If Thanksgiving Day includes a large helping of anxiety and guilt along with your turkey feast, you’re not alone. More than half of type 2 diabetics in the U.S. who are 45 or older report having a difficult time following their diabetes treatment regimen during the five-week period from Thanksgiving to New Year’s Day according to a Harris Interactive® survey.

Thanksgiving is a wonderful day of celebration and gratitude that is centered around food. When you have diabetes, it is easy to justify a little indulgence in the name of the holiday. But how do you keep from letting your diabetes management spiral out of control? It begins with knowing how to enjoy Thanksgiving without throwing the whole treatment plan out the window. Here are tips for getting through the day.

Start the Day Right
Every family has their own traditions. But if you have diabetes, Thanksgiving Day should include a tradition to begin with exercise. Whether it’s a walk on the treadmill, a jog through the neighborhood, a flag-football game with the cousins, or lifting weights, exercise will provide several important benefits for the day. First, it helps reinforce your commitment to your health. Second, it can help reduce your appetite. (Some research shows that the hotter you feel during exercise the more suppressed your appetite will be. So be sure to work up a good sweat.) And third, exercise has a positive effect on your insulin sensitivity, making it easier to stay in your target range.

Test, Test, Test
Stay committed to testing your blood sugar. Start early in the day and make sure you’re within your target range before the big meal. Make sure you test about two hours before your meal is supposed to start. This is so vital because if you test right before Thanksgiving dinner and you’re high, are you really going to wait to eat? Honestly, most diabetics will simply justify ignoring a high because of the holiday. Then your numbers will likely be out of control for the rest of the day. After the big meal, test again about two hours after your meal began. This will allow you to make any corrections should you have made any mistakes counting carbs during the meal.

Counting Correctly Makes All the Difference
No matter whether you’re using insulin or oral medications, correctly counting the carbohydrates in your meal is the only way to keep your post-meal blood sugars in control. Below is a list of the nutrition facts for many of the most common thanksgiving foods. One of the best tips I can give you is to use measuring cups in place of serving spoons for the high-carb foods. This will help you accurately judge portion size. If you’re on insulin, you have more flexibility because you can give more insulin in response to eating extra servings. (If you don’t know how to adjust your insulin based on your food intake, talk to your doctor first. Overdosing on your insulin can be very dangerous.)

3 oz white meat without skin Cal: 120, Carbs: 0 g., Fat: 2.5 g., Protein: 23 g., Fiber: 0 g.

3 oz. dark meat without skin Cal: 145, Carbs: 0 g., Fat: 6 g., Protein: 22 g., Fiber: 0 g.

1 / 2 cup candied yams Cal: 170, Carbs: 46 g., Fat: 0 g., Protein: 2 g., Fiber: 4 g.

3 T. cranberry relish Cal: 25, Carbs: 7 g. , Fat: 0 g. , Protein: 1 g. , Fiber: 1 g.

1 / 2 cup mashed potatoes Cal: 80, Carbs: 27 g. , Fat: 2.5 g., Protein: 3.5 g., Fiber: 4 g.

1 / 2 cup dressing Cal: 160, Carbs: 20 g. , Fat: 6 g. , Protein: 5 g., Fiber: 2 g.

1 / 2 cup green beans Cal: 64, Carbs: 7 g. , Fat: 4 g. , Protein: 2 g., Fiber: 3 g.

1/2 cup corn Cal: 80, Carbs: 16 g. , Fat: 1 g. , Protein: 2 g., Fiber: 2 g.

1/4 cup gravy Cal: 47, Carbs: 4 g. , Fat: 3 g. , Protein: 1 g. , Fiber: 0 g.

1 Slice (1/8 of pie) Homemade Pumpkin Pie Cal: 265, Carbs: 45 g. , Fat: 18 g. , Protein: 8.5 g. , Fiber: 2 g.

As you can see, if you’re looking for second helpings and you’re trying to limit your carb intake, reach for the turkey. Watch out for loaded dishes like the candied yams and the sneaky carbs like the cranberry relish and the gravy. Also, try to add some dishes to complement your meal that have little to no carbs, such as green salads, sugar-free gelatin dishes, or fresh vegetables.

Watch Out for Portion Size
As noted above, using measuring cups in place of serving spoons is a great way to easily monitor portion size. But also, watch out for your aunt who likes to cut pies in six pieces instead of eight. That would take a piece of homemade pumpkin pie from 45 g of carbs and 18 g of fat to 60 g of carbs and 24 g of fat. And don’t forget to count extra carbs if you add whipped cream or ice cream to the pie.

Another tip is to put everything on your plate and then pause to count your carbs. If you’re reaching for the rolls throughout your meal, are you really going to remember if you ate two rolls or three? If you go back for a second helping, go once, measure portions, and pause to count before you start eating. It only takes a second and it can make a tremendous difference in staying in control throughout the day.

How to Handle the “Pushers”
We’ve all seen it. The aunt, cousin, friend, or spouse who “pushes” food on Thanksgiving Day. “Oh, you can have a little. It won’t hurt.” They can be tough. But you don’t have to be rude. The first step is to form your own team. Ask those who are closest to you, who understand your diabetes the best, to be on your team for the day. Ask them to help you do the things we’ve talked about—exercise, watch portion size, etc. You’ll be amazed how helpful your team can be when the “pushers” start. Another helpful tip is to make sure “pushers” know that you are making a choice. Don’t say, “I can’t.” Instead, say, “I don’t.” What can they say to that?

What to Do If You Blow It
We can be honest here. Everyone with diabetes has had those days—especially around the holidays. It happens. The most important thing is how you approach the situation. As the Harris survey showed, more than half of adult diabetics report having a tough time from Thanksgiving all the way to New Year’s Day. Don’t let one mistake at Thanksgiving spiral into five weeks of high blood sugar. You can correct one high blood sugar. Adjust your insulin dose if you can. Get up, exercise, help with the dishes, take a late afternoon walk. Commit yourself to having great blood sugar control on Friday. The scientific evidence shows that the effort it takes to keep tight blood sugar control pays off with tremendous long-term benefits. Blowing your blood sugar goals for one day isn’t good. But throwing your hands in the air and giving up for the next five weeks can have a serious negative impact on your health. So, take control and stay committed to being as healthy as you can.

I hope you have a truly wonderful and healthy Thanksgiving!

Note: This information is not intended to be a substitute for consulting with your doctor and diabetes care team. Please, do not make any changes to your diabetes management plan without first consulting your doctor.