Halloween Trick or Treating with Type 1 Diabetes

Halloween should be about costumes, pumpkins, friends and coming home with a bucket full of treats.

When your child has Type 1 diabetes, Halloween can involve a little more planning. There are sweets to carb count, extra walking and running to think about, glucose levels to watch, and diabetes equipment that still needs to be accessible underneath that fantastic costume.

But Type 1 diabetes does not have to take the fun out of Halloween.

With a little preparation, children with T1D can enjoy trick or treating just like everyone else.

Here are some practical tips from Lewcose to help make Halloween night a little easier.

The first rule: sweets aren't off limits

Children with Type 1 diabetes can eat sweets and chocolate.

The important part is knowing approximately how much carbohydrate they contain and managing them according to your child's normal diabetes plan.

Halloween can actually become easier if you avoid trying to calculate every sweet while walking from house to house.

Where practical, let your child collect their treats and bring most of them home first.

Once you're back, you can sit down together, empty the Halloween bucket and see exactly what they've collected.

That gives you time to check labels, work out carbohydrate amounts and let your child choose what they actually want to eat.

How many carbs are in Halloween sweets?

One of the biggest Halloween headaches for T1D families is the tiny sweet.

Fun-size chocolates, individual sweets and mini bags often come without nutritional information on the individual wrapper.

Here are some useful examples for popular UK treats.

Important

These figures are intended as a helpful guide only.

Manufacturers can change recipes, portion sizes and packaging.

If carbohydrate information is available on the packet you have in front of you, always use the current manufacturer's nutritional information.

When carb counting, look at the total carbohydrate figure rather than only the "of which sugars" figure.

Don't forget the walking

Halloween isn't just about what goes into the trick-or-treat bucket.

Think about how much activity is involved too.

Walking around the neighbourhood, running up driveways, climbing steps and excitedly racing between houses can add up to considerably more exercise than your child normally gets during an evening.

Exercise can affect glucose levels both during and after activity.

Keep an eye on your child's CGM or blood glucose readings throughout the evening and follow the advice you have been given by your diabetes team about managing activity.

The important thing is not to assume that every Halloween glucose change is caused by sweets.

Sometimes the running around is just as important.

Take the diabetes kit

Even if you're only going around the local neighbourhood, bring the normal diabetes kit with you.

Depending on your child's diabetes setup, that may include:

• their insulin or insulin pump supplies
• CGM receiver or mobile phone
• blood glucose meter
• hypo treatment
• glucagon, if prescribed
• spare supplies you would normally carry

Keep the diabetes essentials separate from the Halloween sweets.

A pumpkin bucket full of chocolate isn't much help if you're trying to quickly find the hypo treatment you normally use.

Keep hypo treatment separate

This is particularly important.

Although Halloween means being surrounded by sugar, not every sweet is ideal for treating a hypo.

Chocolate, for example, contains fat as well as carbohydrate, which can slow down how quickly the carbohydrate is absorbed.

For a hypo, use the fast-acting carbohydrate recommended in your child's normal hypo treatment plan.

NHS guidance for treating a hypo generally recommends fast-acting carbohydrate, followed by checking glucose again after around 10 to 15 minutes.

If the glucose level is still below 4 mmol/L, further treatment may be required in line with the person's normal diabetes management plan.

So enjoy the Halloween sweets for what they are.

But keep your normal hypo treatment somewhere you can reach quickly.

Think about the costume

Halloween costumes can create some surprisingly practical T1D problems.

Before heading out, ask yourself:

Can we easily reach the insulin pump?

Can we get to the CGM sensor if necessary?

Can they comfortably carry their phone or receiver?

Could we give an injection without having to completely remove the costume?

A brilliant costume is great.

Having to dismantle a seven-foot inflatable dinosaur because you can't reach an insulin pump is slightly less great.

Check everything before you leave.

Keep an eye on glucose

Halloween combines several things that can affect glucose levels:

Sweets + exercise + excitement + a different routine + a potentially later bedtime.

That makes glucose monitoring particularly useful.

If your child uses a CGM, keep an eye on both the glucose reading and the direction of travel.

A number by itself doesn't always tell the whole story.

For example, a glucose reading that looks comfortable but is falling quickly after an hour of walking may need to be viewed differently from the same reading with a steady arrow.

Follow your child's normal diabetes plan and the guidance provided by their diabetes team.

Make glucose easier to see at home

Once everyone gets home, Halloween can become organised chaos.

Costumes come off.

Pumpkin buckets get emptied.

Sweets cover the kitchen table.

Everyone starts talking at once.

This is where having glucose information that can be understood at a glance can be particularly useful.

The Glowcose Light, available from Lewcose, works alongside compatible CGM systems and turns glucose information into an easy-to-see coloured light.

Rather than repeatedly opening a phone to check the CGM, parents and carers can glance across the room and see the current glucose status represented by colour.

Glowcose uses:

• Red for low
• Green for in range
• Blue for going high
• Purple for high

Flashing colours can also be configured for urgent thresholds.

Glowcose is designed as an additional visual display. It does not replace your CGM, diabetes alarms or normal diabetes management.

But on a busy night like Halloween, being able to see what's happening from across the room can make glucose awareness that little bit easier.

Sort the Halloween haul

Once you're home, make sorting the sweets part of the fun.

Tip everything onto the table and create a few piles.

For example:

• chocolate
• jelly sweets
• lollies
• mini bags
• sweets with carbohydrate information
• sweets that need to be looked up

You can then let your child choose their favourites.

It also gives you the opportunity to look at the outer packaging if you still have it.

The large sharing bag often contains nutritional information that isn't printed on the tiny individual sweets inside.

Watch what happens afterwards

Halloween doesn't necessarily finish when trick or treating finishes.

The combination of additional activity and unusual food can continue to influence glucose later in the evening.

Continue monitoring as you normally would and pay attention to CGM trends.

Every child with Type 1 diabetes is different, and their response to exercise and different foods can vary.

Over time, Halloween can even become another useful opportunity to learn how your child's glucose responds to certain treats and different amounts of activity.

Our Halloween T1D checklist

Before you head out:

• Check glucose before leaving.
• Take the usual diabetes kit.
• Carry your child's normal hypo treatment.
• Make sure pumps and diabetes devices are accessible underneath costumes.
• Keep the CGM phone or receiver somewhere easy to reach.
• Remember that trick or treating involves a lot of physical activity.
• Keep an eye on glucose levels and trend arrows.
• Where practical, save most sweets until you get home.
• Check current packaging when carb counting.
• Keep monitoring after trick or treating finishes.

And most importantly:

Let them enjoy Halloween

Type 1 diabetes already asks children and families to think about things that most people never have to consider.

Halloween shouldn't become another thing they feel excluded from.

There might be a few calculations.

There might be a few extra CGM checks.

There might even be an insulin pump hidden under a witch, skeleton, vampire or Minecraft costume.

But underneath all of that, they're still a child carrying a pumpkin bucket and hoping the next house gives out the good sweets.

And that's exactly how Halloween should feel.

We control diabetes, diabetes doesn't control us.

Paul @ Lewcose

Lewcose

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