australians, and many are not aware they have the disease.The risk of developing diabetes increases with age.
It is a known fact that undetected or poorly controlled, diabetes can lead to complications. Research studies have shown that control of blood glucose, blood pressure, and cholesterol levels helps prevent complications in people with type 1 or type 2 diabetes and studies have also shown that good control in the beginning stages of the disease will have huge benefits later in life, as risk reduction persists in the long term (this is often referred to as the Legacy Effect).
Complications can roughly be divided in 2 groups:
- Macrovascular Complications which include heart attacks and stroke
- Microvascular Complications which include retinopathy (eye damage), neuropathy (nerve problems) and kidney problems).
Many cases of Type 2 diabetes could be prevented or delayed through simple lifestyle changes that lower the risks of diabetes and other chronic diseases, such as cardiovascular diseases and cancer. These risks include excess weight, poor diet, inactivity, smoking and too much alcohol. Even a moderate weight loss of 4-5 kg has been proven to make a big difference in lowering the risk for developing diabetes.
If you would like more information about diabetes contact us or check the following websites:
Contact Carolien now to arrange an appointment to discuss your individual needs.
Call Carolien on 0402 126 212 or click here