Thanksgiving 2024

Introduction:

Thanksgiving is a time of joy, celebration, and, unfortunately for some, the challenge of managing blood sugars. For those with Type 2 Diabetes, it can be especially daunting to navigate through the piles of food in front of them and the sweets calling their names. Some even decide to ignore checking their blood sugars. Today, I'm sharing a story inspired by an older patient I worked with, whom I'll call Jake for privacy reasons, and the valuable tips that helped him overcome the worst Thanksgiving of his life to having stable blood sugars throughout Christmas.

Tip 1: Always Check Blood Sugars, Even if it Hurts

Jake woke up to his Thanksgiving morning with a blood sugar level of 180 with a strong arrow trending upward. He panicked seeing the number and re-tested his blood sugars again. It read 183 and he decided that he would stop reading his blood sugars for the rest of the day. He skipped breakfast to avoid spiking his blood sugars even more and turned on different television shows to take his mind off his growling stomach. His daughter and grandkids asked if he wanted to taste test any of the snacks or foods they were preparing for the Thanksgiving dinner, to which he said no. His grandkids started making a pouting face and Jake felt horrible making them feel that way. To make amends he said he ate one cookie. He felt amazing when tasting the cookie, but it was followed with fear, anguish, and anxiety because he knew his sugars would spike higher again. He hid his pain by telling his grandkids how delicious the cookies were and carefully threw the rest of the cookie in a trashcan. Jake decided to take a nap to avoid further temptations and suppress his hunger.

Eventually it was time for dinner and Jake took his mediations in preparation for the meals. Seeing the assortment of dinner rolls, candied yams, green bean casseroles, baked turkey, mashed potatoes, and cranberry sauce, Jake caved into his temptation by eating as much as he could. He thought since he hardly ate anything the entire day, his blood sugars should be okay to make it through thanksgiving. After eating to his fill, the aroma of desserts pierced his nostrils and it was as if he was hungry again. He had a slide of pumpkin pie with extra whipped cream, 4 cookies, 2 brownies, a half slice of pecan pie, and a half slice of apple pie. He felt satisfied vanquishing his sweet tooth. He felt hopeless when he ate all those sweets, but figured one day wouldn't hurt him. He fell asleep on the couch while the TV was playing different shows. When Jake woke up, he found himself in the hospital, hooked up to the IV, and thought he was dreaming. He pinched himself and realized he was not dreaming. His daughter then rushed into his room and was saying she was thankful he woke up. Jake's daughter said hours after he slept, he started having a hard time breathing and his breath smelled fruity. She tried to wake him up, but he didn't react. She checked his blood sugars multiple times but it came up greater than 320 each time. So she called 911 to get him to the hospital. Jake knew he had a hyperglycemic episode in his sleep and was embarrassed this situation happened. When the doctor entered his room, she explained how important it is to keep checking blood sugars 2 hours after each meal or consuming any calories so he can be prepared to act according to the numbers. A quote that stuck with him is that "your blood sugar numbers never defines you. What you do when you learn where your blood sugars are at is more important." From then on, Jake was diligent in checking his blood sugars to avoid another trip to the hospital and scaring his family.

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Tip 2: Practice Stress Relaxation Techniques to Focus on What You Can Control

Jake was motivated to change his life after the health scare. Especially since he wants to have more time with his grandkids. He decided to get physical therapy to address his knee pain so he could get back into walking and that was where we met. When I shared I specialized in Diabetes Management as a Physical Therapist, he asked me questions on how to overcome the stress with seeing a high or low blood sugar level. The first piece of advice he received was to take four deep breaths and focus on what he could control. If the blood sugars are high, that means moving or taking his medications a prescribed by his doctor to lower his blood sugars would be the next steps. If his blood sugars were low, then eating or drinking fast acting carbs would be the best course of action. Checking his blood sugars 15 mins after for both situations helped him understand if he needed to do more or if he was on track to having blood sugars within ranges. If he was still stressed despite the 4 deep breaths, then I said he can keep repeating a few more rounds of it until he is able to focus on the things he can control.

Tip 3: Balanced Meals and Light Physical Activity

After successfully incorporating the stress management tips, he was wondering how he could satisfy his sweet tooth but having better blood sugars 2-3 hours after eating. I shared that eating more fiber, lean protein, and low glycemic index foods with the sweets would be helpful. If he planned to eat any Thanksgiving leftovers, then having the turkey breast for the lean protein, green bean casserole for the fiber, a side of beans, and a cookie would lead to improved blood sugars instead of having 5 cookies. After the meal, I encouraged him to use his walker or cane and walk for 15-20 mins after the meal so the muscles can soak up the incoming rise of blood sugars from the food, improve his insulin sensitivity, and improve his knee pain. If his house was too cluttered to walk, then I encouraged him to declutter his house and do other light chores for 15-20 mins for the physical activity component. During the next physical therapy session, he reported that his blood sugars was at 137 after implementing the tips I shared with him. Jake said this was one of the lowest numbers his blood sugars have been 2 hours after a meal despite eating a decent amount of food!

Tip 4: Mindful Eating

Jake mentioned he would like to lose weight in the future and would like to avoid overeating during the holidays. I asked Jake if he's heard of mindful eating practices, to which he said no. To improve his awareness of his hunger and fullness cues, I said he can practice taking a bite of food and slowly chewing it to observe the taste, texture, and how the bite of food makes him feel. After he swallows, I recommended he takes a sip of water to cleanse his pallet then have another bite to repeat that step. After he feels full, he can put the leftovers in the refrigerator or if he finished his plate, then he can start cleaning up. This way, it'll help with his fullness/hunger cues and prevent overeating foods. Generally, foods that taste very sweet will eventually taste bitter and have worsening texture that can increase fullness cues and prevent overindulging in sweets.

Conclusion:

After practicing these tips, making small adjustments to his routine, and giving himself positive reinforcement for every attempt and progress towards learning a new habit, Jake was able to enjoy Christmas with blood sugars that never went past 178! He was able to enjoy having a balanced meal during the holidays and felt like he was in control of his life again. Jake's success story serves as an inspiring example of how small, mindful adjustments can make a significant impact on blood sugar levels during the holiday season. By incorporating these tips into your routine, you too can enjoy a festive meal without compromising your health. To keep it simple, check your blood sugars 2 hours after meals and when you wake up/before going to bed, walk or do a form of physical activity after eating meals or drinking calories, drink water in between bites of food, and pair all sweets or fast acting carbs if you choose to indulge in it with lean protein and fiber rich foods. If blood sugars are still high, keep walking/doing physical activity until it's in ranges again. Here's to a happy and healthy holiday season! Please share this with anyone who might find these tips beneficial.

Other resource to improve mindful meditation to lower stress.

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