Navigating holiday meals is tricky for anyone, but the potential for harm can increase for diabetics if care is not considered when planning a meal experts warn.

The biggest concern comes from the restrictions on food intake and too many food choices, Anna Betancourt says.

She is a wellness dietitian at McChord Air Force Base Health and Wellness Center.

Added to that concern is the idea that people with diabetes will fear they won’t be able to follow their diet and the pressure they might encounter from family and friends to eat everything that is offered, she said.

“With Type 1 diabetes the concern would be the need to maintain glucose control and more vigilance with insulin administration,” Betancourt said. “The meals have to be more closely monitored in order to adjust insulin needs.”

Type 1 diabetes is characterized by the body’s inability to produce insulin and was formerly known as juvenile diabetes.

With Type 1 diabetes the concern to maintain glucose control is even more challenging for children and young adults.

Type 1 is related to insulin needs and food intake, the focus is on glucose levels and supplying adequate insulin for the meals, Betancourt said.

“With Type 2, there is more emphasis on weight management,” she said. “The loss of weight, which will improve the glucose levels, is compromised and they fear regaining weight. Also, paying closer attention to glucose levels pre meals, and remembering to keep your medication schedule. Diabetes doesn’t go on holiday.”

It didn’t go on holiday for James Nolan one Thanksgiving after he was mistakenly diagnosed with Type 2 diabetes.

Type 2 is characterized by a resistance to insulin. The majority of people diagnosed with diabetes have this form.

In Nolan’s case he was actually Type 1 and didn’t know it.

He was taking pills for the disease instead of shots of insulin at the time.

“And I was pretty sick, but I was kind of in denial,” Nolan said. “Ate what I wanted on Thanksgiving day, took my two pills a day and didn’t think about it.”

Nolan ended up in the hospital for eight days, three days of which he spent in a diabetic coma in the intensive care unit.

Based on his personal experience, Nolan said that it doesn’t have to be that extreme for something to be wrong.

“Some people, they may not feel quite right or they may not feel great,” he said. “But they don’t really see it necessarily as diabetes; they may not even be able to put their finger on it.”

For him, Nolan feels pretty lousy when his blood sugar gets to a certain point.

“So, I always try and keep in mind that I really don’t want to feel like that,” he said.Nolan, now as a diagnosed Type I diabetic, relies on an insulin pump to regulate his blood sugar levels.

He also uses Valley Medical Center’s education services for diabetes and an endocrinologist at their Southlake Clinic.

Betancourt advises the following for surviving the holidays for people with diabetes:

• Make smart choices and concentrate on the family, friends, socializing, fun stories and don’t stress too much about the diet restrictions.

• Make time to walk especially after having a meal.

• Consider colorful choices of fruits and vegetables.

• When dining out, research menus before you arrive and know what you will eat.

• Scan buffet tables first for healthier choices.

• Choose less creamy sauces and fried products to avoid added calories.

• Use smaller plates and savor the flavors and textures.

• Small amounts of sweets are OK as long as you don’t overindulge.