Managing Diabetes during the Holiday Season
December is here, and with it comes the tasty treats of the holidays. I'm not talking about some crappy fuitcake - I mean the really good stuff. Like the pumpkin roll (with cream cheese frosting) that my aunt makes, or the delicious apple pie my grandmother used to make, or the red foil wrapped Hershey Kisses and let's not forget the holiday cookie swap. All kinds of foods that just scream "OMG BOLUS!!!!!"
But what's a person with diabetes to do? Sometimes that holiday feast looks more like torture than temptation. For me, I was never particularly good at saying "no" to all the sweets and treats. I learned the hard way, as a kid, that if I don't allow myself an indulgence now and again, I'm liable to fly completely off the wagon and dive face-first into a pile of frosting. While the urge to watch my weight worked 80% of the time, there is that small percentage where I just want a snack. A tasty snack, at that.
So I've done some research. And I've found that one of the best tricks to keep my blood sugars from skyrocketing during indulgences is almost too simple: count the carbs and bolus well in advance of consuming those carbs. I learned this about a year and a half ago, when I was working closely with the Joslin Clinic in Boston to prepare my body for pregnancy. A simple, almost blindingly-logical solution to a problem that had plagued me for years.
You'd think that I'd know this already. I've been diabetic for more than two decades, and pumping for almost seven years - wouldn't this method of dosing be common sense to me by now?
Unfortunately, no. It seems like common sense, but that would mean I'd have to actually THINK about it first. I was under the impression that it only took my fast-acting insulin 15 minutes to start working in my body. This is what I was told when I switched from Regular to Humalog so many years ago. But what I didn't realize is that while 15 minutes may play host to some effects, the majority of my insulin isn't active in my body until the 30 minute mark. So a lot of the time, my food was active in my body before my insulin was. That fact, coupled with my tendency to get lazy about carb counting with precision, made my numbers wonky. This created chaos in my post-prandials, and sent my A1C pinging all over the place.
I've finally started listening to my body, and asking questions of my doctors. (Always something to learn with diabetes, even when you think you may have seen it all. The learning curve for type 1 diabetes is truly a lifetime!) I'm taking the time to count the carbs (even in the things I'd rather not admit to consuming - see aforementioned pumpkin roll) and I'm dosing my insulin well before I sink my fork into the dessert. And once my blood sugars are stabilized, it's easier to thwart the diabetes police and their well-intentioned musings.
One of the things I've learned about diabetes management is that it's not all about hard and fast rules. They are some moments, particularly with type 1 diabetes, when you have to cut a bit loose and enjoy the most delicious things in life … like pumpkin roll.