Christmas hints for Insulin users
Christmas brings extra challenges for managing blood glucose levels, but it can be done without affecting your enjoyment of the festivities. Several elements affect blood glucose, not just food and insulin. A little planning can help you have an enjoyable and relaxed Christmas, without blowing the blood sugar bank.
- Make sure you have plenty of insulin, test strips, pump supplies, hypo treatments and Glucagen. 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. Check over the list before you leave.
- 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 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 often got hypos 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.
- Insulin is damaged when it is subjected to too high or low temp. (e.g. left on a hot radiator or in a car in freezing weather). Once that happens it shouldn’t be used. Test meters may not work if they are left in a cold place. It is particularly important to think about this if you are staying in someone else’s house over the holidays.
- 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, especially if your BG is in range. If dinner is delayed you can end up hypo before dinner is served. Dinners at Christmas time often contain more butter and cream than usual. Fat slows the speed at which carbs are absorbed. If you take the normal amount of insulin for potatoes, veg and gravy the insulin can overtake the carbs. You can end up with a hypo (low blood sugar). 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 for the day.
- The same applies to dessert. There are plenty of calories in creamy rich deserts but they aren’t as high in carbs as you think, which can result in carb miss calculation and a hypo. Check BG 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 beforehand 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 ending up with a high or low BG 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 BG 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.
- Brandy butter, cranberry sauce and relish contain sugar and need to be carb counted for insulin. Desserts cause less impact to BG if they are eaten within an hour of dinner. The protein, fibre and fat in the dinner help to slow down some of the carbs in dessert.
- Alcohol can affect BG levels for up to 24 hours, so keep an eye on BG’s the next day. I find having a couple of drinks with a meal has little effect on BG level. Drinking alcohol on an empty stomach is a disaster for BG levels. 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).
- Keep track of how many sweets you eat (count the sweet papers!), check how many carbs are in them and give insulin immediately. It’s easy to forget!
- Blood Glucose levels
- Most of us will have some high BG levels 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 or end up feeling awful. If you have a high glucose level in the evening it’s best to stay away from carb heavy food until they improve.
- Exercise is great for balancing BG. Don’t forget to check BG before you exercise and regularly after. Always carry your quick acting hypo treatment with you even for short trips.
- Stress (good or bad stress) can affect BG levels, so it’s a good idea to have some quiet time during the busy days of Christmas. A walk or a rest are beneficial. Children with diabetes may have high BG levels due to the excitement of Christmas and will benefit from quiet periods and exercise too.
- Try to get your BG levels stable in the days before Christmas. Confine carbs to familiar ones that you are sure of the insulin dose needed. If you start from a good base (stable BG’s), the festivities won’t have the same impact than if you start off with high BG (or unstable – high/low).
- Staying well hydrated with lots of water really helps.
- Enjoy Christmas and stay healthy!
BG = blood glucose