7 Holiday Diabetes Management Tips

In the midst of all the holiday hustle and bustle, people with diabetes can have a mound of other stresses to contend with, such as blood sugar fluctuations as a direct result of a full calendar. Living with type 1 diabetes for over 25 years, MiniMed Ambassador, previous Medtronic Diabetes Clinical Manager and blogger Regina Shirley, RD, LDN shares 7 tips of how she uses the features on her MiniMed insulin pump and continuous glucose monitor (CGM) to guide her through the holiday season.
1. MiniMed Connect
While I’m out holiday shopping with my daughter, my husband is still able to check how I’m doing through MiniMed Connect. He gets a text message when my Low Predictive Alert or Threshold Suspend alarm go off, and can call me or send me a text to make sure I’m okay. It’s comforting knowing someone else is there to help me manage my blood sugars.
2. Monitor Trends with Continuous Glucose Monitoring (CGM)
I’m able to monitor my sensor glucose trends throughout the day by looking at my pump or my smartphone (using MiniMed Connect). Knowing what my glucose levels are and where they’re going, especially in social settings, really helps me enjoy my time, leaving me less worried about my sugars are doing.
3. Threshold Suspend
After a long day of celebratory activities, I’m exhausted at night and am out as soon as my head hits the pillow. When my blood sugar drops, it tends to drop fast and hard. It’s nice having the Threshold Suspend feature by my side to take action when I need it. Especially during the times I’m too tired to wake up to respond to the alarm.
4. Square Wave Bolus for Grazing
I use the Square Wave bolus when grazing at parties. This feature delivers a bolus evenly over a period of time (20 minutes to 8 hours). It’s great for those times when you’re eating a long meal with extended snacking. It can also be useful if you have delayed food digestion due to gastroparesis or meals that are high in fat.
5. Dual Wave Bolus to Cover Holiday Meals
When indulging in those special holiday dishes, (rich, high-fat foods), I typically use the Dual Wave bolus. This provides me a combination of an immediate normal bolus, followed by a Square Wave bolus. The amount of insulin given at each time depends on my current BG levels, and how many carbs I’m about to eat. For example, if my BG is high, I’ll set my bolus so that I get more insulin in the first wave, as opposed to the second, and vice versa. I can also set how long I want to have between the first and second wave of insulin. The time between waves can vary depending on each person and the amount of fat eaten in the meal. If you haven’t used this feature on your pump, advanced bolus settings like this one would be a great discussion point for your next doctor appointment!
6. Adjust Predictive Alerts
To make sure my pump settings best meet my needs, I work with my doctor to adjust my predictive alerts for the day and night. During the day, I can typically feel my low and high symptoms, so I keep my Predictive Alerts further apart (70 mg/dL for low, and 220 mg/dL for high). At night, I don’t typically wake up naturally if I’m having a low, so I tighten up the range to 85 mg/dL for low, and 180 mg/dL for high.
7. Setting Temp Basal Rates
When going to a get together, I set up my Temp Basal Rate to make an immediate short-term change to my basal insulin for a specific period of time. For example, if I’m having more than one drink at a party, I usually decrease my basal rate that night so any impending lows alcohol usually causes can be blunted.
Guest Blogger – Regina Shirley, RD, LDN
Regina Shirley is a Registered Dietitian, Licensed Dietitian Nutritionist, and previous Medtronic Diabetes Clinical Manager. She has lived with type 1 diabetes for 25 years, and has been a Registered Dietitian for over a decade, specializing in helping people better manage their diabetes. Regina chronicles her path to a healthy pregnancy and being a mom on her personal blog, Serving Up Diabetes, and runs her own nutrition consulting services, My Menu Match. You may remember Regina Shirley from Diapers, Drop-offs, Dancing… and Diabetes.
Important Safety Information
Medtronic Diabetes insulin infusion pumps, continuous glucose monitoring systems and associated components are limited to sale by or on the order of a physician and should only be used under the direction of a healthcare professional familiar with the risks associated with the use of these systems. MiniMed 530G with Enlite is intended for the delivery of insulin and continuous glucose monitoring for the management of diabetes mellitus by persons 16 years of age or older who require insulin.
Pump therapy is not recommended for people who are unwilling or unable to perform a minimum of four blood glucose tests per day. Insulin pumps use rapid-acting insulin. If your insulin delivery is interrupted for any reason, you must be prepared to replace the missed insulin immediately.
The information provided by CGM systems is intended to supplement, not replace, blood glucose information obtained using a home glucose meter. A confirmatory fingerstick is required prior to making adjustments to diabetes therapy. MiniMed 530G with Enlite is not intended to be used directly for preventing or treating hypoglycemia but to suspend insulin delivery when the user is unable to respond to the Threshold Suspend alarm and take measures to prevent or treat hypoglycemia themselves.
WARNING: The Threshold Suspend feature will cause the pump to temporarily suspend insulin delivery for two hours when the sensor glucose reaches a set threshold. Under some conditions of use the pump can suspend again resulting in very limited insulin delivery. Prolonged suspension can increase the risk of serious hyperglycemia, ketosis, and ketoacidosis. Before using the Threshold Suspend feature, it is important to read the Threshold Suspend information in the MiniMed 530G System User Guide and discuss proper use of the Threshold Suspend feature with your healthcare provider.
Please visit www.medtronicdiabetes.com/importantsafetyinformation for more details.
Please keep the info coming. I have been on the pump almost 2 years now after undergoing a complete pancreatectomy in Oct 2012.
Jill, I’m happy you’re enjoying the blog articles. Please let us know if there are any topics you’re interested in learning more about that we haven’t posted.
Great information. I am new to the 530g and the Threshold info is great as well as the adjustments to the predictive alerts. Talked to my Endo yesterday and made some adjustments since it was going off almost every night with high, then low then high within 30 minutes. Hard to sleep. Slept like a baby last night.
Margaret, it makes me happy to hear you’re enjoying your new MiniMed 530G system and the Threshold Suspend feature. I’m glad your endo was able to make adjustments to your pump so you can get a restful night of sleep. We’re always here if you need anything.