Healthy Holiday Tips for People With Diabetes

The holiday season is often called “the most wonderful time of the year,” yet if you have diabetes, you may want to rename it “the most challenging time of the year.”

There are a few reasons why late November and the month of December can get trickier when you have diabetes:

If you’re not careful, those changes to your healthier routines can turn into real health hazards, including hypoglycemia, which involves low blood sugar levels, and hyperglycemia, or high blood sugar levels. Hyperglycemia can happen if you’re on insulin and not using enough or if you’re not using your diabetes medications as prescribed.

Another potential health consequence is a life-threatening emergency called diabetic ketoacidosis. This can occur if your body doesn’t have enough insulin to permit blood sugar into your cells to use for energy. Diabetic ketoacidosis can happen if hyperglycemia is left untreated, and it tends to be more common in people with Type 1 diabetes. Diabetic ketoacidosis can lead to what’s called a diabetic coma or even death.

Some research has also suggested that people with diabetes are more likely to have serious complications from COVID-19, such as blood clots. Spending more time socializing with others could raise your risk for exposure to COVID-19 as well other illnesses, including the flu.

Despite these scary risks, there are ways you can enjoy the holidays, even if you have diabetes. Here are a few healthy holiday tips:

Many of the challenges people with diabetes face during the holiday season can be managed with good planning, says Amy Kimberlain, a registered dietitian based in Miami and a national spokesperson for the Academy of Nutrition and Dietetics.

Here are a few examples of when to plan ahead so you can stay on track with healthy habits:

With all that planning, don’t forget to plan to enjoy your food. “I try to remind clients that any food can fit, it’s a matter of how much and how often,” says Grace Derocha, a registered dietitian and Detroit-based national spokesperson for the Academy of Nutrition and Dietetics.

Between cookie-baking sessions, big dinners and other special occasions, it’s easy to avoid physical activity during the holidays. Don’t! Here’s why: Physical activity offers so many benefits, especially during the holidays, including:

If you find yourself pressed for time, do what you can — even if it’s less than usual. “Doing something is better than doing nothing,” Derocha says. That could mean 10-minute brisk walks after each meal, moving more as you clean up your house or decorate or finding ways to work in more steps while shopping. For instance, park your car farther away from a store entrance or take an extra lap or two around the perimeter of the mall.

It may be tempting not to check your blood sugar regularly during the holidays because it’s just one more thing to do. However, knowing your blood sugar level helps you to manage your insulin dose if you’re taking insulin, Kimberlain says. If you’re feeling more fatigued or off in some way, you should check your blood sugar. This could alert you to possible hypoglycemia or hyperglycemia. Also, know where your numbers are before the holidays so you have something to compare them to once you’re in the swing of holiday celebrations.

“The goal is to consistently be within the normal ranges for a person with diabetes,” Derocha says. Before a meal, the normal range when you have diabetes is 80 to 130 mg/dL; two hours after a meal, it’s less than 180 mg/dL, according to the Centers for Disease Control and Prevention (CDC). These numbers can vary by age and health factors, so always double check with your health care provider about the norm for you.

It’s good practice to work toward healthy eating year-round, but especially during the holiday season. This includes a balance of protein, fiber and healthy carbs and fats. When eating carbs, having these other food components helps to slow digestion and keep your blood sugar level stable, Derocha says.

Here are a few ideas for snacks that help balance carbs, protein and healthy fats:

You can make your meal choices more balanced as well with these diabetes-friendly choices:

Controlling your blood sugar involves carb control. This includes distributing your carb consumption as evenly as you can throughout meals and snacks and sticking to healthy carbs, such as whole grains. It may sound like a good idea to have, say, 15 grams of carbs at breakfast time to save 105 grams for a holiday dinner. However, your body and your blood sugar work a lot more efficiently when you keep your carb count consistent with every meal, Derocha says. Having too many carbs at once can make it a challenge to keep your blood sugar levels stable.

Plus, banking your carbs or calories may make it more likely that you’ll get hungry and overeat, Alesiani says.

Alcohol adds calories and carbs. It can also raise and lower your blood sugar quickly. If you choose to have a drink, enjoy it with a meal to keep effects to a minimum. When in doubt, ask your health care provider for guidance on how much alcohol, if any, is OK for you, Kimberlain says.

Traveling has become crazier than ever, and the last thing you want to worry about is whether you have enough of your medications or if your blood sugar will spike and affect your health when you’re not home.

Here are a few ways you can travel smarter during the holidays when you have diabetes:

Even with all the fun, the holidays can be stressful. Getting too stressed can increase your blood sugar and just make you feel bad. Find ways to relax, whether through a walk, meditating, a nice bath or anything you do that gives you a healthy, stress-busting outlet, Kimberlain advises.

Keeping any eye out for signs of low or high blood sugar can help you avoid any associated health risks. Even a small health issue can become a challenge during the holidays.

Symptoms of hypoglycemia, or low blood sugar, include:

Check your blood sugar to confirm it’s low, which is below 70 mg/dL, according to the CDC. If that’s the case, aim to consume 15 grams of fast-acting carbs, such as 4 ounces of regular soda or fruit juice or three to four glucose tablets. Check your blood sugar 15 minutes later. Repeat this again if it’s still low after 15 minutes. Continue to do this until your blood sugar is above 70 mg/dL, and eat a snack if you don’t plan to eat your next meal for another hour or more. Ask your health care provider in advance if there’s anything else you should do for low blood sugar.
Symptoms of hyperglycemia, or high blood sugar, include:

After confirming your blood sugar is high, plan to do some physical activity, such as taking a walk for a few minutes; exercising may help lower blood sugar. After that, you can check your blood sugar again to see if it’s still high. Ask your health care provider in advance what else you should do if you have high blood sugar. Your provider may want you to change your medications or take a closer look at what you regularly eat.

A visit to the emergency room may be in order if you are confused, have shortness of breath, are vomiting, have ketones in your urine or if your blood sugar is 300 mg/dL or higher. Ketones are types of acids the body makes when it breaks down fat for energy. This could indicate diabetic ketoacidosis, the medical emergency that could lead to a diabetic coma. Your health care provider can advise if you should have a urine dipstick test at home to check for ketones.

With some good planning and trying to stick to your routine as much as possible, you can enjoy a wide variety of holiday foods when you have diabetes. Take these tips, and apply them throughout the year to holiday celebrations in which food and drink play a major role, Kimberlain advises.