Surviving the Holidays With Diabetes

The 2-minute discussion all clinicians should have with their patients with diabetes

Akshay B. Jain, MD

Disclosures

November 14, 2018

'Tis the season to be merry! With Diwali having gone by; Thanksgiving knocking at our doors; and Hanukkah, Christmas, and New Year's Eve just around the corner, this joyous time of year flies by quickly.

Akshay B. Jain, MD

I shudder to think of my appointments in January and February when I notice high A1c levels and patients shrugging them off as a normal consequence of holiday eating. Surprisingly, this reasoning sounds acceptable to many healthcare providers, too, and many of us have acceded to higher blood glucose levels being the norm during the winter months.

It is a well-studied fact that blood sugars, body weight, and triglycerides tend to run higher during the holidays,[1,2] but many of our patients can avoid excessive glycemic surges with a few simple steps.

The following tips are practical, easy to follow, and surprisingly effective. And for the busy clinician, they can be discussed in less than 2 minutes.

1. Cook at Home, Eat First

Do your own cooking from scratch and keep the purchase of premade holiday foods to a minimum. Cook the right quantities to avoid being stuck with excess food that you might eat just so that it doesn't go to waste.

Eat at home before shopping to help you avoid the food court. Consider parking farther away from the entrance of the mall, or walk around the mall once before you start shopping to help get some exercise during the busy holiday season.

On the day of a party, eat healthy, balanced meals throughout the day and plan to have something small to curb your hunger before you go. Sometimes people will "save their calories" for the party, which can lead to overeating as a result of difficulty controlling portions and recognizing fullness cues.

2. Be Picky and Have Your Favorites

Wait for the entire meal spread to be laid out and then pick your favorites. This helps limit food intake compared with eating as each new item comes out. Eat the better-for-you foods first (eg, soups, salads) before having the holiday delicacies.

Allowing yourself to enjoy your favorite foods instead of restricting them can be helpful. Use the smaller dessert plates and balance off your indulgences with some healthier, satisfying choices, such as veggies and lean meat.

3. Mind the Alcohol and Cut Out the CRAP

In addition to increasing caloric intake, alcohol can lead people to lose control of their eating and give up on making mindful food choices. Drink slowly. Alternate alcoholic beverages with low-calorie drinks like sparkling water with lime, sugar-free Kool-Aid or Crystal Light Pure, or cranberry juice with soda.

Cut down the intake of CRAP (carbs, refined sugars, aerated sugary sodas, processed foods), and monitor blood sugar levels even more regularly during the holidays to ensure that things don't get too out of control.

The day after an event, go back to your usual routine with healthy, balanced meals. Just because you indulged at a party doesn't mean that you need to give up your healthy-living goals for the entire season.

4. Take the Focus Off of Food

Plan events with family and friends that are centered around activities instead of food. Skating, tobogganing, snowshoeing, and skiing are all great sports to enjoy with your loved ones during the holiday season.

Briefly discussing lifestyle modifications during the holidays can lead to significant improvement in glycemic control.[3] Pick and choose which of these high-impact tips are most applicable to your patients. I give a printout of tips to all patients with diabetes at this time of the year, which I encourage them to display on their refrigerators. After all, there's no reason why one can't remain healthy during this time of merriment!

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