In this section
As the year progresses, we will keep building on this resource for managing diabetes on different special occasions!
Passover is a Jewish festival that is observed and
celebrated over 8 days. It is a festival where food eaten is affected. During
Passover, all leaven, whether
in bread or other mixtures, is prohibited, and only
unleavened bread, called matzo, may be eaten.
A Sedar is held on the first
two nights of Passover.
The following tips can be viewed to manage your
diabetes within this time where different foods are eaten.
Remember, Passover is a time of celebration and coming
together with your family and friends. You may see more swings in your glucose
levels over the festival. Remember no-one is perfect and not everyone can keep
their levels within the target range at all times.
However, some planning
around the foods that you will eat (and likely eat at the same time each year)
can help keep your levels in range as much as possible.
For example, Sniders Matzah Meal – 1
serve is 25 grams and contains about 18 grams of carbohydrate or 1 serve.
Matzah: 1 piece of Matzah is about 25
grams of carbohydrate (about 2 serves of carbohydrates)
however you get your insulin, and whatever the celebration, carbohydrate
counting is key, take the time to count correctly, speak with your team to get
extra help as needed and enjoy your celebrations!
You may need to make insulin dose changes over the holiday period. With having a different routine over the holidays and eating different foods for Passover, your insulin doses may need to change e.g. you may need more/less insulin to cover a meal. See dose adjustment guidelines on when and how to change your insulin doses. You may then need to change back to your original doses when Passover is over and your return to school.
Fixed dose insulin injections
If you have a fixed dose of insulin and eat a fixed amount of
carbohydrate with your meals make sure to:
Dosing cards or dosing app with insulin injections
Using an app or dosing cards help you adjust your insulin dose
based on the amount of carbohydrates you are eating and your current glucose
level. Some cards/settings in the app recommend different insulin doses for
different times of the day.
If you are eating extra food between meals, you can use your
dosing card or app to give an extra insulin injection.
Make sure to:
Insulin pump therapy
Remember to count
the carbohydrates and bolus for all of them.
For Control IQ® consider setting another insulin profile to support the algorithm working off adjusted settings for this time period where your routine is different
Temporary Basal Rate
(TBR) - If you can set a TBR (not using Control IQ® or SmartGuard®)
Easter is all about having an egg-cellent time. It is a time of celebrations with family and food and your diabetes management shouldn’t get in the way of enjoying yourself. Indulging in some chocolate and hot cross buns is often part of the tradition. Not being able to eat chocolate if you have diabetes is a myth, but some moderation, awareness of what you are eating and carbohydrate counting is important.
Here are some tips to help you hop right into the holiday period:
No one is perfect: Don’t be too hard on yourself. This is an occasional not a daily occurrence and you might see more swings in your blood glucose levels (BGLs). Remember all information is good information, even if you notice that after a meal or Easter egg hunt your BGLs aren’t where you thought they would be. Think about the carbohydrates you’ve eaten and when and how much insulin you gave. If your glucose readings are high, use this as an opportunity to discuss with parents or your diabetes team what did and didn’t work and learn some tips for next time.
Plan ahead: Where possible plan your day. Make sure to still have regular meals, as this will help stop hunger taking over when the treats come out. Think about when the Easter Bunny or Bilby usually comes to visit, and when these treats might be eaten. Incorporating the additional carbohydrates into your meal can be helpful and avoiding the need for additional injections. Check out the dosing section at the end, to see how to manage extra carbohydrates eaten based on your insulin regimen.
Quality: Not all chocolate is the same. Dark chocolate is often praised as being a better choice, but Easter is about having a treat. You might see “Diet or “No Added Sugar” chocolates, but this usually means artificial sweetener has been used instead. Like standard chocolate, these products are generally still high in saturated fat, so why not pick something you will enjoy?
Quantity: Moderation will help prevent overindulging, particularly outside of meal times. When selecting your Easter eggs think about the portion size. Instead of going for the biggest egg on the shelf try selecting a couple of smaller ones. Smaller amounts of carbohydrate will ease ebbs and flows in glucose levels, help with the accuracy of your carbohydrate counting - you’ll also get to enjoy your Easter chocolate supply for longer!
When looking to count carbohydrates, the nutritional information panel will provide you with everything you need to know!
Get creative: It doesn’t have to be all about chocolate. Try adding non-food gifts into the celebrations.
For example: fill some hollowed plastic eggs with arts and craft supply to make your own Easter hat! There are lots available to search online – try entering “Easter plastic egg” or “colourful plastic Easter eggs”
Incorporate activity: being active is beneficial for both mental and physical health. It is recommended for all children to have 60 minutes of activity most days of the week, and Easter is no expectation. With exercise, the body uses insulin more efficiently, so if you have diabetes, glucose levels generally lower with exercise. If needed, we suggest eating ~ 10 grams of low glycaemic index (GI) carbohydrate (activity food) before or during physical activity, and a few small Easter eggs could be used for this. Doing a bit more exercise during Easter celebrations will allow for some extra activity food to be eaten; maybe think about walking to the local park before starting the Easter egg hunt, or play a game of capture the egg (flag) with the extended family. Most importantly, like always with physical activity, make sure to monitor your BGLs, and carry hypo treatment on you. Please remember, chocolate is not first line hypo treatment, but could be used as a follow-up carbohydrate.
Insulin dose, the time it’s given and the types of carbohydrate eaten all play a role in what your BGLs is 3-4 hours later. Fast acting insulin takes around 15 minutes to start working, so aim to give it 10 -15 minutes before eating. The carbohydrate content you are eating ideally determines your insulin dose, so carbohydrate counting is key, but also, what comes with the meal is also important. Fats and proteins can slow down the glucose rise, which is why chocolate has a lower GI than standard sweets and lollies. Have a look at the nutritional information on the wrapping to work out matching insulin and carbs, and speak with your diabetes team if you are needing help with this.
Here are some suggestions about adjusting insulin for both insulin pump use and injection use:
Remember to count the carbs in the chocolate you are eating and bolus for it!
Temporary Basal Rate (TBR) - If you can set a TBR:
Consider increasing your TBR if the excitement of the day causes glucose to be above target range. You might try an increase of ~ 10-20%;
Consider decreasing your TBR if you will be more active than usual. You might try a reduction of ~ 10-20%
Your dietitian may have spoken to you about extended boluses. They can be used with meal boluses if eating low GI food or if the meal will be eaten over a long period of time to allow the delivery of insulin to match the release of glucose into the blood stream.
These are usually provided by your diabetes team and help you adjust your insulin dose based on the amount of carbohydrates you are eating and your current blood glucose level. Some cards recommend different insulin doses for different times of the day.
If you are eating extra food between meals, you can use your dosing card to give an extra insulin injection.
Use the meal time recommendation on your card closest to that time of day
DO NOT include any correction dose with the extra injection
Make sure there is at least 3 hours between each of your meal time injections
If you have a fixed dose of insulin and eat a fixed amount of carbohydrate with your meals make sure to:
Incorporate your Easter treat carbohydrates into you mealtime carbohydrate allowance. This might mean eating less savoury carbohydrates to accommodate for a hot cross bun or Easter egg at the end of the meal
Introduce an additional injection between meals to allow for large, between meals snacks. Please discuss this with your diabetes educator if you haven’t done this before.
Meals eaten during times of celebrations can take longer and may be more mixed in type (i.e. protein, fat, carbohydrates). If your meal is of a long duration, you might find it helpful to split you meal time dose.
Giving ½ the dose 10–15 minutes before your meal starts
Giving the next ½ ~ 1 hour later
Eg: if you normally give 10 units of insulin with your meal, give 5 units 10 -15 minutes prior to eating and 5 units around 1 hour into the meal.
Please remember, however you get your insulin, and whatever the celebration, carbohydrate counting is key, so take the time to count correctly, speak with your team to get extra help as needed and enjoy your celebrations!
Whether it is a trick or a treat that you are looking for this Halloween, it is important to know how to manage your diabetes care on the most Ghoulish night of the year!
Whether it is a house, street, or neighbourhood event, it is important to keep safe this Hallows Eve.
Your blood glucose can really swing when you’re having fun! Here are a few quick tips to help make sure you are prepared:
Below are some common treats that might end up in your pumpkin:
Credit: Adapts from Children and Young People’s Wales Diabetes Network Halloween Leaflet
Updated October 2022