Enjoying Halloween Living with Diabetes
Admit it! It is fun to trick-or-treat; even if you are 20 years old. Many children, teens, and adults with diabetes dread this holiday. Clearly that is because Halloween is associated with candy corn, chocolate, and other sweets. In an effort to join the Halloween fun and spirit, today we are going to discuss strategies to fully participate and enjoy the holiday.
About eight years ago, I was walking the neighborhood in the vicinity of my then teenage son as he and his friends were trick-or-treating. I enjoy seeing the community spirit and looking at all the outlandish costumes. On this occasion, I happened to run into one of my little patients who was making the rounds in the neighborhood with a huge bag of collected treats. Much to my mortification, the child began to cry because she truly thought that her mother had asked me to keep an eye on her to keep her diabetes in control. Quite the contrary! I had a lot of explaining to do to reassure this child that I was just a normal parent wandering the streets, I was not working (no white coat), and that she should just have fun and enjoy Halloween. I had to do some quick thinking to help work out a strategy for the child and the mom so that the treats could be enjoyed and not cause major hyperglycemia the rest of the week. I want to share the results of our brainstorming.
First, keep in mind that you are exercising as you collect your goodies. This will certainly help you when you decide to consume some of your booty. Second, diabetes doesn't mean you can't have sugar or treats; you have to just plan ahead. Do not let social pressure/misinformation prevent you from going out with your friends. Canvass the neighborhood and collect as many treats as possible (walk, walk, walk). Bring along your meter and periodically check your blood sugar. You never know--you might be slightly low and need a fun carbohydrate to raise your blood sugar. Keep in mind, though, that chocolate is not necessarily a simple carbohydrate that will rapidly increase blood sugar (candy corn might).
Next you go home and empty out all the goodies onto the kitchen table. It is always a good idea to have mom or dad check the candy and make sure everything is closed and safe. Many kids get together during this process and do inventories. Trading is an excellent way to get the goodies that appeal to you and not necessarily to others. Get rid of the treats that you do not particularly enjoy. You don't need carbohydrates that don't taste good to you. Trade for the treats you like and give away those you do not. (Some kids even donate their less favorite treats to shelters, etc. if they don't congregate with their friends for the massive swaps.)
Now that you have accumulated all the treats that you enjoy, planning and strategizing is required. My suggestions revolve around doling out treats over the next few weeks based on your insulin regimes. If you are on conventional split mixed insulin three times/day (NPH/regular/analog), plan to include the treat with your meal and/or snack based on allotted carbohydrate counts. Or, add a bit of extra regular/analog insulin before consuming one of your collected treats before a snack or meal. If you are on a basal/bolus regime with either multiple daily injections or the insulin pump, go ahead and bolus for the goodie based on your best guess of the carbohydrate amount. It certainly is possible that you may have underestimated the carbohydrate content and three hours later you are high. NO WORRIES! Just go ahead and give yourself a hefty correction bolus and all will be well. Keep in mind, however, that you might actually go low due to post exercise induced hypoglycemia from all that walking around and excitement. Go ahead and enjoy your treat (free of insulin) if you are low! Checking your blood sugar is imperative, however, so that you know what is going on and can enjoy treats without the fear of going either too high or low. (Don't get into the same situation as one of my teen patients. He ended up in DKA because he decided to ignore the need to check blood sugars and take insulin accordingly.)
If you are clever, you can keep Halloween going over the next few weeks. Go ahead and portion out the treats for your daily enjoyment, determine the carbohydrate content, and bolus your insulin accordingly or add the treat to your recommended carbohydrate meal and snack allowance. There is no need to deprive you of the fun or the chocolate if you just strategize and plan ahead. Incidentally, I recommend the same daily treat doling strategy for all families: with or without children that have diabetes. Everyone should be treated equally... especially during Halloween. Have fun!