I know what you're thinking. How in the world can you possibly navigate Halloween, a tradition based upon obtaining copious amounts of candy from strangers one night of the year? When your child is diabetic, the thought of sending them out into the streets to fill a bag with candy for consumption is panic-inducing. I get it. I've lived it. My daughter LIVED for Halloween when she was little. She loved everything about it. The costumes, the decorating, the candy. She loved all of it. I never would have dreamed of dimming the light of the holiday for my girl when it brought her so much joy and excitement. That being said, it needed to come with some parameters in order to keep her safe and healthy. Here are a number of "tips and tricks" I've learned through the years to maintain the fun but keep it safe.

Before trick-or-treating: Make sure you provide your Type 1 child with a healthy, protein-rich meal ahead of time. Including some complex carbohydrates and healthy fats is also key to helping keep blood sugars stable at the start of the night. Ensure that you can access your child's pump and continuous glucose monitor (CGM) easily through their costume. Consider using a T1D belt or fanny pack to keep all the tech contained and safe under or over a costume. Ensure that you have packed fast acting sugars for possible 'lows' while out trick-or-treating. Consider Skittles, Rocket candies, or Dextrose tablets to be accessible for low blood sugars that may arise. 

During trick-or-treating: Watch for lows as a result of exercise. Walking door to door may cause blood sugar to drop suddenly, so it's a good idea to check blood sugar readings frequently during the outing. If your child is using a pump, consider setting the pump to 'exercise mode' to account for the extra activity they may not have on a regular night. Another important consideration is to have your T1D child keep their candy in the bag until you bring it home to sort. This is good practice for any child on Halloween, but T1D kids especially. Also, it's a good idea to make sure your child is comfortable in layers if the temperature is cooler on Halloween night. If their body temperature drops, it may cause fluctuations in blood sugar levels as well.

After trick-or-treating: Sort through the candy once you're back home. Decide on an amount ahead of time that you are comfortable with your child consuming, and be sure to bolus appropriately for the treats. Consider ideas for swapping out the candy for a toy or book that your child would love to have (i.e., the Switch Witch). Candy can also be donated to local food banks if you're looking for alternatives to keeping the candy around. Coming up with a plan ahead of time can alleviate some of your own stress around managing the excess sugar that your T1D child may innevitably consume. If you do decide to keep the candy around and control their consumption, you may want to keep the candy hidden to avoid unnecessary spikes in blood sugar.

Halloween can still be fun, but it's a good idea to have a plan and be prepared for the process from start to finish ahead of time. The point is not to put a damper on your T1D child's fun but to ensure their safety and well-being in a controlled way. Wishing you a safe, balanced, and joy-filled Halloween! You've got this, parents!

A.