Thanksgiving meal plated and on decorated table

The holidays arrive each year with familiar comforts: crowded dining tables, family gatherings that stretch long into the evening, and an abundance of once-a-year dishes that invite even the most disciplined eaters to indulge. But for families of children with diabetes, the season can also bring a quiet layer of pressure, balancing celebration with careful monitoring.

At Loma Linda University Children’s Hospital, Sena Orsdemir, MD, medical director of the Pediatric Diabetes and Endocrine Center, hears these concerns every year. Parents want their children to participate fully in the festivities without feeling different or restricted. And, Orsdemir says, they should.

In a conversation ahead of the holiday season, she discussed misconceptions, planning strategies, and small but meaningful habits that can help families navigate this time with confidence.

Q: What are some of the biggest challenges kids with diabetes face during the holiday season?

Orsdemir: I always begin by acknowledging the joy of the holidays. It’s a time filled with family, celebration, and a lot of delicious food. Food is a meaningful part of our cultural traditions, and it should be enjoyed. Our goal is never to make families feel stressed or restricted. We want children with diabetes to be fully included in the festivities and enjoy the holidays just like everyone else, but in a way that supports their health and safety.

Q: Some children can feel “different” during the holidays due to food restrictions. How can families help with that?

Orsdemir: No child should feel left out. Holidays shouldn’t be something they dread because of their diagnosis. The key is planning ahead. If your family is hosting, take a look at the menu to ensure there are balanced options available. Things with protein, fiber, and lower carbs. But importantly, kids with diabetes can enjoy desserts. They just need to do so in a balanced and mindful way.

Q: So if desserts are allowed, how should families approach this?

Orsdemir: Absolutely, dessert is okay. What matters is the structure of the meal. If the child has already eaten a balanced plate with protein and fiber, the body can handle dessert more easily. Portion size matters, and we don’t want dessert eaten in isolation. Back-to-back cookies, cake, and ice cream can quickly spike blood sugar levels, making management much harder. The biggest misconception is that kids with diabetes can’t have any sweets at all. That kind of all-or-nothing approach often backfires, as kids may end up sneaking more treats later. Balanced meals and mindful portions work much better.

Q: Do you recommend parents help plate their child’s food?

Orsdemir: Yes, and the way it’s presented makes a big difference. Instead of saying, “Don’t eat anything without asking,” frame it positively: “We’re going to have a wonderful Thanksgiving dinner with great food and dessert. Let’s make your plate together so you can enjoy everything.” When kids feel supported rather than restricted, they tend to follow healthy routines more easily.

Q: Should families adjust blood sugar checks or medication routines on big holiday meal days?

Orsdemir: Yes, they should expect that this won’t be a typical day. Holidays often mean multiple rounds of eating, dinner, dessert, and then more snacks later. Blood sugar levels may rise, so monitoring is essential.

  • Kids using finger-stick checks should check more frequently.
  • Those using continuous glucose monitors (CGMs) should check their devices more often.

Parents should simply be aware that they may need more insulin than usual and follow the high- and low-blood-sugar management guidelines they’ve been taught.

Q: If families are traveling for the holidays, what should they prepare for?

Orsdemir:

  • Check airline policies: Some require letters to carry medical devices like insulin pumps or supplies. Families should contact their endocrinology team in advance if they need documentation.
  • Pack snacks: Airport food can be unpredictable. Bringing snacks that pair carbs with protein is especially helpful for younger children.
    Again, planning is key.

Q: Do you recommend parents model their own eating behaviors during the holidays?

Orsdemir: Definitely. Even if parents don’t have diabetes, modeling the same balanced eating patterns they expect their children to follow is extremely helpful. We recognize that big gatherings make this harder, and parents shouldn’t feel pressured to police the entire room. But children naturally mirror their parents, so small examples go a long way.

Q: Anything else families often ask about this time of year?

Orsdemir: One more important tip: encourage activity. Even a short family walk after a big holiday meal can make a big difference in regulating blood sugar. Kids can ride bikes, scooters, or just run around the neighborhood. Physical activity helps the body better handle blood sugar spikes, and it’s a great way to spend time together.