Type 1 Diabetes Thanksgiving Guide: Prep Week Strategies & Meal Plan

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.

The Week That Can Make or Break Your Thanksgiving

Thanksgiving is next week. And if you have Type 1 Diabetes, you're probably already thinking about it.

Not just the food (though let's be honest, that's a big part of it). But the insulin calculations. The family dynamics. The questions from relatives who don't understand your diabetes. The worry about whether your blood sugar will cooperate. The stress of trying to enjoy yourself while also managing a condition that doesn't take holidays off.

Here's the thing: the week before Thanksgiving is when you set yourself up for success or set yourself up for stress.

Most people wait until they're sitting at the table on Thursday to start thinking about their diabetes strategy. By then, it's too late to prepare. You're reacting instead of planning. You're guessing instead of knowing. And that's when blood sugars get messy and the whole experience feels more stressful than enjoyable.

But you? You're reading this a week early. Which means you have time to get ahead of the chaos.

So let's create your game plan for a stress-free Thanksgiving with Type 1 Diabetes.

Step 1: Communication with Your Host

This might be the most underrated part of Thanksgiving prep, but it can make a massive difference.

If you're not hosting Thanksgiving yourself, you might consider reaching out to whoever is hosting and having a quick conversation. Not to make demands or be difficult, but to set yourself up for success.

What You Might Ask

"What time are we eating?" Knowing the actual mealtime helps you plan your insulin timing, your previous meal, and whether you need snacks to hold you over. If dinner is at 2:00 PM, that's very different from 6:00 PM in terms of how your day unfolds.

"What's on the menu?" Getting a sense of what will be served helps you mentally prepare for carb counting. You don't need an exact list, but knowing whether there will be mashed potatoes, sweet potato casserole, stuffing, rolls, and dessert helps you start thinking about dosing strategy.

"Is it okay if I bring a dish?" This gives you control over at least one item on the table. You could bring a vegetable dish you love, a protein option, or even a lower-carb side that you know works well for your blood sugar. Having something you're confident about can reduce stress.

"Can I peek at nutrition info if anything is store-bought?" Some hosts use pre-made items (nothing wrong with that!). If they do, you might ask if you could snap a photo of the label so you can carb count more accurately.

Setting Boundaries

You might also consider letting your host know if there are certain topics you'd prefer not to discuss at the table. If Aunt Susan always comments on what you're eating or Uncle Bob likes to give unsolicited diabetes advice, a quick heads-up to the host like, "Hey, I'd really appreciate if we could keep diabetes talk off the table this year. I've got it handled and just want to enjoy the meal," can go a long way.

Your host wants you to have a good time. Most people are happy to help if you just tell them what you need.

Step 2: Insulin Planning

Let's talk strategy for the actual meal, because this is where a lot of people get stuck.

Know Your Timing

Thanksgiving meals are notoriously unpredictable in timing. Someone always shows up late, the turkey takes longer than expected, or everyone stands around chatting for an hour before anyone sits down to eat.

You might consider:

• Asking what time food will actually be on the table (not what time guests should arrive)
• Planning your pre-bolus based on that timing, but being flexible if things run late
• Having glucose tabs or a small snack on hand in case you pre-bolus and then the meal gets delayed

If you tend to spike quickly after eating, you might benefit from pre-bolusing 15-20 minutes before the meal. But if the timing is uncertain, you could consider dosing right when you sit down, or even using a split bolus if you have a pump (part of the insulin upfront, part extended over a few hours to cover the slower digestion from all that fat).

Account for the Fat and Protein

Thanksgiving is the ultimate high-fat, high-protein meal. Turkey, gravy, butter in everything, cream-based casseroles, pie with whipped cream. All of that fat slows down digestion, which means your blood sugar might not spike right away, but it could creep up several hours later.

You might consider:

• Not taking all your insulin upfront if you know fat causes delayed spikes for you
• Using an extended bolus or taking a second dose 2-3 hours after eating if you notice your blood sugar climbing
• Checking your blood sugar more frequently in the hours after the meal, not just right after eating

If you're not sure how your body responds to high-fat meals, you might want to test this before Thanksgiving. Make yourself a rich, fatty meal this week and pay attention to what your blood sugar does. That data will help you plan better for Thursday.

The Stuffing Story (And Why Permission Matters)

Let me tell you something personal. My favorite food at Thanksgiving is stuffing. Hands down. I could eat an entire pan of it by myself if given the chance.

For years, I would put one small serving of stuffing on my plate, maybe about half a cup. And I did this because I wanted to be a "good diabetic." I didn't want to take too much insulin. I didn't want anyone looking at my plate and judging me. I wanted to prove I had control.

But here's what would happen, every single time: I would finish that small serving and want more. So I'd go back for seconds. And then thirds. And then I'd realize I was stacking insulin as I went, my blood sugar was spiking because I didn't have the pre-bolus timing on my side anymore, and I'd end up frustrated and high for hours.

Finally, I realized something: I know myself. Thanksgiving is one day out of the year. I'm going to eat three or four servings of stuffing. That's just the reality.

So now? I put three servings on my plate from the start. I dose insulin appropriately for what I'm actually going to eat. And my blood sugar is so much better because the insulin timing works in my favor.

Is it the most "balanced" plate? Maybe not. But it's honest. And honestly, taking care of my blood sugar instead of worrying about how I'm perceived in one single meal has changed the game for me.

If you know you're going to eat more of something, you might consider just dosing for it upfront. Give yourself permission to enjoy the foods you love without the guilt spiral.

Step 3: The Balanced Plate Method (If That's Your Thing)

Now, let's talk about creating a balanced plate. But I want to be very clear about something first:

You do not have to create a balanced plate on Thanksgiving if you don't want to. You don't have to. It's one day out of the year. It's not going to ruin everything.

Many dietitians act as the food police. I am not one of those dietitians. If you want to load up your plate with all the carbs and have the time of your life, go for it. Just make sure you're dosing insulin appropriately and you're prepared for what might happen with your blood sugar.

That said, if you do want to create some balance (whether for blood sugar reasons, for satiety, or just because it feels better to you), here's a method that works really well:

The Plate Method

This is a visual guide that can help you build a plate that includes a variety of nutrients without having to measure or stress too much.

Half your plate: Non-starchy vegetables Think salad, green beans, roasted Brussels sprouts, asparagus, roasted carrots, or any other veggie that isn't loaded with starch or sugar. These foods have minimal impact on blood sugar, they add fiber and nutrients, and they help you feel full.

Examples for Thanksgiving:

• A big scoop of green bean casserole (yes, even with the fried onions on top)
• A side salad with vinaigrette
• Roasted or steamed vegetables

If you want a comprehensive list of non-starchy vegetables, you could reference the American Diabetes Association's guidelines, they have great resources on this.

A quarter of your plate: Protein This is your turkey, ham, or any other protein source on the table. Protein helps stabilize blood sugar, keeps you satisfied, and doesn't require insulin (though if you're eating a ton of protein, that's a different conversation, we can talk about protein bolusing if needed).

A quarter of your plate: Carbs This is where all the fun stuff lives. Mashed potatoes, sweet potato casserole, stuffing, rolls, cranberry sauce, mac and cheese, and all those amazing carb-heavy sides that make Thanksgiving what it is.

You might notice this method naturally limits your carbs to about a quarter of the plate, which can make dosing insulin easier and can help prevent massive blood sugar spikes. But again, if you want more carbs, take more carbs. You're the boss of your plate.

Why This Works

The reason the plate method can be helpful is because it gives you a visual guide without requiring you to measure everything or stress about exact portions. It's flexible, it's practical, and it still allows you to enjoy all the foods you love.

Plus, having that balance of vegetables, protein, and carbs can help slow down digestion (thanks to the fiber and protein), which might make your blood sugar more stable overall.

But let me say it one more time: this is optional. If the plate method feels restrictive or stressful or like it's taking away from your enjoyment of the meal, skip it. One meal is not going to derail your health or your diabetes management.

Step 4: If You're Tracking Calories or Macros

Some of you might be in a phase where you're tracking your food intake, whether for weight management, athletic performance, or body composition goals. If that's you, Thanksgiving can feel especially tricky.

Here's my suggestion: you might consider taking a break from tracking on Thanksgiving Day itself.

One day of not tracking is not going to undo your progress. In fact, giving yourself permission to enjoy a holiday meal without the stress of logging every bite can be incredibly freeing and can actually support a healthier relationship with food long-term.

But if you do want to stay somewhat mindful, you could consider:

• Eating a lighter breakfast and lunch so you have more room for the big meal
• Focusing on protein and vegetables earlier in the day
• Not restricting yourself at dinner, but also not going into it feeling deprived or starving

The goal is to enjoy the meal without feeling guilty, and also without feeling physically miserable afterward.

A Note on Weight Loss and Body Recomposition

Speaking of weight management, I want to address something that comes up a lot this time of year.

A lot of people with Type 1 Diabetes want to lose weight, build muscle, get leaner, or improve their body composition. And the holidays feel like this massive obstacle to those goals.

If you're someone who has been trying to lose weight but hasn't seen results even though you've been eating very little (like 800 or 1000 calories), or if you've been yo-yo dieting for years and the weight keeps coming back, I want you to know: there is a better way.

I work with individuals on sustainable weight loss and body recomposition. Not quick fixes. Not overnight solutions. Not restrictive diets that leave you miserable and bingeing later.

What I mean by body recomposition: More muscle, less fat. Toned, lean, strong, and functional. What most people actually mean when they say "weight loss." And critically, maintaining stable blood sugars throughout the process.

This Is For You If:

• You're willing to invest time and money to achieve your weight loss goals, and you recognize that a sustainable plan (as opposed to a quick fix or an overnight solution) is ultimately ideal for your blood sugar and your health
• You're willing to track some nutrition data and collaborate honestly about your eating habits, with the understanding that you'll receive kindness, not judgment
• You've been trying to lose weight by eating very little (like 800-1000 calories) but you're still not seeing results
• You've done yo-yo diets before and the weight came back (plus extra) after you stopped
• You want to understand how your insulin needs change as your body composition changes, so you're not dealing with constant highs or lows
• You want to be strong, functional, and independent for your whole life, not just smaller on the scale

This Is NOT For You If:

• You're not willing to put in work or effort
• You want an overnight solution or a quick fix
• You don't want to learn about nutrition or create a sustainable lifestyle
• You don't care about physical activity or building strength
• You're absolutely unwilling to track any nutrition data
• You don't want to put in time or money
• You just want a meal plan handed to you, or you just want me to tell you what to do without collaboration

Here's what I promise: I don't promise overnight results. But what I do promise is that if you follow along on this journey, the results you achieve, you will maintain. I do not give you a yo-yo diet. Your body will not regain the weight (and then some) once we're done working together.

If you've dieted before and this exact scenario has happened to you, you might be exactly the person I'm looking for.

And if you have Type 1 Diabetes, I'll help you understand how your insulin sensitivity changes throughout the process so you aren't dealing with constant highs or lows. It is completely possible to be on a weight loss journey and have great blood sugar. In fact, they can support each other.

If this resonates with you, let's chat: calendly.com/typeonetypefun/30min

Step 5: Prep Work You Can Do This Week

Okay, back to Thanksgiving prep. Here are some practical things you might consider doing this week to set yourself up for success:

Monday-Tuesday: Information Gathering

• Reach out to your host and have those conversations we talked about
• Look up carb counts for common Thanksgiving foods if you're not familiar
• Review your insulin ratios and correction factors to make sure you're confident in them
• Check your diabetes supplies (do you have enough insulin, test strips, CGM sensors, pump supplies, etc.?)

Wednesday: Mental and Physical Prep

• Get a good night's sleep (seriously, sleep impacts blood sugar so much)
• Eat regular, balanced meals so you're not going into Thursday feeling deprived or starving
• Pack your diabetes bag if you're traveling (insulin, backup supplies, snacks, glucose tabs)
• Set realistic expectations for your blood sugar (it might not be perfect, and that's okay)

Thursday Morning: Final Setup

• Eat a lighter breakfast with protein and fat to keep you stable until the big meal
• Check your blood sugar before you leave the house
• Bring extra supplies with you (you never know)
• Take a few deep breaths and remind yourself: you've got this

Step 6: Managing the Social Dynamics

We've talked a lot about the food and insulin, but let's not forget: Thanksgiving is also about people. And people can be stressful, especially when you have diabetes.

You might encounter:

• Relatives who comment on what you're eating
• People who confuse Type 1 and Type 2 Diabetes
• Well-meaning family members who give unsolicited advice
• Questions about your CGM or pump
• Pressure to eat more (or less) than you're comfortable with

Here's my advice: decide ahead of time how you want to handle these situations.

You might consider:

• Having a few go-to phrases ready ("My doctor and I have this handled, but thanks for caring")
• Identifying one person at the gathering who "gets it" and can be your ally if things get uncomfortable
• Giving yourself permission to step away if someone is being particularly difficult
• Remembering that you don't owe anyone an explanation about your diabetes management

You're allowed to set boundaries. You're allowed to protect your peace. And you're absolutely allowed to enjoy your meal without defending your choices to anyone.

What If You Need More Support?

Look, Thanksgiving is just one meal. But if you're feeling overwhelmed by the thought of managing your diabetes through this meal, or through the entire holiday season, that might be a sign that you need more support.

If you're struggling with meal planning, insulin dosing, or just feeling confident in your ability to navigate food situations with diabetes, I would love to help you.

I offer personalized coaching where we work together to develop strategies that actually fit your life. We'll talk through scenarios like Thanksgiving, figure out your personal insulin patterns, and build your confidence so you're not constantly stressed about food and blood sugar.

You can schedule a free 30-minute consultation call with me here: calendly.com/typeonetypefun/30min

We'll chat about where you're at, what you're struggling with, and how I can support you. No judgment. No pressure. Just real help from someone who actually understands what it's like to live with Type 1 Diabetes.

And don't forget, you can grab a free copy of my book at typeonetypefun.com/free-book, it has tons of strategies for navigating meals, understanding insulin, and building a healthier relationship with food and diabetes.

You're More Prepared Than You Think

Here's the truth: you already know more than you think you do about managing your diabetes around food. You've been doing this for a while. You know your body. You know what tends to spike you and what doesn't.

The week before Thanksgiving is just about taking that knowledge and creating a plan. It's about setting yourself up to enjoy the holiday instead of stressing through it.

You might not have perfect blood sugars on Thursday. That's okay. Perfect blood sugars are not the goal. The goal is to enjoy time with people you care about, eat foods you love, and manage your diabetes in a way that feels sustainable and not overwhelming.

You've got this. And if you need help, I'm here.

Happy (almost) Thanksgiving!

Need help with meal planning or diabetes strategies for the holidays? Let's create a personalized game plan together: calendly.com/typeonetypefun/30min