There are few holidays that seem scarier to newer diabetes families than Halloween. Candy, running around, costumes that can make diabetes tech difficult to reach, and more candy! Once diabetes is in the picture, it’s hard to look at Halloween the same way.
My son, Benny, was diagnosed just over a month after Halloween in 2006. When I look back at the photos that year, it’s clear something was going on. He was fine one minute and then cranky and tired the next. Of course, we know now that he was in the early stages of type 1. But back then, we were much more concerned with getting the kids’ costumes on and heading out with our little red wagon. It’s Halloween! Let’s go!
As we talk about Halloween strategies, it’s important to remember that this has to also feel right for your family. We all parent in our own way, even without diabetes, so why should we expect everyone to “diabetes parent” the same way? That might mean adapting one of the strategies I talk about here, or it may mean coming up with one of your own.
Over the years, we tried lots of strategies. Whatever the plan, we talked about it in advance, so everyone knew what to expect. A lot of families celebrate Halloween in different ways, and we realized the kids talk about it at school and on the bus. Setting expectations always made it easier.
That first year, Benny traded in all his candy for a toy. I vividly remember it was a Play-Doh—The Backyardigans set. Many people do this now and call it the Switch Witch. We didn’t do anything elaborate, like setting out the candy and pretending the Witch came overnight. It was just, hand over the candy and here’s your toy!
A couple of years later, we tried paying for the collected candy. A friend of mine has a child with severe food allergies and this was their method. We decided on a dime for each piece. I almost went with a quarter, but then I remembered how huge Halloween is around here. Good thing — the kids brought home more candy that year than ever!
Finally, when Benny was about six or seven, we did Halloween like everyone else. Some candy that night, a few pieces for dessert or a treat over the next week, and then giving whatever’s left away to the dentist or another community collection. My kids were always more interested in running all over the neighborhood to collect the candy than in eating a ton of it all at once. Keeping Halloween more “normal” helped make it less stressful for me and I don’t think his blood glucose numbers dramatically changed no matter what we did.
Let’s talk about the candy itself. I’m sure you’ve seen the memes and jokes about the after-Halloween “low BG supply” sales. I never thought about keeping the Halloween stash to treat low blood sugars. We had decided early on to only treat lows with juice boxes.
There are a couple of reasons for this. First, I didn’t want Benny to think he could only eat candy or dessert when he was low. That’s not how our family eats; we enjoy dessert a couple of times a week and we let the kids have sugary snacks here and there.
I liked the idea of keeping low treatments boring and uneventful — not something to look forward to. If low treatments were the only time he got a yummy sweet treat, I worried Benny would make himself go low. He’s a smart kid. It wasn’t an impossible situation to imagine. I didn’t want to take that kind of chance.
Second, I also didn’t trust myself to not dip into the low supply if it was something I enjoyed. You can shake your head, but I know myself. If there’s a giant bag of Halloween candy in my pantry, I’m eating it. So will my husband. And my daughter, without diabetes, will not be happy knowing there’s a bag of Snickers or Smarties that’s off-limits to her. So, boring juice boxes and peanut butter crackers have stayed as our low-BG treatments even to this day.
If you do use candy to treat lows, you should know that not all sweets are created equal for that task. Many people don’t realize that different candy affects blood sugar in different ways. There are some terrific carb-counting guides for Halloween, but a carb count won’t explain the speed of the sugar in your Halloween haul.
Candy made only with very simple sugar, like dextrose, is going to give you the fastest rise in blood glucose. Skittles, Smarties, and Airheads break down quickly. Chocolate and chocolate-combination treats will bring blood glucose up more slowly. The addition of fat and protein slows down the way the body breaks down glucose.
It’s important to know how candy will influence BG for many reasons, but this one might be unexpected: a lot of kids go low during Halloween, especially overnight. How can that be? Well, after you’ve done an amazing job of counting and dosing for every carb, your kiddo goes to bed. Most kids walk (or run) around their neighborhoods on Halloween. That’s a lot more activity than your child may normally get at 7:00 p.m. on a Tuesday night. It’s also exciting, so a lot of kids see their blood sugar shoot up just from adrenaline, a hormone that signals the body to release more glucose and makes them more insulin resistant. If you’ve treated that, and bolused for every single carb of candy, you’ll likely see a big drop a few hours later.
What to do? The first year is always the hardest. Our endo suggested trying to avoid overcorrecting and letting Benny run a little bit higher during trick or treating and at bedtime. Then, not correcting blood glucose for at least three hours after bedtime. That can be hard if you’re used to adjusting several times an hour, but sometimes hands-off is the way to go, especially if you’re not sure how your child will react.
For us, that meant giving a little bit less insulin at dinner and letting him have two or three pieces of candy without dosing. These days, with newer technology, it could mean setting a temporary basal rate on an insulin pump or putting an automated system into an “exercise” mode.
Halloween nights were never perfect, but I can tell you this: we never had an endo appointment where our doctor said, “This is an unhealthy A1C and it’s because he went up to 250 mg/dL on Halloween.”
It’s very common to feel like life after diabetes will never be the same; holidays like Halloween really nail that point home. But most diabetes families find a way through with a new routine that works for them. In the long run, I remember very little about Benny’s blood sugars on Halloween. But I remember every costume and I remember all the fun.
“Still the World’s Worst Diabetes Mom” is available for preorder at www.diabetes-connections.com It will be available in paperback, eBook & audiobook in November via Amazon or wherever you order books.