Five Thanksgiving tips for parents of diabetic children

Diabetologist Fran R. Cogen, M.D., CDE, helps parents keep Thanksgiving both kid- and diabetes-friendly.

Thanksgiving: Smiling Boy Waits As Turkey Is Brought To Table
© seanlockephotography, Adobe Stock

While the holidays are a great time for indulging in your favorite sweets and treats, they can be particularly stressful if you have a child with diabetes. You’re tasked with paying close attention to your child’s eating choices while making sure that he or she doesn’t feel left out of the festivities.

With careful planning and some help from the following five tips, your child can make the most of the holiday without worry.

Monitor blood sugar levels frequently

High-carb holiday foods like cakes, breads and pasta can cause blood sugar levels to spike. Therefore, it’s a good idea to check your child’s level more frequently during the holidays and dose insulin accordingly; keeping in mind that activity may also affect blood sugar levels.

Make sensible snacks readily available

Snacking and the holidays often go hand-in-hand. But for children with diabetes, grazing on carbs and holiday sweets can be dangerous. Swap the cookies for a fun, holiday-themed vegetable display. For example, arrange a variety of veggies in the shape of a turkey or use carrots to create a pumpkin. Your child could also indulge in fancier finger foods such as miniature cucumber and hummus sandwiches or lettuce wraps with cream cheese and turkey.

Have a plan for timing meals with insulin dosing

If your child is on an insulin regimen requiring two or three shots per day (conventional insulin therapy), try to time the holiday meal around dinner so that the short- or rapid-acting insulin can be easily adjusted. If tradition dictates that the main meal take place in the afternoon, consider adding an extra dose of rapid- or short-acting insulin.

If your child is on basal-bolus therapy with multiple daily injections or insulin pump therapy, it is easier to be more flexible with meal times. Provide insulin for carbs and to lower blood sugars.

As a rule of thumb, it’s always best to discuss specific questions with your child’s health care team ahead of the holiday, that way they can help you set up a tailored insulin management plan.

Use a sugar substitute to make healthier desserts

To eliminate sugar in baked goods, try using a substitute such as stevia. Unlike sugar, artificial sweeteners do not raise blood sugar levels.

Kids can join in on the dessert prep process by helping make sugar-free Jell-O®, which they can then cut into leaves, pumpkins or other holiday shapes using cookie cutters.

One word of caution: Avoid giving your child foods made with sugar alcohols, such as “diabetic candy or ice cream,” which can cause an upset stomach and diarrhea.

Start a new, active tradition

Family traditions are often a mainstay of the holiday season. This year, after your meal, go for a hike or play an interactive game to get the entire family up and moving. Exercise not only helps to keep blood sugar levels stable, it also provides the family with a great way to bond and avoid excessive snacking.


Photo courtesy of Children’s National Health System

Fran R. Cogen, M.D., CDE, diabetologist, is the acting division co-chief of Endocrinology, and director of the Childhood and Adolescent Diabetes Program at Children’s National Health System. Her clinical interest includes intensive insulin therapy and its effect on quality of life. She is dedicated to advocating for the needs of patients and their families in managing diabetes and in 2007 was named as one of the “Best Doctors in America.” Dr. Cogen lives in Bethesda, Maryland, and she enjoys playing pingpong, movie going, reading British literature and walking her bichon frise.

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