Expert Advice: How to Enjoy Thanksgiving with Diabetes

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By : Suvarna Sheth

Maintaining your blood sugar levels during Thanksgiving can be challenging for someone with type 2 diabetes, whether you are newly diagnosed or have been managing it for years.

However, with some thoughtful planning, you can make healthy choices that fit into your diabetes meal plan and enjoy this wonderful celebration with friends and family.

We speak to Susan Watkins, RD, CDE, a registered dietitian with St. Jude Heritage Medical Group in Brea, Calif., for some expert tips on how to prepare for Turkey Day.

Q: Does the Thanksgiving Holiday pose an extra challenge for people trying to manage blood glucose levels?

A: Thanksgiving is not as hard as some holidays as the eating frenzy tends to only last only one day. The problem is the overindulgence that can last from morning until night!

So it can not only throw your blood sugar off for that day, but it is often hard to get back on track the following day. People tend not to want to exercise when they overeat or feel sluggish.

Exercise is like “invisible insulin,” it helps sugar get out of your blood and into your cell. So start off Thanksgiving day with a long walk or bike ride to prepare you for the day.

You can also take a walk after dinner to help balance your blood sugars before diving into that dessert.

The key to your diet is having a plan.

This plan can include treating yourself to some of your holiday favorites. But the plan should also include balancing your plate, which means including carbs, with protein and lots of nonstarchy vegetable dishes.

Pick a carb or two for the meal and save the others for another meal.

I would plan to buy or make some of your own dishes to contribute to the meal. This way, it will ensure you have healthy options.

Also, plan to eat normally for your other meals of the day such as breakfast and lunch. By skipping meals, it will often cause you to eat even more when the holiday meal arrives.

If you are on insulin you can talk to your doctor or diabetes educator about how to dose for the extra carbs you plan to eat.


Q: What’s the best way to Keep on Track?

A: Buy quick, easy healthy foods to have on hand at work and home. This can help keep you on track during this busy time of year.

A good example is premade chicken and salad mixes. These can make for a quick, low-calorie meal.

Pick and choose what parties you will eat at and which ones you will plan to eat ahead. At those, you will eat at, ask the host if you can bring an item to share. This way it can ensure you have some healthy choices, such as a big roasted vegetable salad.

You can include some of your favorites and still balance your calories and carbs by adding in lots of vegetables.

Try having your dessert a few hours or more after your meal, this will help prevent a spike in your blood sugar.

If you are already having carbs at your meal, go for a walk after and then a few hours later dive into a small piece of cake or eat that cookie you have been eyeing.

If you are on insulin you can talk to your doctor or diabetes educator about how to dose for the extra carbs you plan to eat.


Q. Many traditional Thanksgiving dishes are high in fat and carbohydrates. How can someone plan around that?

A: Plan to make or purchase a few lower calories dishes of your own to share such as a zucchini noodle or warm roasted vegetable salad (you can even add in a grilled protein).

These can help fill half of your plate and that way you can control the portion of the others.

Add in an extra activity that day to help burn the extra calories and help keep your blood glucose levels controlled.


Q. How Should Someone with Diabetes Start Thanksgiving Day off?

A: If you already have a good routine, I would keep the morning meal as normal as possible on the actual holiday.

If you do not already have a good routine then you can try a scrambled egg or eggs whites (or 1 whole egg and one just the white) with spinach and feta on a slice of sprouted grain toast or whole-wheat English muffin.

You can pair it with a small fruit or a few nuts if you are on a lower carb plan. You can also make a morning parfait with plain Greek yogurt, nuts, and your favorite fruit.

Buffet Tables

Q. What are some good tips for navigating the buffet tables at a gathering?

A: Try not to socialize around the food table, that will lead to nibbling when you are not really hungry.

People often do not realize how much they eat when they are snacking or taking a bite here and a bite there, but the calories, carbs, and fat add up quickly.

When you are at the buffet table for your meal, keep the balanced plate in mind – ½ vegetables, 1/4 carb, 1/4 protein.

Even if you decide to go back for seconds, always add more vegetables to your plate. This helps you get more volume for fewer calories.

Mashed Potato

Q: Do you have an Alternate Mashed Potato Recipe?

If you still want the potatoes as I do, you can make a lower calorie version that tastes just as good!

I like to boil and mash the potatoes with the skin (which contains fiber and healthy nutrients).

By cooking the potato with the skin it also helps prevent the nutrients in the flesh of the potato from leaching out. I then use a little fat-free milk instead of whole milk or cream for my liquid, as well as a light version of butter. You can also use light butter or spread such as “Land O Lakes Light.”

You can use one that is diluted with water, whipped or mixed with healthy oil to keep the calories down. If you don’t want to part with 100% real butter, that is ok too, just use less of it.

I then add sea salt, a little garlic powder and for a twist, a little Thyme.

The carbs in the recipe would be similar to regular mashed potatoes but it contains more fiber and nutrients and fewer calories and fat. This can help control your weight and therefore your diabetes.

Other ideas are making cauliflower mashed potatoes, where you can drastically cut the carbs and calories (by subbing cauliflower for the potatoes and using all of the same add-ins as above).

Green Beans

Q: Any suggestions for good ways to prepare vegetable dishes?

A: There are so many tasty ways to make vegetables – you can grill,  roast, sauté, broil and the list goes on and on.

I love broiling zucchini and portabella mushrooms in the oven. Just wash, slice, drizzle with olive oil, sea salt and garlic powder (or your favorite seasoning).

Put your oven at 425 degrees Fahrenheit, or use the broil converter option if your oven has it.

Put your rack near the top. 10 minutes or so on each side (flip halfway through) until desired consistency (I like mine more al dente).

You can then use these warm vegetables in a cold salad, put on top of brown rice or make a pasta salad out of it (can use Chickpea pasta for added protein, fiber, and nutrition) or even make a roasted vegetable wrap.

I even like snacking on them alone!

Another dish I love to make at the holidays is sautéed almonds and green beans. It is simple: just add olive oil to a skillet and sauté garlic and onion, then add green beans and little more olive oil – you can use a lid for part of the time to speed up cooking.

Drizzle in a little white wine if you have it, as well as sea salt, lots of garlic powder and a bag of slivered almonds. Keep cooking until desired consistency.

These even taste great leftover and you do not miss the cream, fat, and calories you get from green bean casseroles.


Q: Any tips for preparing Turkey?

A: A great way to make a good, moist turkey without adding calories or fat is by using an oven bag. You put the turkey in an oven bag with added vegetables such as onions and carrots and then put into a roasting pan.

It cooks faster and comes out moist and delicious (you can follow instructions on the bag for more details).


Q: What about Alcohol?

Stick with alcohol that doesn’t have all of the added sugar and calories such as margaritas, wine coolers, and daiquiris, etc.

The best choices are wine, beer or liquor mixed with something noncaloric (such as vodka seltzer with lime or lemon).

Alcohol is one of the most misinformed topics when it comes to diabetes.

Most people (even those that have had diabetes for many years) think that is will automatically jump up the blood glucose levels. But alcohol can also have a lowering effect on the blood sugar,  possibly causing hypoglycemia.

The reason is that your liver normally kicks sugar into the bloodstream as needed, but when your liver is busy breaking down alcohol this process is altered.

The low blood sugar effect of alcohol can happen many hours later, making this dangerous if drinking late at night if you are on insulin or oral medications that also lower the blood sugar.

So the key is to use your meter to determine how alcohol affects you. Also be sure to have a drink with food and not on an empty stomach.

Also, the risks of high or low blood sugar with alcohol increases the more you drink at one sitting. And when you are intoxicated you will often also make poor food choices. So keep a limit on it!

Food police

Q: How to deal with people who tend to be “food police?”

For those close to you, I would talk to them privately about how they can support you with your diabetes.

Others that you don’t see as often you can let them know that you appreciate the help, but that you have a plan for the day and even though you may not follow it perfectly, you have strategies for taking care of your diabetes (such as walking after the meal).

On the other hand, some people are very difficult and if you don’t see them as often it may be easier to just change the subject!


Q: How to deal with people who want to load up your plate because it’s “once a year?”

I would politely just say that you have a plan for the day to stay as healthy as possible and that you would prefer to do the plating.

Or say, that vegetable dish looks delicious – you can fill half of my plate with that!


Q: How can someone incorporate some exercise into the day before or after the dinner?

Start the day with exercise, which often will help you want to eat healthier throughout the day. Exercise is like a magnet it attracts other healthy behaviors.

Catch up with family and friends by taking a neighborhood walk after dinner.

Q: How can you stick to your meal plan when everyone else around you is overindulging?

  • Stay full by bulking up on low-calorie items.
  • Let yourself have some of your favorites.
  • Distract yourself, stay away from the food table and find other fun activities and games to socialize with family and friends other than just eating.

The bottom line is you want to enjoy your holiday and the tasty foods that go along with it, but not at the expense of your health.

So try to find a good balance between eating some of your favorites, adding in lots of vegetables and increasing your walking! This way you can leave the holiday feeling good about yourself and your commitment to your health.


Susan Watkins is a Registered Dietitian and Certified Diabetes Educator. She is the manager of the Center for Health Promotion at St. Joseph Health and the coordinator for St. Joseph’s ADA recognized diabetes program. She also manages their HMR weight program, which has been nationally recognized by U.S. World News and Report as a best, fast weight loss diet in the country for the last 3 years. In addition to diabetes, she creates programs and educates patients on a variety of conditions such as IBS, heart disease, kidney disease, and liver conditions.