Thanksgiving, Diabetes, and Planning for Success

Thanksgiving is a time where families and friends get together, laughs are had, games are played, and let us not forget... The food.

On this day, social media feeds fill up with pictures of plates stacked high with food. Beautiful table settings with turkey, stuffing, potatoes, cranberry sauce, and desserts accompanying them. Many people look forward to this day, but what if you’re one of the 34 million Americans living with diabetes? Do you still anxiously await the day of foods that spike your blood sugar?

I had the pleasure of interviewing Donna Rosenthal — a psychotherapist and licensed counselor who has been living with type 1 diabetes since the age of 11 — to talk about coping with diabetes during the Thanksgiving holiday. With type 1 diabetes being an autoimmune disease, I started the conversation off by gaining an understanding of how Covid affects diabetes. 

"I felt like I was a walking target for this virus"

Back in March when Covid-19 was making its way throughout the world, so was mixed information. Everyone knew the virus was dangerous and that the immunocompromised, the elderly, and those with preexisting conditions were at higher risk for life-threatening complications if they caught Covid. Donna falls under that umbrella with type 1 diabetes and the fear of catching Covid surely did follow.

A visit with her endocrinologist put her at ease when she learned that the associated risk for Covid and diabetes comes from trying to manage your blood sugar levels while you're extremely sick. It seems that according to some, being diagnosed with diabetes doesn't necessarily make you more susceptible to catching Covid, but can make managing diabetes more difficult if you do. Follow CDC guidelines to stay as safe as possible and devise a plan for managing your blood sugar if you were to catch Covid.

With Thanksgiving a few days away and Covid cases still on the rise, I'm sure this day will look much different for everyone than it has in the past.

First Thanksgiving after my diagnosis

Donna, now 59 years old, has had many Thanksgivings since her diagnosis at 11. She has had the time to figure out a plan that works best for her during the holidays. I was curious to see if she could recall her first Thanksgiving after her diagnosis and she remembers it as being "awkward."

"It was a tough juggling act because there were still a lot of new aspects of the disease for me and my family to comprehend." 

Donna remembers family members being yelled at for eating sweets in front of her, lots of food guarding, and hearing loads of "don'ts" coming from people's mouths. "Don't let her see the ice cream... Don't let her near the cake." At 11 years old it's hard to understand why this year you can't enjoy Thanksgiving like you did last year. For most kids, the dessert table is the highlight of the day, but for kids with diabetes, the dessert table is mostly taboo.

In the previous blog, we discussed how managing diabetes requires a care team. Donna's doctor knew that this Thanksgiving was going to be a unique experience for her, but wanted her to feel as normal as possible. He told her family that if she wanted a piece of cake, she could, but she would just need to take more insulin. Although this isn't a sustainable way to manage diabetes, it appears to be an option for insulin-resistant people during special occasions.

Now and days with the creation of insulin pumps, it's less of a risk to stray away from your diet. You enter the food's sugar/carb information into your insulin pump and it will dispense the correct amount of insulin you'll need to maintain normal blood sugar levels.

Planning for Temptation 

Being diagnosed with diabetes at such an early age gave Donna time to experience and navigate through her nutritional landscape. She acknowledges being a diabetic is still a work in progress with some temptations being easier to resist than others. Initially, her parents had to be the authority in her diet and lifestyle changes. Donna points out that it takes a combination of support at home, a good care team, understanding one's condition, and education in self-care to be successful.

"Hopefully, you're educated in a way that doesn't frighten you and lead you to bad behaviors. If you feel your efforts are going to waste and you're not emotionally sound, then you may lead yourself down a self-destructive path."

When Donna was a child she recalls being in the supermarket and reading a headline from a popular tabloid that stated, "Type 1 diabetics die at the age of 32."  With a new diagnosis that she didn't fully understand and reading this headline led her to think she was going to die in her thirties. She knew she had to be disciplined, but this added an unnecessary notion of fear that didn't exactly help. Although this headline may be true for some, it doesn't speak for everyone living with diabetes.

Learning information like this without knowing more can lead you to irrational behavior. Why should I stick to my plan if I'm going to just die in my 30s? When in actuality, it's the opposite. Not managing your diabetes by sticking to your plan increases your chances for complications at a much higher rate.

Donna's advice for dealing with temptations is to be mindful and aware. Educate yourself with what you can and can't have, understand how things affect your blood sugar, and take a moment before making decisions that affect your health. Ask yourself, "Do I really need this?" and if you decide yes, take the steps to do it safely.

Thanksgiving Day: What's on my plate?

I was curious to know what Donna's Thanksgiving plate looked like and if it differed from mine. To my surprise, the contents weren't vastly different!

Donna's Thanksgiving plate usually consists of:

• Turkey
• Mashed Potatoes
• Cranberry Sauce
• Stuffing
• Vegetables
• and the occasional bite of dessert.

The difference in our plates... portion sizes. She still enjoys the same foods everyone else would, but just in smaller quantities. Now, as an adult, her portion sizes are much smaller and she often skips dessert altogether. When it comes to drinks, she sticks to flavored seltzer or water.

For those with diabetes struggling with discipline during this tempting holiday, Donna says "balance is important."

Identify:

1. The healthy foods you can have more of
2. The foods you can do without
3. The foods you shouldn't eat a lot of

Structure your plate accordingly:

1. Eat more of the foods you can have
2. Skip the foods you can do without
3. Eat very small portions of the foods high in carbs and sugars

Plan out your meal before you get to the table and stick to your plan. If you feel you want more of something you shouldn't, then make sure you take the necessary precautions.

Cut yourself some turkey and some slack

Towards the end of our conversation, Donna touched on the emotional aspect of living with diabetes. Because diabetes is one of the most common diseases and one of the trickiest, there will be times where you do everything right and your blood sugar still spikes. There will be days where you're so frustrated that you want to resort to comfort foods that contain sugar and carbs.

The important thing to do — understand and accept that these things will happen, allow yourself to feel how you feel, and determine ways to cope that work for you.

"It's important to be able to let yourself feel frustrated. Yes, technology is great, but you do have a medical condition. You do have to be more careful. There are complications and I think it's important to be as open as you can with yourself about it and If you need support, take the steps to get it."

In other words, cut yourself some slack. Diabetes shouldn't become your whole identity, but simply a part of it. From speaking with Donna, I learned that diabetes isn't a one size fits all type of disease. What makes one person's blood sugar spike may have the smallest reaction for someone else. Taking the time to understand what works for YOU, finding your support system, and cutting yourself some slack will keep you mentally and physically prepared so you can continue to live your life!

If you only take away one thing from this blog post, then remember this quote from Donna that sums it all up —

"Allow yourself to enjoy your experience with

restraint, compassion and mindfulness" 

Stay Safe and Happy Thanksgiving from Onthemuv!

Donna S. Rosenthal is a psychotherapist and licensed counselor who specializes in loss, grief counseling, chronic pain and chronic illness. If you would like to reach out to Donna for support services, she can be reached at donna.sue.rosenthal@gmail.com or 516.318.1970.

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