what's hot

december 2003

Every year we receive many e-mails concerning how to prepare the comfort foods of the holidays, asking if people with diabetes can drink; and e-mails from worried spouses and parents concerned about blood glucose levels which worsen under the added stress of the holidays. Without stopping to talk, we will begin because we have a great deal of information to share with you.

Eating during the holidays Before you attend a party, why not think about the foods that make your knees and will power weak ... For some years we have stressed that surprises when trying to control your world can be bad, so do think ahead and have a plan. You know what they serve at the company party or at cocktail parties. Now, look at how a taste of it will fit into your diet. Are you under control? Trying a favorite that is high in carbohydrates when your blood glucose levels are high is not a good idea. Take your blood glucose levels frequently so you know exactly how you are doing. Holiday days can be very busy with work, shopping, cooking, parties etc. Take time to make sure you have healthy snacks and meals that you can take in the car or to work. Remember that a healthy snack before a heavy meal can curb your appetite and help you eat less. Before you pile your plate high with foods, peruse the buffet table or dining room table, and select only those foods that are on your diet. These may include the skinless turkey rather than a turkey wing, fresh vegetables without the cheese sauce, and fresh fruit wedges rather than sugar sweetened cranberry sauce. Change your recipes. For example if you love sweet potato pie, recycle the potatoes by reducing the fat, adding only egg whites or egg substitute, and by all means add the spices. Use a non-caloric sweetener instead of sugar. Bake as a soufflé and enjoy. You have saved the carbohydrate and fat of a pie crust, but you retain the wonderful taste of the filling. Add new vegetables and dishes at parties and holiday meals. Make sure that there are vegetables that you can eat, like oven-roasted vegetables with a splash of balsamic vinegar. Look at our vegetable recipes for many ideas. Make a sugar free cranberry sauce or chutney, so you and anyone on a diet can enjoy the turkey or ham served. Remember, you do not have to taste every ham that is served this holiday. You already know what it tastes like. What ever you do, reread the size of portions that we have on the site. You can use those that use hand parts, (see our article on estimating portion size in the August, 2000 'cooking tips') so that you always have a measuring tool. If you know how much to eat and are serious about not gaining weight or raising your blood glucose levels, you can enjoy tastes of many foods on the table. Look for foods that are high in fiber at the party. When you go out, suggest seafood restaurants, and SHARE. In the past we have suggested ordering an appetizer and salad or ordering a salad and sharing a main course. We still do. Finally, keep exercising. No one gets a holiday from keeping one's heart healthy and one's mood high. Alcohol and diabetes I can't tell you how many questions we get about drinking and diabetes especially from the newly diagnosed. Many people read a newspaper article that touts the benefits of moderate drinking to forestall type 2 diabetes, or others that espouse alcohol as a way of controlling diabetes. Let's look at the facts. Before you take a drink, please talk to your physician. Why? There are some oral agents and insulin which lower blood glucose levels, so if you do get the go ahead, never drink without having some food in your stomach. Alcohol can cause hypoglycemia itself, and this can happen right after you drink or up to 8-12 hours later. It is therefore very important for you to take your blood glucose level before you take that first sip of alcohol. You will also need to take your blood glucose level before you go to bed. Alcohol moves quickly through the body without being metabolized, so that within five minutes there's enough alcohol in your blood to be measured. Thirty to ninety minutes later the alcohol is at its highest level in your blood. It takes a 150 pound person about 2 hours to metabolize a beer or mixed drink in your liver. If you drink too quickly, the excess alcohol moves though your blood to other parts of the body. Brain cells become easy targets. The liver reacts to the toxic alcohol in your system and tries to clear it as soon as possible so it does not produce glucose to raise your blood glucose level. Remember that the symptoms of hypoglycemia are the same as being tipsy, so whenever you go out, wear some medical identification. You never want anyone to confuse low blood sugar and drunkenness. Alcohol has the ability to allow you to lose your resolve to keep healthy. As you sit with people at a party sipping wine, you may well eat things you shouldn't and/or in proportions that are too large. If your physician gives you the thumbs up, women should drink fewer than 1 or fewer alcoholic beverages a day. By the way, one drink equals 12 ounces beer, 5 ounces of wine or 1 1/2 ounces distilled spirits. Men should drink 2 ounces or fewer per day. If you drink alcohol at least two times a week, make sure you share this with your physician before you have any oral medication prescribed. Never drink if you do not have your blood glucose levels under control or if you have a medical condition that precludes you from drinking. Do not drink and omit a meal, but do know how to add blood sugar lost to alcohol in your meal plan. To keep safe, never drink quickly, rather sip your drink. Try a wine spritzer to decease the amount of wine you are drinking. Choose light beers and dry wines. Mix alcohol with sugar free sodas. Don't drink if you have nerve damage from diabetes in your arms or legs. As we said before, alcohol is toxic, so it can increase the pain, numbness, burning or tingling of nerve damage. Heavy drinking can make diabetic eye disease worse. If you stop this heavy drinking, you can lower your blood pressure Remember that one drink equals 2 fat exchanges. Never drink and drive or ride with someone who has been drinking. The holiday season can turn deadly. Please be here as our guests on Diabetic-Lifestyle for years to come. Control Holiday Stress We have written about stress before here in our What's Hot articles because controlling stress is very important for controlling diabetes. Stress results when something causes your body to behave as if you were under attack. Sources of stress can be physical such as having a disease or injury. It can also be mental like relationship problems, job problems, or financial problems. The holidays can exacerbate any or all of these, and that can lead to poorer diabetic control. When stress occurs, the body prepares to take action. We want to act! To do so we need a lot of stored energy in the form of fat and glucose which are available in the cells. When this happens, glucose builds up in the blood stream because in people like us with diabetes the fight-flight response does not work well. Insulin is not always available to let the extra energy into the cells. Many stresses are long term. Having a disease that you have to care for 24/7 can be one such stress. Other such stresses are the body's reaction to surgery which may go on for months. Many long-term sources of stress are mental. Your mind reacts to something as if it were a major physical stress. How does stress affect our diabetes? It does this in two ways. First, people under stress may not take good care of themselves. They may turn to alcohol or other self-destructive behavior. Blood glucose levels may not be taken regularly, meal plans may be forgotten and work habits may falter. Second, stress hormones may also alter blood glucose levels directly. As someone with type 1 diabetes, I can attest to research that says that stress can make blood glucose levels either go up or down in type 1 diabetes. Controlling stress, especially for those with type 2 diabetes, can make a significant difference in life style. The reason for this is that stress blocks the body from releasing insulin. Type 2 diabetics still make insulin, so making sure that you control stress will also help you control your diabetes, and just plain feel better. It is also thought that some type 2 diabetics are more sensitive to some stress hormones than those who do not have diabetes. Relaxing can help. Do you want to know how stress affects you? Rate your level of stress before you take your blood glucose level. Do this for a week and see how well you understand this association. How can we reduce our stress level during the holidays? First, examine how you have responded to relatives, heavy meals, parties, family, finances, etc in years past. Once again, rate your reaction to these things and then start to plan ahead. Over and over, we have shared that no one likes bad surprises in their lives so, like the Boy Scouts, be prepared. Make a budget for the holidays. It doesn't matter if it's $200.00 or $2000.00. If you overspend by two or three times that figure, January will seem like hell and just thinking about January will make December very stressful. Shopping for gifts off season will save you money. Do not carry your credit or bank cards to stores. With cash, we all think about our purchases more. Make a list and stick to it. We all know that walking through a store can be a lesson in responsibility. Now, you deserve a reward. When you have all your shopping done and the wrapping paper and bows purchased, go to a restaurant, sit down, and order the best cup of tea or coffee that they have and just relax. One chore is done. Are you in charge of decorations? Make up a COMMITTEE! What does that mean? It means that if you work 40 hours a week or are busy with children even more hours, get those who will enjoy the decorations to give a hand. Husbands do know how to put up a tree and even hang balls. Children can help make breads. Use mixes if you have to. Are you the one to make the family dinner? Make sure every family member brings a dish. You call and tell them what you need: salad, steamed vegetables, potatoes, desserts, appetizers, etc. Make sure that you have recipes for sugar free and lowered carbohydrate items for the meal. Just look at our web site for holiday meals. Feel free to download them and hand them out. You will not feel overwhelmed by the work or cash outlay if you delegate, and relatives will be pleased to have recipes that they can enjoy for future reference. Make sure you also relegate baby sitting chores if you have youngsters coming to the festivities. How can you be in the kitchen and make sure everyone is safe? The answer is, you can't. Plan when you go shopping. If you get stressed by traffic, make sure you go to the market or store during low traffic hours, or change your route. Finally, take care of yourself during the holidays: Learn breathing exercises. Your doctor can help with these quick relaxing tools. Learn progressive relaxation therapy. Go for a massage. Keep exercising ... it will keep your mood better and it provides a great release of energy and stress. Learn to replace bad thoughts with healthier ones. The holidays come and go each year and you have made it through each one, so with a good plan that protects you, you will be better off than you were in years past. Make sure you remember that holidays are for socializing, not just eating or drinking. Make memories! We send you our wishes for a joyous holiday season no matter which December holiday you celebrate. We look forward to having you here each month and will continue to try to make this the monthly magazine that you read and enjoy. BSP