Trick-or-treating for children with diabetes requires careful planning, monitoring

Trick-or-treating poses several risks for children with diabetes, but there are many strategies families can employ to ensure that all children safely enjoy the holiday.

“I don’t think we can take the candy out of Halloween,” Irina Nayberg, RN, BSN, CDE, senior clinical research coordinator at the Dorothy L. and James E. Frank Diabetes Research Institute of Mills-Peninsula Medical Center in San Mateo, California, told Healio Family Medicine. “The best thing we can do is plan ahead. Parents should discuss the plan with children in advance so they know what to expect.”

The plan should account for the factors that may cause blood glucose to increase or decrease during trick-or-treating. Consumption of candy and increased physical activity during trick-or-treating can both affect blood glucose.

“Halloween can be a very unpredictable night for families with diabetes. There are a lot of variables between the candy, the running around and the excitement,” Rachel Head, RD, CDE, an AADE media spokesperson and a CDE for One Drop, said in an interview. “The candy and the food children eat are the main factors that raise blood glucose, but stress and excitement may also have an effect, because both release hormones that increase blood glucose.”

There are different methods families can employ to manage a child’s blood glucose during trick-or-treating. One strategy is to stop carbohydrate intake at a certain point.

“There are plenty of candy carbohydrate counts available from the American Diabetes Association, the Juvenile Diabetes Research Foundation and other similar organizations,” Head told Healio Family Medicine. “You can get a sense of what candy has more carbohydrates and what candy has fewer carbohydrates. It’s also important to keep in mind that candy with a higher fat content may take longer to digest, so the rise in blood glucose might be partially delayed with those. There are plenty of treats with low carbohydrate counts available, such as sugar-free jelly beans.”

Other families may decide to track the child’s blood glucose while trick-or-treating. This approach requires close attention to the candy and snacks that are being consumed.

“Parents can help children select the better candies. There are certain ones that are better as long as the child doesn’t have allergies,” Nayberg said. “For example, candies with nuts are better because there’s protein and fat - those won’t spike blood sugar as much.”

How to deal with leftover Halloween candy also needs to be considered.

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“There are many strategies families can use for leftover candy,” Nayberg continued. “Children can enjoy a few candies throughout the week. Candy can be put away and used for future episodes of low blood glucose; certain candies, like Skittles, are good for episodes of low blood sugar. Children can also donate their candy to a charity or turn it in for money, perhaps, if there’s a toy they really want.”

No matter what strategies families choose to employ, monitoring a child’s blood glucose level throughout trick-or-treating is important.

“Check children’s blood glucose levels frequently on Halloween,” Head said. “Keep tabs on the child’s blood glucose and determine how it’s trending over time, whether you’re using the glucometer or the continuous glucose monitor. You want to be aware of the factors that can increase, decrease and delay changes in blood glucose.”

In addition, the strategy should apply to all children in the household, not just the child with diabetes.

“If there are multiple kids in the household, it’s a good idea to treat everyone the same so you’re not doing one thing differently for the child or children with diabetes and something else for the children without diabetes,” Head continued. “In addition, whatever the strategy is, communicate those expectations very clearly.” – by Julia Ernst, MS

Disclosures: Head is employed by One Drop. Nayberg reports no relevant financial disclosures.