Malcolm L. Steiner, MD, Answers Questions About Diabetes.
Malcolm L. Steiner, MD, is an endocrinologist at Atrium Medical Center in Middletown.
Q.What are some tips for getting through the holidays with diabetes or pre-diabetes?
Thoughtful planning makes all the difference for safe and enjoyable holidays when you have diabetes or pre-diabetes, whether you’re enjoying a holiday feast, going to parties or traveling.
When you’re surrounded by food at the holidays, making healthy choices can be challenging. Develop an eating strategy that allows you to enjoy yourself and keep your blood sugar in an acceptable range.
Choose snacks, such as vegetables with your favorite low-calorie dip, that won’t sabotage your blood sugar levels before you sit down to eat. During holiday meals, don’t try everything! Choose foods most enjoyable to you and pass on the rest. Opt for either the sweet potatoes or mashed potatoes, but not both. If you want a serving of pie, skip the potatoes with dinner. Take smaller portions so you can savor high-carbohydrate holiday foods, but try to keep your total carbohydrate intake at your everyday level. A good rule for planning meals is 30-45 gm carbohydrate per meal for women and 45-60 grams for men, or more if you’re physically active.
Alcohol decreases the liver’s ability to make glucose. If you take diabetes medication, drinking alcohol may cause your glucose level to fall. People who drink also tend to snack more and fail to account for snacks as part of their meal plan, driving up glucose levels. If you drink in moderation, remember to maintain discipline in your eating strategy and drink with a meal or snack. Limit yourself to one to two drinks with 12 oz. of beer, 5 oz. wine or 1.5 oz. liquor. Checking your blood glucose is a good idea if drinking alcohol.
Be aware of meal timing. If you’re eating later than normal, you may need a snack at your regular meal time to avoid low blood sugar. Add physical activity during the holidays if you’re eating more than usual. Get your whole family moving for some group fun.
When traveling, take copies of your prescriptions, a list of all medications and other medical documents. Carry enough medications and supplies in your carry-on bag to cover unforeseen situations, such as a lost checked suitcase. Insulin travels well when kept at room temperature, between 38 and 86 degrees. In airports, security personnel occasionally ask for prescriptions or a doctor’s note from travelers with diabetes supplies. Carry snacks for unexpected travel delays.
Good diabetes self-management requires being aware of your blood sugar level. Check it frequently when traveling and after meals. Glucoses should be under <130 mg% prior to meals and <160 mg% two hours after a meal. The unusual foods, stress and excitement that are part of traveling and vacations can have unpredictable effects on blood sugar.
Plan for common illnesses like colds and diarrhea, pack appropriate over-the-counter medications and ask a pharmacist for advice as needed. You should already have a sick-day plan that you’ve agreed upon with your health care team. Know how to adjust your medications appropriately when you’re ill or your blood sugars are rising or falling.
For more information about diabetes basics, treatment and holiday recipes, visit the American Diabetes Association.
Ultimately, diabetes holiday survival skills are no different from everyday guidelines, but they may require more discipline and planning to maintain. Talk with your health care team to brush up on the basics for your situation. Then you’ll be able to enjoy this festive time of year without worry.
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