Diabetes Care Around The Holidays
Brownies, and cupcakes, and pumpkin pie--Oh, my! Here we go again-- it's the holiday season and you may feel like you are traveling through a forest of fearful temptations. You want to celebrate with family and friends, enjoy yourself, and honor your traditions, but you know you've got to watch your diabetes. The holiday season brings added difficulties to the daily care of diabetes, but keeping your blood sugar in control can be done with a little wise planning.
We all enjoy the holidays, but what is key for patients with diabetes is moderation. As my colleague, Dr. Sol Jacobs, the Director of Clinical Endocrinology at New England Sinai Hospital in Stoughton, MA, says, "I tell my patients that they still have to live and enjoy life and the point is not to never eat anything again that they enjoy, but to limit it to special occasions and don't overdo it." The problem, he says, "is that we all get carried away and instead of having a couple of appetizers we wind up having thirty."
Plan Ahead
To guard against a natural tendency to overeat when confronted with all the wonderful smells and sights of holiday treats it is important to formulate a game plan before going to a holiday party or family gathering. If it is a sit-down meal, ask the host or hostess before the party what will be on the menu. Then you can mentally prepare for your choices. Once at the table, remember to watch portion size. Also, monitor your alcohol intake. One or two drinks should be the most you have.
Dr. Jacobs says, "At a buffet, the danger is that you can eat from 2pm until 9pm and overdo it." Instead, first survey all the choices before you put any thing on your plate. Note lower fat alternatives, like baked potatoes instead of mashed, or steamed vegetables, instead of buttered. Put a moderate amount of food on your plate, sit down away from the serving platters, eat your food and enjoy it.
Since diabetes is a chronic disease, it is best treated by maintaining a diet and lifestyle that remains as consistent as possible. Extreme changes in daily food intake or activity level can yield fluctuations in blood sugar levels. High blood sugar levels can lead to damage of internal organs such as the kidneys or eyes. Extremely low blood sugar levels can also be dangerous, as cells don't get the sugar they need for normal metabolism. To guard against these ups and downs in blood sugars, it is best to try to keep to your usual diet and exercise regimen throughout the holiday season. As Sue Pearson from Fitchburg, MA, who has had diabetes for many years says, "If it's a turkey dinner, I take the same helpings I would as if it was a regular supper."
Do It Yourself
Another way to avoid encountering unhealthy and fattening foods at parties is to host the gathering at your own home. Making your own food allows you to serve lower fat foods and more healthful choices. It also allows you more control over when the meal is served so you can adhere to your usual mealtimes.
Monitoring Your Blood Sugar
However, we all indulge occasionally. Sue Pearson admits to a weakness for chocolate and a cocktail now and then, especially around the holidays. To compensate, she will test her blood sugar at home more frequently than usual during the holiday party season. This is a good way to monitor how controlled your blood sugar levels are. For people with diabetes who take insulin, like Pearson, the dosage can sometimes be adjusted in anticipation of a higher calorie meal. Speaking with your physician about this option may give you more flexibility in dealing with the holidays.
People with diabetes who take pills generally do not have this flexibility in changing their medications. But they can still test their blood sugars more frequently to monitor fluctuations and follow-up with their physicians if the levels remain too high or too low over a period of a few days.
Dealing With Guilt
But what if you do have that extra piece of chocolate cake or a second cocktail? Feeling guilty is common among people with diabetes around the holidays. Dr. Jacobs' advice is not to beat yourself up about slipping once or twice. Just make sure not to overindulge consistently everyday. Also, don't set unreasonable goals for yourself. Don't try to lose 10 pounds over the holiday season. "If you can maintain your weight in December, you're in good shape," he says.
"It's a constant battle," Dr. Jacobs concedes about dealing with the holidays. He notes that people with diabetes may feel deprived as they watch other friends or family members indulge over the holidays. "But what they're witnessing is everyone else overeating," he says. Other family members can overeat and may get away with it, but people with diabetes can't. Overeating tends to push blood sugars out of control and can contribute to other health problems for people with diabetes.
Seek Out Support
Seeking out support for maintaining a healthful diet or dealing with the emotional toll of a chronic disease is essential to how you care about your diabetes. Sue Pearson feels that the most important thing is to always be up front about the condition that you have with those people you are going to be around. Her experience, like many others with diabetes, is that people will be understanding if you explain to them why you need to know what is on the menu, leave the room to check your blood sugar, or refuse to sample some of the hostess' special dishes. "Even if I'm with strangers," Pearson says, "I always make sure that someone I am sitting with realizes, because it's important." Enlisting support everywhere she goes has helped Pearson maintain a healthy outlook and a relatively normal lifestyle throughout her years of having diabetes. Peer support groups are also available through the American Diabetes Association or sometimes through your local hospital.
Remember, restricting intake of holiday foods and alcohol is difficult for everyone, whether they have diabetes or not. But the holidays are also a time for so much more than eating and drinking. Spend time with family and friends doing other holiday-related activities, such as singing, gift-giving, and decorating the house. Also, remember your cultural and religious traditions.
The holidays are a time for fun, sharing, and caring, as well as eating and drinking. Enjoy them!
Written by Monica Zangwill, MD, MPH. Assistant Clinical Professor, Tufts University School of Medicine