Understanding Diabetes During the Holidays: A Conversation with Dr. Scott T. Hines

This November marks American Diabetes Month, a time when millions of families gather for the holidays — and also a moment to talk honestly about a condition that affects more people than ever. According to the CDC, 38 million Americans are living with diabetes, and 1 in 3 adults are living with prediabetes. Many don’t even know they have it.

Diabetes brings not only health challenges but also a growing financial burden, with medical costs more than double for those diagnosed. But there’s encouraging news, too: diabetes can be managed — and in some cases prevented — through lifestyle habits, early detection, and good medical guidance.

To help us understand what living with diabetes really looks like, we spoke with Dr. Scott T. Hines, an endocrinologist with Crystal Run Healthcare and part of Optum Health. In our conversation, Dr. Hines breaks down the different types of diabetes, explains why early screening matters, and offers practical steps people can take — especially during the tempting holiday season — to stay healthy.

Type 1 vs. Type 2: What’s the Difference?

Dr. Hines began by explaining the essential role of insulin, the hormone that moves glucose out of the bloodstream and into the body’s cells for energy.
Type 1 diabetes occurs when the pancreas cannot produce insulin at all. While often diagnosed in childhood, adults can develop it too — and treatment requires insulin injections.

Type 2 diabetes, however, accounts for 90–95% of cases. In this form, the body does make insulin, but not enough to overcome insulin resistance — a condition where the body’s cells don’t respond properly to insulin. Genetics play a role, but lifestyle factors such as weight, diet, and activity level strongly influence risk.

Warning Signs — and Why Many People Miss Them

A striking point Dr. Hines made: by the time noticeable symptoms appear, diabetes is often already advanced. These symptoms include:

Frequent urination

Increased hunger without weight gain

Blurry vision

To catch diabetes earlier, the U.S. Preventive Services Task Force recommends screening every 1–3 years for adults ages 35–70 who are overweight or obese. Early testing can help prevent complications long before symptoms develop.

Who’s Most at Risk?

Family history matters — but differently depending on the type:

Type 1 diabetes: Only about 10% of people have a family member with it.

Type 2 diabetes: Up to 70% of people have a first- or second-degree relative with the condition.

But genetics are only part of the equation. “Fat cells produce hormones that counteract insulin,” Dr. Hines explained. “With weight loss, exercise, and healthier eating, you reduce those hormones — allowing your body’s natural insulin to work more effectively.”

Lifestyle Changes That Make a Difference

The first line of defense for both diabetes and prediabetes is lifestyle change. But Dr. Hines stresses realistic, long-lasting habits — not extreme or restrictive diets.

His core advice:

Moderation, not elimination. You don’t need to give up bread or pasta — just be mindful of how much and how often.

Choose complex carbs and add fiber. Higher-fiber foods have less impact on blood sugar.

Measure serving sizes. Knowing what a true “portion” looks like can make a big difference.

Incorporate both aerobic exercise and strength training. Movement helps the body use glucose more effectively.

Aim for gradual weight loss. Losing just 5–10% of body weight can significantly improve blood sugar control.

For people with prediabetes, these steps can sometimes reverse the condition entirely — or at least prevent progression to full diabetes.

Staying Healthy Through the Holidays

Thanksgiving and the winter holidays can be especially tough for people trying to manage blood sugar. Dr. Hines encourages people not to fear enjoying special foods — as long as they keep portion sizes in check.

“If you want a slice of pumpkin pie, have it,” he said. “Just don’t have a quarter of the pie.”
And remember: it’s one day. What matters most is getting back to healthy routines afterward.

Understanding Medication Options — Including Insulin and Ozempic

Medication is often part of diabetes management, especially when lifestyle changes alone aren’t enough.

Today, treatment plans vary widely based on a patient’s:

Heart health

Kidney function

Risk for low blood sugar

Medication costs and insurance

Dr. Hines noted that insulin carries a lot of stigma, often due to stories from decades ago when it was used only in very advanced cases. Today, insulin may be introduced much earlier — sometimes temporarily — to bring blood sugar under control.

He also addressed the growing interest in medications like Ozempic, Mounjaro, Wegovy, and Zepbound, which belong to a class of drugs known as GLP-1 agonists. While originally developed for diabetes, some versions are FDA-approved for weight loss as well.

“These medications help people lose significant weight and improve heart health,” Dr. Hines said. For some patients, weight loss medications can even prevent the onset of chronic conditions like diabetes and high blood pressure.

When Does Dialysis Become Necessary?

Dialysis is a treatment for end-stage kidney failure — a complication linked to many years of poorly controlled diabetes. Dr. Hines emphasized that patients who manage their blood sugar well dramatically reduce their risk of ever needing dialysis or a kidney transplant.

A Final Message: It’s a Marathon, Not a Sprint

Dr. Hines closed with a message of reassurance:

“Diabetes is not your fault. It’s a complex condition influenced by genetics and lifestyle. What matters most is taking small, sustainable steps — and working with your healthcare provider on a long-term plan.”