The winter holiday season is a wonderful time to catch up with friends and family and venture out into the pristine landscape for a refreshing walk or spontaneous snowball fight.
Punctuated by big meals, special treats, and, for some, a lot of toasting with seasonal nog, it can be tricky for people with diabetes to navigate. For some people with diabetes, colder temperatures can mean higher blood sugar. With winter weather keeping us inside, we tend to exercise less and eat more.
According to Dr. Rushika Conroy, endocrinologist at Baystate Children's Hospital, “With some advanced planning and preparation, you can enjoy the season without compromising your blood sugar goals or putting your health at risk. It just takes a little forethought and common sense.”
Be a party smartie
If you are going to a small family or friend gathering, be sure that you know everyone is fully vaccinated. Beyond the COVID-19 safety basics, Conroy advises watching out for sugar-rich foods.
Conroy notes, “Nobody wants to go to a party where they can’t eat the cake. With the right planning, you can have your share of good holiday eats.”
If you are going to be around a lot of rich holiday foods, she advises the following:
- Don’t arrive hungry. Eat a healthy snack in advance to keep your appetite in check.
- Bring a dish that’s low in carbs, fats, and calories. This way, if the other options are limited, you’ll still have something to eat and enjoy.
- Check your sugars and bring your medication. If you are enjoying holiday treats, be sure to check your sugar often and keep your numbers in check.
When filling your plate at holiday meals, aim to fill half your plate with fruits and non-starchy vegetables. The other half should be a 50/50 combination, with one half being your protein and the other a combination of grains and starchy vegetables (potatoes, sweet potatoes, and squash).
Raise a glass wisely (if at all)
Toasting to the holidays is a time-honored tradition but for people with diabetes, it comes with risks.
Alcohol immediately raises sugar levels in your blood but it can later lower them to dangerous levels. In addition, it can interact badly with certain diabetes medications, most notably sulfonylureas.
If you choose to drink, be smart and always eat when you drink to keep sugar levels in check. Be sure to check your sugar levels frequently when drinking and consider having a small snack before bedtime to reduce low sugar risks while you sleep.
Dr. Conroy notes, “It’s also important to choose your drink wisely. As a rule of thumb, light or low-carb beers are a better choice than wine, and wine is a better choice than liquor. Avoid sugary drinks, liqueurs or any drinks mixed with sugary sodas.”
Stay active, stay safe
Exercise is an important part of managing diabetes. “It’s easy during winter months to just want to curl up with a warm blanket and stay put,” says Conroy, “but when you exercise regularly, your cells become more sensitive to insulin so it works more effectively.”
Dr. Conroy advises patients to do anything to keep moving. “Aim for 150 minutes a movement a week,” she says, “That includes doing chores, walking to get the mail, dancing, and, of course, exercise at home or at the gym. Check with your local library to see if they have exercise DVDs. It’s a fun and free way to try out different types of exercise in the comfort and privacy of your home."
Protect Your Feet
If you choose to exercise outdoors during the winter months, Dr. Conroy notes it’s important to protect your feet. “Poor circulation from diabetes can reduce the sensitivity in your feet,” she says. “It’s not uncommon for diabetes patients to end up with frost bitten toes simply because they didn’t realize how cold their feet had gotten.”
She encourages patients to wear moisture-wicking socks in cotton or wool when venturing outdoors. In addition, always wear the proper footwear for the activity. As she says, “Sneakers in snow will not cut it. If you plan to spend extended periods of time outdoors in the winter, invest in good boots with a thick insulating sole.”
When coming in from the cold, she cautions patients against warming their feet on a radiator, close to a fire, or with a heating pad. “That same lack of sensitivity that can lead to frost bite can also lead to severe burns.”
In addition, be sure to examine your feet daily and keep them moisturized. Diabetes contributes to dry skin of the feet. Dry, cracked skin can lead to infection that can be hard to knock out if your circulation is poor.
If you’re traveling over the holidays or any time during the winter months, be especially careful transporting insulin and glucose test strips.
Insulin should never be stored below 36 degrees F. For that reason, don’t leave insulin your car when temperatures drop. Similarly, glucose strips should not be kept below 45 degrees F. If you’re planning to ski or outdoors for long stretches of time, keep your strips in an inside pocket where they can absorb some body heat.
Mind your mood
Research shows that people with diabetes are 2 to 3 times more likely to have depression than people without diabetes. Things get even more complicated as some of the behaviors associated with depression—poor sleep habits, overeating or not eating enough, lack of focus, and withdrawing from activities and socialization—make managing diabetes difficult. And when diabetes management gets difficult, people tend to get depressed. It’s a vicious cycle in which two serious conditions fuel each other.
Things get even further complicated in the winter months when daylight hours are in short supply. Seasonal Affected Disorder (SAD) is a very real condition experienced by 1 in 20 people and its symptoms mirror depression in many ways.
The good news is that treatment for depression and SAD can be very effective. Speak to your doctor about treatment options including therapy, medicine, or both.
In addition, push yourself to stay active and engaged. Exercise actually produces “happy hormones” that can boost your mood. Make a point to spend time with other people.
Confiding in a trusted family member or friend can be a good way to reduce stress and cope with the challenge of managing both your diabetes and depression.
Talk to an Endocrinologist
If you have questions or concerns about managing your diabetes over the holidays and winter months, reach out to your doctor for advice. Learn more or contact Baystate Endocrinology & Diabetes at 413-794-7031.