Enjoying Halloween When You Have Diabetes
For all of the costumes and cobwebs and carved pumpkins, Halloween is for most kids one big sugar rush. It's all about the candy: whose house has the best selection, how much you can carry, and which pieces to eat first. But what about children (and grown-ups) with diabetes who want to participate without sending their blood glucose levels soaring?
Here's some good news: Trick-or-treating isn't off-limits. "Diabetes is just part of their whole life," says Joanne Roney, RN, CDE, a certified diabetes educator with the Rush Adolescent Diabetes Program at Rush Children's Hospital in Chicago. "We don't want to prevent kids from having regular childhood experiences. It needs to be incorporated into their lives."
Sure, high blood glucose is a concern. But you can play it safe by allowing your child to eat candy only once he or she has returned home. There you can dose the correct amount of insulin for the carbs in the candy. "It's really a matter of the parents' need to keep an eye on everything," says Debra Counts, MD, division chief of pediatric endocrinology at the University of Maryland School of Medicine. "The kids can have some candy, but they need to account for the sugar and cover it with insulin." In fact, allowing your child to have some candy can be a good thing. "Anytime you completely restrict anyone from something, it creates this taboo around it. And it increases the chances they'll sneak it," says Michael Avram Harris, PhD, a psychologist and associate professor of pediatrics at Oregon Health & Science University. "It's not like [eating candy is] life-threatening. So why create the taboo?"
While you want your child to celebrate the holiday just like all the other kids, there are ways to take the focus off the sweets. "Our family is really big on Halloween, and we have a big dress-up party every year," says Leighann Calentine of D-Mom Blog, whose 6-year-old daughter, Quinn, has type 1 diabetes. "For my daughter, it's more about dressing up and trick-or-treating and seeing all the people in the neighborhood than the candy." Cutting down on sweets is smart for the whole family, too; no one really needs to eat 10 mini Snickers in one sitting.
Host a costume party where the kids are the stars. Invite a bunch of your child's friends over to carve jack-o'-lanterns. Or gather family and friends to bob for apples, make papier-mâché pumpkins, or paint their faces like goblins or ghouls. When the party's at home, you can control the food, swapping candy for healthier—but still festive—fare (like the recipes here, here, and here). "The focus is less on getting as much candy as possible and consuming it," says Harris. "It's focusing on these other things, which kids actively enjoy."
As for the massive bag of loot most kids tote home after trick-or-treating, some parents "buy" their kids' candy with cash (which the child can then use for toys or games), or trade it directly for toys or trinkets. Calentine picks through her daughter's stash and sets aside any non-chocolate sweets for treating future low blood glucose (hypoglycemia). Roney suggests invoking the Great Pumpkin: Let your young children keep a handful of candy, then set the rest outside. Overnight, you can secretly replace it with a gift or toy, attributing the switch to the mythical character.
Many of Counts's patients save a stash for hypoglycemia and then donate the rest to a children's hospital for kids who are too ill to trick-or-treat. It's a good reminder to children with diabetes that there are other kids in the world who are much sicker than they are. Experts also recommend buying small toys—Calentine picks pencils, plastic rings, and mini containers of Play-Doh—to hand out in place of candy. At night's end you won't be left with buckets full of sweets that will tempt both you and your children.
Another tip: If you're an adult with diabetes but want to give out candy, purchase sweets you don't like. If Skittles don't do it for you, stock up on those to avoid temptation. Adults with diabetes who don't have kids begging to celebrate the holiday can form their own ritual. Instead of giving out candy, make a tradition of going to dinner with close friends, seeing a movie, or hosting a Halloween cocktail party.
After the festivities, kids who took home a sack brimming with sweet plunder may be tempted to eat it all at once. According to Harris, portion control is key. (It's important for adults with diabetes, too.) "In general, teaching moderation across the board is important, and we tend not to moderate well during the holidays," he says. "It's pretty hard to eat and take control, whether you have diabetes or not."
So set a rule as to how many pieces of candy your child can eat each day (as long as his or her blood glucose isn't high) and stick to it. If you have more than one kid, make the rules for everybody. It's an extra step the whole family can take to make sure your child with diabetes doesn't feel left out.
Above all, it's important to remember that even with diabetes, no holiday foods are forbidden. Enjoy treats in moderation, but keep in mind that there's more to October 31 than sweets. You'll enjoy the holiday most when your focus is on friends, family, and celebration—instead of what you can or cannot eat.