Welcome plunk for to our weekly diabetes advice column, Ask D'Mine, hosted by veteran eccentric 1 and diabetes author Wil Dubois in New Mexico. Present, you can ask all the flaming practical questions you may not neediness to ask your doctor. With Christmas just close to the corner, Wil's offering some insight this weekend around navigating this food-centric holiday with diabetes.

{Got your possess questions? Email us at AskDMine@diabetesmine.com}

Brandon, type 1 from Grand Canyon State, writes: So it's that clock of the year again. The big fellowship vacation carb feast is on the near horizon, and it's e'er a BG calamity for ME. No matter what I try, IT's a draw near- DKA fest. It seems to me my options are to debased carb IT, live like there's nobelium tomorrow and throw insulin at it, or attempt something in the middle. What say you, Master Wil? How do you approach big celebratory meals?

Wil@Ask D'Mine answers: Like you, Brandon, I've tried all three approaches. And I've fallen flat on my face victimization for each one unity. But, luckily for you, from that prone position on the floor, I've had metre to analyze my failures, and I've unlocked some secrets that will maximize your chances of success with for each one of these three approaches to extant holiday meals.

And then let's view completely three survival strategies, the hidden pitfalls of each, and many ideas on how to overcome them.

Flat-growing Carb It!

Big, heaping, steaming plates of protein. Heavy happening the salads and veggies. No bread, please. Make you're allergic to desert. This approach should work, but IT often doesn't. Why? Several reasons. First of all, it takes an iron will, and peradventur a encouraging category—both of which are in short issue now. Merely even devoted D-peeps with both happening their position still sometimes suffer holiday meal spikes.

WTF?

Does the smell of pecan pie climb blood sugar? Are there carb fumes in the air? Sometimes I think so, but the truth is that food for thought isn't the only matter that raises blood sugar. Stress can carry a wallop as large equally confetti dodge.

Any tension at a typical stupendous family gathering?

And don't forget that in add-on to the stress of tolerating that annoying uncle or your brother's twit-brained wife, simply concentrating so heavily on resisting culinary temptations is stress inducing itself. Plus your inner cave person is in fight or flight modal value in the presence of that home of holiday cookies, merely you give the sack neither flee nor engage in moolah-burning combat with a cooky—so your sugar spikes. And, course, if you've traveled any distance the least bit to this gathering, you penury to take the effect of travel happening blood sugar. What can you do? As many of these stresses are stable, inferior, and present at the holiday gathering, I'd suggest some extra basal to combat IT.

But you probably knew whol that. So what's the secret I promised? The volume ambuscade. Another factor at play with people trying to limit holiday feasting to low carb options is that they tend to eat waaaaaay more of those low carb portions than they mightiness at a run-of-the-mill meal; and it's important to remember that scurvy carb foods are just that. Low carb. Non none carb. Veggies experience carbs that need to be counted. Even meats have some carb. It's tenuous enough that we can safely push asid the carbs when eating regular medal-sized portions, but if you are feasting, you're going to want close to insulin to summons the conveyer belt of food resounding into your mouth.

Isu-nami!

Why not retributory bolus the bastard? Eat everything in heap and blanket it with enough insulin? Yes, a tidal wave of insulin should wipe all the carbs hit the beach, right?

This is one of those things that whole kit on paper, simply doesn't tire arsenic well as you'd expect in the real world. Function of the hugger-mugger is that most of us are also yellow-bellied to take the amount of money of insulin this approach truly requires. The number of units required just sounds too scary. We aren't used to taking high volumes and the spector of the Hypo Reaper causes us to hold back.

And that's just the start.

To make this approach work, you need to make up a carb counting mavin, including making allowances for fibre too as reckoning trace carbs in veggies. And you need to carb count each round of feeding and intentionally stack the insulin. On some pumps, if you use a pump, you may have to override the insulin on board software to do this. If you'atomic number 75 using a pen and an app like RapidCalc you'll want to ignore the "suggested Cupid's disease" window that you usually use, and interpret the fine print that shows the meal and discipline adjustment to determine the non-well-balanced dose for the carbs.

And that's non altogether. It's winter, and insulin doesn't work as well in winter A it does at new times of the twelvemonth because our bodies are more insulin resistive. This effect increases with loudness. Just making up some numbers here so that you get the point, let's say that you're 10% more insulin resistant. If you were taking three units using your modal IC ratio and undershot by 10% you'd Be 3/10th of a unit short of the insulin you required for the repast. No big deal. But now let's say you pauperization 20 units to cover a feast. Now you'Ra a chockful two units short of what you need. Antimonopoly from seasonal insulin resistance alone. Between fear of high doses, and the fact the doses don't work "right" this season, you throne see how IT's easy to think you're bolusing with abandon, when in fact you'ray below-bolusing.

Merely here's the real secret: If you'Re eating like King Henry the One-eighth, you need to king-sizing your basal insulin, besides. PWDs tend to think of our basal needs as a geosynchronous measure, simply that's not true. Basal should live some half of the insulin your body is victimisation. If you've jacked your fast-acting through the roof, you need to a greater extent basal to match information technology. Ideally, you want an increase of basal going into the feast, and over the night following it as well.

Still, even with heavy insulin use, it seems our insulins are poorly matched for much a huge digestion equivalence, so I recommend frequent follow up corrections in the hours following the repast.

Soh it's more work than you'd think, just it's a sight of fun to be fit to eat everything in sight, and it reduces the strain that's part of the crushed carb overture. For what's information technology's worth, despite all the problems with it, the Isunami has been my historic go-to approach, merely this year, I'm…

Standing midmost of the Road

The lowest approach to the holiday meals is to lightly sample all that is offered. To not go crazy, but not do without anything either. In other words, to engage in pure and unadulterated moderation.

As I said, this is the approach to the holidays that I'm using this twelvemonth, but not so untold because I equivalent it, or that I'm good at it, but because someway—mysteriously—I've become quite fat this twelvemonth. Apparently, it's from eating and drinking excessively much. Who knew? Oh… that's right: Everybody.

Anyway, my free weight gain strike a chord when I was invited to a swanky vacation company and discovered that no of my dress shirts would button over my belly. (This is the risk of mainly effortful T-shirts. They stretch with increasing free weight and if you avoid mirrors, you'll never know what's natural event.) And so I'm primarily eating light portions to taste to reverse my waistline, but it's also a legitimize way to control blood sugar at holiday gatherings.

The like the abstinence approach we started with, this proficiency takes around will power (or in my case Wil index). In reality, many people find that it takes more will powerfulness than the low carb route because of the habit-forming nature of carbs. Small bites of things that meld in your mouth can go forth you panting for more like Pavlov's dog. But the upside is that you get at least a sample of all that's organism offered, and even though some underground to seconds is needed, I in person find it little stressful than the low carb approach.

The secret here is psychological. Having a tool to keep you from falling completely off the carb wagon. What I find works best is to guess that I'm eating a good old-fashioned TV dinner. There are atomic number 102 seconds, much to a lesser extent thirds. I but have what came served on the aluminum tray.

And extending that doctrine of analogy foster—the dessert? Whatever you choose, information technology has to acceptable in that diminutive square at the top center of the tray.

This is not a medical advice column. We are PWDs freely and openly communion the wisdom of our collected experiences — our been-there-done-that knowledge from the trenches. Merely we are non MDs, RNs, NPs, PAs, CDEs, operating room partridges in pear trees. Bottom demarcation: we are only a small part of your total prescription. You still require the guidance and care of a licenced medical professional.