Christmas is a time for celebration and over-indulging which can make managing diabetes over the festive season a little more difficult. It can be easy to be tempted by foods high in salt, sugar and fat content and whilst it is important to stick to a healthy, balanced diet there’s no need to miss out completely. With a little planning and our tips below, you can still make the most of this wonderful time of year.
Everyone’s diabetes is different, so it’s important to follow the plan agreed with your diabetes team and never change your medication without medical advice. The tips below are general guidance to help you think ahead and stay as safe as possible over the festive period.
Before the festivities begin, a little logistics planning goes a long way. Remember that pharmacies and GP surgeries often close for extended periods over Christmas and New Year. Check your supplies of insulin, test strips, and needles at least two weeks in advance to avoid a last-minute panic.
It’s also smart to carry extra hypo treatments (like jelly babies or glucose tabs) in your pocket, as holiday shopping and parties might burn energy faster than usual.
If you use insulin or tablets that can cause hypos, ask your diabetes team in advance how to adjust your doses if you are eating more, eating at different times, or drinking alcohol. Having a plan before things get busy can make it much easier to stay in range and avoid both highs and lows.
If Christmas dinner is running a little late it can lead to a longer period of hunger which could cause you to overeat once dinner is served. It’s a good idea to have a small, pre-meal snack. Something with plenty of protein is a good choice as it will curb the hunger pangs and will break down slowly.
Try drinking a glass of water before your meal. This can help you feel full more quickly and may reduce your appetite, which in turn can help with blood glucose control. If you take insulin or certain diabetes tablets, remember that you may still need to match any carbohydrates in your snack with your usual medication, so follow the advice given by your diabetes team.
When you are facing a buffet and don't know the carb counts, use the "Plate Method" to keep things simple: Fill half your plate with non-starchy vegetables (sprouts, carrots, salad), one quarter with protein (turkey), and one quarter with carbs (roasties, parsnips, stuffing). This naturally controls blood sugar without complex counting.
If you usually count carbohydrates and adjust your insulin, you can still use the Plate Method as a visual guide, then estimate the carbs for the quarter of your plate that contains starchy foods. This can be helpful when exact carb information is not available.
There are so many low fat and low calorie options to choose from that it should be easy to find an alternative without compromising the taste of Christmas dinner staples:
Traditional Christmas foods like roast potatoes, Yorkshire puddings and pigs in blankets can be higher in fat as well as carbohydrate. Fat can slow down digestion and cause your blood glucose to rise later than usual. If you use an insulin pump or adjust your rapid-acting insulin doses, speak to your diabetes team about whether split or extended boluses might be helpful for you with these types of meals.
Puddings at Christmas can be really tempting. It’s ok to have pudding, it is Christmas after all but it’s best to stick to the one and keep the portion a sensible size. Sweet foods are absorbed very quickly and it’s probably a good idea to eat slowly and savour every mouthful.
If you take insulin with meals, try to count or estimate the carbohydrates in your dessert as best you can and match it with your usual mealtime insulin, following your individual ratios. If you are on a fixed-dose regimen, talk to your diabetes team in advance about how to handle occasional treats so you can enjoy them as safely as possible.
Alcohol contains a high amount of calories and mixers can be high in sugar content so it’s definitely something to be aware of. It’s a good idea to alternate between alcoholic and soft drinks to limit the amount of alcohol consumed. Choose sugar free or diet soft drinks and opt for those as mixers too, and be aware that some festive drinks such as mulled wine, creamy liqueurs and sweet cocktails can be very high in sugar and may raise your blood glucose quickly.
Those who are dependent on insulin should be aware that alcohol can lower your blood glucose levels for several hours after drinking, including overnight, which puts you more at risk of a hypo. Crucially, alcohol can sometimes mask the symptoms of a hypo (as feeling "woozy" can feel similar to being tipsy). Make sure the friends or family you are with know you have diabetes, recognise the signs of a hypo and know how to help if your blood glucose drops too low.
Don’t drink on an empty stomach as this can also decrease your blood glucose levels. Choose a protein based snack to slow down absorption and the effects of alcohol. You can also choose a starchy, slow release snack at bedtime such as toast, cereal or a sandwich.
It is also sensible to check your blood glucose (or scan your CGM) before going to bed after drinking. If your levels are on the lower side of your target range, speak to your diabetes team about whether you should reduce your usual night-time insulin dose and what sort of snack is best for you. Never ignore repeated hypos or very high readings after drinking; seek medical advice if you are unsure.
We often focus on food, but did you know excitement and stress release hormones like cortisol and adrenaline? These can raise blood sugar levels even if you haven't eaten anything sweet. Late nights and lack of sleep can also make your body more resistant to insulin.
Try to stick to your normal sleep routine where possible, and don't be afraid to take 10 minutes for yourself away from the noise if the festivities get overwhelming.
Yes Christmas should be about relaxing and snuggling on the sofa but it’s really important to stay active. This can help to manage your blood sugar levels, blood pressure and burn excess calories. Going for a brisk walk, even when it is cold, is a great physical activity. Wandering around the shopping centres and browsing the sales counts too. Get up, dance with the children or grandchildren or why not have a go at ice-skating.
It’s quite likely that at some point over the festive period you may find your blood glucose levels are higher than usual. Don’t panic, one or two higher readings won’t impact your overall control of your diabetes, but you should try to manage it so as not to compromise your overall health.
If you self-test it’s a good idea to do so more often (or scan your CGM sensor more frequently) so that you can monitor and manage any changes in your glycemic levels quickly and avoid a hypo (low glucose levels) or a hyper (high glucose levels). This could be especially important if you are driving to visit relatives.
Extra checks can be particularly useful before driving, before bed, and after larger meals or alcohol. If your readings are consistently higher or lower than your usual targets, contact your diabetes team for tailored advice rather than making major changes on your own.
Nothing has to be completely off limits, and everyone should be able to enjoy a treat or two and make the most of this special time of year, as long as it fits with the advice about your diabetes care routine. Being mindful about your food and alcohol intake is key but if you do stray a little, don’t be too hard on yourself. You can always start afresh tomorrow.
If you are looking to stock up on supplies, we offer a wide range of insulin needles and syringes that will help to administer insulin safely at home.
Sources:
https://www.diabetes.org.uk/guide-to-diabetes/enjoy-food/eating-with-diabetes/christmas-food-and-diabetes
https://www.bbcgoodfood.com/howto/guide/what-eat-christmas-if-you-have-diabetes
https://www.diabetes.co.uk/food/diabetes-and-christmas.html
https://www.diabetes.ie/christmas-diabetes/
https://diabetesfoodhub.org/blog/what-diabetes-plate
