Happy Holidays With Type 1 Diabetes

Thanksgiving and Christmas can bring joy, but for people with diabetes, the holiday season can be the most stressful time of the year. The focus on food (especially sweets), the family get-togethers (often including people you’d rather not see), the office parties, the shopping, the travel — all can create a minefield for diabetes management.

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Too much feast

From Halloween through New Year’s Day, sweet unhealthy food crowds around us in offices, homes and family gatherings. Friends and relatives may create especially appealing treats to tempt you, while others may keep reminding you, “You really shouldn’t eat that.”

Mary Ann, a 52-year old woman with type 1, told me, “I used to reject every holiday food that wasn’t on my diet, and I hated life until January. But over the years, I found some ways to enjoy holidays again.”

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Type 1 blogger Amy Mercer writes that Thanksgiving is particularly hard because the whole day focuses on food. “My mother will have 25 people over, and most likely ‘dinner’ will be held at 2 or 3 PM.” It’s one thing to manage your own life for regular eating, but quite another when 25 other people’s lives are involved.

Typical Thanksgiving feasts have tables full of carbs: starting with sweet potatoes, stuffing, bread and rolls and moving on to a choice of pies and cakes. Mercer writes that wearing an insulin pump and/or a CGM “would allow more flexibility and better insight.” If this technology is not an option for you, you may want to monitor and/or bolus more often. You may want to consult with your doctor or diabetes educator about modifying your management for feast days.

The feast itself can also be modified. Amy Mercer brings low-carb options like roasted Brussels sprouts. (Roasted vegetables are delights for some people.) You can see other diabetes-friendly Thanksgiving recipes on our site here, and there are more all over the Web. Our site even has recipes for the inevitable Thanksgiving leftovers here. Similar food ideas will work for Christmas and New Year’s.

Family holiday stress

Seasonal holidays bring families together, often in settings with a lot of alcohol. The results can be unpleasant and stressful, like when a relative you haven’t seen all year lectures you about how to care for your diabetes.

Some people just have to be avoided or politely stopped. Others, though, can help you get through the day. The Joslin Diabetes Center advises, “Make your day about togetherness and family fun, and not just about the food…Let your family members know they can support you by walking around the block after dinner” for some quality time.

In dealing with families, the number one holiday rule is don’t drink too much. It’s not so much that alcohol disrupts blood sugar levels (although it does); it disrupts our judgment and makes us do stupid things.

According to Ken Duckworth, MD, medical director of the National Alliance on Mental Illness, family gatherings can cause depression by bringing back unhappy memories, putting you face-to-face with unpleasant relatives or by reminding you of what you have lost and what you would like to lose but can’t. Family times can cause stress with hosting parties or traveling to relatives, shopping and wrapping presents, and all the “traditional family holiday” practices we think are required, but are really optional.

Writer R. Morgan Griffin recommends changing practices that are too stressful, not trying to be perfect and not overdoing it. “Stay one or two nights at your parents’ house instead of three or four. Plan to drop by the holiday party for a couple of hours instead of staying all night.” If you always host the family Christmas gather and it’s too difficult, can you ask someone else to do it for a change?

Similarly, do we really need to buy ideal gifts for everyone we know? Maybe a donation to a good cause in their name would be easier, or just a nice card.

Coping with holiday loneliness

Some people have the opposite problem: loneliness, having nowhere to go or people to spend holidays with. Painful loneliness can hit anyone, even married people or those who live in large households. And loneliness can drive us to self-damaging behaviors, which in the case of diabetes may also taste good.

On the site VeryWell Mind, psychology writer Elizabeth Scott, MS, advises: Be good to yourself, like giving yourself a long hot bath or a spa treatment or curling up with a good book. Realize you’re not alone; most people report occasionally or usually feeling lonely at holiday times. Keeping a gratitude journal and giving to others — isn’t that what the holidays are supposed to be about? — will raise spirits at holidays or any other time.

My favorite advice is “Rethink your expectations. Few people’s lifestyles truly measure up to ‘movie standards’ of perfect living, or the standards of [your social media friends who only post their good stuff.] Remember that the flawed love of a difficult family member still counts as love.”

Among the reliable beings from whom to get support are pets. If relying on a pet for contact sounds a little pathetic to you, that’s because you haven’t tried it. Animals are people too and make perfectly good friends or family members.

Holiday travel: On the road

Holiday travel presents diabetes management problems. Amy Mercer wrote here that “travel with diabetes is a challenge (higher blood sugars from sitting for long periods of time, low blood sugars resulting from a change in diet, time zone changes, and so on).” Holiday travel is usually harder because of crowded airports and highways, plus the hazard of drunk drivers.

If you are going to travel, Certified Diabetes Educator Amy Campbell has some important ideas in this article and I have some good strategies here. But sometimes limiting travel is the best option. Do you need to visit everyone in your extended family every year? Can some of them come to you instead?

Dealing with office sweets

Why do offices turn into candy stores during the holidays? It’s like everyone’s competing over who can bring the most tempting stuff. People attracted to candy will need coping strategies to avoid unintentionally drowning themselves in sugar.

Health coaches and educators advise having your own healthy snacks like nuts and seeds and eating them before you get hungry, separating your work space from the treat supply area or just taking one bite and walking away.

Finding holiday joy

Society’s marketing department has turned the holidays into profit-centered stressors, but underneath all the hype, they still have meaning. They are not just family traditions but cultural and human traditions going back thousands of years. They are meant to be times of thanks and sharing that connect us with others and with life. The feasting and the family stress can threaten diabetes management, but the skills that living with diabetes has taught you can get you through. Wishing all our readers a wonderful holiday season!

Want to learn more about maintaining your health during the holidays? Read “The Holiday Meal Survival Guide,” “Have a Relaxing Holiday: 7 Tips to Relieve Seasonal Stress” and “Master Holiday Health Pitfalls.”

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