It’s official: the holidays are upon us! For many with diabetes, the holiday season leads to mixed emotions. On the one hand, it’s a time of year spent with family and loved ones, celebrating with traditions, old and new. On the other hand, the holidays can often trigger feelings of depression, sadness and loneliness, worries about money and lack of time, and this year, COVID-19. There is often pressure to feel excited and happy during the holiday season, yet the very opposite can occur. To top it off, people with diabetes may feel extra stress or concern about managing their condition during a time of excess food and drink, disrupted schedules and diminished finances.
Diabetes self-care behaviors
According to the Association of Diabetes Care and Education Specialists (ADCES), “Diabetes is a complex and serious disease, and managing it every day can be challenging.” No doubt, you knew that already! Fortunately, you CAN effectively manage your diabetes; one way to do this is with the AADE7 self-care behaviors:
· Taking medication
· Problem solving
· Healthy coping
· Reducing risks
These self-care behaviors can help you at any time of the year, not just the holidays. But since we’re in the midst of the holiday season, let’s take a look at how these behaviors may make it a little easier to stay merry and bright right now.
“Eating healthy can fit all tastes and traditions while choosing a variety of nutritious foods and beverages. Be mindful of added sugars, saturated and trans fats, sodium and alcohol.”
Whether it’s Thanksgiving, Hanukkah, Christmas or New Year’s Day, one thing is for sure: food is a central part of the celebration. And not just any food, but food that tends to be rich in carbs, fat and sodium. How do you partake in holiday feasts without throwing your blood sugars off kilter, gaining weight, and offending loved ones by turning down offers of treats?
· Stick with your usual eating schedule as much as possible. Don’t skip breakfast and lunch, for example, if you know you’ll be eating a large dinner later on. Overeating is inevitable if you skip meals.
· Plan for goodies. If you wish, you CAN eat a favorite holiday treat. Options include eating a small portion, swapping a treat for another carb food at a meal, or bringing the treat home to eat the next day.
· Reach for the veggies and salad before diving into the mashed potatoes and stuffing. And drinking water before your meal can make you feel full and less likely to overindulge.
· Proceed with caution when it comes to alcohol. Stick with wine, champagne or prosecco, or light beer, as they have little to no carb and aren’t loaded with calories. If you take insulin or diabetes pills called sulfonylureas, be sure to eat a source of carb when you drink to lessen the likelihood of a low blood sugar.
“Being active is not just about losing weight. If you have diabetes, physical activity can also help you keep your blood sugar levels normal and help you keep your diabetes in control.”
· As with your meals, stick with your usual physical activity plan as much as possible. Doing so will not only help you better manage your blood sugars, it will keep your energy levels up, burn off calories, improve your mood, and lower levels of stress and anxiety
· Be flexible. If you can’t do your usual walk or workout, compromise and try something different. In this time of social distancing, you can still get outside and be active with others (wear your mask and keep at least six feet apart!), whether it’s walking (bring the dog along), tossing a football or, if there’s snow, going cross-country skiing. If you’re housebound, find an exercise video on YouTube, march in place while watching your favorite holiday moving, or put some tunes on and dance!
· Use activity as a way of balancing things out if you happen to eat an extra slice of pie or cup of eggnog. Doing some activity can prevent your blood sugars from climbing too high. And if you are feeling stressed, anxious or sad, get up and move to help release endorphins, those “feel good” chemicals that are released during exercise.
“Checking your blood sugars regularly gives you vital information about your diabetes management. Monitoring helps you know when your blood sugar levels are on target and it helps you make food and activity adjustments so that your body can perform at its best.”
· Check your blood sugars more often than usual over the holiday season. Doing so will help you more quickly identify and treat lows and highs that can put a damper on the festivities for you.
· Make sure you have monitoring supplies, such as test strips, lancets, sensors (if using CGM), and that your meter or CGM is in working order.
· If you adjust your mealtime insulin for your carb intake, not only do you need to be aware of how much carb you’re eating, you’ll need to know how much insulin to give yourself. That’s where your meter or CGM comes in: knowing your glucose level gives you information to help you dose your insulin.
“Insulin, pills that lower your blood sugar, aspirin, blood pressure medication, cholesterol-lowering medication, or a number of others may work together to lower your blood sugar levels, reduce your risk of complications and help you feel better.”
· Once again, plan ahead: make sure you have enough of all of your medications on hand (especially if you’ll be traveling [currently restricted in many areas due to the COVID-19 pandemic]).
· Schedule disruptions may cause you to forget to take your meds. Limit the chances of this by setting reminders on your smartphone, smartwatch or home assistant (e.g., Alexa). Or simply write a note to yourself to help you remember (sticky notes are great for this).
· If you’ve been having side effects from any of your medicines or have questions about how or when to take them, address these before the holidays with your healthcare provider or pharmacist.
“Everyone encounters problems with their diabetes management; you can’t plan for every situation you may face. However, there are some problem-solving skills that can help you prepare for the unexpected — and make a plan for dealing with similar problems in the future.”
· Before you get caught up in the seasonal hustle and bustle, anticipate possible problems that may occur around food, activity, medication, getting sick, or eating out, for example. Even family feuds can be problematic and impact your diabetes management.
· Think about possible solutions to your possible problems. Ideas include bringing a healthy dish to a family gathering, practicing saying, “No thank you” to offers of food, excusing yourself from stressful conversations, or making sure to get enough sleep so that you stay healthy.
· Decide on a few solutions to try so that if and when problematic situations arise, you’re ready. Let your partner, child or friend in on your plan so that they have your back and can support you if things get sticky.
“Having diabetes puts you at a higher risk for developing other health problems. However, if you understand the risk, you can take steps now to lower your chance of diabetes-related complications.”
· If you are at risk of hypoglycemia (low blood sugar), make sure you have treatment with you at all times, such as glucose tablets or gel.
· Start off the holidays on the right foot: that means checking and caring for your feet regularly, especially if you’ll BE on your feet a lot at this time of year.
· Don’t forgo your regular medical appointments with your primary-care provider, endocrinologist or diabetes educator. They can help you stay healthy and give you tips for navigating the holiday season. And be sure to get your flu shot!
“Diabetes can affect you physically and emotionally. It’s natural to have mixed feelings about your diabetes management and experience highs and lows. The important thing is to recognize these emotions as normal and take steps to reduce the negative impact they can have on your self-care.”
· If the holidays fill you with feelings of dread, sadness or anxiety, seek out support. A friend or family member, a diabetes support group or a counselor can be a lifeline for you and help you to feel that you are not alone.
· Be realistic and don’t feel like you have to do everything. It’s OK to say “no” to some things, or to pare down the usual traditions. You may need to do this anyway because of the pandemic. Holiday plans may be different this year out of necessity, and that’s OK. You can still find ways to celebrate on your own terms.
· Make time for yourself. Going for a quick walk, taking a nap, reading a book or listening to music can help lower stress levels and restore some perspective.
Everyone faces holiday hurdles. The key is to learn how to navigate them and jump over those hurdles with ease. Use the above self-management behaviors to help you have an enjoyable holiday season, this year and every year. Learn more about the AADE7 self-care behaviors here.
Want to learn more about maintaining your health during the holidays? Read “Master Holiday Health Pitfalls,” “Have a Relaxing Holiday: 7 Tips to Relieve Seasonal Stress,” “The Holiday Meal Survival Guide” and “Navigating the Holidays.”