Thanksgiving blood sugar

Holidays always have been a bit of a puzzle for me and my blood sugar. But this year will be different.

I, as with the rest of the nation, plan to overindulge with food, but that requires preparation. Typically I take more insulin Thanksgiving or Christmas morning and eat a modest breakfast with the intention of taking liberal test-bites of food throughout the morning as I help prepare the feast.

But often I take too much insulin and don't eat enough breakfast. As a result, dear Suellen constantly is advising me to drink juice or eat something sugary when I show signs of low blood sugar. She can read it my expression, which usually is further confirmed by my inability to follow through with her orders to wash lettuce, peel potatoes or make the cheese ball.

A better approach, which I will try tomorrow, will be to take a normal amount of insulin in the morning and eat sparingly but certainly enough to keep the sugar stable through the food-preparation stage. Then I'll take a liberal bolus of Novolog insulin about a half hour before sitting down to enjoy Thanksgiving gluttony. With fresh insulin percolating through my veins, I can eat as much as I care to consume without worrying about sugar levels rising too high. Meanwhile, the volume of food typically prevents the blood sugar from dipping too low.

Still, you cannot make any grand assumptions on a unique and unpredictable day like Thanksgiving.

Taking extra insulin directly before the meal means testing your blood-glucose levels about an hour or two later to make sure the insulin and calories remain balanced.  I've had times when my sugar was low an hour after the feast because I took too much insulin. But that's not a problem. Juice, pumpkin pie or a number of different high-carb foods will return it to the normal level. If the blood sugar is too high after the feast, simply take more insulin.

That's to say, for insulin-dependent diabetes, starvation is not necessary over the holiday if you understand how fast-acting insulin works and you can accurately predict how much insulin is needed to overcome a given level of consumption. Anyone with diabetes already should know these details, and a holiday full of excess offers a chance to test your skills.

With enough insulin, you need not pass up the potatoes, breads, cranberry sauces or desserts. Test your sugar and take action based on test results. It will get you through the day without avoiding desired food. That's the one reason why I tell people with diabetes, be it type 1 or 2, that insulin can be your best friend. Eat too much and a quick shot or bolus from the insulin pump will return it to the normal range. Eat too little, and a snack is the cure.

Beward: Once the holiday is over, return to a healthy diet and daily exercise regimen to avoid weight gain.

Eat well tomorrow. Keep your insulin handy. Don't let one day of over-indulgence be a ready excuse for high-blood sugar.

And have a healthy Thanksgiving.