The holiday season brings many things—joy, family gatherings, reconnecting with old friends and for some a months-long bump in A1C levels.
The holidays themselves are traditionally a time for indulgence, but there are also numerous gatherings around those holidays that layer on the temptation. For diabetic patients and their physicians, it can be a difficult time to manage and stay on track.
An estimated 30.3 million adults in the United States are estimated to have diabetes, including about 7 million who have not been officially diagnosed, according to the Centers for Disease Control and Prevention (CDC). For seniors aged 65 and up, diabetes affects about a quarter of the entire age group, CDC notes.
There are numerous studies that illustrate the negative impact the holidays can have on a diabetic diet, including one from Diabetic Care that shows the dietary derailment extends long past the new year. The report found that while A1C levels increased during the pre-holiday and holiday season, it wasn’t a significant jump. The bigger problem, however, is that those increases, while small, did not return to baseline in the months that followed, leading researchers to conclude that the poor glycemic control of the holidays is not often reversed afterwards and can lead to substantial cumulative effects.
Robert Raspa, MD, a family physician in Jacksonville, Florida, said it’s important for patients and physicians to remember that straying from a diet for one day doesn’t have to be the beginning of a new trend.
“Christmas and Thanksgiving are one day and you can kind of reasonably splurge on those days, but you have to get back to your diet,” Raspa told Medical Economics. “Don’t just give it all up because you fell off the wagon for one day.”
Physicians can offer key support
Diabetes and depression often go hand-in-hand, and the holidays can be a difficult time to stay on track, he added. Physicians should encourage patients to plan small indulgences in advance, and perhaps sample a small amount of several foods rather than to indulge in them all.
“Plan which foods you are and aren’t going to eat,” he said. “Make allowances somewhere else if you know it’s not something you’re supposed to have on your diet.”
Raspa also suggests urging patients to give leftovers away and plan activities that offset the dietary disruptions.
“Our family enjoys taking a walk together on Thanksgiving of Christmas,” Raspa said. “It’s a very enjoyable time that’s not spent sitting around the table.”
Too many times, patients who slip during the holidays get caught up in that momentum and have a hard time getting back on track. Physicians can help patients plan and offer support, Raspa said.
“If you plan in advance it really helps because the weakness of the moment will overtake you if you’re not careful. I tell all my diabetics they can probably splurge and eat poorly on one day a week, but if you eat poorly seven days a week that’s not going work,” Raspa said. “Don’t fall into the defeatist trap.”
The holidays can also be difficult for physicians managing these patients, but Raspa has advice for them, too.
“Be kind. It can be the quickest thing to do to blame and get frustrated. Find your patience; we are all going through it,” Raspa said.