Prep for Passover: Managing Your Diabetes During a Seder

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This article was first posted on March 22, 2013. The date of Passover shifts according to the Jewish calendar.

Seder plate 2Pesach, or Passover, is almost upon us. This year it started on the evening of April 10. Passover is the Jewish holiday that celebrates the Jews’ freedom from bondage under Egyptian rule about 3000 years ago.

For the seven days of the Passover holiday, celebrants avoid foods made with leaven (or yeast) to commemorate the hardship of their forebearers in having to leave Egypt in such a hurry that they were unable to wait for their bread to rise. To remember and celebrate, there are two special meals called Seders on the first two nights of Passover.

Like many traditional holiday feasts, there is an abundance of food served, some healthy and some…not so healthy. For people with diabetes being aware of the carb and fat content of foods served during Seder can help you keep in good metabolic control while enjoying the symbolic, aesthetic and sensory aspects of the meals.

Traditionally, for the main meal, hardboiled eggs, gefilte fish, matzo ball soup, a brisket or chicken dish, vegetables, such as carrots or asparagus and potatoes, rice or potatoes kugel is served. Desserts are fruit compote, unleavened cakes such as chocolate covered macaroons or sponge cake and sweets, such as fruit jellies. Four glasses of wine or grape juice (for the temperate) accompany the telling of the story of the Israelites exodus from Egypt.

The following are average nutrient breakdowns for the foods served during Passover. Remember, these are averages. Your Passover Seder may have more more less of each nutrient listed, depending on ingredients used and preparation.

Matzo ball soup 1 cup = 120 calories, 4.5 grams fat, 13 grams carbs

Non jellied gefilte fish 1 piece– 80 calories, 1.5 grams fat, 9 grams carbs

Matzo 1 oz. (1 piece) 111 calories, .5 grams fat and, 24 grams carb

Potato Kugel one 2-inch square 270 calories, 12 grams fat, 37 grams carb
(try a lower-cal version from DLife)

Fruit compote ½ cup 75 calories, 0 grams fat, 18 grams carb

Grape Juice 1 cup 150 calories, 0 grams fat, 30 grams carb

Sweet Wine 1 cup  160 calories, 0 grams fat, 14 grams carb

Dry White Wine  1 cup  120 calories, 0 grams fat, 1-3 grams carb

Chocolate Coconut Macaroon 1 each 127 calories, 8 grams fat, 7 grams carb
(try a lower-cal version from DLife)

If all four cups of wine are consumed in their entirely, the alcohol content of the meal is considerable. It is important to remember that alcohol can cause low blood glucose levels in those who take insulin and or oral agents that increase insulin output from the pancreas. Reduction in insulin dose may be appropriate.

Since Seders take place after sundown, there can be a large lag time between the previous meal and the main event. Therefore, having a snack before the start of the Seder can help control hunger and overeating later.

In addition, for those people who take insulin, determining when to give their dose can be problematic. Some Seders can stretch for over four hours, leading to confusion about the optimal time to give an injection. Usually the Seder is divided into a number of parts: the Kiddush or blessing begins with the first glass of wine, followed by the Karpas or ritual appetizer in which a bitter vegetable is dipped in salt water and eaten. Then the second cup of wine is consumed prior to the telling of the Passover story. After the second cup of wine, there is a staged set of prayers eaten with a ritual meal of bitter herbs (usually horseradish), matzo (unleavened bread), and charoset (chopped apple with honey). The main holiday meal commences with a hard-boiled egg and ends with the eating of the afikom (the hidden matzo). After the main meal two more cups of wine are consumed.

People on pumps can use their square or dual wave options to compensate for the length and higher fat content of the meal. They can also use a temporary basal adjustment to reduce their insulin does for the glucose lowering effects of the wine.

Those taking insulin by injection may find it helpful to split their insulin doses, taking a small amount upfront to account for the carbohydrate in the matzo and charoset and a second does to compensate for the second wave of dishes.

As with any prolonged, hearty meal, having a plan before you sit down to eat can avoid unexpected results. And finding time for mild exercise such as walking can help prevent spiking glucose levels, reduce stress as well as revive the senses.

Talk with your physician or diabetes educator about a plan appropriate for you prior to the beginning of the holiday on Monday evening.

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