Life has a funny sense of humor, sometimes... A funny way of testing our wits.

I have a lot of jobs. One of my jobs is for a local church, as their Administrative Assistant. This is a job in which I am transitioning, and their old Administrative Assistant trained me last week, and suggested if I had any questions at all, I could call her. She gives me her business card, and I take it. Later, I'm looking at it, and I find it a bit unusual, as she's labeled herself as a 'Certified Hypnotist and EFT Practitioner,' whatever EFT is. 'Call Your Power Back' it says, under the main header. Under her picture, she claims 'Empowerment and Nutritional Cleansing.' -- Now, this is where I give you guys the disclaimer that I am a skeptic, and I am not fond of new age methods and things. I really like science a lot. I don't believe in cleanses and other kinds of 'fasts' people do to get 'clean' or whatever -- because science doesn't back them up (they can also be dangerous).

I flip the card over -- and what do you know... before and after pictures of people at the worst of their weight gain, and then ripped to no end with muscle, and 'in shape.' I feel the sudden judgmental thoughts going through me -- the sudden comparisons of 'I'm not as good as these people.' Then I'm reminded this person just wants to make a compelling case to get my dollars. I'm reminded that she has confessed to me that she has a lot of health issues herself, and from her appearance is not in what one could term as 'ripped' or in as 'excellent' shape as the people on the back of her business card, and that she's just another human being. I tell myself I have a binging problem, not a weight problem. That I need love, and not a carrot on a stick. I don't need to be Mrs. Olympia 2015.

I will write her numbers down -- and just throw the card away.

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So, recently I was given the chance to try out a ton of Level Life Products and tell you folks what I thought about them. I've been offered other products to try and review before, and I am careful about what I would recommend to anyone: there are many, many, MANY products out there on the market claiming to understand the needs of persons with diabetes, and selling all manner of things, particularly shakes and meal replacement bars. I hate most of them, and tend to not endorse many. They tend to have a lot of sugar, or be a lot higher in carbohydrates than I would personally want. 

Enter Level Life. 

Level Life started out as a company that makes glucose products to help treat hypoglycemia, in more delicious flavors than just chalky orange... So when Level Life contacted me, stating they now had shakes and bars and the like, for me try out, I perked up. You see, Level Life is a company that was founded by a young man who lives with type 1 diabetes. A person with diabetes who couldn't find what he needed out there -- and knew the rest of us probably couldn't, either. 

Finally, a diabetes management product by someone who gets it! 

I am always in the market for the best shake, or meal replacement bar -- one with not a lot of carbs, that won't make me feel sick later... and let me tell you, this is it. I lead a pretty fast paced life these days, since I have two jobs, and often have to squeeze a meal or a snack wherever I can get it. 

These products are fantastic. The bars have around 140 calories, with 14 grams of carbohydrate per bar, and the shakes have around 170 calories, and 10 grams of carbohydrate per shake. They are rich in protein and fiber. I tended to feel satisfied for long stretches, and my blood glucose remained nice and level. Many of us do not want to exceed 140 mg/dL wherever possible, and most shakes and bars can quickly put me at 180 mg/dL. I tested regularly while trying these out, and I feel confident that I can trust Level Life to help me keep my blood glucose goals, and to keep a level lower than 140 most of the time. These products are also gluten free for those of you suffering from any form of gluten intolerance.

I have to admit that I am pretty biased and my favorite flavor is the Rich Caramel Shake. I just grew up with too many vanilla, strawberry and chocolate diet products, or glucose management products... and well. Yuck. lol While ALL of these were actually good tasting compared to other products, I'll stick with Caramel. :-D Thanks. But if you miss strawberry flavored milk, though, you will like the Strawberry Creme shake. It's just yummy!

Level Life has been very generous in their efforts to try to get the word out about their great product, and have given me the opportunity to give away a generous package to one of my lucky readers! You too could win a premier bundle of bars and shakes valued at $60.

To enter, you just have to do three things:

• Follow/subscribe to this blog;
• Like us on Facebook; and
• Leave a comment below about what you're looking for in a meal replacement bar, or what you like about Level Life if you've tried them in the past. 

A winner will be chosen at random and will be announced Saturday, July 12th.  Good luck!!

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I've had type 2 diabetes for nearly 4 � years. Though not a very long period of time, it's still been very challenging...

I've lost weight, gained weight, lost weight; I've low carbed, extremely low carbed, and eaten intuitively; I've exercised myself to death, been a couch potato, and a simple walk around the block lover; I've quit soda, drank only water, and then gotten on diet soda, again... I've had highs and lows, and lows, and highs. I've been proud of myself, and disappointed in myself -- and I've learned just how HARD it is to change myself -- all willpower aside. I've even dealt with some very angry type 1 diabetics and some very unhealthy diabetes forums and communities.

All of these challenges aside, none of these compare to the one big challenge I've had to face while living with type 2 diabetes... keeping my dignity as a patient.

I'm no stranger to the discussion of keeping the patient dignity. I've challenged various prominent diabetes writers on their own biases and deliberate fact twisting, I've written various letters to television programs, to diabetes programs like Take Care of Your Diabetes, to celebrities like Conan O'Brien, and have even hosted an online Diabetes Ice Cream Social event to get people thinking differently (and been skewered for it). My most famous of these discussions on patient dignity, however, happened as an ePatient Scholarship recipient, when I attended Stanford University's Medical School, for their 2012 Medicine X conference. (For that little escapade, I got editorialized by Esther Dyson as someone who was wanting to pass the buck for being fat.) 

And therein lies the rub. We want to find people to punish and blame. We want to skewer people for "giving themselves" type 2 diabetes. 

This is not an abnormal thing. It's actually a part of human nature to want to find vindication for issues -- it's a form of 'negative altruism.' The problem is that the social dialogue that has been crafted in the media, and in part thanks to illness advocacy organizations like the ADA, various medical groups, and those who want to exploit the obesity and diabetes medical communities -- has been centered on discussing obesity and diabetes as though they were a crime against society (i.e., obesity and diabetes are going to bankrupt the economy, destroy the healthcare system, our children, bring governments to their knees, destroy third world countries, bring a second coming of Christ, etc.) So, people with either obesity or type 2 diabetes, are not seen as persons struggling to take ownership of their health issues -- but as people failing to take accountability for a crime against society. "Be accountable for your health," they say. Obesity and diabetes are not seen as personal struggles for personal health ownership -- but as a moral failing of the individual, a crime against society, and as a justification for social outcasting.

This is a HUGE undercurrent in the diabetes dialogue at large! 

It colors the mindsets of many an educator, clinician, registered dietitian, media or TV personality, people trying to sell us goods and services, and of course... persons presenting new technology at a conference like Medicine X. It's a problem. It's a HUGE problem. And when one addresses such a problem, one is portrayed as though one were trying to pass the buck for being obese, or having diabetes. There's a certain self important arrogance about it all... If I point out your moral failing for having 'given yourself diabetes,' then I must be a more moral, and worthier, contributing citizen to the society at large. 

Now, this blog post is not about whether or not one can 'give oneself' diabetes. That would be an entirely new blog post -- and I think I've spoken on that before... My overall view on whether one 'gave oneself' diabetes, however, is that it's IRRELEVANT. Yes, it's irrelevant. Once a person has diabetes, whether or not they 'gave' themselves diabetes is, quite frankly, irrelevant. One can analyze a person's decisions and life style choices till the cows come home... but once that person has AIDS, cancer, diabetes, heart disease, etc... is it now time to start treating them without respect, or dignity? Should we spit on their faces, and socially mock them while at the same time claiming to try to help them? "I'm going to help you, fatty, because you can't help yourself! You have no self control, and you can't stop eating!" 

I think many misunderstand my words here, when I speak of patient dignity. Patient dignity is NOT a patient passing the buck; it is not a patient not taking ownership of their health... Dignity simply means treating someone with a certain basic level of respect for being a human being in the midst of a trying, and challenging situation -- whether of their own doing, or not. We are all human; none of us is above the struggle to make the best choices. Though this is another topic worthy of further exploration in a different blog post, the food choices many of us make day in, and day out, cannot be completely and genuinely labeled as 'mistakes,' for they are the product of our programming as children, as members of some particular society, and as mammals evolved (thanks to natural selection) to prefer more nutritionally dense foods, especially in order to better face periods of famine. While many have had the blessings of genetics, and a healthier food environment overall (familially and culturally), it takes enormous effort to change oneself as an individual, because it is not simply a product of will -- it is a product of reprograming, and reprogramming is HARD. You aren't just fighting your family's bad eating choices, you are also fighting millions of years of evolution! So it is thus, unfair to treat these issues as though they were black and white, and as a people's moral failings, or as a crime against society. Also -- the person with type 2 diabetes is NOT accountable for their health to you -- so get over yourself. Type 2 diabetes has many different triggers (not causes), of which obesity is just one of them, and the others are not quite as uncommon as people want to think. The scientific and peer reviewed studies showing this are there -- but they seldom get public light, because they are NOT media-attention worthy. Sensationalism is simply what sells. 

All of these things aside -- the overall goal of ANY health initiative by any group is to make positive change. But if we want to help a patient community to make positive changes toward a general health improvement, what we want to do is focus on that 'positive' word. Putting the word "skinny" in front of your company's marketing, cracking jokes about a community's obesity or bad eating habits, how they gave themselves diabetes, stereotyping, claiming diabetes can be cured (or blaming people for not curing themselves), turning them into a 'meme' or down talking to them is NOT going to make positive change. Instead, all it will create is an underculture of social pariahs who are not just denied services and tools, but who do not seek the necessary medical attention they need, the tools and education they deserve, or the new lease on life that they could have. In other words, the culture we have NOW.  

If you make it too embarrassing and shameful to have diabetes -- people aren't going to work toward not getting diabetes... People are still going to get diabetes, and they are going to die in silence, from diabetes. 

In the end, the person who'll end up costing more to a society is not the person with diabetes: it is the diabetes bully. 

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Two years ago, I wrote a blog post about diabetes and anger. In that post, I explored a lot of the day to day reasons why a person with diabetes might feel anger, and frustration. In fact, there are many reasons why a person with diabetes would, indeed, become angry. Those reasons can be varied, including anger at oneself for 'failing' to prevent the disease, to anger at family for not understanding or patrolling/policing the person with diabetes' behavior, etc. These are common types of anger: the anger that results from struggling to cope with a new and changing environment, for which we might have little control. (You can check out that blog post link, above, for a more in depth look at that topic.)

However, little did I realize that I was going to get such a huge response from the public -- but not about anger in this usual, common sense -- but anger in the chronic and mental health sense. Folks from all over the country have poured out their hearts to me in sheer frustration and worry over their loved ones, from sons to spouses, to friends. From lay people, to mental health professionals as well.

I must emphasize here, that I am NOT a mental health professional. I am not a medical expert of any kind, or a scientist. I am just a person with diabetes, with a blog. A person who loves learning every day, researching my own condition, and learning how to live and cope with it. Anything I say here is information you must take to your own clinician, or consult with your own mental health professional. It is also information that anyone can research on their own: never take my word for anything. Always be a skeptic.

Now that we have gotten that out of the way, let's start with the ways in which diabetes can clinically affect our moods.

Day to Day Blood Glucose Swings

When our blood sugars are not within normal or euglycemic boundaries (i.e., between 70-120 mg/dL, or 3.9-6.7 mmol/L), our mood and emotions will be altered. In some extreme cases, a person who, for example, experiences severe low blood sugar may become angry and even combative, or violent, or may seem 'drunk.' A person who experiences high blood sugar may experience sadness and depression, inability to concentrate, fatigue, etc. The root of all these glucose related mood swings has to deal with their association with the neurotransmitters in our brains, and how those in turn, communicate messages to our nerve cells about mood, appetite, and even sleep. Dealing with these states of mind is challenging, and can be tiring for the person with diabetes, as well as bring on a short temper. To top it off, having a negative disposition may also bring on bad blood glucose numbers, creating a vicious cycle that feeds off itself.

Chronic Mood Swings

The problem with being on this persistent 'roller coaster' of high and low blood glucose swings is that it can be bring about permanent, and chronic, mental health problems. Problems such as clinical depression, anxiety, anger, and a whole host of mental health conditions, like bipolar disorder.

According to a study on "Diabetes and Psychiatric Disorders," by the Indian Journal of Endocrinology and Metabolism, "Diabetes and psychiatric disorders share a bidirectional association -- both influencing each other in multiple ways." So much so, that apparently scientists back in the late 1800s found diabetes to be a disease which had been present in families with a pronounced history of mental health problems, so that insulin shock therapy was used as a treatment for mental health disorders even as shortly as insulin was isolated for the first time.  (Yes, insulin has a role in mental health, and even in the development of such diseases as Alzheimer's.)

This study further points out that there are several ways in which both diabetes and mental health problems can show up:

• As two parallel conditions, which developed independently of each other, with no apparent connection;
• As a complication of the diabetes, or as a complication of the mental health problem: type 2 diabetes may lead to depression, as well as depression may lead to type 2 diabetes, for example;
• As a product of hypoglycemia or hyperglycemia (and ketoacidosis), such as the development of chronic anxiety;
• And as a result of taking various medications for treating mental health -- many of these medications can lead to a triggering of a type 2 diabetes diagnosis. 

In my personal and anecdotal experience, I am a person who suffers from dysthymia. Dysthymia is a type of low grade, long term depression, which can subside and be in the background, for much of one's life. It is much milder than regular depression. However, in situations in which I have had an undiagnosed, and chronic health condition, such as hypothyroidism, or type 2 diabetes -- the imbalances in health provoked episodes of severe depression. The conditions influenced my depression and worsened it. In this way, uncontrolled diabetes can worsen or complicate a mental health condition that is already present, making overcoming of both conditions a challenge. 

It could very well be that the sudden and deep mood changes many persons with diabetes have experienced were the result of these drastic, and long term changes in blood glucose influencing an already underlying mental health problem -- especially if the diabetes was left undiagnosed or untreated for an extended period of time. It is particularly difficult for a person with diabetes that is weighed down by these mood changes, to find the motivation and positive inclination to manage their health condition. Quality of life tends to be reduced, and so does optimism, which can lead to development of unsavory habits, such as uncontrolled diet, smoking and drinking -- habits which can exacerbate mental health problems and lack of control, to an already breaking point. 

How Do We Help? 

In my previous blog post on anger, I noted several ways in which we could be of support to a person who was being burdened every day by the management of their diabetes. Being a good listener, helping a person cook meals, and being empathetic, are all proper ways in which we can deal with a loved one's chronic health condition. The Behavioral Diabetes Institute provides resources for us to utilize when we are overcome by our day to day emotions when managing diabetes, and may feel burnt out, or depressed. 

However, there are situations in which we need to be more proactive in identifying the mental state of our loved ones. Understand that, outside of a rare and severe hypoglycemic event, violent and aggressive behaviors are NOT standard complications of diabetes. These are not typical or normal behaviors for a person with diabetes. (Grouchiness is.) If a person you love is experiencing warning signs of serious mental health problems, you might need to have a conversation with them about visiting a mental health professional. This is an intimidating task, and there are suggestions out there, on how to broach the subject. 

The National Alliance on Mental Illness (NAMI) has a good Resource Guide for Families Dealing with Mental Illness. In it, they address what to do for 'crisis intervention,' when a person's behavior is particularly violent, or out of control:

If the individual with mental illness is in danger of physical injury, if his or her behavior is out of control or others are in danger, it is important to know what steps to take. Plan ahead by locating available sources for help: your emergency phone number (911), police or sheriff department number, Community Mental Health crisis or emergency number, name and phone number of a mental health professional, friends or neighbors who may be of help, and the nearest NAMI affiliate. Keep these numbers posted by the telephone. 

Any behavior such as this, that falls outside of both a mental health disorder, or a severe hypoglycemic episode, is unjustified violence, and should never be tolerated. Do not put up with it. 

. . .

Mood swings can be a standard part of diabetes mellitus and its attendant blood glucose fluctuations. However, when chronically unregulated, these blood glucose fluctuations can bring about more serious mood disorders. These mood disorders are NOT a standard symptom of day to day diabetes management, and will usually not ameliorate on their own. If you are living with a person who has become unpredictable, or violent, due to a potential mental health disorder, please seek help from your local community mental health centers, a mental health professional, or from your family physician.

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His foot was black and woody; gnarled, like dirt covered ginger. I will never forget the terror in my mother's eyes as she fruitlessly tended to its bandaging, and yelled at him for letting things get to this point. It was a shocking state of affairs. My father was now blind, bedridden, undergoing dialysis, and at the verge of needing his foot amputated.

My old childhood home had changed from whatever it was in my memories and into a hospital. Dad's room was an intensive care unit; my sister's old room was storage for the massive amounts of dialysis fluid boxes he would be needing.

I knew that dad was struggling... but I didn't know the extent. I had been gone from home for far too long, I guess, where at least reality wouldn't have denied me the right to know the truth. My parents, however, were the kind of people that lie by omission -- never telling their youngest daughter whatever might have worried her, or troubled her; never keeping her up to date with issues such as this. It was their way of protecting me... but it was far less protective than the truth. On May 5th, 2003, dad passed away. I only got to spend one last weekend with him the previous March... where he couldn't see me, couldn't go on walks with me, and had the beginning stages of dementia.

For the longest time I was very angry at my dad. To be and feel desperate at the healing of the unhealable is one of the most impotent feelings a loved one can experience. You are overcome with anger at the selfishness of the 'uncompliant' diabetic, not thinking how this would impact family; not thinking of the burdens of family having to be nurses, diaper changers, dialysis providers, and well... at the other end of helplessly watching them rot.

It has taken me years to deal and cope with these feelings; to come to terms with acceptance and forgiveness, and understanding that although complications happen, they are not always due to our choices as people with diabetes. That sometimes, the long ride is just too much -- and the genetic deck is not stacked in our favor.

Except on December 20th, 2013...

A desperate message was posted in a large online community to which I belong by a young man seeking advise about his father's infected wound, how it was not healing, and asking about what all that needed to be done. Someone -- knowing about me and my advocacy -- gave him my name. Then the desperation began anew... this unreasonable feeling of 'how can I save this person's loved one?' What all can I do to turn back the hands of time? I answered as best I could... with all the information I knew.

But information is cold, and stiff. It doesn't change his lack of access to resources, to well educated medical professionals, to the state of the art facilities we enjoy here in the states. It doesn't change that he knew not much about neuropathy, how to care for poor circulation, how to effectively and diligently monitor blood glucose levels, let alone what healthy blood glucose levels were, that Indian food is not exactly diabetic friendly, and that years and years of this status quo would likely not be undone.

Every day, the young man messaged me. "What can be done?" Sometimes, a few times a day. I could see the desperation of his situation -- I could see in my mind's eye, the terror on his face. At some point, I had to say "I am sorry. I am not a medical professional. These are the best guidelines I can give you... and to urge you to seek a wound care specialist." I wish I could have done more. I felt like I was needing to save my own father all over again.

I heard little from the young man, after that... But I had my suspicions. My gut feelings. On December 31st, he wished me a Happy New Year, perhaps in the most somber of ways one could wish it. Just words on a page... not even capitalized. Then by January 5th, he finally mustered the courage to tell me that on the 2nd, his father passed away. And it all came back around, home for me...

I mustered an "I'm so sorry,"  in the best way that I knew how, never once telling him about my own pain. My own loss. "It's fine," he replied.

Perhaps not so, today... and that's just fine, as well.

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My fasting glucose at diagnosis,
versus currently.

All around us there are people who are struggling or living with challenging health conditions or diseases. Some are very visual, and apparent, and some are not. For those with apparent health conditions or diseases, we feel an immediate sense of empathy. However, it is not so easy for us to empathize with those whose needs we cannot openly see. We may assume a person is exaggerating (they really don't have it that bad), is being 'wimpy' (they should just shut up and 'deal with it'), or is simply lying.

Type 2 diabetes is one of these misunderstood diseases; it is a hidden illness and people with hidden illnesses often end up being judged as if they had no needs, or should be restricted in needs. These attitudes often end up in discrimination, particularly from employers, health insurance companies, and some health care providers and agencies. The problem becomes compounded because type 2 diabetes is also a silent disease. It is a disease which can remain silent (not showing very many outward signs of its presence) for many years, even decades. Hence, many people will often ignore their condition because they feel fine and healthy, and the condition does not seem real to them. Because there is NOTHING telling them they are sick, they feel a certain sense of invincibility... until they get their blood glucose level tested with a finger prick.  Persons with type 2 diabetes must check their blood glucose levels regularly if they are to be kept constantly aware that they a.) have a serious medical condition, and b.) that they need to adjust their food intake according to what their glucose levels are. A person with type 2 diabetes needs to be able to eat 'to their meter' in order to be able to manage their disease.

If the medical establishment (who are constantly preaching on the diabetes 'pandemic,' and how serious this matter is, and how the condition is costing our governments, worldwide, billions of dollars) had any inkling of the issue at hand, or indeed, if they believed their own warnings, they would realize that in order to reduce the risk of type 2 diabetes, and to control the health of those with current type 2 diabetes diagnoses, we need...

• Educated clinicians: Clinicians who are not trivializing the condition to their patients, but which strive to understand the condition, its potential risks and dangers, and who are committed to empowering their patients and properly educating them as to what the condition is; and
• Access to Proper Tools and Medicines: Sufficient glucose testing strips to make appropriate nutritional decisions, from day to day, to help control glucose levels, as well as access to necessary medications -- including insulin. 

How do we expect to control already diagnosed type 2 diabetes, in patients, if we will not allow patients to have an adequate amount of testing strips? Yes -- a testing strip should not just be a tool that is used to avert immediate danger (an extreme high, or an extreme low level of glucose.) A test strip is also a rudder to help a patient know to make the best, and most appropriate meal decisions, because we never know just how much glucose we have in our bodies at any given time. You can't just tell us to go eat whole wheat, grains, and fruit, and call it a day. I am sorry, medical establishment... Diabetes doesn't work that way. I have the RIGHT to know what my blood glucose is doing, and to be able to make educated decisions on what to eat, as to to reduce the risk of the potential long term complications of high blood glucose. It is my right, as a patient! You preach about the costs of diabetes, but something tells me you really do not understand how the game works. You see -- no one complains about the high cost of performing 3,000 mile oil changes on their vehicles; instead, they understand that if these are not performed, instead of paying $19.95 for an oil change, they'll end up paying over $1,000 for a new engine. But clinicians and insurance companies are practically telling people with diabetes that they'd rather they pay $1,000 for a new engine, than $19.95 for an oil change. I mean, isn't it cheaper, long term, to pay for some strips than to, oh, I don't know... have to pay for someone's dialysis, new organs, eye procedures, or amputations? 

Where is the common sense in the medical establishment, right now? I want to KNOW. I am SICKENED that people with type 2 diabetes who are on Medicaid  in Oregon, right now, are close to being severely restricted on their glucose test strip usage. According to diaTribe, 

Currently, the OHP provides 100 test strips every 90 days, but a new plan would severely restrict access to strips for type 2 patients unless they are newly diagnosed, take insulin, or meet a few other special requirements. For people not taking insulin � which covers the vast majority, about 70% of all type 2 patients � those with an A1c above 8.0% would be entitled to one test strip per week, while those with an A1c below 8.0% would not be provided with any test strips at all.

This is obscene!! One test strip a week tells NOTHING to a patient with type 2 diabetes! Tests need to be done in pairs so that we can see the cause and effect of things like meals, exercise, illness or periods, or even overnight sleep. Patients with type 2 diabetes are practically being PUNISHED for having good control, and being told that their health is not important enough to merit an educated management of their disease. Besides that, patients are supposed to work hard to keep an A1C which is at or below 6.5%. Telling a person that they will only get strips if they have higher A1C levels is not only not a good recommendation, but it is also unconscionable. It is the testing that keeps me at a lower A1C! I'm not psychic, for crying out loud. As of yet, there is no magical Glucose Level 8-Ball.

We need to stand together as a type 2 community against these kinds of things, or we will continue to be bullied by the medical establishment. If we are to stem the tide of unfortunate complications, and type 2 diabetes diagnoses, then we need to stand up for our rights as patients. We DESERVE education, quality treatment, tools, and medications, to manage our condition and lead healthy lives.

Really... whatever happened to the Hippocratic Oath?

DO NO HARM. 

We have very little time... Please sign the petition, here: Don't Restrict Test Strips for People with Diabetes.  

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Happy Holidays, to you and yours! As my turkey slowly cooks in the oven, I've decided to take a moment to write a little bit. I've had a few comments from fellow sweet peeps, lately, in regards to traversing the holiday food extravaganza that is approaching, and there's much understandable fear and trepidation. 

So, I wanted to take a moment to reassure my fellow readers, especially newcomers, that, yes...

You Can Do This: 

1. DO count your carbohydrates. Think about your favorite foods for the holiday, and plot out your total carbohydrates through the day. For example, have some turkey and greens, if you prefer to have a small piece of pie later. Or... Have some turkey, some greens, and a small amount of mashed potatoes, if you're not much into pies. But... 
2. DON'T practice deprivation. Instead, practice moderation. Try eating just a tiny amount, of some of your favorites, instead of telling yourself you can't have anything. Besides, do you see the skinny people NOT eating anything? What do they do on a holiday like this? Some definitely pig out, and some others simply grab a few things, and taste here and there. But... 
3. DON'T feel like you have to eat everything there, out of obligation. Instead, you may find  it helpful to plan ahead of time which two food favorites you HAVE to have, and when the day comes, pick one extra item you'd like to try. If you have more things you'd like to try, you can always get a doggy bag, and eat them later.  
4. DO have some salad, leafy greens, and non-starchy veggies. Veggies are full of fiber, and because of this, they don't just help us with sensations of fullness and satiety, but also help keep our blood glucose levels steady throughout digestion. In other words, fill up on the broccoli on the snack plate, as it passes by... it'll help you absorb carbs, and digest and deal with any extra fat. Raw is better. But...
5. DON'T assume all veggies will be good. There are quite a few veggies out there that are high in their own natural sugars and starches. To help you navigate through the confusion, the American Diabetes Association has put together a list of non-starchy veggies, for your review. Assume that any veggie dishes which are slathered in various sauces have extra added sugar before consuming them. When in doubt, ask the host. 
6. DO make your own diabetes friendly dishes. Whether at home, or if going to a party, feel free to make one or two dishes which you know will be diabetic friendly -- whether that is a dish that is low carbohydrate, or a dish that is made with alternative sweeteners. Perhaps even have a favorite beverage with you, so that you can have something to 'nurse' through the day. This can be bringing your own diet tea, diet sodas, etc. But... 
7. DON'T forget to have water. Water is essential for your body. It helps control our eating signals of hunger, satiety and fullness. In many ways, water helps us appreciate the food we consume, and taste it better. When we taste food better, we can better focus on it, and we can better tell when we've had enough. 
8. DO try to practice eating with awareness. We go through life in such a hurry all the time, that we often eat incredibly quickly! Before we know it, the food is gone. Instead, really take some time to revel in the food you're about to consume. Notice its aroma, its colors, its textures, and flavors. Take each bite with slow, and deliberate delight. If you feel you need to put your fork down between bites, or have a sip of water, please do. Try to listen to when you're body has told you it's had enough, or even, if it is simply just satisfied. But... 
9. DON'T feel guilty if you overeat. It's a very food centered holiday. There is soooo much food, and people do tend to overeat, or indulge a little extra. It comes once a year, and we only live once. Focus instead on friends, family, loved ones, and being thankful. 
10. DO make it a family tradition to go for a walk around the block when you're done. A walk after eating a meal helps digestion, can bring time for conversation, and the focus AWAY from the table. If it's too cold outside, maybe it's time to break out the Wii Sports. 

Just remember, diabetes is NOT a life sentence because you 'messed up' being healthy, and active. It's simply a condition a few of us developed because we have the genes for it. Regardless of our past life choices, we can still live daily, healthful lives, and enjoy holidays and celebrations in moderation. So, kick back, and relax!   

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