It's that time again: leaves turning orange and falling to the ground, a chill in the air, and scary props placed on lawns. Halloween is coming. For most families, this is a holiday that has mixed blessings in terms of usually forbidden treats and fears about safety of trick-or-treating in neighborhoods. For our families with children that have diabetes, the holiday is fraught with additional concerns.
Can and how do we allow our children to enjoy Halloween as much as their peers without Diabetes?
Answer: Yes we can (with a bit of planning)!
Last week, at one of my outpatient visits, one of my delightful patients asked me this particular question in anticipation of Halloween as she was planning to go trick-or-treating with her friends. We then spent much of the visit discussing Halloween and making plans.
1. Halloween candy is forbidden due to diabetes
2. One treat only should be allowed on Halloween
3. No trick-or-treating on Halloween (due to the potential of hypoglycemia)
4. Keep only non-glucose related items after trick-or-treating and toss everything else
I shall now attempt to debunk these myths. Halloween is but ONE day out of 365. The goal is to allow your child to achieve an outstanding quality of life, and that includes having the same fun on Halloween as those children without diabetes. The key to Halloween fun is planning ahead. Therefore we discussed strategies for prior, during, and after the big day.
These include the following:
1. Consult a reference that indicates carbohydrates in all available treats.
Calorie King is one example. This reference can be downloaded as an app to a smart phone, ipod/ipad, etc., and can be available as needed. Highlight the carbs in your favorite goodies and keep notes so that you can apply this information on Halloween and thereafter.
2. On the big day, as you trick-or-treat, bring a blood glucose monitor with you so that you can check your blood sugar as necessary. WHY? You will be walking around and getting exercise! If low, determine how many carbs you require and choose a goodie with the appropriate carbs (known in advance due to outstanding detective work) to treat the hypoglycemia.
3. After you come home with your buddies, dump out all the candy onto a large table. As everyone has specific favorites, divide the loot among yourselves in equal piles based on individual preference. Choose a number of treats (reasonable amount for all participants), count the carbs, and bolus insulin appropriately. (NOTE: if your child is on split mixed insulin and receives 3 shots/day, another strategy is to determine with your healthcare team a dose of regular/rapid insulin to administer prior to the eating fest so that your child can enjoy with the other kids. Another strategy is to time the eating around dinner and include with desert-adjusting fast or rapid acting insulin accordingly.)
4. Plan on the possibility of highs or lows several hours after the event. It is possible that blood sugar may remain stable due to all the exercise. However, it is more likely that highs may result due to the fat content in association with carbohydrate. Be prepared to administer extra insulin to correct high blood sugars 3-4 hours later.
5. Take the remainder of the loot home and enjoy slowly over the next few weeks by bolusing for the carbs appropriately. For those on conventional, split mixed insulin 2 or 3 shots/day, enjoy your goodies as part of a snack or meal.
6. Other strategies include donating the extra candy to a Children's Hospital for those hospitalized children that cannot go trick-or-treating!
7. For those children for whom candy is not particularly appealing (and I know that there are a few), exchange the candy for something else that the child would prefer. Examples include money, iTunes, apps, cards, etc.
8. ENJOY the day and realize that with a bit of planning, all kids can participate in fun events such as Halloween!
If you have any other Halloween strategies, please comment!
Published On: October 25, 2011