Managing diabetes at Christmas time

The diabetes team have revisited their tips for managing diabetes over the Christmas holidays and updated them for 2022  

Christmas Food  

“There is no reason children and young people with diabetes cannot enjoy festive foods and treats, just like anybody else. If your diet is healthy most of the time, treats at Christmas are fine, just try to make sure Christmas does not last four weeks (and count your carbs)!” 

“Check the labels of sausages, gravy and stuffing as some may contain carbohydrate, for example some stuffing may just contain meat whereas others may contain breadcrumbs or dried fruit, which contain carbohydrates” 

“If you are eating out during the holidays (or ordering a takeaway/delivery) then have a look at the nutritional information on the website before you go – you then have a head start on carb counting!” 

Remember that eating more protein and fat can also cause higher glucose levels. You may need more insulin with some meals 

Tech tips 

Using manual pump therapy 

“Try to give your bolus about 15minutes before you start eating your Christmas meal. You might want to give a bolus for each course instead of all at once” 

“Christmas dinner is usually a bigger meal than normal. If you like turkey or pigs in blankets, then this means more protein. High protein meals can cause high glucose levels for many hours after eating so try using a combination type bolus (DualWave or extended bolus) over 2-3 hours to help prevent this rise.” 

If you are not sure how much you will eat, enter some carbohydrate before you eat and the rest once you know the total amount” 

Using hybrid closed loops systems 

“If you are using the TSlim with Control IQ, remember you may need to adjust the time your pump thinks you are going to “sleep” as your sleep pattern may be different over Christmas” 

“If you are using a hybrid closed loop system, it should be able to deal with slightly raised glucose levels caused by high fat and protein foods.  

“Remember to bolus 10 minutes before you eat, this helps the system keep your levels in the target range”  

Moving move 

“Relax and enjoy. If you are noticing some high glucose levels, then you could try to get out for walk with your family” 

“Being active after eating helps glucose move into the muscle which helps lower glucose levels after eating, a burst of activity after meal can avoid needing to give a correction dose for a high level” 

Seasonal settings 

“Excitement can lead to high or low glucose levels. If you are correcting a high glucose that is caused by excitement, only give 50% of the correction suggested by the bolus calculator” 

“An increased temporary basal rate might be useful for relaxing days at home or for long journeys” 

“If you are using an insulin pump, rather than adjusting the basal rates of your current pattern, copy and create a new pattern to use for the holidays. You may already have a pattern that has been adjusted for late nights and lie-ins!” 

“If you are using the Medtronic 780G or CamAPS systems remember that these learn your insulin requirements, you may need to use a higher glucose target when you go back to school/college/university/work to avoid lows” 

“If you are on injections, you might need to make adjustments to the doses or carb ratios– make a note of your original settings so you can go back to these after the holidays have finished” 

Staying safe 

“If you are drinking alcohol, remember to stay safe. You may need less insulin if you have been drinking alcohol, you may also need an insulin free snack before going to bed. Always let the people around you know that you have diabetes so they can help you if needed.” 

“Check what supplies you have at home and check they are in date. If you use an insulin pump, check that you have insulin cartridges and a pen device, for both long and short acting insulin, in case you need to give a pen injection” 

“It is easy to lose track of time but remember to change your cannula every 2-3 days and if corrections are not working remember ABCC (Assess, Bolus, Check, Change) - it is still an insulin pump, and the basic rules still apply! Auto corrections not working can be a sign of cannula failure”. 

“There are lots of bugs about. If you are unwell, remember to check your glucose and ketones regularly. Remember to use ABC (if you are on injections) or ABCC (for insulin pumps) and check for ketones if glucose is >13.9mmol/L. If you have high glucose and ketones >0.6 then use the sick day rules” 

More information can be found on our website and at www.Digibete.org 

We will have fewer staff working over the Christmas period (28th – 30th December). For any out of hours queries please call the emergency mobile number  

The children and young people’s diabetes team at UCLH wish all the families a very merry Christmas and a happy new year.