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November is American Diabetes Month, an important time to take a look at the concerns - and some good news - about diabetes. The burden of diabetes in Montana is substantial: Almost 48,000 adults (6.4 percent of residents) have diagnosed diabetes, a rate that has more than doubled in the past 20 years. The rate among American Indians is 2½ times that of the general population and has also increased dramatically. The vast majority of Montanans with diabetes (90 to 95 percent) have Type 2, sometimes called a "lifestyle disease," since it is largely preventable with nutrition and physical activity.

"The good news is that we are making real progress with programs to prevent and treat diabetes in Montana," said Marci Butcher, coordinator of the Quality Diabetes Education Initiative. "The Montana Diabetes Project has funded four effective prevention programs in Billings, Helena, Miles City, and Missoula - and we have plans to expand into more communities."

Information about the programs and recipes are available on the initiative's blog, at

Thanks to Butcher's position and other efforts at the Department of Public Health and Human Services, Montanans with diabetes also have improved access to quality education programs and qualified health professionals. There are now 23 nationally recognized diabetes education programs and 85 certified diabetes educators across the state. Butcher proudly notes that many of these programs and professionals are in Big Sky country's rural communities.

According to Butcher, there is also plenty of good news about managing diabetes during the holidays. "Sadly, many people think that healthy holiday eating is all about deprivation and avoiding the luscious once-a-year goodies that seem to be everywhere. Nothing could be farther from the truth," she said.

Here are some tried-and-true tips for folks with diabetes - and anyone else who wants to feel better this season - on ways to enjoy healthy holidays without stress or guilt:

nPlan ahead: very expert on the planet preaches the benefits of making smart choices by planning. During hectic holidays, writing down plans can actually help reduce stress. Write times for walking or other activities into your daily calendar. Write out a few simple menus for busy evenings and choose some new, lighter recipes for potluck events.

nEat smart: Enjoy a nutrient-rich meal or snack first, then slowly savor a moderate portion of your favorite holiday food. For smart diabetes advice and recipes, Butcher recommends http://

nPlay hard: Physical activity is essential for maintaining normal blood sugar levels. Being active is also an important key to holiday stress relief, so have fun by being active. Take a walk with a dear friend or dance with someone you love.

nRest well: Too little sleep increases underlying stresses and also makes it harder to maintain a healthy weight. Make a good night's sleep a priority. Refresh your holiday spirit and improve your mood with a quick catnap during the day.

"Lifelong health is all about small steps - making smart food and fitness choices every day," Butcher said.

Registered dietitian Dayle Hayes is a consultant to school districts and other groups across the U.S. and co-chair of Billings Action for Healthy Kids. Contact her at Past and current issues of Eat Right Montana's monthly packets can be downloaded at