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Balance holiday eating to control glucose levels

Many people who have diabetes debate whether they should eat various high sugar, high fat holiday foods. Many just give up and eat what they want and hope to gain some control after the holidays.

Some people do stay in control over the holidays and manage to eat some of the extras as well. This requires planning and a willingness to test your blood glucose level more often to see how different foods, activities and stresses affect you.

First, talk to your medical team about your desire to experiment this year with a more liberal meal plan. Ask them for a target range of blood glucose values to reach before each meal and two hours afterwards. Make a list of the foods that you fully expect to add to your diet, like your favorite Christmas cookies. Then estimate how much of each you expect to eat. Maybe you did well during Thanksgiving, but you know you'll eat at least two cookies a day during the entire week of Christmas.

Books of food composition tables may help to estimate portion size and carbohydrate content. If the food has a nutrition facts label, you can figure that each 15 grams of carbohydrate in the amount you intend to eat can replace a starch, a fruit or a milk serving.

Then you may decide how you can either eat less of other carbohydrate-rich foods you normally eat or adjust your diabetes medication or activity to make up the difference in carbohydrates and calories. But if you eat more instead of substituting the holiday food, you will take in more calories and may gain weight even if your blood glucose stays in the desired range.

It is important to test your blood glucose before and two hours after you eat holiday foods. Be objective and see how each food actually affects you. Write down all that you ate and your blood glucose readings. These are not judgments about you, but raw data to help you decide how meal or snack changes affect your blood glucose.

Also note how much diabetes medicine you took before eating and how active you were around meal time. Record whether you were more emotional during this time -- excitement can release some of the stress hormones that can raise blood glucose levels.

You should notice patterns in your blood glucose control. For, example, you may see that when you eat Aunt Joan's pie and just sit around after dinner, your blood glucose goes over 200. But if you take a walk, your blood glucose is below 140 two hours later. You may even see that a higher fat snack or meal slows down how quickly your blood sugar rises even when you eat foods with equal amounts of carbohydrates.

Or you may find that if you take an extra unit or two of insulin before you eat the pie, your blood glucose also is below 140, even if you just sit around. Testing more often lets you know what really is happening and helps you handle any situation.

Web posted on Thursday, December 17, 2009

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