Christmas is a challenging time for managing blood glucose levels and this year will be no different in that regard, even though it will be quieter for many of us. We will eat treats if we are celebrating Christmas on our own or with others!
Several elements affect blood glucose, not just food and insulin. A little planning can help you have an enjoyable and relaxing Christmas, without blowing the blood sugar bank.
• Make sure you have plenty of insulin, test strips, pump supplies, hypo treatments and Glucagen (check that it is in date). You don’t need the stress of running out of your essentials over Christmas/New Year. If you are travelling, make a list of everything you will need, including hypo treatments and check over the list before you leave. This year there are added precautions needed to protect yourself and others from Covid19, so it’s even more important to be organised.
• As much as possible keep to the same insulin routine. At least give your Basal (long-acting) insulin at your usual time. When you are out of routine, like staying in bed later and eating later (and not too healthily!) it is easy to forget. Set an alarm and/or leave your insulin in a particular place to remind you.
• Always have your insulin, testing kit and hypo treatment with you. Getting a hypo (or several) over Christmas seems impossible but it’s not. I used to get at least one hypo on Christmas day until I understood how different food combinations are digested and their relationship to insulin. Even now I don’t have perfect blood sugars but manageable ones that don’t stay high or low all day.
• Consider when you will give your insulin for Christmas dinner or other big meals – they are usually served over a long period of time. It’s best to pace your insulin. Pre-bolusing can be tricky. If dinner is delayed, you can end up hypo (low blood sugar) before dinner is served. Christmas meals usually contain more butter and cream than usual. Fat slows the speed at which carbs are absorbed. If you take your normal insulin dose for carby veg like potatoes the insulin can overtake the carbs. You can end up with a hypo. The carbs will catch up later (high blood sugar), leaving you with a hangover feeling without any booze. Throw in some alcohol and you will be wiped out for the day!
• The same applies to dessert. There are plenty of calories in creamy rich desserts, but they aren’t as high in carbs as you may think, which can result in carb miss calculations. Check glucose level before eating and be careful that you only give enough insulin for what you will eat. It’s easier to have a small portion with the correct amount of insulin and go back for second helpings and give additional insulin than go hypo because you weren’t able to eat what you thought you would. As if!
On Christmas day or other big occasion days it is almost impossible to have good blood sugars all day, but a small bit of thought can really improve things. You will feel better and enjoy the day more if you haven’t crazy blood sugar.
• Look up the carb count of unfamiliar foods rather than guessing and suffering the consequences later on. There are so many different foods and recipes, not to mention that different foods affect people in different ways it would be impossible to always get carbs and insulin balanced but an educated guess is much better than a random one.
• Plan to have the foods you eat normally for some of your meals, particularly breakfast. If you deal with any high BG issues (as instructed by your medical practitioner) in the morning and have your normal breakfast you will be well set up to enjoy whatever the rest of the day brings.
• Christmas dinner – Turkey is lean protein, so no insulin needed. Large amounts of protein do turn into carbs eventually and may affect blood sugar many hours later. There are a few carbs in the honey/brown sugar glaze on ham but not a huge quantity. Carbs in creamy garlic potatoes are slowed down considerably due to the cream. Butter and nuts are often added to Christmas vegetables, which slow the rate in which the carbs in the vegetables and other foods are absorbed.
• Cranberry sauce and relish contain anything from 27% to 50% sugar and need to be carb counted for insulin. The protein, fibre and fat in the dinner help to slow down some of the carbs in potato, stuffing and dessert.
• Alcohol can affect blood sugar for up to 24 hours, so be mindful of unexpected low blood sugar the next day. I find having a couple of drinks with a meal has little effect. Drinking alcohol on an empty stomach is a disaster for blood sugar levels, liver, kidneys and brain. It’s easy to unintentionally get extra carbs in drinks (e.g. hot whiskey/brandy usually has sugar added and many cocktails have lots of sugar).
• Needless to say, sweets will raise blood sugar! Keep track of what you eat (count the papers!) and give insulin for them immediately. It’s easy to forget! Dark chocolate has much less impact on blood sugar than milk chocolate or other sweets.
• Most of us will have some blood sugar issues during Christmas. Deal with them asap. Don’t let them drag on for days. As well as being very bad for your health you will have no energy and end up feeling awful. If you have high glucose levels it’s best to stay away from carb heavy food until they improve and drink plenty of water.
• Exercise is great for balancing blood sugar. Don’t forget to check before you exercise and regularly after. Always carry your quick acting hypo treatment with you even for short walks.
• Stress (good or bad stress) can affect sugar levels, so it’s a good idea to have some quiet time during Christmas. A walk or a rest are beneficial. Children with diabetes may have high sugar levels due to the excitement of Christmas and will benefit from quiet periods and exercise too.
• In my experience it is well worth making the effort to get blood sugar stable in the days before Christmas. If you start from a good base the festivities won’t have the same impact as if you start off with unstable blood sugar.
• Staying well hydrated with lots of water really helps. Enjoy Christmas and stay healthy!
This is not medical advice. If you are unwell or unable to manage your blood sugar or have high ketones, please contact your Doctor or A&E department.