This story was originally posted on December 27, 2013.
In a few days, it’ll be New Year’s Eve and you have dinner plans for midnight! And, you are getting together at 9:00 for drinks and dancing with friends. New Year’s Eve isn’t as punishing on your diabetes schedule as Yom Kippur or Ramadan, but it’s a challenge nonetheless.
Consistency in the timing and amounts of medications and in the timing and amounts of carbohydrate you eat are important considerations for many people who have diabetes. It isn’t easy to be consistent in an inconsistent world, not under the best of circumstances. However, it becomes just that much more difficult when New Year’s Eve rolls around.
The hectic schedules everyone has during the holidays, the parties, the staying up late and sometimes sleeping in can throw normal schedules tospy turvey. New Year’s Eve is the culmination of six weeks of excess food, excess “holiday cheer” and excess running around. Sometimes people become so busy they forget to eat and/or take their medicines, especially insulin. This can lead to either high or low blood glucose levels.
Although, arduous, eating the same amount of carbohydrate at meals (not the same food) can take some of the variability out of your blood glucose readings. If you take a fixed dose of insulin at meals, a once-a-day basal insulin or oral agents that cause the pancreas to secrete insulin -such as glyburide or glipizide- keeping carbohydrate consistent takes one variable (food) out of the multi-variable equation of trying to stabilize your blood glucose.
One way to ground yourself and help keep on schedule is to plan actives to happen around your medicine and food needs. Keeping some regularity in your life can make the chaos of the holidays less exhausting.
Setting up reminders can go a long way to help you maintain your equilibrium. Setting an alarm on your watch, phone or blood glucose meter can keep you on schedule for your meals, checking your blood glucose and taking your medications.
If you are going to go out on New Year’s Eve try to keep the rest of the day as stable as possible. Eat and take your medicines on time. Then when your usual dinnertime rolls around, have a snack and “cover” it with medication if necessary. If you take insulin or a dinnertime oral agent, save it for the big meal. Pace yourself with the booze; after all you want to be clear headed to ring the New Year in.
Below are some tips that will work for any holiday, not just New Year’s
If you can’t eat full meals on your regular schedule: Make sure you carry snacks and eat something every 4 to 5 hours. This will help keep your blood glucose steady and avoid low glucose readings. Keeping a few nonperishable snacks with you, such as peanut butter crackers, low-fat sports bars, or a piece of fruit, can keep you going strong even if you are on the run.
A word about alcohol: If you are not careful, alcohol can cause you to have low blood glucose levels. If you decide to drink, do so in moderation— 1 alcoholic beverage for women and 2 alcoholic beverages for men. Always eat carbohydrate foods along with your beverage and check your blood glucose levels more often.
If you miss a dose:
For most oral medicines, take the dose as soon as you remember. If it is close to your next dose (meaning you are scheduled to take your pills at noon but remember at 5 pm and your next dose is at 6 pm), skip the missed dose. Never double the dose of medication without talking with your health care provider.
For a basal insulin such as Lantus® or Levemir,® if you remember within a few hours take the full dose. However, if it is longer than you will need to decrease the dose by the percentage of time that has elapsed. It is usually best to call your health care provider and ask them to help you calculate the correct dose.
If you take meal time insulin, the insulin should join the food; if you normally have lunch at 1 pm but need to eat at 3 pm, wait until 3pm to take your insulin. If you forget to take your insulin right before the meal, then take it immediately after the meal. If you have forgotten entirely, wait 3 hours and correct your blood glucose.
To better diabetes care in 2014! Happy New Year!