Susan Steinweg

Susan Steinweg, RN, program coordinator at Carroll Hospital Center's Diabetes Center. (Barbara Haddock Taylor, Baltimore Sun / December 8, 2011)

More than 20 million Americans are living with diabetes, and another 40 million are in the early stages of the disease. Managing diabetes can be a challenge all year long, but the holidays can pose special problems. All those extra treats, meals and drinks can add up to extra pounds and higher glucose levels. But a little planning, and will power, can keep diabetes in check, according to Susan Steinweg, a registered nurse and a certified diabetes educator. She's also the coordinator of Carroll Hospital Center's Diabetes Center.

Why are the holidays a particularly perilous time for those with diabetes?

Typically, the holidays are a time for traditions, family and food, and nurturing through food is a common theme. Individuals with diabetes often feel obligated to partake of these tempting delicacies, and once they do, like all of us, they often overindulge. This overindulgence can lead to weight gain and blood glucose level elevations.

What is a good strategy for handling the season?

Do not go to any holiday gatherings "starving." Have a healthy snack before attending. Bring a platter of fresh-cut vegetables with low-fat dip to share and to nibble on. Choose only the food items that are "worth it" and sample them. Do not feel obligated to try everything or to eat everything once you have put it on your plate.

When not at parties or gatherings, continue to be careful with your food choices and increase your activity level. Walking is a great way of burning calories that otherwise would be stored as fat, resulting in weight gain.

What happens if you do overindulge at a party? Do drinks count?

Strive not to overindulge at a party. You will feel sluggish and tired as a result, and you will lack energy to participate in holiday activities. Most folks regret overeating mentally and physically. However, if you should overindulge, exercise more and cut back on portion sizes throughout your day.

Alcoholic beverages do count. Your body recognizes alcohol as a toxin and immediately tells the liver to "detoxify" the alcohol. The calories are immediately stored as fat. People living with diabetes must be especially careful when consuming alcohol, as their blood glucose could drop suddenly, causing safety issues, including loss of consciousness, falls and accidents.

People with diabetes should always include a light snack when consuming alcohol to prevent sudden drops in their blood glucose. Many alcoholic beverages contain sugary mixes and fruit juices, which also will affect a person's blood glucose in a negative way. So stick to one light beer or a glass of wine, and avoid mixed drinks unless they are mixed with diet tonic. One mixed drink (with diet tonic) should be the "limit."

What about pre-diabetes?

Like all of us, people with "pre-diabetes" need to also pay particular attention to their intake over the holidays. Pre-diabetes is the state that occurs when a person's blood glucose levels are higher than normal, but not high enough for a diagnosis of diabetes. In other words, it is the very early stages of diabetes. Most people with "pre-diabetes" have an opportunity to slow their progression to diabetes by eating well, exercising and losing 5 percent of their body weight. Though it may not be realistic to lose weight during the holidays, certainly focusing on making healthy choices, cutting portion sizes and getting plenty of exercise can be steps in the right direction.

What are the long-term repercussions for those who don't manage their disease well?

Diabetes is a sneaky disease. Early on in their diagnosis, most folks do not notice any symptoms of diabetes. They spend some time in denial doubting that they even have it. It is hard to believe that you have diabetes if you don't feel any different, and that makes it easy to ignore.

However, diabetes that is not well controlled can lead to serious complications. These very debilitating complications can include heart and circulatory issues, kidney disease, eye disease, neuropathy ("pins and needle" sensations, pain, burning in the hands and feet) and erectile dysfunction.

Early diagnosis, education and support from certified diabetes educators are essential. We help people understand their diabetes — how to monitor their blood glucose levels using a meter and how to care for themselves, for example —and we're here to answer any diabetes health-related questions they may have.

Diabetes is hereditary, so if you have diabetes, make sure your loved ones are screened regularly.

meredith.cohn@baltsun.com

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