Saturday, November 26, 2016

Grazing at holiday parties: How to safely manage blood sugars this holiday season.


Not much is worse for blood sugars than grazing. Whether its eating Pringles on the couch all Saturday long watching football or the new seasons of Gilmore Girls on Netflix with your fiancé or grazing at holiday parties, its all difficult to manage. Diabetes educators and dietitians will tell you how to avoid this: count your chips or crackers and put them in a bowl, measure the hummus, bla bla bla….

Yes! That's exactly what you should do! For diabetes! For health! For weight! But... we don't. Especially at parties. I don't know what you are into but I don't go to parties to count carbs, I go to mindlessly eat carbs!—and socialize of course.

[Disclaimer, these content of this article should not be interpreted as medical advice. Consult with your healthcare provider before making significant changes to your diabetes management routine.]

There are three results to grazing at parties: Under-estimation of carbs consumed, over-estimation and right on target.
-Being on target… Lets just call that luck.
-Under-estimation results in sustained highs, often overnight paired with multiple overnight bathroom visits. 
-Over-estimation is dangerous. Often I find myself on-target or a little high during the party/grazing period, and then, just as I'm about to go to bed, my blood sugar begins to drop, like a rock. Or, even worse, the drop can happen after I'm already sleeping. 

That happened once. I woke up to my fiancé, friends and EMS standing over me. I regret to inform you that this is on the top of my "most embarrassing moments" list. It had a debilitating effect on my fiancé for months. But most importantly, seizures can jeopardize mental and cardiac health.

I never want that to happen again. And I never want that to happen to you. So I have some easy options that will keep you free of dangerous lows and out of the bathroom peeing out annoying nighttime highs.

I give you the four step plan managing blood sugars at parties:

Step One is programming a temporary basal rate (if you use an insulin pump). Assess the situation before you even start. If you are walking into a party where you see lots of delicious fatty food and will be sitting, this is what you need. I choose a basal rate of 150-200% that will end at least 2 hours before you plan to leave the party.

Side note: If I am hosting the party, I will actually decrease my basal rate. Hosting not only requires the physical exertion between cleaning, cooking and prepping it also requires a drastic amount of mental energy through stressing, planning and managing multiple conversations at once. Remember: pound for pound, the brain is the largest pound for pound consumer of glucose.

Steps 2 and 3 are more of a rule: NO MORE THAN TWO BOLUSES AT A PARTY. Why?: 
  1. Less decisions to make. - Bolusing is decision making. The more decisions you make in the day, the more likely you are two screw one up. Thats why the president doesn't pick his own tie in the morning.
  2. Fully engaged bolusing. - While you are deep in conversation with a scotch in one hand and that pile of cookies within arms reach, it's tempting to do a no-look bolus a.k.a. Russian roulette. Don't do it. Follow the two bolus rule.
  3. Avoids stacking insulin. - This is what will make your blood sugar bottom out right after your fall asleep. 

Step Four, analyze your night and make any corrections needed before bed and set an alarm for the middle of the night. 
Ask yourself the following questions: Whats your current blood sugar? how much insulin did you take tonight? How much insulin is still active? How physically active were you tonight? If you consumed alcohol, how much?  If you wear a CGM, which direction is your glucose trading?

The main idea is to limit the decisions you need to make about diabetes while socializing. Better decisions will be made when they have your full attention. 


Do you have a game plan with proven results for social gatherings? Please share below to contribute to the discussion.  

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