Newswise — Nicoleta Schock was diagnosed with Type 1 diabetes as a child. In the 26 years she has been managing her diabetes, the holidays have always presented her with the greatest challenge in maintaining healthy blood sugar levels.

For Schock, and the more than 18 million Americans estimated to have diabetes, holiday food, parties, alcohol and stress can create serious problems.

"We are all exposed to a lot more food, a lot more sweets, a lot more alcohol and a lot more stress," says Cecilia Sauter, MS, RD, CDE, and director of the University of Michigan Health System Diabetes Education Program. "For people with diabetes, that can be very difficult because they really need to watch portion size, when they're drinking and how much, and pay attention to how stress affects their blood sugar levels."

Diabetes is a disorder that leads to high glucose or sugar levels in the blood when the body produces little or no insulin " the chemical the body uses to break down sugars in the blood. Those with Type 1 diabetes produce little or no insulin and require daily insulin, meal planning and exercise to stay healthy. Those with Type 2 diabetes are insulin-resistant, and manage their blood sugars by meal planning, exercise and medication.

Most people with Type 1 diabetes already know how to manage their blood sugar from day-to-day, but the holidays present unique challenges, especially for those with Type 2 diabetes. Sauter offers these tips to people with diabetes to help them enjoy a healthy holiday season.

Sauter's seven strategies for surviving the holidays with diabetes: "¢ Plan ahead: If you've been invited to a party and you won't be preparing the food, call ahead to find out what they plan to serve, Sauter suggests. If you've got Type 2 diabetes, Sauter says that following a meal plan is important whether it's the holidays or not.

"¢ Keep counting the carbs: "Carbohydrates are what really affect your blood sugar," Sauter says. "When it's time to eat, look at the overall meal and ask your self, 'Which foods contain carbohydrates? What do I really want to eat?' Be careful with your portions and make sure the meal is balanced."

"¢ Sugar-free isn't always carb-free: "We often get tempted by sugar-free products, but that doesn't always mean they don't contain carbohydrates. It's extremely important to buy the real thing, watch what you are eating, look at the total carbohydrate levels and enjoy it," Sauter says.

"¢ Check blood sugar before cocktails: Alcohol can cause low blood sugar. Sauter suggests checking your blood sugar level before you drink. She also recommends eating foods containing carbohydrates, if you plan to drink. "Don't just eat appetizers if you plan to drink. It's best to drink alcohol after eating a full meal," Sauter says.

"¢ Make sure someone knows you've got diabetes: "The symptoms of low blood sugar and being drunk are pretty much the same. It's really important that if someone knows you have diabetes and you begin to exhibit these symptoms, that they take you aside and have you check your blood sugar level," Sauter says.

"¢ Walk after your meal: Sauter often encourages her patients to go for a nice long walk about an hour after a meal. That's when most of the sugar is in their blood stream, and exercise will have the greatest impact on lowering blood sugar.

"¢ Plan for relieving the stress: Stress can be challenging for people with diabetes because it can increase blood sugar. "While walking helps to relieve stress, I often suggest that people think about stress management strategies that have worked for them in the past and use them," Sauter says. She also suggests listening to relaxing music and being organized during the holiday season to alleviate stress.

For more information, visit these Web sites: UMHS Health Topics A to Z: Diabetes: http://www.med.umich.edu/intmed/endocrinology/patients/diab_learn.htm

UMHS Pediatric Advisor: Food Managementhttp://www.med.umich.edu/1libr/pa/pa_diabfood_hhg.htm

American Diabetes Association: Type 1 Diabetes http://www.diabetes.org/type-1-diabetes.jsp

American Diabetes Association: Type 2 Diabeteshttp://www.diabetes.org/type-2-diabetes.jsp

American Diabetes Association: Holiday Meal Planninghttp://www.diabetes.org/nutrition-and-recipes/holiday-meals.jsp

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