TIPS & TRICKS FOR MANAGING DIABETES DURING CELEBRATIONS / FESTIVE MEALS
During the festive season most of us tend to eat and drink more than we probably should when considering healthy eating guidelines, but then again that’s one of the main reasons that we all love this time of year too.
Having Diabetes doesn’t mean that you need to have a different outlook over the festive period, but it may mean that you need to think ahead and put a plan in place on how to manage all that the festive season has to offer. Doesn’t it always seem to be chocolate that makes a great gift? And one can turn into two and so on. What about a party with Alcohol and dancing as well as different foods to carbohydrate count? Managing your diabetes even with an insulin pump and access to CGM can still be difficult. So why not try and plan ahead and expect the unexpected.
PARTIES AND ALCOHOL
Parties can be difficult to manage as there can be so many different elements to them. The meal, alcohol and if you are any good at it, dancing
Firstly there is often a pre-set menu choice. While sometimes it can be difficult to find something you like and the choice may be a bit more limited, this is a great opportunity to plan ahead. Look at the menu and scan for anything that looks unfamiliar so that you can look up the approximate carbohydrate content and make a note of it or add it into a carb counting app if you use one. You can also contact the venue ahead of the party and ask for the carbohydrate content of the menu, or even check online. Many restaurants and bars may have this information available already. If you are unable to plan ahead or are unsure of the carbohydrate content of the meal, underestimate the amount of insulin required, you can always correct a little later when you blood glucose test.
Next thing to think about will be alcohol. Alcohol seems to creep into parties over the festive period very easily and can be just as difficult to manage. Think about the type of alcohol that you are consuming and how it usually affects your blood glucose. Dry wines and spirits tend to contain very little carbohydrate, whilst other drinks will contain carbohydrate.
Remember that the overall effect of alcohol will be to lower your blood glucose levels so you need to assess how it affects you personally and remember that you may potentially require insulin for the carbohydrate-containing drinks.
You could try to alternate drinks with low sugar or diet soft drinks or water to reduce your alcohol intake and remember try to drink in moderation to avoid the excess calories too. It is always a good idea to make somebody in your group aware that you have diabetes, so that they can help you if your blood glucose levels do drop and carry some ID out with you at parties too, particularly if you don’t want to advertise your diabetes to those you are out with. Remember this lowering effect from alcohol can be seen up to 12 hours later so you may need a reduction in your basal insulin requirements.
Below is a reminder of some of the carbohydrate contents of a few alcoholic drinks.
|Alcoholic drink||Measure||Approx Carbohydrate content|
|Dry cider||1 pint||15g|
|Premium lager||1 pint||12-15g|
Finally you have had the meal, you have had a few alcoholic drinks and now you plan to show people that you have the moves to some cheesy disco tunes. Even though you may not think that your dancing is particularly impressive or energetic, or that it might even be completely embarrassing, it is still activity and may lead to low blood glucose levels. It might be worth considering the lowering effect of any alcoholic drink you had earlier as well as any mis-calculation of carbohydrate added to the lowering effect of exercise. It might be worth trying a temporary basal reduction or even setting a new basal pattern completely for the evening so you can switch to it ahead of the party and don’t have to miss out on anything while you are programming your pump.
With the MiniMed® 640G you can also set up a pre-set temp basal for just this sort of event too.
Christmas day can be the sort of day where people will graze on food throughout. Diabetes shouldn’t change that. Pump therapy means that you have more options on how to bolus and typically people might encourage you to trial a square wave bolus in this instance. However this in practice is difficult to put in place as it means you need to estimate your total carbohydrate over the length of time you plan to programme the Square wave, which is from 30 minutes to 8 hours.
An alternative approach might be to try smaller boluses as you need them when you graze on food.
This would eliminate any potential low blood glucose whilst the square wave is running if you decided you didn’t want that extra chocolate or snack. The Minimed 640G also has the ability to pre-set boluses too. You could set up a pre-set amount to that snack you tend to keep going back for like a mince pie or chocolate and then deliver it via your Contour Plus Link 2.4 meter this way you don’t need to keep taking your pump out.
Your celebratory meal may look like a loaded plate but may actually be low in carbohydrate. We all know that roast potatoes and parsnips will need to be counted but your turkey and lots of vegetables contain little or no carbohydrate but they may lower the glycaemic index of the meal. Also look for the hidden carbohydrate at the meal such as from stuffing, which may contain dried fruits and breadcrumbs, not to forget cranberry or bread sauce. When you have assessed the carbohydrate content you may want to trial a dual wave bolus with this meal due to the lower glycaemic index from the vegetables and fats, and then cover your pudding with a normal bolus top-up.
It is likely that over the festive period you will have blood glucose results that are higher than you would hope for, whether that be down to miscalculation of carbohydrate or a change in your regular routine to a more sedentary one. Don’t let this get you down instead put the figure into bolus wizard and correct as necessary. It is always better to under-bolus and correct later than hypo and spoil your day.
A FEW FINAL TOP TIPS
Test your Blood Glucose or check your CGM regularly and adjust your management of your Diabetes accordingly.
Make sure you have hypo treatment available at all times and why not stock up on it? Who wants to be making a last minute dash to the supermarket because you have realised you are running low on whatever hypo treatment you usually use.
Carry some ID out with you at parties, particularly if you don’t want to advertise your Diabetes to those you are out with.
Prepare for set changes, don’t ignore them, if needs be get them out of the way a little earlier so you don’t get caught out later.
It might also be worth preparing for illness. Obviously nobody wants to be struck down with a cold or flu bug over the festive period, however why not set up a basal pattern with any adjustments advised by your healthcare team just in case. Why not also check what kind of service your team is running over the festive period, will they have an out of hour’s service, so that you will know who to contact if you need further advice.
Finally and most importantly have a fantastic festive period and have fun!