How does one approach glucose control during the holidays?
Holidays are generally a time where we relax and let our hair down a bit more than at other times. Included in this are dietary relaxations like consuming more refined sugar than normal as well as alcohol in slightly greater amounts and strengths, depending on your preference and age. Also for some it may include more than normal outdoor activity and exercise.
All of these have repercussions for glucose levels.
So, obviously each person has an entirely unique set of circumstances as well as metabolism but roughly speaking here are some basic holiday guidelines.
If you are a type 1 and injecting insulins and testing :
1.) Consider testing your sugar more often if you are exercising more and possibly feeling hypo.
2.) Consider adjusting your insulin dose at meals with more carbs and simple carbs than you are used to (perhaps go through your dietician and doctor re this).
3.) Understand that if you drink a lot and sleep in the next morning this is dangerous and alcohol will at first raise your sugars and then after about 10-12 hours drop your sugars, so watch out for a “missed” hypo and make sure you tag a mate to check on you at least.
4.) If you are snacking and the carb count is more than 10-15 g of carbs you may need to bolus for this kind of snack in order to keep your sugars stable but it really depends on a number of factors other than just this.
5.) the weather plays a bigger role than you think, some people will go either high or low depending on very hot or very cold conditions so try to understand your body and rather pre-empt the rise or fall or at least be vigilant and test more often.
6.) consider wearing a type of medic alert bracelet in case of unconsciousness – it may save your life.
For type 2 diabetics on oral agents only or have additional insulin injections
1.) Most importantly holidays can mean massive weight gain, and this is very bad and hard to get rid of in the long run. Pre-empt this by seeing a dietician who could give you guidelines on how to cheat without too much weight gain. Also see it as a challenge to maintain your weight rather than a punishment and reward yourself with things other than the wrong food on the holidays. Set incentives and be kind to yourself with spoilers that blow your hair back and don’t put weight on.
2.) Make sure that you have enough medication and testing strips for the time that you are away as well as some back-up diabetes supplies.
3.) Know what carbs are and how they affect your sugars and plan accordingly.
4.) Know the carb content of the alcohol you are drinking and factor it into the daily calculation of insulin (if injecting) as well as the total effect of the alcohol and your activities (physical) or not.
5.) Try to see the holiday as an opportunity for increased movement -exercise in many different forms and find one that works for you, start the routine on holiday.
6.) Experiment with different healthy food and take mental note of how you feel and what it does to your sugars.
We all need a break, a re-set and a proper unwind. So most of all give yourself the mental “space” and time you need to do just this. Planning for your holiday around your diabetes will aid in enjoying this time more and taking stress out of certain situations.
There are always healthcare professionals on duty, know the nearest casualty location and telephone numbers as well as ambulance and other emergency numbers before leaving home.
Why is it that when we are ill either physically or mentally and it comes to support for the person it is hard to find. In fact a very common reaction is for people by and large is to withdraw. Leaving an already vulnerable person more vulnerable and more likely to become sicker. Why do we do this as a society?
It seems we are quite cruel.
Much like being a type 1 diabetic. Once diagnosed your life depends on testing sugars and injecting insulin. People are wary, they hide, they run they disappear from your life entirely. Schools refuse to admit children with it. Kids don’t want to have them at their party. And why ?
Yes it’s different. Yes it’s a disease that requires things that some humans are uncomfortable with. But, can you not dig a little deep and conquer that fear, reach out and be a friendly face, hand , eye?
We are actually all connected and our reactions have repercussions. We have choices to make daily.
I challenge you today to not run and hide. To be present, even when it is uncomfortable. To be present. Really there. In the flesh and the mind. Present. That’s all. To be there.
Pushing past impossible is something that is actually possible.
And you know that we all – collectively benefit from that.
And the world at large can be a better place.
Why is this not a more pressing issue? The diabesity epidemic threatens to ruin the whole world and yet so much of silence?
The log curve that shows no even inkling of abating rises like a tsunami and we are all “thula-msindo” – zulu for not saying a word.
Urgent action is required, yes I said action. Urgent.
Alternatively we can go with the tsunami of medical costs that are unsustainable, ill populations, knock effect to the economy due to loss of income, knock on due to high costs (medical) etc etc. It is a disaster and yet we look on.
Wake-up oh sleeper!
Now is the time to do something, its fast becoming too late.
In my opinion which some may argue is not humble. I argue it is.
Medical aids restrict care for patients as well as shoot themselves in the foot when it comes to downstream costs.
Particularly in an environment like south africa where we have this tsunami wave of a diabetes epidemic. Approaching things holistically (as CDE which originated in Joburg and is now all over RSA) is the only way to manage the finances we have. Yet the push back from some medical aids is interesting to use a word so as not to offend.
I am merely a GP – general practitioner. I have made it my mission to stay up to date (as well as the most qualified I can be) regarding diabetes at large. I am passionate about it. I am even more passionate about the best care for my patients. This largely could translate to the best money spent for medical aids but alas it does not turn out that way 9 times out of 10.
There are medical aids who are open minded and practice preventative care like Discovery and medications and appliances are provided with insight and good application.
I wish this were across the board. Alas not in our beautiful country.
Patients vote with where they pay their money. The next few years are critical as to both the direction of medical aids and whether the money will be spent effectively saving downstream costs or whether the whole thing just implodes. Every day another massive wave of patients are added to this problem. It is soon to hit that critical mass where devastation occurs.
We have to become more preventative, we have to manage what we have to the best of our abilities with what we have. That is best done with more brains. Team is key. Technology is key and unfortunately not everyone is on this boat.
Think before you drink before you drive, think before you eat that cake and you don’t survive.
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