By Lisa Kaylor, Wellstar MCG Health Medical Center
With Thanksgiving fast approaching, many families are looking forward to gathering and feasting. However, for millions of Americans living with Type 2 Diabetes, the holidays can present serious health challenges. Indulging in an abundance of sugary and starchy foods can lead to spikes in blood sugar, which over time can damage vital organs like the heart, blood vessels, eyes, nerves and kidneys. Armed with knowledge and an informed strategy, navigating the holidays can still be enjoyable…and delicious.
Diabetes isn’t new. It’s been documented for centuries. It is a condition in which glucose, or sugar, from food is not processed by the cells for energy as it should be.
“Think of your body’s cells as houses. Glucose from food is the energy we need to get inside the cells. Insulin, created by the pancreas, is the key that unlocks the door,” said Dr. Earl Stewart, Internal Medicine Physician and Medical Director of Health Equity at Wellstar Community Health and Center for Health Equity.
In a person with Type 2 Diabetes, one of two things happens. The person can develop insulin resistance, in which the locks (cells) become rusty and don’t respond well to the key (insulin). Or, they can develop insulin deficiency, in which over time, the pancreas wears out trying to produce enough keys (insulin). In both situations, too much glucose remains in the blood stream, which can lead to greater health complications.
Today, the numbers of people affected worldwide are reaching epidemic levels. This is due to rapid shifts in diets toward processed convenience foods and lifestyles that have become more sedentary. Black Americans are more than twice as likely to be diagnosed with diabetes as white Americans. But the solution is not as simple as eating less and exercising more.
“This is not a moral failing. It is a complex issue rooted in historical and systemic factors that affect access to care, nutritious food and safe places to exercise,” Stewart said.
Effective management combines lifestyle, medication, and monitoring. The goal is to keep your A1C (average blood sugar over three months) below 7% in accordance with the American Diabetic Association guidelines, and control blood pressure and cholesterol.
Medications may help. Some of the most common include Metformin, which helps reduce glucose production by the liver and makes your cells more sensitive to the insulin you already produce. SGLT2 inhibitors like Jardiance and Farxiga protect the heart and kidneys by removing excess sugar from the bloodstream through urine. GLP-1 receptor agonists like Ozempic and Mounjaro slow digestion and help the pancreas make insulin.
You can also manage blood sugar by choosing whole foods that are low in starch and sugar.
“Focus on intentional choices. Prioritize non-starchy vegetables, lean meat or plant-based proteins, and quality carbohydrates,” Stewart said.
It’s also important to monitor blood sugar levels regularly. Technology has made this easier and more comfortable with monitors like continuous blood glucose monitors, which provide personalized insights into how specific foods, exercise and sleep affect your glucose levels.
The good news is you don’t have to give up the pumpkin pie or sweet potato pie at Thanksgiving! But be sure to have a strategy and enjoy your favorites in moderation. Stewart recommends using smaller plates and filling up on healthy dishes first. Go ahead and grab a spoonful of dressing or stuffing and macaroni and cheese but keep the portions small and keep your blood sugar goals in mind. After dinner, take a walk. Aim for 30-minute brisk walk five days a week.
With mindfulness and planning, the holidays can be happy indeed.
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