Sugar Rush

By Elizabeth Somer
WebMD Feature

Many people find it hard to refuse the onslaught of sweet and creamy temptations during the holiday season. Diabetics, who must watch their sugar intake, are no different.

They may say "No, thank you" to the department-store Santa offering a candy cane, but then succumb to the pumpkin pie, Grandma's cheesecake, and maybe the fruitcake that inevitably serves as the finale of any traditional holiday feast.

But with the right game plan, people with diabetes can maintain their blood sugar without completely depriving themselves.

Hello, Sugar!

In the old days, doctors thought sugar enters the blood rapidly and aggravates already temperamental blood-sugar levels, so they warned people with diabetes to avoid sugar at all costs. However, the majority of scientific evidence does not support this recommendation. In fact, studies have found that blood sugar rises no higher in response to sugar than it does to white bread, rice, carrots, potatoes, and many other foods. Although various types of foods do cause levels of blood sugar to respond differently, the total amount of carbohydrates consumed is more important than the type.

Because of these findings, the American Diabetes Association loosened its recommendations on sugar. According to the association's 1999 recommendations, sugar and sugar-containing foods can be a part of a diabetic diet, but they shouldn't be simply added to the diet. Rather, they should be substituted for other carbohydrates already in the diet.

And while the green light may be music to the ears of anyone with diabetes, it is not a license to go overboard. That's especially true during the holidays, when worrying about gaining weight can in itself raise blood-sugar levels. In other words, if you want a small serving of pumpkin pie, then you must give up the baked potato with toppings at dinner. Or have half a serving of each. You can't have one serving of each.

If you're taking insulin, you must eat at consistent times synchronized with the action of the insulin you're using. If you're not taking insulin, spreading your food intake -- such as the day's allotment of carbohydrates -- throughout the day helps you avoid large increases in blood sugar that might otherwise occur.

Holiday Survival Kit

The goal during the holidays is to budget your sweets. That requires:

Advance planning
An emphasis on healthful recipes
Daily exercise

Here are some ways to put those guidelines into action:

Decide ahead of time what and how much you will eat ("I'll only have a small piece of apple pie with no ice cream") and how you will handle social pressure ("No thank you, I'm too full"). Then stick to your plan.
Develop personal "rules" for sweet indulgences -- such as sharing one dessert with a friend, limiting serving size, scraping off the high-fat whipped-cream topping, or rationing desserts to three per week (in which case you're only postponing, not denying, yourself a treat). Remember, failing to plan is planning to fail!
Volunteer to bring a favorite low-sugar dessert, such as plain cookies, baked apples, or sugar-free puddings, to social functions. That way there will be something appropriate for you to eat.
Make sure you don't take a holiday from daily exercise. Continue your routine workouts in addition to extra activities, such as parking far from and walking to the mall, or power-walking while shopping.

Revising Recipes

Almost any holiday dessert recipe can be revised to be healthier without sacrificing taste. Cut the sugar by one-third to one-half in a recipe and increase the use of cinnamon, nutmeg, vanilla, and other sweet-tasting spices and flavorings. Many sweet desserts are also high in fat, so replace fat with pureed fruit, such as applesauce or baby-food prunes, in recipes for chocolate brownies, cakes, or cookies. You'll also find you don't need as much sugar, since fruit supplies sweet taste. (You still must keep the portion small, since replacing fat with fruit increases the carbohydrate content, which must be monitored closely.) Sugar substitutes are another alternative for just about everyone, including diabetics.

Happy Holidays

People with diabetes can look forward to the holidays, with their seasonal traditions and social celebrations, as long as they remember that the game plan doesn't start at the dining table; it includes the entire day's food intake as well as exercise.

Medically reviewed December 2001

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