Blog Layout

Navigating Carb-Centered Holidays Like Thanksgiving

Jewels Doskicz

Food-focused holidays like Thanksgiving can pose a challenge for people with diabetes and obesity. Here’s how one person with type 1 diabetes navigates the holiday.


Holiday eating can be tricky with diabetes (sweet potato casserole with marshmallows on top, I’m talking about you). To be fair, I’ve never heard anyone refer to Thanksgiving dinner as a “healthy meal,” so it’s not an overindulgent surprise. But while Thanksgiving may not be a holiday of deprivation, noshing beyond my fill has only ever given me eater’s remorse.


So, I’ve come to a certain conclusion: It’s moderation (and lots of vegetables) for the win. 


In all seriousness though, I realize the way we eat can be very personal, regardless that we hold diabetes in common. Facing a spread of food that can trigger all sorts of responses and having a chronic disease that needs to be managed can have its own set of difficulties. Practicing self-kindness, while keeping time in range goals top of mind, can be tough on carb heavy holidays, so finding what works best for you is key. 

Unless someone can see deeply into our souls, most people never know the mental gymnastics we go through around the holidays. People with diabetes are quiet warriors who belly-up to huge buffets of food year after year, with expected super-human powers of resistance in tow. It’s a true testament to finding balance – with a sprinkle of self-compassion.

People with diabetes are quiet warriors who belly-up to huge buffets of food year after year, with expected super-human powers of resistance in tow. It’s a true testament to finding balance – with a sprinkle of self-compassion.

Handle Thanksgiving like a boss


Overeating can steal my sparkle, so I try really hard to avoid a food coma on Thanksgiving – especially one that coincides with high glucose levels. So how do I find my happy-medium and not faceplant on the couch? I give most of the credit to non-starchy vegetables.


What’s the hype about vegetables? They’re often low-carb, nutritious choices that create fullness and help to keep my glucose in range. By starting off with veggies and having a belly full of greens, I’m less likely to overindulge (it’s vegetable science). If you don’t like veggies, it’s never too late to try something new. I swear I put salad on my daughter’s plate for two years before she would eat it – never give up on yourself. 


My food choices are often driven by how I think they’ll make me feel, which varies with how active my day is. If I had to slap a label on myself, I’d say I’m an intuitive eater, not really identifying with foods as being “good” or “bad.” I know that eating a huge carb dump doesn’t feel the best for me, so I moderate with a balanced plate. Even with a continuous glucose monitor (CGM) and closed-loop pump, there are many factors to consider; insulin isn’t always fast or smart enough to tackle it all. 


Because I believe in the power of healthy eating, and I’ve had type 1 diabetes for over 30 years, it’s become cemented into my very being – a side benefit of sorts. And much to my children’s dismay, I’m also that mom handing out raisins on Halloween, making tofu cookies at Christmas, and trying to substitute black beans for ingredients in chocolate cupcakes (yup, not very palatable) – but I really can’t help myself.


Carb Counting Conundrums

Thanksgiving Dinner with DiabetesYou know the carb counting drill – it’s not always easy – especially when you’re not making the meal. Automated insulin delivery (AID) systems can’t account for every single decision you make, and sometimes it can truly feel like a guessing game. Taking enough insulin to cover a big carb load can feel absurd (and scary), causing anxiety about hypoglycemia. So, if you’re telling yourself: “Oh my gosh, I ate X carbs and took X units of insulin,” know you’re not alone. (And this circles back to the vegetable conversation.)


Being diagnosed with diabetes in 1984, I was fairly blind to details in between blood sugar checks. At the time, I checked my blood glucose by putting blood onto a strip, wiping it off, and holding it up to a container to see my “glucose range.” Basic management consisted of insulin injections, exercise, and a healthy, balanced plate. As a result, my meal planning revolved around counting calories and food exchanges – it was way before carb counting became a thing. 


The “eat whatever and however much you want” mentality wasn’t a part of my repertoire; I followed a healthy diet with caloric goals instead. But in 2007, at age five, my daughter Emma was also diagnosed with type 1. I quickly realized that carb counting had become the centerpiece of diabetes management; there was a shift away from simply “avoiding sugars and unhealthy foods,” and there seemed to be more of an emphasis around the idea that you could “take insulin for it.” 


Do I count carbs now? Yes, I do, and I appreciate doing so. I need to for the sake of using my Control-IQ AID system (which is a specific AID system that combines a Tandem t:slim X2 pump and a Dexcom G6 CGM). But my healthy eating habits haven’t gone by the wayside either. 

Eat the protein

As a conscious vegetarian, I raised my girls similarly until Emma, at the ripe age of six, said, “Mom, I’m going to get a bow and arrow, shoot an animal, and [emphatically, with both arms in the air] EAT IT!” 


Shocking coming from a six year old, I know, but she clearly wanted meat. So, off to Whole Foods I went, and that was the end of her vegetarianism. 


I joke that I can cook a meal for anyone; we’re kind of a needy bunch with diabetes, celiac disease, a vegetarian, and even a vegan under one roof (thankfully my husband will eat anything). Come on over, we’ve got you covered! Needless to say, we do turkey and “tofu” turkey; protein takes up about a quarter of my plate.


Diabetes friendly Thanksgiving: Can I eat it all


The short answer is – yes, you can. But do you want to? 


Sure, you can choose to go in and eat all the carbs (while carefully dosing your insulin), and you can do your best to avoid them, or you can find a sweet spot in between. Stuffing myself to the point of discomfort never works out well for me personally – especially since insulin isn’t always that effective at nailing large amounts of carbs. I’m much more successful at staying in range when I moderate; otherwise it can be a roller coaster ride.


Here’s what else helps: exercise. I try to squeeze in some kind of movement on Thanksgiving morning to get my metabolism up and increase my insulin sensitivity. Some years that equates to a bike ride; others it’s a run, hike, or even family olympics. Keeping some aspects of normalcy on holidays helps with my Time in Range.


We typically host Thanksgiving, and a side benefit to that is we choose the offerings. While potatoes, stuffing, dinner rolls, and other carbs may be sides to choose from for some families, so are salads, cooked greens, green beans, squash, roasted cauliflower, brussel sprouts, and others. 


As a family we motivate ourselves for an after dinner walk or games – it’s a great shift out of the kitchen, allowing for digestion and a break before dessert. The day after Thanksgiving our tradition is to hike in the Grand Canyon. Leftovers are great in a backpack or for dinner when we get back home – and after a long hike, they’re certainly well deserved. 

While potatoes, stuffing, dinner rolls, and other carbs may be sides to choose from for some families, so are salads, cooked greens, green beans, squash, roasted cauliflower, brussel sprouts, and others. 

Thanksgiving Meal Tips

  • Have an earlier meal to allow for a walk between dinner and dessert
  • If you aren’t the one cooking, ask what’s on the menu ahead of time so you can carb count and dose your insulin correctly
  • Get some exercise in the morning like a run or bike ride (who doesn’t love a Thanksgiving 5K Turkey Trot?)
  • Make cauliflower mashed potatoes to decrease the carb load; Use low-carb flours such as almond flour for biscuits and pie crusts
  • Eat a plate of veggies ahead of time, make a keto charcuterie board, or fill your dinner plate with veggies first, here’s why
  • Consider filling half of your plate with veggies, a quarter with proteins, and a quarter with carbs
  • Stay hydrated, water helps with fullness
  • Pre-bolus your insulin – you may also want to consider multiple boluses if the meal is going to last for a very long time
  • Eat slowly throughout the meal to help with fullness
  • Avoid foods that you know you can’t stop eating
  • Pick your carbs, you don’t have to eat some of everything
  • If you’re not eating at home, bring what matters to you
  • Ask yourself: “Am I still hungry?” If you’re not sure, get a glass of water and wait — leftovers are much more enjoyable if you don’t overeat.

Photo credits: iStock


Credited: [Author: Jewels Doskicz], [Source: diaTribe Learn MAKING SENSE OF DIABETES], [Site: https://diatribe.org/]


Healthy Bites

Spinach Salad with Creamy Strawberry Vinaigrette

15 May, 2024
Strawberries are coming into season right now, which means they’re at their sweetest and most fragrant. Take advantage of their peak by giving them a starring role in a versatile spinach, feta, and cucumber salad. It’s well-known that fresh strawberries play well in spinach salads. While it’d be easy enough to slice them and toss them alongside baby spinach leaves, putting fresh strawberries in the dressing helps guarantee that bright berry flavor in every bite, and turns the whole dish a gorgeous shade of rose.  Add sliced strawberries too, if you like, and call it a double strawberry salad. While you’re at it, feel free to add other ingredients as well. Grilled chicken will turn this salad from a side into a weekday main dish; diced avocado and chopped toasted almonds will add richness and crunch. Or make it as written and it will be simply wonderful.

Diabetes Fast Food Guide: What to Order at Taco Bell

15 May, 2024
Ever wondered how to survive the drive-thru with diabetes? In this series, a dietitian walks through the best things to order at top fast food chains. This week we see what’s happening outside the bun at Taco Bell. Taco Bell is a beloved Mexican-inspired chain known for its bold flavors and creative menu offerings, from the Nachos BellGrande to the now-viral Crunchwrap Supreme. But to the dismay of glucometers everywhere, many of these menu items are centered around spiky carbs , which can make eating at the chain especially challenging for anyone with diabetes. There are, however, certain menu items that are less impactful on blood sugar than others.  “Taco Bell is very customizable to your needs and health goals,” said Andrew Akhaphong , a registered dietitian at Mackenthun’s Fine Foods in St. Paul, Minnesota. He shared his top diabetes-friendly menu choices from Taco Bell.

Quick and Easy Low-Carb Breakfast Recipes

08 May, 2024
Looking for a breakfast dish that you can grab on your way out the door? These low-carb recipes are easy to make and and taste great straight from the fridge. These breakfasts are the lovely kind that you can make ahead of time because you’re a good friend to your future morning self – the one who needs to start the day with a nourishing meal. The kind you need in your repertoire if you live with people who claim they have no time for breakfast.  They’re all easy to make and taste great straight from the fridge (although you can reheat the egg-based meals if you prefer). They also make excellent snacks – and, luckily, there’s no law saying you can’t eat the same thing at 3:00 pm that you ate at 8:00 am.

Best Ever Guacamole

01 May, 2024
This tangy guacamole with lime and salt is a perfect accompaniment to any Cinco de Mayo celebration. Avocados are also nutritional powerhouses, making them a healthy choice for people with diabetes. Probably you think your favorite part of chips and guac is the chips, but if you make really excellent guacamole and serve it with an exciting assortment of vegetables, you might not miss those chips as much as you imagine. Feel free to add whatever you like to this recipe: salsa, chopped tomatoes, even corn kernels. But try it plain first – that’s how we grew to love it after a trip to Mexico, where we were served chunky, simple guacamole seasoned only with lime and salt, and it was absolute perfection. Plus, avocados are filled with nutrients – like healthy fats, vitamins, and minerals – so you’ll feel great after eating it.

Diabetes-Friendly Sushi – Your Ultimate Guide

24 Apr, 2024
Sushi is a favorite dish for many, but navigating this carb-heavy food can pose a challenge for those with diabetes. Learn more about the varieties of sushi, nutrition information, and tips for enjoying diabetes-friendly sushi.  Sushi can be challenging for people with diabetes, who often refer to it as the “food they love that doesn’t love them back.” Why? Because depending on the type of sushi you order and the portion you eat, it can be a healthy pleasure, or a decadent disaster.

4 Plant-Based Proteins for People With Diabetes

18 Apr, 2024
Plant-based proteins like tofu and tempeh help with blood sugar control and support weight loss, making them a healthy food option for people with diabetes.  You might be looking to cut back on meat for several reasons. Red and processed meats have been linked to the development of type 2 diabetes and can worsen existing diabetes complications.

Five Best Diets for Diabetes

10 Apr, 2024
The U.S. News & World Report recently released its 2024 list of the best diets for people with diabetes. See which diets made the list, and the benefits and drawbacks of each. In descending order, the top five rankings of the best diets for people with diabetes were the Mediterranean, DASH, Flexitarian, MIND, and vegan diets. While all of these diets – better described as meal patterns – favor whole foods as well as minimize added sugars and refined carbohydrates, their approaches vary. All five diets, however, have been shown to help improve blood sugar levels while providing adequate nutrition.

DIABETES AND DRY MOUTH: HOW TO ADDRESS THE ISSUE

05 Apr, 2024
Beyond the impact diabetes has on blood sugar levels, one overlooked but critical issue is dry mouth. Dry mouth, also called xerostomia , occurs when there is a lack of saliva in your mouth to keep it moist. The persistent dryness of the mouth can create a number of challenges for people living with diabetes. Continue reading to learn more about diabetes and dry mouth. WHAT CAUSES DRY MOUTH WITH DIABETES? Anyone can get dry mouth, but it is particularly common in individuals with diabetes . The primary reason for this association is likely due to elevated glucose levels. When blood sugar levels are persistently elevated, it can lead to frequent urination, resulting in dehydration and dry mouth.

8 Best Grains for People With Diabetes

02 Apr, 2024
Grains are an excellent source of fiber and other vital nutrients, but which are best for diabetes? Here's why nutritious options like farro, oats, and quinoa are at the top of the list. You’ve heard both sides of the story: watch out for carbs and eat whole grains. Whole grains are indeed carbs. So, do you have to avoid them? The answer is a resounding no. You can enjoy an assortment of whole grains as part of your balanced diet. Grains have a blood-sugar-lowering effect , are extremely versatile, and can add variety to your meals. Which ones should be on your plate? Explore these grain options and discover why you should be eating them. What are grains? Grains are the seeds of grassy plants or cereals like wheat and corn. The seeds of non-grassy plants or pseudocereals like quinoa and buckwheat are also edible. Common grains include: 

Spiced Eggplant Steaks

21 Mar, 2024
This Middle Eastern-inspired roast eggplant dish comes from the “The Noom Kitchen,” a new cookbook from Noom that features nutrient-dense, calorically mindful recipes.
More Posts
Share by: