Navigating the Holidays with Diabetes

A figurative mine field of savory dishes and desserts await many this holiday season, from pumpkin pies topped with whipped cream, green bean and mushroom casseroles, pork tamales, cranberries and cornbread dressing to fruit salads and oven-roasted turkey. 

While most will indulge in these tasty foods and gain some weight, those with diabetes will need extra willpower and a plan to stay healthy.

For Dr. Ashok Balasubramanyam, chief, Endocrinology, Ben Taub General Hospital, and Talar L. Glover, MS, RN, CNS, CDE, director, Diabetes Service Line and Patient Education, Harris County Hospital District, the strategy for people with diabetes is simple — portion control, planning sensible meals and getting regular exercise.

“The rules for taking care of diabetes on a daily basis are straightforward. Eat right, exercise, take your medicines and check your blood sugar. But following this schedule every day, all the time, is very hard,” says Balasubramanyam, also a professor, Baylor College of Medicine. “Everyone knows the rules, but the practice is difficult because you have to do it year-round for every meal, including during holidays.”

Unfortunately, for diabetes sufferers the inability of the body to control blood sugars causes significant health problems.

Symptoms of diabetes:
• Blurry vision
• Excess thirst
• Fatigue
• Frequent urination
• Hunger
• Weight loss

Complications from diabetes:
• Heart disease
• Stroke
• High blood pressure
• Blindness
• Kidney disease
• Nervous system disease
• Amputation of limbs

While diabetes sufferers face a challenge to stay healthy, they can still enjoy the abundance of tasty foods available during the holidays.

“There’s nothing that you need to avoid eating,” Glover says. “You just need to plan your meals and make sure you monitor your sugar levels frequently.”

Because temptation is at every table, you can’t afford to indulge on a whim.

“You can’t skip a meal to ‘save up’ to eat a big lunch or dinner if you’ve got diabetes,” Glover says. “You’ve got to know what’s on the menu and try to spread your eating throughout the day. Don’t try to eat it all in one sitting.”

Normal blood sugar ranges for non-diabetes sufferers are between 70 and 99. Even if you don’t have diabetes, you may still feel the effects of temporary high sugar levels.

While tryptophan in turkey is usually incorrectly blamed for post-holiday meal sleepiness, the real culprits may be overeating and the increase in sugar levels. A good way to avoid this is to take a walk or plan some other physical activity after your meal, says Balasubramanyam.

Getting the family together or having out-of-town guests can be stressful, which can trigger overeating. During the holidays, people may overeat or fail to monitor their blood sugar levels, which can make them sick and ruin the holidays. 

Balasubramanyam warns people with diabetes against upping prescribed medicine doses to compensate for their food indiscretions. Because of the danger of potential side effects, any change in dosage should be carefully monitored by a physician.  But patients taking insulin, who know how to adjust their mealtime doses based on calorie counting and “correction” factors, can make appropriate changes to their insulin doses to cover a little extra intake with holiday meals, he adds.

Glover says most people with diabetes can usually eat about four high-carbohydrate foods a meal. However, if the meal you’re attending will have eight high-carbohydrate foods, then you’ve got to spread them out between lunch and dinner and not eat them all at once.

“Most of us know what’s going to be on the table for the holidays, because it was on the table the year before and the year before that,” she says. “The best thing to do is figure out what’s going to be on the table and how you’re going to pick and choose for each of your meals.

“A small serving of pecan pie is fine, but don’t overdo it. If you’re going to have pecan pie, then you can’t have cranberries and cornbread dressing and gravy and mashed potatoes and macaroni and cheese,” she adds.

The Harris County Hospital District treats about 50,000 patients with diabetes, roughly one of every six patients seen through its network of hospitals and health centers. The hospital district’s diabetes education program has 15 sites recognized by the American Diabetes Association as being programs of excellence in providing comprehensive outpatient diabetes education. 

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