As Missouri families navigate a season filled with travel, celebration and calorie-heavy holiday traditions, health experts say it’s also a critical time to pay attention to blood sugar.
More than 600,000 adults in Missouri are living with diabetes, and many more are unknowingly on the brink of developing the disease. Between oversized meals, sugary desserts, alcohol and the stress that comes with disrupted routines, the weeks between Thanksgiving and the New Year can pose real health challenges — especially for people already working to manage a chronic condition.
To help Missourians navigate these pressures without missing out on the festivities, Dr. Heidi B. Miller, chief medical officer for the Missouri Department of Health and Senior Services, shared practical tips on balanced eating, early risk detection and building sustainable habits that can carry well beyond the holidays. Her guidance emphasizes not perfection, but mindful choices and long-term health.
St. Louis American: The holidays are known for rich meals and disrupted routines. What makes this season particularly challenging for Missourians living with diabetes?
Dr. Miller: We often show our love through food — bigger portions, sweeter treats, snacking outside normal routines and alcohol. Combined with travel or irregular schedules, all of this can disrupt digestion and metabolism. For people with diabetes, it makes blood sugar management significantly harder. They need to be especially mindful of what they consume, monitor their levels closely and continue taking medications as prescribed.
American: For people who want to enjoy their favorite holiday dishes without harming their health, what does a balanced holiday plate look like?
Miller: Aim to fill half the plate with vegetables, a quarter with lean protein and a quarter — or less—with grains or complex carbohydrates. It’s not about restriction; it’s about proportion. Eating slowly, savoring food, drinking water and avoiding distractions can also reduce cravings for second or third helpings.
American: What are some realistic swaps or small changes that can help with blood sugar management during holiday gatherings?
Miller:
- Sweet potatoes are naturally sweet — skip the added sugar or marshmallows and season with herbs instead.
- Choose roasted vegetables over creamy casseroles.
- Try mashed parsnips or cauliflower as alternatives to mashed potatoes, or mix them 50/50 for fewer carbohydrates.
- Stick to single dessert servings or opt for fruit. Completely avoiding treats can sometimes lead to bingeing later.
- Replace sugary drinks with sparkling water and a squeeze of lemon or lime. And be mindful that many alcoholic drinks are high in carbohydrates.
American: Many people don’t realize they’re at risk for diabetes. What early signs of pre-diabetes should Missourians watch for?
Miller: Pre-diabetes often has no symptoms at all, which is why screening is essential. People should talk to their healthcare provider about checking their blood sugar. Risk factors include being 45 or older, having a first-degree relative with diabetes, being overweight, physical inactivity, high blood pressure, or high cholesterol. Even those who feel healthy should consider screening if they fall into these categories.
American: If someone suspects they have pre-diabetes, what steps should they take — and what resources are available?
Miller: Start with a simple blood test ordered by a healthcare provider. Lifestyle changes can make a major difference: eating whole foods, prioritizing vegetables and lean proteins, avoiding sugary and processed foods, being active daily, maintaining a regular sleep schedule and caring for mental health. Missourians can also search for a Diabetes Prevention Program through the CDC’s registry.
American: Holiday stress and shifting schedules can make it hard to maintain healthy habits. What practical advice can help people stay consistent without feeling overwhelmed?
Miller:
- Don’t skip meals, which can lead to overeating later.
- Slow down and enjoy the taste of your food — mindful eating helps.
- Avoid short-term crash diets and focus on long-term healthy habits.
- Address shame or emotional distress around food; it can drive unhealthy behaviors.
- Stay hydrated.
- Move your body every day if you’re able — even short periods of immobility affects physical and mental health.
And remember: one meal won’t undo long-term progress. Moderation and self-care matter more than perfection.