First festive season with type 1? There’s so much excitement, and odds are your routine will be interrupted, so it’s understandable if you’re feeling a little apprehensive about managing your condition effectively during this time. To help, Amy Rush and Beck Newton, our Family Centre diabetes educators, are sharing their top ten tips for managing type 1 at Christmas. With some good plans to support you, you can minimise the challenges and maximise the fun!
Tip # 1: Be prepared for some of the things people might say.
At Christmas parties and family gatherings, sometimes you hear things like:
I couldn’t give myself injections!
Surely one day/one meal won’t hurt!
Are you allowed to eat that?
Doesn’t that alarm annoy you?
As frustrating as it is, they are most likely not being intentionally rude. Chances are they are curious, just don’t know what to say, or genuinely think they are being supportive. Have a short response ready to go that includes why you now require insulin, how certain foods impact your blood glucose, and how that makes you feel. Let them know the injections and the alarms are there to keep you safe, so it’s not too annoying.
Tip # 2: Have a plan of attack ready in case there’s no food!
Some Christmas functions don’t provide much food, some none at all. However, they’ll likely offer you a drink! Be prepared: ask in advance, eat beforehand, carry a snack, or be ready to limit alcohol if food is scant, you haven’t eaten, or if you are not confident about keeping your blood glucose levels stable.
Tip # 3: Don’t overbook yourself.
Consider whether you need to say yes to every invite if it all seems too overwhelming. Give yourself time to recover physically and emotionally between events – particularly on Christmas Day. Mum and Dad’s for breakfast, sister-in-law’s for lunch, and friends for dinner is a marathon for anyone. Perhaps look to spread your feasting over more days – make your celebrations last from Christmas Eve to Boxing Day!
Tip # 4: Pace yourself during the (or any) long lunch!
Avoid drinking too much if you haven’t yet worked out an insulin and alcohol strategy. Make sure you space drinks and always eat when drinking alcohol – never drink alcohol on an empty stomach, as it increases your risk of hypos. Until you are confident managing your blood glucose while drinking, you may wish to run your blood glucose slightly above your preferred target when drinking alcohol, especially before going to sleep.
Serve yourself – grandad is only trying to be a good (generous) host, and your meal may include multiple courses over a couple of hours (think canapes, followed by turkey with all the trimmings, and then Christmas pud!). It’s easy to ‘stack’ doses (i.e., give multiple doses of rapid-acting insulin at close intervals), and this could happen if you administer insulin with every course. Injecting more insulin before the previous dose has had time to work can lead to a build-up, which may lead to a hypo. A strategy to consider: keep your carbs for one course, to reduce the number of injections you need. For example:
Choose a carb-free entrée (such as prawns and avocado)
Have your insulin with your main course and enjoy Mum’s famous roast spuds
Enjoy a low-carb treat for dessert, such as Denada sugar-free ice cream
No matter what, keep a close eye on your levels by testing often.
Tip # 5: Have a carbohydrate counting app on your phone.
Wherever you are, keep monitoring your food intake, and continue your management plan. Consider downloading Carbs & Cals: Diet & Diabetes – the carb counting app with visual representations of food portions. It works by showing you foods that many people eat regularly, so it’s a quick reference that’s easy to use while eating out or dining with family or friends. CalorieKing and Easy Diet Diary are other favourites.
Tip # 6: Keep moving.
Start Christmas Day with a walk to improve insulin sensitivity all day. Join the backyard cricket game after lunch, even if Uncle Max always wins! Plan a Boxing Day morning stroll if you wake up with high blood glucose to help kick start your insulin sensitivity first thing.
Tip # 7: Be sun smart!
Before type 1, sunburn today (accidental, of course!) might have meant a great tan tomorrow. However, sunburn can trigger the release of stress hormones, and these hormones increase the risk of high blood glucose. Sunscreen, a hat and shirt, sunglasses, and shade are your friends!
Tip # 8: Swim safely.
You might think this is a shark warning – not in this instance! Really cold water, such as open water swimming at the beach, can make you more likely to have a hypo. Even a dip in the pool can lower your blood glucose, and it may lead to increased insulin sensitivity for several hours after exercise. Test your blood glucose at least half an hour before swimming – you may need an extra snack before you swim if your blood glucose is between 4-7mmol/l…an easy task with the Christmas trimmings available!
Tip # 9: Do a little shopping for yourself!
You may be madly running around buying last-minute gifts (or even just starting to fill the stockings…there’s heaps of time!). While you’re out and about, stock up on the things you need!
Get scripts from your GP before they close for the holidays, or you go away.
Review your sick day management plan, and have the supplies to implement it on hand, particularly a glucagon injection and hypo kit if you are heading away or if you plan to be drinking more than usual.
Christmas Day in Perth is notoriously hot. Have a cooler bag on hand and keep your insulin in it if you’re travelling in a hot car or if you’ll be out all day.
Stock up on medications and consumables before your local pharmacy is closed. If your script is on file at your local pharmacy, and they close on public holidays, ask for a copy, just in case. Find out which pharmacy near you will be open – this will give you a backup to use if you need urgent supplies while your local is closed.
When ordering your pump and glucose monitoring supplies, allow a little more lead time. With public holidays, festive season closures, and extra demand on courier services, the supplies may take longer to arrive. Consider organising a backup plan in case there are any unforeseen delays.
NOTE: If you need urgent medical advice while your GP is closed, call 000 or present to the Emergency Department near you.
Tip # 10: Be kind to yourself.
This is your first Christmas Day. The day is known for being all about food, activity, alcohol, excitement – all of which impact your blood glucose. Some of these are beyond your control. So is the heat…! If your blood glucose is not within your target range for the day, be ok with this. Later in the evening, take the time to assess your blood glucose, how much insulin you have on board, how much alcohol you may have consumed, and how active you have been. Make some safe adjustments before bed if needed, then aim to get back on track the next day.
Overall, expect a break from the norm – and love it! It’s all part of learning to live the life you want, even with type 1.
Interested in building your capacity to manage your condition effectively? We’re here to help! Contact us on 08 9446 6446 or firstname.lastname@example.org to find out how.
Here are some options:
Make an appointment with one of our diabetes educators, Amy Rush or Beck Newton.
Brush up your carbohydrate counting and insulin dosing skills with our online course Cyber Carbs
Aged 16-30? Thanks to our generous sponsors, you can access four appointments with a diabetes educator, and two HbA1c tests for a total of just $100! For extra information, see the Level Up flyer attached.