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Grazia Aleppo, MD, FACE, FACP Associate Professor of Medicine

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1 Grazia Aleppo, MD, FACE, FACP Associate Professor of Medicine
Diabetes And The Holidays: Practical Tips To Help Managing Your Diabetes And Keep Healthy! Grazia Aleppo, MD, FACE, FACP Associate Professor of Medicine

2 It’s the most wonderful time of the year….
…BUT, holidays can be also be the most stressful! 'Tis the season for shopping, decorating, parties, and cooking. Tempting treats are everywhere…

3 Exercise plans are put on the back burner...
For anyone, these are the ingredients for diet disaster For some, another problem is added to the mix: Diabetes


5 Diabetes Is a disease that results in high levels of sugar (glucose) in the blood Diabetes type 1, usually in children, almost total lack of insulin production Diabetes type 2, usually in adults, both insulin resistance and decreased levels of insulin

6 Holidays= especially tricky time of year to manage health with diabetes Even though you can take a holiday, diabetes never does! With some careful planning and smart choices, anyone can have holidays that are both happy and healthy!


8 Planning Ahead Look at your schedules!
Are you going out of town with your family? Having visitors stay with you? Do your plans usually include a lot of parties and food-oriented events? Are your holidays more active? Is the most important thing about managing diabetes during the holiday

9 Tips To Get A Good Start Just like everything else with diabetes, you have to take a few extra steps Put yourself at the top of your list Be aware of challenging environments , i.e. travel, parties, big meals, snack foods at the office and drinking

10 Make a “Healthy Eating Contract”
Focus on friends and family instead of food The holidays are a time to slow down and catch up with your loved ones Monitor your blood glucose level and don't skip meals Be positive. YOU control your diabetes; it doesn't control you


12 Exercise Stay active, follow a regular exercise routine to help regulate metabolism Try 10- or 15- minute brisk walks at intervals throughout the day; they all add up Start a game of pick-up football or play other games in the yard The holidays are busy, but plan time into each day for exercise and don’t break your routine. Make the holidays an active time!

13 Go for a walk with your loved ones after eating a holiday dinner
Offer to help clean up after a meal instead of sitting in front of leftover food or the TV! This will help you avoid  snacking and get you moving around

14 Few More Tips On Exercise
Walk Park your car at the far end of the lot Power walk while shopping the mall Take a twilight stroll around your neighborhood to admire the holiday lights Try a seasonal activity Snow shoe Ski Build a snowman

15 Planning A Meal with Diabetes During The Holidays

16 Menus Do you have traditional dishes that you make every year?
You may need to fine-tune the menu a bit because of diabetes, but not totally There are some ways for making your traditional holiday foods a bit healthier

17 Revising Recipes Steam the green beans instead of sautéing them in butter Lower the amount of fat, sugar, and carbohydrate in your favorite foods while keeping taste and texture Replace sugar (up to half)in dessert recipes with a sugar substitute Increase the use of cinnamon, nutmeg, vanilla, and other sweet-tasting spices and flavorings ; use applesauce or baby-food prunes when making chocolate brownies, cakes, or cookies

18 Example Of Holiday Meal

19 Are You Hosting A Dinner?
Make sure the menu includes fruits, vegetables and lean meats Baking, broiling and barbequing are good methods for cooking meats such as turkey Avoid frying or adding extra fat during cooking

20 Avoid sampling the foods while cooking more than necessary
Calories may add up with “just tasting”… Clear the table and put unused food away to help guests avoid grazing

21 Family Members With Diabetes
Extra treats and late meals that can alter blood sugar levels of your loved ones with Diabetes Ask your guest with diabetes if he/she must eat within a certain window of time If so, plan on serving food at that time, and let the rest of the celebration fall around the meal


23 Find out if there are foods that must be avoided
Find out if there are foods that must be avoided. Add alternate choice without removing a favorite dish from the menu Offer your guest a private spot to test blood sugar or to inject insulin Find out what your guest uses to treat a low blood sugar (juice or fruit), stock some, just in case Stick to the planned timetable. If your meal is later than anticipated, tell your guest, so insulin adjustments can be made or provide a snack to keep blood sugar steady


25 You Are Invited To A Holiday Meal
Eat breakfast or snacks earlier in the day “Saving carbs” for the big feast later on does not work! Do not skip meals, blood sugar mar be more unstable Eat before you eat. If you arrive hungry, you will be more likely to overeat! Eat a small meal or snack before you leave home

26 Bring what you like. Don't worry about what will be served
Consider a vegetable-based dish that contains little or no carbohydrate Study ALL of the food options, and think (!) what you are going to have before you put anything on your plate Decide which foods are worth eating and which can be ignored Offer to bring your favorite diabetes-friendly dish. If you count carbs, check your recipe’s nutrition facts so you know how big a serving is and how many carbs it has. and definitely avoid eating them straight from the bag. Put some on a small plate and don’t load them down with creamy mayo-based dips.

27 If the meal is at your usual meal time, try to eat the same amount of carbohydrate you normally would for a meal Limit the number of servings of starchy foods on your plate, choose one item or take a few spoonfuls or bites of each Choose vegetables first. Broccoli, baby carrots, cauliflower and tomatoes are good choices. Go easy on the dip or skip it! Avoid vegetables in creams, gravies and butter

28 If you taste something that you don’t enjoy, leave it on your plate—don’t finish it!
Eat chips and crackers in moderation Take small portions of holiday treats, eat slowly, and savor the taste and texture


30 Focus On The Fun, Not The Feast
Eat slowly, and enjoy the foods that you may only have once a year Make sure your portions are reasonable and resist going back for second helpings! Focus on socializing instead of eating, enjoying the entertainment than worrying about what’s on your plate After your meal, take a walk with family and friends

31 Alcohol And Diabetes: How To Accomplish “Healthy Drinking”

32 What Do I Drink With My Meal?
Sip a large glass of water or mineral water, it keeps you hydrated and is a better option than alcohol Stick to calorie-free drinks such as water, tea, seltzer, or diet sodas instead of punch or mixed drinks Drink in moderation! If you drink alcohol, eat something beforehand to prevent low blood glucose levels later  Holiday drinks can add a significant amount of calories to your holiday intake

33 What Is Allowed: Women should drink no more than one alcoholic beverage a day and men should drink no more than two A DRINK IS: 12 fluid ounces (fl oz) of beer 5 fl oz of wine 1½ fl oz of 80-proof distilled spirits 1 fl oz of 100-proof distilled spirits

34 Fitting in Sweets Dessert, one of the most
tempting part of the holidays… Decide ahead of time what/how much you will eat and how you will handle social pressure ("No thank you, I'm too full.") Most sweets have a lot of carbohydrate in a small portion, so keep portion sizes small

35 Substitute small portions of these sweets for other carbohydrate already in your meal plan
Share one portion of dessert with someone else, and scrape off whipped-cream topping or extra frosting Volunteer to bring your favorite dessert to social functions. Some ideas are plain cookies, baked apples, or sugar-free puddings

36 Oops, I ate too much…. Don’t beat yourself up! Make a plan to get back on track Stop eating for the night, focus on the people around you The next day, exercise, monitor your BG, and get back on track with your usual eating habits!

37 Holiday Stress and Diabetes

38 The holidays can be a very busy and stressful time of year
With stress, blood glucose may increase Try to simplify this holiday season Avoid taking on extra duties or extra cooking for holiday events Focus on spending time with people! (think less about food and gifts…)

39 How To Beat Stress During The Holidays
Plan your gift-giving list and shop before Thanksgiving to beat the crowds Save time! Shop online or from catalogs Don't always cook from scratch Say no! You don't have to accept every holiday invitation Find some quiet time for yourself every day Listen to favorite carols, have some hot tea or just sit and watch the snowfall

40 Stay organized and do things ahead of time
Plan diabetes-friendly meals in advance Make a plan so you know how to deal with the pressure of indulging in holiday food. Exercise! It helps stress AND blood glucose

41 Traveling With Diabetes During The Holidays

42 Tips for Travelers Diabetes travels with you!
Get your diabetes scripts refilled before you go Get an influenza vaccination before traveling Take enough medicines and supplies for the entire trip; better yet, take extras!

43 Always wear medical identification, i.e. a bracelet
Monitor blood sugars regularly Remember your basic rules of foot care: Don't wear new shoes on vacation since you may get blisters Never go barefoot Check your feet daily and take care of any cuts or blisters immediately


45 Air Travel Carry all medicines and equipment with you on the plane!
Tell the flight attendant or someone you travel with that you have diabetes Drink plenty of non-alcoholic, caffeine-free beverages throughout the flight Because of increased security at airports, get a Diabetes travel letter from your doctor Bring the original containers, as they usually have a label and pharmacy instructions Get up and move around every one to two hours to increase comfort and reduce risk for blood clots . Suitcases stored in cargo holds may get very hot or cold

46 Smart Checklist For The Diabetic Traveler
Prescription medicines (insulin, pills) for diabetes and other medical conditions Pack twice amount of supplies in case of travel delays in carry-on Keep your insulin cool with insulated bag with refrigerated gel packs Bring two blood glucose monitoring devices with extra batteries Pack syringes, lancets, and test strips Health insurance card and emergency phone numbers, including your doctor's name and phone number Glucagon emergency kit in case of hypoglycemia Med- alert bracelet or Diabetes identification Fast acting sugar such as glucose tablets/gel or candy Complex carbohydrates (crackers, granola bar, trail mix) in case meals are delayed Keep time zone changes in mind For insulin pump users: pump supplies, extra batteries, insulin and syringes in case of pump failure If you're flying and do not want to walk through the metal detector with your insulin pump, tell a security officer that you are wearing an insulin pump and ask them to visually inspect the pump and do a full-body pat-down


48 References


50 Thank You!

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