The use of carbohydrate counting should make it possible to incorporate occasional treats into your child’s meal plan with just a little extra planning. One option is to serve the candy instead of another carbohydrate-containing food, so the total amount of carbohydrate in the meal stays the same. (Consuming consistent amounts of carbohydrate from one day to the next can help with overall blood glucose control.) A second option is to adjust the premeal insulin dose according to how much carbohydrate will be eaten.
According to certified diabetes educator Gary Scheiner, if you opt to let your child have part of his candy haul, “you can manage blood glucose levels if you administer the right amounts of insulin at the right times. There is nothing about having diabetes per se that should force kids to not eat things that their peers are eating.”
Eating some candy can even be a good opportunity for teaching your child to take a more independent role in his diabetes management. According to Stephen Ponder, a physician and certified diabetes educator with Type 1 diabetes, partaking of the spoils of trick-or-treating “can be an opportunity for kids to learn some practical aspects of carbohydrate counting.” He added, however, that candy should not be a dietary staple, and he supported the idea of keeping a few pieces of Halloween candy to work into a child’s meal plan and throwing out the rest.
Dietitian Amy Campbell says that the trick to incorporating treats into your child’s diabetes meal plan is to know how much carbohydrate is in the candy and how much carbohydrate your child is allotted for a meal or snack. Because the nutrition information for snack-size candies is rarely printed on each individual candy, children can make a game of finding out how much carbohydrate each treat contains and labeling each accordingly (with masking tape or a small sticker). Company websites generally contain either product nutrition information or a phone number to contact customer service.
Parents of children who have celiac disease (an intolerance to gluten, the protein in wheat, barley, rye, and possibly oats) may also need to call companies to confirm whether candy is gluten free or encourage older children to start learning how to collect this information.
Bear in mind that the spoils of trick-or-treating should not be made available for continuous snacking. As noted by Scheiner, “‘Grazing’ tends to produce a prolonged post-meal high since the meal is virtually nonstop.” Instead, a piece or two of candy should be incorporated as dessert after a meal or as a snack, which can be covered by a bolus of insulin. For kids who don’t use an insulin pump, including treats in a meal or a regularly scheduled snack also limits the number of extra injections that may be needed to cover candy eaten at other times.
Pediatric nurse practitioner Jean Roemer supports the idea of allowing your child to pick 10 or so favorite candies from the bag and offers another suggestion for what to do with the rest: Auction it off to family members for spending money.
No matter which approach you take, one thing that is important is to make sure that your child with diabetes does not feel singled out. As Kelly Kunik, diagnosed with diabetes on Halloween at age 8, recalls, “We didn’t have carb counting back when I was diagnosed. My first night in the hospital, all the other kids were trick-or-treating, but I wanted no part of the special diabetes candy.” (It is worth noting that sugar-free versions of candy often contain more carbohydrate than their regular counterparts.) And according to Morrone Sparling, “It’s important to let the child with diabetes know that he isn’t ‘banned’ from treats, just that it requires a little extra planning and patience.”