Managing Diabetes During The Holidays

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“It’s the most wonderful time of the year,” as the song goes — and for many people that is questionably true. However, for someone with diabetes, it can be true, as long as you use some common sense.

In fact, Dr. Boris Draznin, Professor of Medicine and Director of the Adult Diabetes Program at the University of Colorado, Denver School of Medicine, says that diabetics’ having to remain on a healthy diet does not eliminate fun at all: “Fun is to be with family and friends, to prepare and eat what you like from a long list of what is allowed, not to gain weight, which will undoubtedly cause guilt, depression and anxiety, and stay free from diabetic complications.”

That sounds like a tall order, but the way Dr. Draznin broke it down in a recent interview, being part of the holiday fun is a more attainable goal than you might initially think. The first area of concern is handling stress.

Stress hormones such as adrenaline and steroids raise blood sugar levels. Stress also changes eating behavior in an unpredictable way. Some people under stress eat whatever is in sight, while others stop eating at all. Dr. Draznin noted that neither possibility is acceptable for diabetes control. Holiday stress can last days, if not weeks. There is last minute shopping, dealing with houseguests, and making sure meals are ready, all the while submerging personal problems like diabetes management. Dr. Draznin says that regardless of all the holiday goings on, a diabetic mustn’t forget to monitor their condition.

Even all of the parties and dinner invitations that are a part of the holiday season don’t have to be an overwhelming hurdle, according to Dr. Draznin: ”Most people with diabetes have already made their commitments to a prudent diet that excludes sweet, sugary, doughy items. They just have to stay true to this lifestyle. I recommend having a small snack before going to the party, so one would not feel hungry. Hunger is the worst enemy of the diet. At the party, eat vegetables, fish, poultry or meat and avoid high carb and high fat items.”

Of course, alcohol is usually a prominent part of most parties and dinners; can a diabetic indulge some holiday cheer, or is abstinence the rule of the day? Here’s what Dr. Draznin had to say:

“Alcoholic beverages can raise blood sugar in three different ways. First, some drinks, particularly mixed drinks, contain sugar. Second, alcohol is a sugar of sort and if consumed in large amounts can raise the levels of blood sugar. Third, and probably most important of all, alcohol consumption before or with meals increases appetite and people eat more than they would have without alcohol. I recommend no more than one drink per party, either a mixed drink based on sugar-free additive (i.e. gin and sugar free tonic water), or a glass of wine, preferably cabernet, Shiraz, or pinot noir.”

Some diabetics feel that adjusting medications you take for the condition can compensate for increased sugar intake. In the case of Type 1 diabetics, who take insulin, Dr Draznin says, “Yes, it actually must be done, but my advice is to stay on the diet as much as possible to avoid this necessity.”

However, this isn’t necessarily the case for Type 2 diabetics. Dr. Draznin says, “They can [make adjustments] if they take insulin. It is not recommended to increase the dose of oral medications.” In fact, popular diabetes medications like Januvia, Metformin, Avandia, etc., all have side effects. That’s why Dr. Draznin cautions, “Increasing their doses just to compensate for dietary indiscretions is simply dangerous. Insulin, on the other hand, does not have side effects beyond lowering blood sugar too much. Therefore, people treated with insulin should take a bit more to cover additional calories, while those on oral medications should maintain their commitment to their diet.”

Dr. Draznin recommends plenty of exercise during the holiday season because it is critical for diabetes management. He says, “It helps muscles take up more sugar from the blood, thus lowering blood sugar levels. Furthermore, exercise helps burn calories so that they are not deposited as fat. Having an exercise program is vitally important for patients with diabetes and stepping it up seems like an excellent idea.”

A diabetic’s chances of enjoying the holiday season are increased if they have support from family members. But that doesn’t mean monitoring every bit of food they put into their mouths. If you want family support to be effective, here’s what Dr. Draznin recommends:

“I always felt that prudent diet, particularly one designed for weight loss or treatment of diabetes, is a family affair. It is virtually impossible to have pasta for everyone else and salad for a person with diabetes at the dinner table. Having separate meals is difficult to prepare and detrimental for compliance. So the answer is not ‘monitoring what they eat,’ but to follow the same healthy diet as a diabetic person in the family.”

Diabetics can still be “the life of the party,” just as long as they don’t make the party all about overindulging in food and alcohol. If you are hosting a holiday event, help your diabetic guests enjoy themselves not only by having low-carb menu alternatives and non-alcoholic drink choices, but also by taking the emphasis off of eating, and putting it on activities that everyone can do together. That will level the playing field, and it won’t matter whether they have diabetes or not.

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