Thanksgiving Meal Guide for Type 1 Diabetes: Dietitian Strategies

Disclaimer: While I am a registered dietitian nutritionist and certified diabetes care and education specialist with Type 1 Diabetes myself, this blog post is not intended as medical advice. I'm sharing from my personal experience and professional knowledge, but your diabetes management should always be discussed with your healthcare team. What works for me or others may need to be adjusted for your unique situation.

It's Thanksgiving soon! The turkey is thawing, the grocery list is written, and you're probably wondering how you're going to manage your blood sugar through the biggest food-centered holiday of the year.

Here's what I want you to know: you don't have to figure this out alone, and you don't have to reinvent the wheel.

Everything you need to navigate Thanksgiving (and every other food situation with Type 1 Diabetes) is already laid out in my book. And today, I'm going to give you a taste of what's inside so you can see exactly how these strategies apply to your Thanksgiving meal.

Then, you can grab the full book for free at typeonetypefun.com/free-book and have the complete resource at your fingertips, not just for this week, but for every holiday, restaurant meal, and food situation you'll face.

Let's dive in.

The Carb Counting Reality

In my book, I include a comprehensive carb counting food list that breaks down common foods by their carb content. And guess what? Thanksgiving foods are all over that list.

Here's what you might consider for Thursday (keeping in mind that every recipe is different):

Stuffing/Dressing: The list suggests about 15g of carbs per 1/3 cup, though this can vary based on the recipe and ingredients used. If you're like me and you eat 3-4 servings, that could be around 45-60g. You might want to check the recipe if you can.

Mashed Potatoes: Roughly 15g of carbs per 2/3 cup according to the reference list. And let's be real, most of us are eating more than 2/3 cup. Homemade versions with added butter and cream might vary slightly.

Sweet Potato Casserole: This one varies wildly depending on how much sugar and marshmallows are involved. You might estimate somewhere in the range of 30-45g of carbs per serving, but definitely check the specific recipe if possible since some versions can be much higher.

Dinner Rolls: One small roll (about 1 oz) typically contains around 15g of carbs. If you're having two rolls, that could be closer to 30g.

Cranberry Sauce: This can be tricky since recipes vary so much. You might estimate around 15-20g of carbs per 2 tablespoons for canned sauce, but homemade versions with extra sugar could be significantly higher. When in doubt, you could check the label or recipe.

Pie: A standard 1/6 slice of two-crust pie (like pumpkin or apple) might contain around 45g of carbs, though this can vary by recipe. Add whipped cream and you might be adding a bit more.

The point here isn't to scare you with numbers. The point is: knowing what you're working with makes dosing insulin so much easier. And my book has an entire section dedicated to helping you estimate carbs in real-world situations, including when you're at someone else's house and don't have access to a food scale or exact recipes.

Grab the book here: typeonetypefun.com/free-book

Total Insulin vs. Timing of Insulin

One of the most important concepts I teach in my book is understanding the difference between total insulin (how much you're taking) and timing of insulin (when you're taking it).

For Thanksgiving, this distinction is crucial.

If your blood sugar spikes super fast right after eating, that's usually a timing problem. You might benefit from pre-bolusing earlier, maybe 15-20 minutes before you start eating, so the insulin has time to start working before the food hits.

But if your blood sugar goes high and stays high for hours, that's likely a total insulin problem. You might not have taken enough insulin to cover everything you ate, especially if the meal was high in fat and protein (which slows digestion and causes delayed spikes).

Thanksgiving is the ultimate high-fat, high-protein meal. Turkey, gravy, butter-laden sides, creamy casseroles, and rich desserts all slow down digestion. That means you might see your blood sugar rise 2-4 hours after eating, even if it looked good right after the meal.

Here's what you might consider:

• Pre-bolusing for the carbs you know you're eating
• Using an extended bolus if you have a pump (delivering some insulin upfront and some over 2-3 hours)
• Taking a second dose 2-3 hours after eating if you notice your blood sugar creeping up

The book goes deep into how to troubleshoot whether you're dealing with a total insulin issue or a timing issue, and how to adjust for each. It's honestly game-changing information, especially for complex meals like this.

Blood Sugar Protocols You Can Actually Use

In the book, I lay out clear protocols for managing high and low blood sugars. These aren't vague suggestions, they're actionable steps you can follow in the moment.

If your blood sugar starts spiking after Thanksgiving dinner:

• Stay calm and use your correction factor if that's part of your plan
• Hydrate (high blood sugar causes dehydration, and dehydration makes blood sugar harder to manage)
• Consider light movement, like a walk around the neighborhood with family
• Be patient, wait at least 2 hours before taking another correction dose to avoid stacking insulin

If your blood sugar drops low:

• Have 12-20g of fast-acting carbs (juice, glucose tabs, or yes, even a small piece of pie works)
• Wait 15-20 minutes and recheck
• Once you're stable, consider adding protein or fat to help sustain your blood sugar

These protocols are spelled out in detail in the book, along with nuances for different situations (like if you're on a closed-loop pump, or if you tend to over-treat lows). It's the kind of practical guidance that takes the guesswork out of diabetes management.

The Leftovers Conversation (And the Rice Trend You've Been Seeing)

Let's talk about leftovers, because Thanksgiving doesn't end on Thursday. You're going to be eating turkey sandwiches, reheated stuffing, and leftover pie for days.

You might have seen a trend floating around a few months ago about heating rice, putting it in the fridge, and then reheating it instead of eating it fresh. The idea is that this process increases resistant starch, which supposedly helps with blood sugar response.

Here's my input: take it or leave it.

Is there some scientific evidence that this is true? Yes. Cooling and reheating certain starchy foods can change the structure of the carbohydrates and create resistant starch, which may have a slightly lower impact on blood sugar.

However, is it so significant for those of us with Type 1 Diabetes that we shouldn't eat the carbohydrates we've created on the first go? No.

Here's why this bothers me:

First, the difference in blood sugar response is often minimal. If you're expecting some magical transformation where your mashed potatoes suddenly don't spike you because you refrigerated them overnight, you're going to be disappointed.

Second, and this is really important: this suggestion can potentially increase food safety concerns.

Reheating food multiple times, or letting food sit at unsafe temperatures for too long, increases the risk of bacterial growth. Rice in particular is notorious for this, Bacillus cereus (a bacteria that causes food poisoning) thrives in improperly stored rice.

So if you're going to refrigerate and reheat your Thanksgiving leftovers (which, let's be honest, you probably are), just make sure you're doing it safely:

• Cool food quickly and get it in the fridge within 2 hours
• Store leftovers in shallow containers so they cool evenly
• Reheat food to at least 165°F (74°C)
• Don't reheat the same food more than once

As for the blood sugar impact? You might dose insulin the same way you would for fresh food, and adjust if you notice any differences. But don't stress about it. One of the biggest messages in my book is that you don't need to make food more complicated than it already is.

Diabetes is hard enough without adding extra unnecessary rules.

Why You Need This Book (Like, Right Now)

Look, I could keep going. I could tell you about the plate method, about how to handle high-fat meals, about the 42+ factors that affect blood sugar, about how to navigate restaurants and social situations and all the chaos the holidays bring.

But honestly? All of that is already written for you in the book.

The book gives you:

• Comprehensive carb counting lists for real foods
• Detailed explanations of how insulin timing and total insulin work
• Protocols for managing highs and lows
• Strategies for navigating complex meals like Thanksgiving
• Permission to break the harmful rules you've been taught about diabetes and food
• A framework for trusting yourself and your body

And it's completely free.

No catch. No email sequence trying to sell you something. Just a resource I created because I wish someone had given this to me when I was first diagnosed.

Grab your free copy here: typeonetypefun.com/free-book

You Deserve to Enjoy Thanksgiving

I want you to walk into Thursday feeling confident, not anxious. I want you to enjoy your meal without the constant background stress of "am I doing this right?"

The book gives you that confidence. It gives you the tools, the strategies, and the permission to live your life fully, even with Type 1 Diabetes.

So before you sit down to that Thanksgiving meal, do yourself a favor: grab the book. Read the sections that apply to where you are right now. Highlight the parts that resonate. Dog-ear the pages you want to come back to.

And then go enjoy your Thanksgiving, knowing you have a resource you can trust.

You've got this. And I've got you.

Happy Thanksgiving!

Ready to feel confident navigating food with Type 1 Diabetes? Download your free copy of "You Have Permission" now: typeonetypefun.com/free-book