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Holidays pose challenges for those with diabetes


Nov. 26, 2013
SPRINGFIELD – It may not be coincidental that the month of November – Diabetes Awareness Month – is chosen to bring attention to the epidemic of diabetes in the United States, as the holidays from Thanksgiving through the New Year pose the greatest challenge for those with diabetes.

Diabetes is an all-too-common disease today that occurs when the body does not produce or properly use insulin. Insulin is a hormone that aids in the conversion of sugar, starches and other foods into energy that is needed for daily life. Persons with type 1 diabetes, previously called juvenile-onset diabetes, have a total lack of insulin that requires insulin injections or a pump. Those with type 2 diabetes, previously called adult-onset diabetes, have insulin but cannot use it effectively and are in a state of “insulin resistance” requiring medications and/or insulin injections.

When it comes to the temptations of a holiday feast awaiting kids with type 1 diabetes, Dr. Rushika Conroy, a pediatric endocrinologist at Baystate Children’s Hospital suggests talking to your children to let them know that they will soon be faced with a table filled with foods and a free-for-all as everyone grabs for their favorites.

“Children with type 1 diabetes can eat a variety of the same foods as everyone at the table, but will need to closely watch their blood sugar levels,” Conroy said.

According to the pediatric endocrinologist, while it may be a holiday, diabetes never takes a day off, and it’s important not to forget to take your child’s glucose meter and diabetes supplies along if traveling to share Thanksgiving and the holidays with family or friends.

“This is not a day to forget to take one’s insulin. We know that carbohydrate counting can be more difficult to figure out when faced with parties and holiday meals and all the unexpected foods that go along with them. So, we expect a child’s blood sugar won’t be perfect in these situations. And, that’s okay, as long as they get as close as possible to their goal. They also must understand that they will need to check blood sugar levels more often and adjust their medication appropriately based on whether they achieve their goals or not,” Conroy said.

When it comes to desserts or other sweet confections, it’s best to stay away from soda, juice and other treats, such as pure sugar candy canes that can rapidly rise blood sugars, which even the fastest acting insulin can’t lower quick enough, Conroy noted.

“So, it’s best to choose from desserts that have some protein or fat in them, like cakes, pies and ice cream, or even fresh fruits,” she said.

As a pediatric endocrinologist who is also concerned with obesity, Conroy recommends, in general, that while a child may fill his or her plate with a little of everything, it shouldn’t be piled as high as the plate is wide.

Karen Zapka, supervisor of diabetes education at Baystate Medical Center, offers the following additional tips for those adults dealing with diabetes:

• As much as possible, try to eat a similar amount of carbohydrates as you would on a normal day. If you plan on having dessert, then cut back on another carb on your dinner plate. Fill up on lower-carb items such as green bean casserole, –, ham, and salads, as opposed to higher carb foods such as mashed potatoes, cranberry sauce, or sweet peas. It’s all about making choices and thinking ahead when you can. If you’re not invested in having those creamy rich potatoes, then you may want to pass on them so you can enjoy some stuffing.

• Very important – do not skip a meal or snack earlier in the day to save on carbs at dinnertime, because it will only lead to overeating when the meal is served.

• Bring your favorite dish along if you are celebrating at someone else’s home, so you have some control over what you are eating.

• If you plan on having an alcoholic drink, remember to eat a little something beforehand, so as to prevent low blood sugars levels. You are better to select drinks like wine or vodka, for example, which don’t have the high carbs found in most beers.

• Drink plenty of water to help dilute the sugar in your body.

• Remember, you are in the driver’s seat with your diabetes as long as you continue to monitor your blood sugars closely, especially during a taste-tempting holiday meal. If you are embarrassed to take your blood sugar in front of people, then go to another room and check them so you can act accordingly if you need to adjust your insulin.

Zapka also suggested for those who may have difficulty counting carbs, and who may not know the menu at their holiday destination, to try two very popular mobile phone applications. Called MyFitnessPal and CalorieKing, these apps can help you determine and choose the “lesser of two evils” when a guest at the dinner table.

Whether adult or child, one of the best things you can do after a holiday feast is to get some exercise.

“Of course, it’s a holiday, and naturally you want to sit around and talk with friends and relatives. It also wouldn’t be Thanksgiving without watching a few football games on television. But, you don’t have to remain a couch potato all day,” Conroy said.

“A healthy, brisk walk after a calorie-laden holiday meal will benefit anyone. However, it’s especially helpful to diabetics, because in addition to burning off those extra calories, it also contributes to lowering your blood sugar levels. So, take a walk for yourself or take your child away from the video games and head into the great outdoors for an adventurous walk or even a bicycle ride if you’re celebrating at home,” she added.

According to the American Diabetes Association, diabetes affects nearly 26 million children and adults in the United States alone, and nearly seven million of them are undiagnosed, putting them at risk for disabling and deadly complications.

Visit the hospital’s website, baystatehealth.org/diabetes to take the Diabetes Risk Test and learn if you are at risk for developing type 2 diabetes.



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