Holiday Highs and Lows

The holiday season is upon us, like it or not. If you’re joining in on the festivities, you no doubt realize that having diabetes means there’s often a price to pay for merriment: blood sugars that soar up, down, or roller-coaster all over. Special foods, holiday gatherings, hectic schedules, and stress are generally to blame. Here’s what you might expect from these holiday happenings, along with some suggestions of how you can handle the aftermath.

Holiday treats
Expect: Higher blood sugars. Special goodies, such as cookies, breads, pies, and potato pancakes are laden with carbohydrate, or carbs. Not only are these foods high in carbs, but the fact that they a) taste so good and b) only come around once a year can tempt even the most determined person to overindulge. The other whammy: fat. Fat can lead to insulin resistance and cause blood sugars to skyrocket hours later.

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To try: No one says that you shouldn’t have a slice of Auntie Bess’s pumpkin cheesecake. But think a moment before you eat. Planning ahead here is key. If you plan to eat a treat for, say, dessert, what carb food could you cut back on at the meal? Pass up on the potato, rice, or bread, for example. Fill up on low-carb, low-calorie veggies, instead. If you take mealtime insulin, talk with your doctor or diabetes educator about how to adjust your insulin to “cover” the extra carb and/or fat that you plan to eat. Be careful of doing this too often, however, as extra treats mean extra calories.

Holiday spirits
Expect: Possibly low blood sugars. Alcohol can sometimes lead to low blood sugars, especially if you take insulin or pills called sulfonylureas. The risk goes up if you drink on an empty stomach.

To try: In general, it’s recommended that men have no more than two servings of alcohol per day and women, no more than one serving per day. A serving is 5 ounces of wine, 12 ounces of beer, or 1 1/2 ounces of distilled spirits, such as vodka, rum, or whiskey. Use your judgment and stick with the guidelines. Switch over to seltzer water or diet soda if the party is kicking into full gear. Also, make sure to have some food in your stomach to help prevent lows. Try to avoid cocktails that may contain a lot of carb, like fruit juice, milk, or ice cream (watch out for the spiked eggnog!). These drinks can end up raising your blood sugar. Finally, because no one’s perfect, pay more attention to your blood sugars after a night of too much holiday cheer. Check them more often with your meter. Also, consider setting your alarm for the middle of the night to check so that you can prevent or at least treat a low should it occur.

Holiday fun
Expect: Lower blood sugars. Ski trips, snow tubing, and ice skating are all excellent forms of physical activity, and they’re a great way to spend time with loved ones and burn off calories at the same time. However, a last-minute decision to go cross-country skiing can set you up for lows, especially if the event is going to last for several hours. Physical activity lowers blood sugars in two ways — by helping your body use insulin more efficiently to lower glucose and by helping cells take up more glucose from the blood to provide energy to muscles.

To try: Ideally, plan for physical activity as much as possible. Map out your schedule so that you’ll know what to do to prepare. For example, if you’re going skiing for a few days and you take insulin, you’ll likely need to dramatically reduce your dose. If you’re going walking or skating after dinner, you may need to either cut back on your mealtime insulin or include more carb at your meal to prevent hypoglycemia. Once again, be extra diligent about checking your blood sugars more than usual, especially right after you’re done with your activity. If you’re not sure how to adjust your insulin for physical activity or how to best plan for activity, get some advice from your doctor or diabetes educator.

Holiday blues
Expect: High or low blood sugars. Not everyone enjoys the holiday season. Some people downright dread it. This time of year can bring up feelings of sadness, loneliness, depression, and stress. And because holiday reminders are everywhere, it’s hard to escape these feelings. People respond to these emotions in different ways, which can, in turn, impact blood sugars in different ways. For example, some people overeat as a way to deal with stress or depression. Other people may forget to take their medicine and check their blood sugars. Because you’re out of your comfort zone and usual routine, your self-care behaviors are affected, possibly leading to higher or lower than usual blood sugars.

To try: If you tend to struggle at this time of year, think about what you could do differently — treat yourself to a massage, go for a daily walk, or go away for a few days. If loneliness is a concern, make a point to get together with friends or do some volunteer work to keep you around people. If you’re feeling depressed, seek out some counseling from a professional or join an online community forum to share your thoughts and feelings. Be kind to yourself and focus on getting enough sleep, eating healthfully, and staying active. And remember that this time of year will soon pass and a new year will begin.