With the holiday season upon us, you’ve got the good—fun holiday parties, the bad—illness, and the ugly—cold weather and fewer hours of sunlight. When you have a child with diabetes, the holidays and winter months in general can be stressful.

I’ve seen for many kids with diabetes, blood sugars rise as the temperature drops. This can largely be blamed on snow, ice, and freezing conditions which discourage outside play or really leaving the house at all. With less exercise, there is a need for more insulin to cover food. Here are some recommendations for children with diabetes to ensure they stay healthy during the holiday season.

Warm up the body

Exercise lowers blood sugar, helps the body use insulin better, keeps body temperature warm, and can even help with mood. There are lots of ways to get active without ever leaving the house. Encourage your kids to try a yoga session or other online class or activity, climb the stairs for 10 minutes, dance to their favorite music, play an active video game—or even clean their room. Try bundling up, too, and go outside to walk shovel, sled, or ice skate with the family! Don’t forget to keep your insulin and meter at room temperature if possible.

Stay healthy

When kids with diabetes get sick, their diabetes can be tricky to control. If your child gets a cold, virus or flu and develop ketones, keep them home and follow sick day rules. Remember, sick kids often need more insulin, so check blood sugar every 2 to 4 hours and correct blood sugar frequently to keep numbers in range. Bodies heal much more quickly when blood sugars are in range. Contact your diabetes provider if ketones persist.

Encourage sleep and good habits

When children and adults get 7 to 8 hours of sleep each night, it helps to ward off pesky colds and more. Be sure to remind them to wash their hands frequently, and have the whole family get a flu shot.

Choose foods wisely

Healthy, balanced nutrition is one of the keys to success. Lots of fun holiday food is hard to count, but you can use your smart phone to look up carb counts for almost anything. Dose insulin correctly for what your child eats. Check blood sugar frequently at parties to make sure that you have balanced the insulin, fun food, and any activity.

Stews and soups with lots of delicious vegetables can help keep warm and are often the healthiest choices. Cooking does not necessarily have to be a chore, either. Getting kids actively involved in the process encourages them to try and hopefully enjoy the finished product. The benefit of cooking in your own kitchen is that you know exactly what goes into the meal. Be sure to make sure kids have veggies and fruit for every meal, if possible—five servings per day is the goal.

Keep spirits up

Encouraging kids and teens to spend time with others can help them ward off the winter blues. This may take some creativity when parents are busy with holiday preparation or if the weather is bad. Think about planning holiday gatherings with your child including some of their friends. This could include a cookie-making sleepover or a meet up at the sledding hill.

With a little planning and lots of blood sugar checks to make sure the numbers stay in range, you can make this this best holiday season yet! Make a big bowl of soup, count the carbs to give insulin, then bundle up and head outdoors for some fresh air! Philly in the winter is lots of fun and diabetes should never stop you!

Melissa Rearson, MSN, CRNP, is a pediatric nurse practitioner in the Diabetes Center and the Division of Endocrinology and Diabetes at Children’s Hospital of Philadelphia.