It's that time of year again: darker mornings, earlier nightfall, and clocks about to be turned back. Halloween is coming! I have to admit personally that I have never been a great fan of this holiday. As a child, my Mom would not let me trick-or-treat at night with the cool kids. Instead, with my ill-fitting store-bought costume my Mom (who worked full time, which was rare in the 1960s) would send me out on my own in the afternoon. It was not a very satisfying or exciting experience. Ironically, as an adult, I still am not overly fond of the holiday due now to scarier wardrobes and strangers knocking at my door (NOT the little ones). Still, the holiday is very popular in our culture and when it involves the collection of concentrated carbohydrate goodies, this presents a major challenge to diabetes healthcare teams. As a professional member of the American Diabetes Association, I subscribe to three journals, including the popular Diabetes Forecast. In the October issue, Tracey Neithercott wrote an excellent article in the Food for THOUGHT section: Trick or Treat? Enjoying Halloween when you have diabetes.
Many of my colleagues throughout the country (J. Roney, RN, CDE, of Rush Children's Hospital in Chicago, Debra Counts, MD, Peds Endo Division Chief at our neighboring University of Maryland School of Medicine, and Michael Harris, PhD., psychologist at Oregon Health and Science University) offered excellent advice for Halloween. I will also include carbohydrate information of popular treats that was presented in Ms. Neithercott's feature.
By all accounts, the most important thing to remember is that your child should have fun! As Roney states, trick-or-treating should not be "off-limits" since diabetes is part of you child's life, just as Halloween is. The trick is to enable your child to enjoy all the activities associated with Halloween, including the carbohydrate treats as well as the excitement of dressing up etc. If you restrict access to these treats, most kids will resort to sneakier means to obtain the "forbidden items." The following is a compilation of tips to enjoy the holiday.
1. Safety: Trick-or-treat in groups. (An adult should be present with younger kids. This is just good common sense.)
2. Consider hosting a Halloween party at your house wherein you will be in control of the goodies provided (make sure that the typical stuff is there or you are asking for disappointment).
3. Upon arrival at home with the goodies, be creative. My son would go to his best friend's house where many of the neighborhood kids would congregate, dump out all their stuff, and trade! Some kids liked the chocolate, others craved twizzlers - to each his own. Some were very entrepreneurial and demanded cash for candy! (I liked that one!)
4. Consider buying up the candy, or trade in for cool non-edible stuff that your kid has been craving.
5. Purchase sweets that your child dislikes, so that there will be less temptation during "door duty."
6. Treats collected during Halloween can be used to treat hypoglycemia (smarties, skittles, etc.).
7. Trick-or Treating is exercise that may predispose your child to hypoglycemia or delayed exercise induced hypoglycemia later. (Keep in mind that the kids also may experience hyperglycemia due to the excitement, as well as from candy).
8. Decide how much candy treats ALL your children should have and stand by your decision. The rules should apply equally. Just make certain that your child gives insulin for their carbohydrate choices. If your child is on basal/bolus therapy by MDI or insulin pump, just bolus appropriately. If on split mixed insulin, discuss in advance a plan for the evening. One suggestion: give a bit of extra regular or analog (humalog, novolog, or apidra) before munching on those goodies.
9. Dole out sweets judiciously daily, if on split mixed insulin regimens, consider including the halloween candy as dessert and part of the meal. Moderation is key!
10. One of may favorite suggestions is an altruistic one, suggested by Dr. Counts of the University of Maryland- donate treats to a Children's hospital or to kids who have to stay at home because they are too ill to go trick- or-treating.
I am sure that you all have many other ingenious ideas for Halloween! Please add your contributions.
My thanks to Diabetes Forecast and Ms. Neithercott for her timely review.
Have a fun and safe Halloween!
Finally, please review the list below for calories, fats, and carbohydrates.
Published On: October 19, 2010