The Doctor Is In: Managing Diabetes During the Holidays

Content is sponsored and provided by Henry Ford Health System

Type 2 Diabetes occurs when a person's blood sugar (blood glucose) is too high. Blood glucose is the main type of sugar found in your blood and it is your body's main source of energy. More than 30 million people in the U.S. have diabetes, according to the American Diabetes Association and 1.5 million Americans are diagnosed with diabetes every year.  

Another 84 million American adults - more than one out of every three - have prediabetes and are at risk for developing type 2 diabetes, according to the Centers for Disease Control and Prevention. Of those who have prediabetes, approximately 90% do not know they have it. Being prediabetic puts a person at an increased risk of developing type II diabetes, heart disease and stroke.  

Henry Ford Hospital Expert: 
Sharon Lahiri, M.D. 
Endocrinologist, Henry Ford Hospital 

Potential consequences from uncontrolled diabetes can include: 

Damage the heart, blood vessels, eyes, kidneys, and nerves. 
Increased risk of heart disease and stroke.  
Combined with reduced blood flow, neuropathy (nerve damage) in the feet increases the chance of foot ulcers, infection and eventual need for limb amputation. 
Diabetic retinopathy can potentially cause blindness and it occurs as a result of long-term accumulated damage to the small blood vessels in the retina.  
Diabetes is among the leading causes of kidney failure. 
The overall risk of dying among people with diabetes is at least double the risk of their peers without diabetes. 

Diabetes Management and the Holidays 

Meal Timing 

Many families eat large meals at odd times on holidays.  For example, Thanksgiving dinner may be served in the middle of the afternoon. 
If a patient is on medication that can cause low blood sugar, they should have a snack during their regular meal time if the holiday meal is delayed or breakfast or lunch are skipped. 
Carbohydrate content of holiday meals 

The carbohydrate content of holiday meals tends to be higher than for regular meals.  For example, Thanksgiving meals often contain stuffing, sweet potatoes, rolls, cranberry sauce, pies.   Medications may need to be adjusted based on the carbohydrate content. 
Healthier versions of your favorite holiday foods 

The American Diabetes Association has excellent recipes that are lower in sugar content. Offer to bring a dish to the holiday party that is healthy, so you know that this option is available. 
Try to stay physically active and fit in exercise 

Diabetic individuals should try to take a break from the food by doing something physically active, such as taking a walk with family or playing sports with their kids. Even breaking up the exercise into 10-minute sessions after meals is helpful. 

How to fit in sweets. 

As for dessert, it is best to include the sweets as part of the carbohydrate content of the meal, rather than in addition to the meal.  For example, if you plan to have pumpkin pie, it may be a good idea to skip the dinner roll or skip the potatoes during the meal. 

Alcohol consumption guidelines 

Alcohol blocks the production of glucose in the liver. (The liver contains “emergency stores” of glucose to raise your blood sugar if it drops too low.) Once the liver's stores of glucose (glycogen) are used up, a person who has drank a lot of alcohol can't make more right away, and that can lead to dangerously low blood glucose especially if the person is on insulin or medications that raise insulin levels. 

It takes about 1 to 1.5 hours for the liver to process 1 alcoholic drink.  So the more alcohol that is taken in, the longer it takes for the liver to process this and the longer the production of glucose is
turned off 

The general guidelines for how much to drink is the same as for those without diabetes: 

Women: no more than 1 drink per day. 

Men: no more than 2 drinks per day. 

One drink is equal to a 12 oz beer, 5 oz glass of wine or 1 ½ oz distilled spirits (vodka, whiskey, gin, etc.). 

If you have diabetes, do not drink on an empty stomach or when your blood glucose is low, since your risk of low blood glucose increases after drinking. When consuming alcohol, always have it with food. This is especially important for those on insulin and other diabetes pills that can lower blood glucose by making more insulin. Don’t skip a meal if you are going to drink.  

Wear an I.D. that notes you have diabetes. If you are in a setting where people are drinking alcohol, hypoglycemia may be mistaken for being drunk.  The symptoms and signs are similar (sleepy, dizzy, confused). 

Alcohol can cause hypoglycemia shortly after drinking and for up to 24 hours after drinking. If you are going to drink alcohol, check your blood glucose: 

Before you drink  

While you drink 

Before bed and throughout the night 

More often for up to 24 hours 

Be sure your blood glucose is at a safe level - between 100 and 140 mg/dL before you go to sleep. If your blood glucose is low, eat something to raise it and be sure to check again before you go to sleep, and again over night to be sure it’s not dropping too low. 

Do not use alcohol as a way to lower blood glucose. The effects are unpredictable and risks outweigh any benefit.