Managing diabetes is difficult any time of the year, but it's especially hard during the holiday season. The hustle and bustle of holiday shopping, parties, travel, and lurking viruses can trigger dangerous sugar spikes and dips. If you live with diabetes, read on for tips on how to feel great during the holidays and stay out of the hospital.
People living with diabetes report that the holiday season is an extra hard time to manage their blood sugar levels.
According to experts, eating ample protein, fiber, and water during a holiday meal helps minimize blood sugar swings.
Avoiding high-sugar treats and dishes is preferred, but one can also eat minimal sweets with protein and fiber to reduce sugar spikes.
Alcoholic drinks can cause blood sugar spikes and dips. Choosing low-sugar options while eating healthy meals is the healthiest way to enjoy a drink or two during the holidays.
In 2021, the American Heart Association and the American Diabetes Association conducted a national survey of 1,079 U.S. adults living with type 2 diabetes. The Know Diabetes by Heart survey found that 49% of respondents reported that managing their diabetes is more difficult during the fall and winter holidays than at other times of the year.
Only 52% felt they controlled their condition well during a holiday week like Christmas or Thanksgiving. During the rest of the year, however, 73% say they manage their diabetes confidently.
Diabetes adds stress and complexity to an already hectic and stressful situation. It’s easy to forget to monitor one’s diet and blood sugar level closely when you have the flu or spend a long day shopping. For someone living with diabetes, these mistakes can lead to a depressing hospital stay just when loved ones gather for Christmas.
For expert advice, Healthnews asked dietitian and diabetic educator Caroline Thomason, RD, CDCES, based in Washington, DC, for her thoughts on managing blood sugar levels during the holidays.
Dietician’s top three tips for holiday meals
According to Thomason, prioritizing protein, fiber, and water is the best way to manage blood sugar during a holiday meal.
Focus on protein
Protein by itself doesn't increase blood sugar, emphasizes Thomason. Instead, carbohydrates are the culprit for sugar spikes. Mixing protein, like turkey, with carbohydrates, like a baked yam, helps stabilize blood sugar levels.
“Protein doesn't spike our blood sugar after we eat it,” Thomason says, “and it also helps stabilize our blood sugar. If you're adding a source of protein to a food with carbs that spike your blood sugar, the protein helps smooth out that spike.”
Fill your plate with fiber
Thomason’s second tip is to fill your plate with more complex carbs than simple carbs.
Complex carbohydrates, like whole grains and fresh vegetables, don't spike blood sugar levels like simple carbs. Complex carbs break down slowly, maintaining steady blood sugar levels. To demonstrate this, Thomason compares complex carbs to chain-link fences.
It takes “a long time to take each chain off the link of the fence and break it down.Caroline Thomason
Unlike complex carbs, “simple carbs" would be one sugar or starch molecule; they don't need to be broken down. So, as soon as we ingest it, it's absorbed into our bloodstream, which does not keep us full or satisfied long-term.
”The chain-link fence effect is what we're looking for. We want something complex that takes time to break down and sits in our stomach and digestive system longer. We get the feeling of being more whole.”
Thomason recommends adding fruits and veggies to your holiday plate and swapping white bread and white crackers for wheat and whole grain products.
Drink plenty of water
It’s easy to skimp on water at any holiday party. However, according to Thomason, water helps dilute blood sugar levels.
“When we're at a holiday party, we're socializing and we're eating, but we're not always drinking enough water, which can actually help dilute blood sugar. So even if we do eat something that causes a rise in our sugar levels, water can help dilute it in our bloodstream and bring it down faster.”
Alcohol’s effect on blood sugar levels
Cocktails, beer, and wine are holiday traditions that celebrate good cheer and loved ones. Limiting alcohol consumption at any celebration can feel like a downer.
Alcohol loaded with carbs, however, is risky for those living with diabetes because it can both increase and decrease blood sugar levels. The fact that alcohol may induce lower blood sugar levels is surprising to many people and is still being studied by researchers.
One theory centers on the liver. Among its many functions, the liver detoxifies our blood and aids in the release of sugar in the form of glucose when required. Too much alcohol consumption may cause the liver to focus on detoxifying the blood rather than releasing sugar when needed. When the liver is distracted by detoxification, a diabetic's blood sugar can drop dangerously.
This does not happen immediately after drinking, according to Thomason. It could happen later, while you are sleeping. If a person with diabetes isn't checking their blood sugar closely or eating adequately, hypoglycemia can sneak up dangerously, especially for those using insulin.
On the flip side, the simple sugars in alcoholic drinks can cause troublesome sugar spikes. Diabetics who want to enjoy a holiday drink should choose low-sugar beverages.
Tips for drinking holiday alcohol
First and foremost, Thomason says, if you want to enjoy a drink or two, don’t skip a hearty meal to drink the alcohol instead. This kind of carb swapping is one way to mismanage blood sugar levels and may lead to dangerously low levels later, particularly for insulin users.
Thomason advises choosing low-carb and low-calorie alcoholic drinks with a well-balanced meal. Instead of sugary cocktails like margaritas or daiquiris, she recommends a lighter option.
“That might look like a skinny margarita,” she explains. “Or it could just be mixing and matching your own options, like soda water, vodka, and lime. You could have the bartender be a little creative here if that sounds too bland for you. But you can also choose a dry red or white wine or a light beer.”
Mocktails are also becoming popular for those seeking low-alcohol and low-carb options.
17 tips to minimize sugar rollercoasters
There are many other great ways to help you enjoy your holidays despite living with diabetes. Consider trying these 17 tips to help minimize sugar swings:
- Enjoy appetizers high in protein and fiber instead of simple carbohydrates.
- Consume the salad and vegetables on your dinner plate first to help slow any following sugar spikes from simple carb foods like cranberry sauce.
- Consider eating bread, sugary treats, and dessert after your meal instead of before.
- To minimize party food intake, try eating healthy foods at home before the gathering.
- Bring your own protein and fiber-heavy snacks, if needed.
- If you make a dish for a potluck, choose a vegetable dish with a little added sugar and fat to help round out the options. For example, instead of a sweet potato casserole, which is rich with marshmallows, butter, and syrup, consider creating sweet potatoes with cinnamon, nutmeg, and a bit of maple syrup. You could also bring roasted root vegetables topped with nutmeg, maple syrup, and balsamic vinegar.
- If appropriate, take home small portions of foods you didn’t enjoy during the party to spread out those carbs over the following days.
- Eating consistent meals of nutritious whole foods is the goal. Don’t skip a meal to “bank” your carbs for holiday food later in the day.
- Try to stop eating when you are 80% full to save room for dessert without overeating.
- If you eat too many carbs, relax and simply monitor your blood sugar levels closely. Move forward confidently with carb counting and healthy, well-balanced meals while adjusting your medications as your doctor instructs.
- Go for a walk, play pickleball, or enjoy another activity after the meal. Engage your loved ones to plan something active together. Activity reduces blood sugar levels.
- Most diabetics don’t need to obsess over carb-counting, but they DO need to be reasonable about filling their plate. Be sure to understand when you’re eating a low-fiber, simple carbohydrate dish compared to complex carbohydrate foods.
- Keep portions of simple sugar foods small, like cranberry sauce, sweet potato casserole, and pie.
- Check your blood sugar often. Ensure you have enough supplies before the holidays, especially if you're traveling.
- If you drink alcohol, choose a low-sugar option and try waiting to drink it with or after the meal.
- Consider a low-sugar mocktail instead of a cocktail.
- Sleep and rest adequately throughout the holiday season because stress and illness can drive sugar swings.
Balanced and consistent meals are the key
According to Thomason, having the right mindset throughout the year is vital to managing blood sugar levels. Those who maintain a healthy lifestyle have better control during the holidays.
Eating a diet that's more modest in carbs, high in lean protein, fiber, and fruits and veggies, drinking more water, being active, sleeping more, and improving stress management are the big things.Caroline Thomason
Consistency over the long haul instead of skipping meals to binge later provides greater satisfaction, mental stability, and energy for people living with diabetes.
"I often encourage people to get off this sort of under-eating and over-eating cycle," says Thomason, "and to focus on managing their blood sugar consistently all day. You can make a lot of progress doing that. But it's definitely a mindset change that people have to make in order to see the value.”
The good news is that we can make that mindset change. It's also great news that one meal won't unravel all your hard work to manage blood sugar levels. Simply keep an eye on your blood sugar levels, adjust safely, and learn from the experience so you can fully enjoy a cheerful and peaceful holiday season.
- American Diabetes Association. Survey: Holidays Place Extra Stress on People Managing Type 2 Diabetes.
- Journal of Diabetes Investigation. Combination of alcohol and glucose consumption as a risk to induce reactive hypoglycemia.