December 14, 2008

Tis the Season

It's cold. It's dark. There is food everywhere, and most of it is full of flour and sugar.

If you are sticking to your diabetes diet, whatever it might be, good for you. If you aren't, well join the crowd.

I've done it both ways. I spent a couple holiday seasons keeping my carbs where they needed to be to keep my blood sugar in a reasonable range. No stuffing. No potatoes. Lots of things made with Splenda and protein powder that looked like the foods they were supposed to replace but tasted like Splenda and protein powder.

But holiday food is a big deal in our family, and invariably after passing on all the traditional foods that had been part of my holidays for the past fifty-some years, I'd end up in tears. Not a happy holiday.

I've done it the other way, too: Declared that food has no carbs on Thanksgiving and Christmas and proceeded to eat accordingly. Back in the days when my doctor wouldn't give me a prescription for insulin, eating like that was a good way to remind myself why it was that I didn't eat carbs. My blood sugars would hover near 300, I'd end up feeling like poison was flowing through my veins and awake with a massive carb hangover and rampant hunger the next day as I fought to get back on track.

At this point you might be thinking? Well, what about moderation? Why not just eat a little bit of carbs? Well, if you can do it, hurrah for you. I can't do it on the big family food holidays.

Now that I use insulin, I can eat the traditional family foods if I use my insulin pen like a pump and inject more insulin every time I eat something with carbs in it. That flattens out the blood sugars very well, so my toes, eyes and kidneys thank me, but boy does it pack on the pounds. Insulin plus carbs and fat is the recipe for weight gain, and even though the blood sugars might be under control, once you start playing "my pen is a pump" it's tough to shut off the overindulgence.

When my blood sugar log isn't full of scary numbers, it's hard to stop eating crap not only on Thanksgiving and Christmas Day but on all the days in between. Since it takes me about a week to gain a pound and a month or more of fasting and repentance (a.k.a. weight loss dieting) to lose that same pound, this is not an ideal solution, either.

So when people ask me what the best way is to handle holiday eating, my answer is, "Beats me!"

But that's largely because I know that holiday eating is one of those areas where the individual differences in our personalities really come to the fore and where there is no "one size fits all" solution, even if we share the same blood sugar issues.

The best way to decide what holiday food approach would be best for you is to take an honest look at your history with food and what you have learned in the past about what it is that you can and cannot handle.

If you have shown in the past that you can take a day or two off of your diet and get back on track, that opens up some possibilities that should not be on the table if you have a history of months-long binges that have erased other months of very hard work.

The trick here is to face facts and not to tell yourself that this year it will be different. It won't. If you binged in the past, you will binge this time too. That is why it is so important to know your own limits.

I know I can diet in January, and in April or September if I have to. Just not in November and December. I knew in the past, before I had insulin, that I could eat a high carb meal and get back on track the next day even though I also knew I would be very hungry. That gave me some options that would not be there for a person who had problems with binging.

Beyond that, I have always had one hard and fast rule: If I go off plan I measure my blood sugar one hour and two hours later.

There is nothing like seeing alarming numbers on your meter to help you get back on track. . That is the main reason that testing is so helpful to anyone who has learned that there is a connection between the amount of carbohydrate they eat and their resulting blood sugar numbers.

And if seeing high numbers for more than a meal here and there doesn't get you back on track and you are spiking over 200 mg/dl meal over meal, it is time for some tough love. If you can't stop eating the high carb stuff that you can't handle, do a Google Search on the words "Diabetic foot."

Then click on the "images" link at the top of the page. What you see there should motivate you to get back in control. Because if you eat like every day is Christmas, what you see in those harrowing pictures is what you will end up with in your stocking.

CODA: If you are seeing numbers over 200 mg/dl meal after meal and it isn't because you are eating a succession of high carb meals, it is time to insist that your doctor help you find a safe drug regimen that will get you back into control--preferably one that uses fast acting insulin--or send you to a specialist who will help you. Most people with Type 2 diabetes caused primarily by insulin resistance can recover very good control by cutting out the carbs. If you are still seeing very high blood sugars after eating lower carb meals, the chances are you are insulin deficient.


Khürt said...

Before diabetes ( BD? ) the Thanksgiving holiday was my faourite American holiday. Family, food and fun. It's also a few days after my birthday and a few days before my daughter's. However, I must admit that after diabetes (AD?) I did not enjoy this holiday as much as I used to. I skillfully limit my carbs but I end the day disatisfied because I could have only a small bit of my sister-in-law's delicious mashed potatoes ( she uses heavy cream ) or my wife's shephard pie and I can quaff my thirst with just one light beer. Sigh!

Kelly the Kitchen Kop said...

I don't have diabetes but thought this was still a great post about self-control in general.

Any chance you could PLEEEEASE add an email subscription option? I never get around to reading my RSS feeds, but always read my email notices.


Meerkatdon said...

I had one of those foot ulcers, and ultimately had to have my big toe amputated. Three weeks in the hospital, two months flat on my back at home, and I'm still in pain a year and a half afterward.

Now I have insulin, and a good diet & exercise routine, and I'm keeping my blood sugar strictly under control. Take it from me, it's definitely worth the effort!

Ian Mackereth said...

A sensible post!

I know what I'm like, so I treat myself like a recovering alcoholic, and just choose to not make that first teeny exception to my low-carb, no sugar/starch regimen.

I also allow myself three "carb-free free" days a year: my birthday, our wedding aniversary and Boxing Day (26DEC), where I eat whatever I like.
They're good relief valves and, after the first couple, I found that my habits had really sunk in and I didn't need to binge the way I used to!

It's still nice to have a bit of chocolate, and white bread, and potato crisps on these days, but not family blocks, whole loaves or mega-packs!

Anne said...

First I found out that I have non-celiac gluten sensitivity. That did not really dampen holiday foods as I could still make all the wonderful traditional goodies gluten free. Then I discovered carbs put my blood glucose over 200.

I cannot take a holiday from eating gluten free without getting ill and I don't like how I feel when my blood glucose goes over 160. It is not worth it for me to go off diet. There is little joy in holiday foods now, but I have great joy and am thankful for my good health.

Five years ago I thought I was dying. The changes in my health have been miraculous and I did it through diet. Yes, my diet is restricted, but it is also freeing. It frees me from the many health problems I once had and hopefully it will keep me from developing complications in the future.

No day off for me.

Trinkwasser said...

My fingers and toes start to tweak around 140 - 150 and if I hit 180 - 200 I become almost comatose so I have every reason to be careful. I hate to sound like K*rt but I've found as long as I portion control stuff fairly carefully and then go for a brisk walk immediately - while my BG is still going up and I am still generating insulin - I can bang down a spike before it happens quite effectively. I don't recommend this as a general course of action but for the occasional (seasonal) blowout it seems to work, though it still leaves the carbs beget more carbs cravings in place. Red wine also helps (cheers) exercise *after* a spike doesn't have such a profound effect, I suspect a combination of muscle use and the highest insulin levels I am capable of generating puts the GLUT 4 receptors into turbo mode. Whether you can emulate this with injected insulin and whether it works in the absence of IR I can't say.

Season's greetings (chomp glug walk)

Jenny said...


When I was controlling only with a very low carb diet and my glycogen was depleted, I could drive my blood sugar low with a prolonged stint on the treadmill set fast and steep. But now that I eat enough carbs that my glycogen is not depleted exercise doesn't make much of a difference in my blood sugars.

OTOH, I have so much trouble with tendons that I avoid intense exercise because every time I push even walking to the brisk level that has benefits, I also manage to tear something in my foot that limits what I can do for weeks afterwards. VERY frustrating.

The tendon problems are the one big probably blood sugar related complication I have, and they really stink. Unfortunately, they are linked with pre-diabetic blood sugar levels and I have had those all my life.

Fortunately, they do heal up, it just takes forever. I was walking 30-40 minutes up hills almost every day this spring and summer and was in great shape until something on the top of my foot went . . . .

Anonymous said...

Not being able to do intense exercises is a bummer, actually worse than that. All the more reason for early diagnosis of BG problems. Intense exercise, and not a lot of it, does good things to the body. 5 minutes a couple times a week is enough. I have several friends who cannot. RobLL

Trinkwasser said...

Just goes to show I suppose how different we can be while still diagnosed with the "same" disease. My tweaking skills work well when applied to my system, last three months numbers have nothing under 70 and two over 120. I'm waiting to see what dort of disaster Christmas is.

I'm with you on the tendons though, mine stand up to normal use but I have been a martyr to not-quite frozen shoulder and not-quite carpal tunnel many times, usually set off by RSI-type events rather than a single stress, and it was only a slightly awkward landing when parachute jumping that tore a tendon in my ankle which took over a year to heal and still over 20 years later leaves me a bit wobbly on one foot.

Like everything else these connective tissue events seem to be much less common now than they used to be but like you they were certainly occurring with "not diabetic yet" BG levels. Apart from tight control which you're already doing I don't know what to suggest that might help, sorry.

Nicky said...

Jenny, do you think your tendon probs are mainly bg related, or linked to cortisol levels? I'm reading around cortisol atm because I suspect that, having gotten insulin resistance under control, it's cortisol that's causing my current tendon issues. The secret to avoiding making things worse seems to be exercise little and often...


Jenny said...


I don't know enough about cortisol to comment intelligently on that. I know that there is solid research linking tendon problems with blood sugars in the pre-diabetic range, and I had those blood sugars all my life, so it seems very likely that they could have weakened the tendons. I have had tendon problems going back to the 1980s.

I have not been evaluated for cortisol problems, but I don't have any of the symptoms associated with that.