Whatever type of diabetes someone may have it can affect your enjoyment of special occassions like Christmas. The typical things people tend to do over the special season, like eating more, exercising less, and even drinking a lot of alcohol (at New Year as well as Christmas) can all have a drastic affect on the body of a diabetic. Because of this, it’s important to keep a few things in mind when planning your Christmas activities, and to keep some of these ideas in mind to make sure that if things don’t go according to plan, you still know what to do.
I have always adored Christmas from a very young age, but after developing type 1 diabetes, the holiday always felt a struggle. I wanted to eat a lot more during my teenage years (comfort eating became a problem of mine as the years went on) and having a range of selection boxes with sweets only made my diabetes worse. Added to that the effects that stress and even extreme laughter had on my body made me aware of exactly how difficult it can be to keep your blood sugars steady, without knowing a few things. It wasn’t until a DAFNE (Dose Adjustment For Normal Eating) course some years later that I finally understood how to take care of things during Christmas, so here are a few of my tips for anyone who has diabetes, especially those of you who treat yourselves with insulin (the first few tips are more obvious ones. Tip 9 is important for non-diabetics to know too!):
1. Keep track of what you eat
When it comes to eating at Christmas, the majority of us tend to overeat. There’s nothing wrong with indulging yourself once in a while, but without keeping track of what you’re consuming and making sure to inject the right amount of insulin (if you inject insulin) things can quickly spiral out of control. It’s never fun to keep an eye on what you eat, and trust me, on more than one occassion I’ve been to a party and completely forgotten how much I’ve eaten, but keeping track either via an old-fashioned notepad and pen, on your blood testing meter or an app on your phone (a notepad app is enough or a more dedicated diabetes app if you want) can really make a difference to your blood sugar when it comes to injecting.
2. Make sure you inject the right amount
Sometimes in the excitement of a party or celebration it’s easy to forget to inject or not keep tabs on how much we inject, but if you take insulin then it’s important to keep a rough idea of how much you’ve done and if you are planning to eat more then inject accordingly. I can’t give exact advice on how much to inject as I am not a doctor and don’t know your individual insulin-to-food ratio but most people on insulin should have this information (especially if you’ve gone on a DAFNE course) or ask your doctor about how much extra to inject per each carbohydrate if you plan to eat more.
3. What to do if you’ve overeaten
If you find yourself eating much more than you expected then there are two options to lower your blood sugar, you can inject more insulin (but as I said this must be done with doctor’s guidance or knowledge of a DAFNE style course). Your other option is one which you may not like at first but it can quickly become something you enjoy which is exercise…Okay, okay, I’m sure plenty of you just read that line and thought “exercise!?” But exercise doesn’t have to mean working out and sweating when you’re feeling stuffed. It can be as simple as going for a walk a little while after eating which can really do wonders for your blood sugar.
When I was diagnosed with type 1 diabetes at the age of nine, I sometimes had an elevated blood sugar before lunch, my doctor’s advice was to take a walk around the hospital grounds and just 30 minutes of slow walking in the outdoors brought my blood sugars to a perfect level. 🙂 The same can really help, especially in December when it’s colder, as colder weather can motivate you into walking more briskly which can help you too, and getting out into the fresh air (even if it’s cold) can really clear your head too.
Hypoing – Extremely low blood sugar:
4. How to treat a hypo
Having a hypo or hypoglycaemic attack can happen to any diabetic on insulin (whether type 1 or type 2) at any time, even at Christmas and while it’s important to know what caused it (to stop it from happening again) the first and most important thing to do is treat the hypo. While hypos feel terrible and you usually feel like you want to eat everything you can get your hands on, you shouldn’t over eat on a hypo and instead stick to around 20g of fast-acting carbohydrates (sometimes called 2 CPS-carbohydrate portions, or in the old days 2 exchanges).
What are fast-acting carbs? Things like a glass of orange juice, sweet drinks like lucozade – it used to be two-thirds of a glass (but check the labels as many manufacturers are now reducing the amount of sugar so you may need more). Around 3ish glucose tablets, (even pure sugar cubes or on a spoon if you’re able to eat that! – again check how much makes up 20g carbs). Other juices like apple, pineapple and grape work well too (grapefruit not so much). Anything that is pure sugar with no fat will fix a hypo fast.
Why not chocolate?
I’ve seen some diabetic leaflets recommend chocolate for treating a mild hypo, but this advice is bad and I’ll tell you why…While fast-acting carbs get absorbed into the blood stream really fast (they literally go through your stomach and straight into the blood stream within 5-10 minutes) anything else with any fat in it which includes, bread, cakes, biscuits, chocolate, etc. won’t break down so quickly. The fat in chocolate and other things keeps the body from absorbing the sugar for a while, this means that while waiting for the hypo to be treated, your blood sugar is falling still, and you body is falling futher and futher towards a severe hypo. I’ve felt this happen when I’ve observed trying to eat chocolate during a hypo (which I always used to do before I was taught properly) and I was aware of how much worse I felt and one time I nearly passed out through waiting so long
At the DAFNE course I was taught that chocolate is not advised for hypos and through my own experimentation on my own body (seriously don’t experient on yourself like I did, it felt terrible) I’ve noticed that fast-acting carbs work within 10 minutes whereas slower carbs don’t. It’s often a lot longer before I feel relief from the hypo treated with slow-acting carbs and by then I’ve started to lose a sense of hearing and in one case (as I said above) everything started to go grey in my vision and I nearly passed out! 😮 😦
So stick to fast-acting carbs to treat a hypo…and make sure to keep testing your blood sugar if you feel at all strange.
5. What causes hypos at Christmas?
Injecting too much/too soon – Sometimes you can inject your insulin expecting Christmas dinner to be ready within a set time, but if you’re not eating by the time the insulin is really circulating throughout your bloodstream, it can cause you to hypo. If for any reason your food isn’t ready on time then make sure to get some kind of carbs into your body. Don’t over-do it but make sure to begin eating something or keep checking your blood sugar and if you notice it heading south fast or you feel a little woozy and you know it’s an early warning of lowering blood sugar then make sure to eat anything with carbs to keep yourself from having a full hypo. Also keep tabs of what you ate.
To avoid this from happening again, in unpredictable situations like this when you don’t know if dinner will be on time, wait until you’ve a plate in front of you before injecting.
The cold air – If you decide to go outdoors and enjoy the cold weather then make sure to remember that shivering in the cold can bring on a hypo. Shivering really makes the body respond a little like exercise does, it makes your entire body move so it can bring about a hypo in the same way that mild exercise can. Keep track of your blood sugar levels and if you plan to spend a long time outdoors and feel yourself shivering then make sure to keep some carbs with you, you may need them.
Excitement/fun/laughter – Believe it or not, having fun and getting really excited about something and laughing can bring on a hypo. There are two reasons for this: The first is that you may be having so much fun you just don’t realise the time and don’t stick to your mealtimes.
The second reason is similar to shivering and one I’ve personally found affected me whatever time of year – whenever I’d laugh, especially for a prolonged time, I’d hypo. The movement of your body when you laugh can actually burn some calories so like very mild exercise it can bring on a hypo if you aren’t prepared. Again keep tabs on your blood sugar and if you feel a little off, check it , and if need be eat a little extra.
6. Alcohol lowers blood sugar
A lot of people like to drink alcohol during this time of year and there is nothing wrong with enjoying yourself in moderation, but it’s important to recognise what happens if you do. Alcohol can act like insulin in the blood, it lowers your blood sugar which can lead to hypos. I don’t know how much alcohol you need to consume in order to have a hypo (everyone’s body is individual) but make sure to keep aware of your own blood sugar when you’re drinking, especially if you plan to drink alcohol without eating. Eating something beforehand is a good way of stopping yourself from hypoing, especially if you plan to drink a lot. Reducing your insulin if you have been on a course like DAFNE that teaches you how to do this, can also be a solution to alcohol-induced hypos, although by how much you reduce insulin should be decided by your doctor and your own individual experiences with this.
7. Be aware of Beer (& ales & maybe other types of very sweet alcohol)
I don’t drink beer (I don’t drink alcohol either to be honest) and all of the following information comes from the course I learned, but it’s not often mentioned so I wanted to share it here in case this may be important to you:
Beer is different to other alcohol, or maybe certain types of sweet alcohol or cocktails are different because of how heavily they are sweetened. Although the effects of all alcohol lower your blood sugar, beer and other sweetened drinks can seem to have the opposite effect in the short term. Apparently (according to the nurses on the course I went on) the sugar in such drinks at first spikes your blood sugar so you may feel your blood sugar rising rather than falling. Whether this should be treated with additional insulin was unclear (there was a suggestion that you should but then you had to be extra careful and eat too – so as I said, unclear), but if you do treat it be aware that after a while, the lowering effects of alcohol will kick in sending you towards a hypo if you don’t eat. While I can’t offer any personal advice on what to do, please keep this in mind and the best thing you can do is get to know your own body and keep testing your blood sugar levels when you go drinking alcohol.
8. Alcohol can impair your judgement
Alcohol can have a severe affect on your judgement which means that you might think you are fine when in fact you are not. Being just a little drunk or tipsy could cause you to not feel your blood sugar going low or high and could lead you to make silly mistakes such as eating too much/too little and even injecting the wrong amount.
Without drinking alcohol I’ve made some really daft mistakes in my injections during a party (including trying to inject a long-acting insulin instead of a short-acting one 😮 ) so with the added bonus of alcohol in the system, it’s important to be aware that you may not make sound decisions around your diabetes if you get too drunk. The only advice I could give is to try to have a friend with you who knows about your diabetes and who can help you if you need it, but again make sure they are reliable and that they aren’t drinking too much themselves or they might not be able to help.
One important factor to add is that to help you avoid a lot of problems with alcohol is to eat while drinking. If you eat something with carbs, you are helping to counter the effects (although I can’t say by how much). Plus when there’s food in the stomach along with the alcohol, the effects of the alcohol are never as severe.
Important to remember:
9. WARNING: Hypos can look like drunkeness (A warning and advice to those without diabetes too)
Please be aware that if you are among people you don’t know or who don’t know about your diabetes, you might seem drunk to them when in actual fact you are having a hypo. Hypos make it difficult to concentrate, they can make you sweat, stumble and collapse onto the floor. In more severe hypos you can even start to slur words when talking and have no idea what people are saying. All of these symptoms can appear to other people as someone being drunk which can cause problems if you need help treating your hypo!
If you appear drunk, others may not want to help you or may dismiss your behaviour as being drunk. So MAKE SURE that someone that’s with you knows about your diabetes. Make sure that the person who knows IS reliable and that theyKNOW how to treat your hypo if you need any help. It may feel difficult at first to tell someone, especially if you don’t want to appear vulnerable or if you don’t know the people you are with very well, but if you plan to go out or visit with people you don’t know (and especially if you plan to drink a lot of alcohol) you should make sure that someone knows. If you can’t do this then try getting hold of a medical bracelet which can also be of help if an ambulane is called.
Don’t worry – I’m not trying to scare you, if you are sensible and careful then you can really enjoy yourself at Christmas, but just be aware of how important it is for you to have someone who knows about your condition, especially if you are someone who doesn’t feel their hypos coming on. Check your blood sugars often and eating some carbs while you drink can also help you to avoid getting into a hypo in the first place.
10. Depression at Christmas
Depression affecting diabetes – Sometimes we can feel depressed at Christmas. Not all of us have reasons to be happy and for many Christmas can unfortunately bring up bad memories or just an overall feeling of sadness from the dark and cold days. Depression can have an affect on blood sugars though and usually the affect is of making them go higher. Although it’s the last thing anyone wants to do, if you are feeling depressed, please try to at least test your blood sugar and keep an eye on where it is. It’s hard to want to do anything when you are depressed, especially as it can bring on a sense of fatigue, listlessness and a general feeling of: ‘What’s the point?’, but days of depression don’t last forever, and I can say, as someone who was so depressed in their past that I didn’t want to live at some point (it’s true 😦 ),…it won’t last forever. 🙂
The depression messes with how we should be feeling and if you are severely depressed then please try to remember that it’s the illness of depression that brings on strange thoughts and feelings and not really you. On a good day you’ll see that the illness is what takes hold and we still should take care of ourselves when we are depressed.
Depression caused by diabetes – Sometimes diabetes can feel like too much. You never get a break, you can’t go away and have a holiday away from the disease and diabetes is always there affecting your everyday life, even at Christmas time. It’s easy to become depressed because of diabetes, and there’s nothing wrong with having a a bit of a blip and wanting to pig-out or ignore the injections and blood testing. But it’s important to remember that we should try to keep our blood sugars as level as possible. If you’ve become severely depressed by your diabetes though, don’t be hard on yourself if your blood sugars are messed up, or if you did take a ‘day off’ and not injected or you over ate (believe me, you wouldn’t be the first to do any of these!).
As much as this can be terrible for diabetics to do, I know it does happen and it’s far worse to beat yourself up about it than it is to get back on track and start injecting and doing blood tests again. So please don’t feel bad if your diabetes is messed up. Take time for yourself, do something to make you smile and happy and if you need to talk to someone there are plently of people online who can be there and you can always contact me too via my contact page or email address on there if you’re feeling depressed ❤
A final message:
Diabetes isn’t meant to stop you enjoying Christmas, but it’s good to be aware of what can happen during this time. So please be aware in the lead up to Christmas and make sure that you know what could occur and how to fix it so you can enjoy the day as much as possible 🙂 🙂 ❤ ❤
-All advice given above comes from my own personal experience. I am NOT a trained doctor so please seek official medical advice before attempting to change your insuline regime or for clarification on any of the above.
Are you affected by diabetes at Christmas? What other medical conditions do you have that might affect your Christmas? What worries or concerns do you have leading up to the Christmas season? Let me know what you think in the comments below 🙂