Sweeping your gaze over the holiday food spread, you can’t help but notice that the eating options lean heavily in favor of high-carb, high-sugar, and high-octane type 1 diabetes (T1D) trouble: candy canes, gingerbread houses, heaping plates of festive cookies, eggnog, and sweet-potato pies. Even seemingly innocent sugarplums are in on the oversaturation of sugar during the holidays, what with their dancing in our heads. Are the holidays all about sweets, treats, and temptations that are challenging to weave into your T1D control?
With such a heavy focus on food, the holiday season also seems to bring the (usually well-intentioned) T1D police out in droves. “Can you eat that?” becomes as pervasive a phrase as “happy holidays.” During these festive months, a person living with T1D or caring for a loved one or friend with T1D might feel overwhelmed by all the carb-counting, or disheartened by the lack of ease in their holidays. More often than not, visions of guilt and hyperglycemia dance alongside those sugarplums. Loading up your plate at the holiday table might make you feel self-conscious, assuming that family members are judging your choices.
How about putting some “happy” back into your holidays? The festivities don’t have to be about exclusion, or feeling like you can’t have something because of your T1D. Those tend to be the stories most often shared when it comes to folding T1D into the holidays, and they aren’t the most uplifting. Where are the stories that are about opportunities to gently advocate, providing bite-size bits of education? What about the holiday moments that are just plain FUN? Are all the moments about feeling left out, or are there bright, shining moments of inclusion that warm you up like a hot mug of tea?
Sometimes it’s as simple as having someone not ask about your disease. “At a holiday dinner a friend of mine prepared, she asked me ahead of time what she could prepare for me to eat. I said, ‘nothing.’ So when it came time for the meal, she said she wasn’t going to worry about me or ask me anything along of the lines of whether or not I had enough food,” said Jessica Apple, who was diagnosed with Latent Autoimmune Diabetes of Adults (LADA) in 1997. When I asked her about a T1D-related holiday moment that stood out as positive, she admits, “I was so grateful to be left alone. Even when you know your friend’s concerns are well-intended, it’s really uncomfortable to have your plate monitored.”
Abby Bayer, who has had T1D for 13 years, likes the whole “no big deal” approach. “I was diagnosed with type 1 diabetes 10 days before Thanksgiving, when I was 10 years old. My family had a trip planned and booked, and we were ready to go. Instead of canceling everything and making me feel really bad about ruining the weekend—which could easily have happened—we went anyway and had a great time. My food was properly measured to fit my meal plan (I was started on regular and NPH insulins), and we fit dessert into my nighttime snack in our cozy New Hampshire time-share. Type 1 diabetes has never been a big deal at holiday time in our family, and that makes me feel a little more normal.” Abby’s favorite holiday feast is one that’s balanced, because it makes her blood sugars play a bit nicer. “In general, carbohydrates digest much more slowly when eaten with protein—so I like to mix my turkey and mashed potatoes together. Making sure that your plate is balanced with carbs, like those mashed potatoes, and protein and vegetables will help your body with that carb load.”
Type 1 diabetes isn’t a reason to avoid the cookie parties and the holiday feasts but instead can be a great excuse to make creative, healthy, delicious food choices—or maybe even new food choices! Scott Johnson, who has been living with T1D since 1980, uses the holidays as a way to expand his culinary palate, taking the path of “I can have that!” instead of focusing on the can’ts. “I have recently started enjoying the opportunity to try new-to-me foods, as I try to broaden my dietary horizons. The holidays and family gatherings present these chances to try things I’d never have made at home, like cheese fondue!”
During my holidays as a kid with T1D, it was my grandmother who made the first efforts to make me feel included in the foodie festivities. My grandmother experimented with sugar substitutes and baked her version of sugar-free apple pies and sugar-free banana breads … only her versions were bitter and sour, thanks to the limited options for baking at the time. (And what kills me is that she used to cook these apple pies with aspartame, which isn’t known for maintaining its sweetness during the baking process. So these deceptively lovely holiday desserts were beyond bitter tasting. Poor Grammie. I’d share a recipe with you all, but the end result would basically be an inedible doorstop. However, every time I see an apple-shaped paperweight, I think fondly of my beloved grandmother.) She tried so hard at every holiday, and I’d be handed this big honking slice of pie. She would proudly watch me eat it, so I’d take big bites and go, “Awww, Grammie! This is delicious!” Which only prompted her to make another one for the next holiday … it was a vicious cycle. But looking back, her efforts to make sure I had something sweet, but safe, on my plate mean the world to me.
Kim Vlasnik, living with T1D since 1986, shared a similar experience, in which good intentions might not be the most delicious, but are so appreciated: “The holiday season tends to put me on a train straight to Carb Town, where every stop is teeming with breads, desserts, and yummy beverages. Knowing that I try to keep the sweets to a minimum in late December, a friend of mine has consistently given me sugar-free candy for the past few years. It’s a kind gesture that I appreciate in theory, but it’s a gift that largely goes unused, as that ‘candy’ does wicked things to my digestive system. I can’t bring myself to tell her, as I know her heart is in the right place, and I’m thankful that she is trying to do something especially for me.”
And then there are those moments of advocacy and education, those bite-size bits we talked about before, where a holiday moment can lead to a positive health outcome. Sara Nicastro, who has had T1D for nine years, tells her story: “As I was explaining the difference between type 1 and type 2 diabetes, I used the tried-and-true analogy of insulin as the key that unlocks the cell door to let the glucose in for energy. It’s a very basic explanation, and one I first heard while lying in my hospital bed the day after my diagnosis. Another member of the extended family has had type 2 diabetes for about 10 years. I told him that my body doesn’t have any keys left and his keys are rusty or just don’t fit into the locks very well. What he said next really surprised me. He thanked me for explaining the basics of diabetes to him and said that was the FIRST TIME anyone had done that since his diagnosis. I think it is a shame he has never received the basic information about his disease, but I am glad to have been able to help him out in the middle of our family celebration.”
Scott also finds the open, nonjudgmental discussions empowering, and views them as an opportunity to educate and share. He says, “I have an aunt on my dad’s side who often talks openly with me (and the gathered family) about how hard it must be to do all of the work that type 1 diabetes demands. I find it comforting that she is curious, asks questions in respectful ways, and helps me educate all those around during our talks.”
People with T1D are exactly the same as people without T1D, when it comes to sizing up a holiday meal: we look for something delicious, and sometimes we seek out a special treat. But “special treat,” in my book, doesn’t always send my blood-sugar numbers into the stratosphere. Since my diagnosis, I’ve sought out the healthiest foods that taste good to me. I love crispy green beans with a dash of salt, or sautéed spinach with plenty of garlic, and I’m first in line to heap my plate with turkey. Even on the dessert table, there can be options that please your palate and stop blood-sugar spikes, like sugar-free chocolate pudding with a dollop of whipped cream, or a mug of peppermint tea and a plate of meringue cookies. Anything that requires me to crank up an insulin bolus that’s markedly different from what I usually take stops me in my tracks, because then I know I’m outside of my T1D comfort zone (which, for me, means unpredictable numbers). Holidays don’t have to be synonymous with high blood sugars, and they can still be tasty … and fun.
When the T1D police start to polish up their badges this holiday season, don’t let them make you feel like a criminal. Explain why you make certain food choices, or just plain ask them not to comment on your decisions. Show people that the holidays with T1D aren’t about saying no and feeling guilty, but about celebrating with friends and family and making healthy decisions. It can be done, and it can be done with flair! T1D doesn’t have to keep you from celebrating in style.
Have a healthy, and HAPPY, T1D holiday. Actually, have a plain ol’ happy holiday, and don’t let T1D stop you from enjoying the magic of the season.
T1D-Friendly Healthy Holiday Chili
1 package of lean ground turkey
1 package of chili seasoning
1 10-ounce can of crushed tomatoes
1 can of white cannellini beans
1 can of black beans
1 can of kidney beans
1/2 onion, chopped
1 bag of frozen mixed vegetables
1 block of sharp cheddar cheese
1 teaspoon olive oil
1 teaspoon cumin
1 teaspoon cinnamon
Salt and pepper
Kerri Morrone Sparling has been living with type 1 diabetes since 1986, and is the creator of SixUntilMe.com. She is a freelance writer and global public speaker, and lends her voice to many diabetes-related publications, conferences, and causes. Her diabetes-related disclosures can be found here: SUM Disclosures. Kerri lives in Rhode Island with her husband and their daughter.
The information in this article is offered for general educational purposes and is not intended to replace professional medical advice. You should not make any changes to the management of type 1 diabetes without first consulting your physician or other qualified medical professional.