By: Barbara Bradley
Do family, friends and co-workers treat you “special” because of your diabetes?
Do thoughts of Aunt Martha’s holiday pie start your calculations of the correct bolus amount?
Are you dreading this year’s office party?
Do family gatherings and holiday traditions cause you stress? Does your glucose level drop when shopping?
Tip #1 You are special. You have an insulin pump. If this is your first year to experience the holiday season with your new management tool, you will be pleasantly surprised to discover enjoyment and glucose control without deprivation or guilt. It may be your opportunity to educate people about pump management.
Tip #2 Plan ahead. A plan will help you enjoy the challenges of the season. Check your pump supplies. Order now, or the Monday after Thanksgiving. At the least, order supplies to be delivered before the holiday mailing and delivery rush.
Tip #3 Know your pump. Discuss with your health care provider how to use all of your pump features, such as the dual wave bolus and extended- or square- wave boluses, basal patterns or temporary basal-rate increases may be needed. If you don’t use these features regularly, review the steps in your training manual or with your health care provider or pump trainer.
Tip #4 Bolus according to your insulin-to-carb ratio. Banquet meals, office-party grazing, high-fat and high-protein meals may need to use a dual-, extended- or square-wave bolus for four to six hours. Check your BG levels every two hours the first few times you try this method. Everyone is different. If you notice the BG going up or down during this timeframe, make the necessary corrections.
Some people use the “bolus when eaten” option, where each food item with a carb value gets a bolus delivery, for grazing at parties.
Tip #5 Manage your choices. Avoid excess. Food, alcohol, parties, spending. Too many calories will lead to weight gain. You need to bolus for those treats, unless you have a calorie burning activity planned.
Too much alcohol can put you at risk for hypoglycemia. When drinking alcoholic beverages, be sure to eat other food along with it. Drink responsibly and always check BGs every two hours while consuming alcohol, especially before bed and before driving.
Too many parties can use up your time for other activities and add to your stress and glucose level. Be selective, especially with food gifts delivered to your employment location.
It is okay to say “No.”
Tip #6 Plan for safe travel. Take enough supplies for each set change plus extra to cover site emergencies. One of my friends always packs five extra set/site changes. Also, take extra batteries.
Don’t forget the insulin. In many states, you need a prescription for Humalog and Buffered Regular. Avoid temperature extremes. Insulate your insulin from severe cold and hot climates.
Don’t be too concerned about airport security. You don’t usually need to show them your pump, however, if they ask tell them it is a medical device that delivers insulin.
Always carry pump supplies and insulin with you in a carry-on bag. Don’t forget to bring along ketone strips. In fact, this might be a good time to replenish your supply of these essential strips. In addition, you might want to take along some long-acting insulin and syringes in case you have to go off your pump unexpectedly.
Tip #7 Anticipate and prevent hypoglycemia. Shopping is exercise. Take your meter and strips, glucose tabs, and medical ID. Use the temporary basal reduction you normally use for mild to moderate exercise. Consider less insulin at a meal bolus preceding your shopping trip. In addition, make certain you have a current prescription for glucagon, and that family members or loved ones know where to find it and how to use it.
Tip #8 DE-STRESS! Excitement and happy times are good stress. Family conflicts, frustrations, disappointments, last minute preparations and unexpected disasters can raise your glucose level. Take a break. Hide. Listen to relaxing music. Take a walk. Do something that pleases only you. Give yourself a present. Create a new holiday tradition that only belongs to you and your immediate family. Communicate your dreams, desires, wishes, needs.