For many Filipino Catholic families, the Christmas season begins with Simbang Gabi, a novena of nine masses from December 16 to 24. In the Philippines, the masses are traditionally held before dawn. In many US parishes, they are held in the evening or early morning. Many people try to attend all nine, and afterward, parish halls and street stalls serve bibingka, puto bumbong, salabat, and hot tsokolate. The novena ends with Midnight Mass on Christmas Eve and the Noche Buena feast that follows.<\/p>\n
If you take Mounjaro or compounded tirzepatide, nine days of early mornings or late evenings, rich rice cakes, and a midnight feast on a smaller appetite take some planning. If you have type 2 diabetes and take insulin or a sulfonylurea, going to an early mass without eating needs extra care.<\/p>\n
Some people skip breakfast before an early mass out of habit. The Catholic Eucharistic fast is one hour before Communion, and water and medicine do not break it. Under church law, older people, the sick, and those who care for them may receive Communion even if they have eaten within that hour. So eating a small breakfast before you leave is entirely in keeping with the tradition.<\/p>\n
Something small and familiar is best: a slice of toast with peanut butter, a boiled egg, yogurt, or a small pandesal with cheese.<\/p>\n
The prescribing information for Mounjaro says people who take it with insulin or an insulin secretagogue, such as a sulfonylurea, may have an increased risk of hypoglycemia, including severe hypoglycemia. The label’s trial data shows why the other medication matters. In a 40-week trial that added Mounjaro to basal insulin, blood sugar below 54 mg\/dL was reported by 14% to 19% of adults across the three doses, compared with 13% on placebo. In the trial where Mounjaro was taken on its own, it was reported by 0% at every dose, compared with 1% on placebo.<\/p>\n
If you take insulin or a sulfonylurea, keep glucose tablets in your pocket or bag, sit when you can, and tell whoever you attend with what a low looks like: shakiness, sweating, a fast heartbeat, sudden hunger, irritability, or confusion. Never change those medications on your own.<\/p>\n
Bibingka, a rice cake baked with coconut milk and often topped with salted egg and cheese, and puto bumbong, purple sticky rice with butter, sugar, and grated coconut, are the heart of the after-mass tradition. They are also rich and sweet. Share one with a friend or family member, or take a piece home for later, and eat it after something with protein rather than on an empty stomach. Salabat, ginger tea, is a good choice if your stomach is unsettled. Our guide on what to eat after an injection<\/a> has more ideas for foods that tend to sit well.<\/p>\n In the placebo-controlled trials for Mounjaro in adults with type 2 diabetes, nausea was reported by 12% to 18% of adults across the three doses, compared with 4% on placebo. If you feel queasy after mass, slow down and choose the salabat over the sweets that day.<\/p>\n Nine days in a row of very early alarms or late evenings, on top of a busy December, can wear you down. Go to bed earlier on mass nights, and do not drive if you feel lightheaded or overly tired. Carpooling with family or parish friends helps.<\/p>\n Side effects tend to be strongest after each dose increase, and many people notice them most in the day or two after an injection. If an increase would fall during the novena or right before Christmas Eve, ask your provider whether to hold it until after the holidays. Our guide on when to increase your tirzepatide dose<\/a> covers how those decisions are usually made.<\/p>\n After Midnight Mass, Noche Buena often brings lechon, ham, queso de bola, pancit, spaghetti, and fruit salad, eaten in the early hours of the morning. On Mounjaro, start with the protein, take small portions of the richest dishes, and stop at the first sign of fullness. Eating a big meal at 1 a.m. and going straight to bed can bring on reflux, so give yourself some time before you lie down.<\/p>\n If someone notices you are eating less, you do not owe anyone an explanation. “Everything is so good, I’m just full” is enough.<\/p>\n It can be tempting to skip an injection so you can enjoy Noche Buena more. Do not. The Mounjaro label says to take a missed dose as soon as possible within 4 days (96 hours), and to skip it and take the next dose on your regular day if more than 4 days have passed.<\/p>\n If you travel to relatives for Christmas, injecting before trips of a week or less can mean you carry nothing. Otherwise, follow your medication’s storage instructions and never leave it in a car. Our guide on storing compounded semaglutide or tirzepatide at home<\/a> covers the basics.<\/p>\n Write down what you ate before and after each mass, how you felt, and any blood sugar readings, and share them with your clinician after the holidays. Watch for the signs of under-eating too: persistent fatigue, feeling cold, hair shedding, dizziness when you stand, losing strength, and losing weight faster than you and your provider intended. Our guide on tracking your progress<\/a> covers ways to record more than your weight.<\/p>\n Consider this scenario: a woman on Mounjaro who also takes insulin decides to complete all nine dawn masses. Each morning she skips breakfast, thinking she has to fast, then eats a whole bibingka and puto bumbong after mass. On the fifth morning she feels shaky and sweaty during the homily and nearly faints. Knowing that a small breakfast is allowed, eating toast and an egg before leaving, carrying glucose tablets, and sharing the rice cakes with her sister would very likely have let her finish the novena.<\/p>\n For Simbang Gabi on Mounjaro, eat a small breakfast before early masses, since the one-hour Communion fast does not require skipping it. If you take insulin or a sulfonylurea, carry glucose tablets and tell someone the signs of a low. Share bibingka and puto bumbong, choose salabat if you feel queasy, ask about holding a dose increase in December, keep Noche Buena portions small, and never skip a dose to feast.<\/p>\nNine days of early mornings or late nights<\/h2>\n
Plan your dose around the novena and Noche Buena<\/h2>\n
Noche Buena<\/h2>\n
Never skip a dose to feast<\/h2>\n
Traveling to family for the holidays<\/h2>\n
Keep a simple log<\/h2>\n
The short version<\/h2>\n