All the Advice You'll Need to Get Through the Holiday Season with Diabetes
Ah the holidays! It’s that time of year for pumpkin pie, eggnog, mashed potatoes, and your Aunt Betty’s killer candied yams. And if you have diabetes, everything I just wrote made you think: "OMG. My blood sugars are screwed for the next two months."
True, the holidays present some unique challenges for people with diabetes. Most specifically, there’s a ton of not-so-diabetes-friendly food around and very little time to sneak in some exercise. But they don’t have to be a total disaster (at least in the glucose department. As far as your crazy in-laws, I can’t help ya there). In honor of Diabetes Awareness Month, here are some tips for navigating the holidays for folks that are new to the diabetes world from a person who knows a thing or two about it.
I was diagnosed with Type 1 diabetes on Christmas Eve 20 years ago. And although that would forever change the holidays for me, I’ve discovered over the years that you can enjoy them just as much as before your diagnosis by planning ahead and making a few adjustments.
Let’s kick it off with everyone’s favorite topic: alcohol. Some alcohols, like beer, eggnog, and mixed cocktails can contain carbohydrates that will initially raise your blood sugar if you have diabetes. Others, like red and white wines, drinks made with pure spirits only or sugar-free mixers (like a vodka soda) don’t contain any carbs. So can’t you just take some insulin to cover the carby drinks?
Despite the carbs, alcohol can actually lower your blood sugar hours later because it inhibits your liver from releasing glucose (one place in our body that can raise our sugars on its own). So although some alcohols can initially raise your blood sugar, all of them can drop you dangerously low later.
My strategy for booze has always been to choose the least complicated way to start: i.e. pick a liquor you don’t have to bolus for, such as wine or a vodka soda. That way, you’re only worried about the low later, instead of both an initial high and then taking insulin followed by a massive low hours later.
Make sure you never drink on an empty stomach. You’ll need to make sure your drinks are accompanied by some food, and keep a close eye on blood sugars two hours after drinking, and especially before bed. If you’re trending towards a low before sleep, it’s best to have a small snack before hitting the hay to avoid a big low in the middle of the night. A small granola bar is a good choice, or an apple with a little slow-digesting peanut butter will do the trick.
After alcohol, food is the next best thing about the holidays, and just as tricky. With all the sweets around, it’s impossible not to try some of it, and there’s no reason not to with diabetes. It’s just that moderation is the name of the game.
Remember that what matters with glucose management is the total carbohydrates in a food, not the sugar. So mashed potatoes might actually wreak more havoc on your glucose than a slice of pumpkin pie, believe it or not. But the good thing about the holidays is that there’s plenty of low-carb fare as well.
Fill up on things like green bean casserole, turkey, sliced ham, salads, and even the gravy. You’re going to eat a lot during the holidays, we all know that. So instead of counting calories, count carbs. Allow yourself to go with high-fat, lower carb foods that will help control blood sugars versus the carb-machines such as yams, potatoes, and stuffing. For those foods, choose one or two to try and keep portions moderate.
Before the holidays even get turned up to full gear, take the time to download an app on your smart phone that can give you the carb counts of your favorite holiday foods easily, as as My Fitness Pal. Often, you won’t know the menu ahead of time for parties and meals that you’ll attend. But with an app, you can find the carb counts quickly for a variety of foods being served and bolus the correct amount for your carbs-to-insulin ratio.
It will help you make those lesser-of-two evils decisions and manage your diabetes more effectively. And don’t be afraid to mix-and-match at cocktail parties. So what if the hummus is being served with super-carby pita bread? Cruise over to the crudité and grab some low-carb carrots to dip instead. Do I get weird looks when I layer a slice of brie on a cucumber slice instead of a cracker? Surprisingly – no. No one notices these things when they’re busy at a holiday shindig.
This brings me to my next point. One of the best things about the holidays is all the parties. If this is your first season with diabetes, you might be panicking about your neighbor's upcoming 43rd Annual Cookie Exchange. Yes, it’s going to be a little different this year but that’s okay.
Be prepared for people to ask questions about your diabetes. The fact is that some folks, because they don’t understand the disease, are going to ask things in a not-so-tactful way. Be up-front and clear with your answers, and never be afraid to do what you need to do for your health. Some folks are comfortable testing their blood sugars and taking insulin in front of others, some people are not. If you’re not one of those people, it’s okay to steal off to the kitchen and test or dose by yourself for a minute.
Ignoring your care during the holidays will make you feel crummy, or worse, land you in the ER, which is as far away from the fun as possible. Remember that you’re in the driver’s seat with this disease. Yes, diabetes is unfair, annoying, and always has poor timing. But thank goodness it’s livable and manageable, right?
If you haven’t already invested in a continuous glucose monitor for your diabetes management, now is the time. Continuous glucose monitors, or CGMs provide real-time, continuous outputs of your blood sugars instead of just relying on finger-stick measurements every few hours. You will have to wear a small sensor on your body that has a tiny wire just under the skin, but each sensor lasts seven days and is easy to insert on your own at home. If your endocrinologist is willing to write you a letter of medical necessity for one of these devices, then most insurance plans will cover them these days. It will give you control like you’ve never had before along with the peace of mind of always knowing your blood sugar. Talk to your doctor about trying one.
The holidays take more planning when you have diabetes, that’s for sure. But even though you’ll be making some adjustments to your food, it won’t take away from the fact that it’s the best time of year to get cozy in a warm house with good friends and family and be grateful for everything that we have. Now pass the cheese plate – hold the crackers!
Alexis Pollak Hauptman writes at I Run on Insulin.