Zoey Sayles is going to be Cleopatra for Halloween. And she plans to collect lots of candy. But, unlike her friends and siblings, she won't eat much of it.
Zoey, 10, of Berwyn, Pa., has type 1 diabetes, so her body does not produce insulin, a hormone needed to convert sugar (glucose), starches and other food into energy.
Most diabetes experts say children with type 1 can eat some treats -- unlike a few decades ago when sweets were heavily restricted -- as long as they balance it by taking the right amount of insulin. Still, moderation is advised, and families should figure out ahead of time how to handle trick-or-treating.
"Sugar isn't the no-no it once was, but it's still never a good idea to sit down and just gorge on as much candy as you can. We recommend having a plan," says Debby Johnson, a nutrition and wellness coach for diabetes website Fit4D.com.
Johnson recommends getting your child involved in his or her health choices before the chocolate and Gummi worms come home.
"Do some exploring in the grocery store before Halloween. Look at different bags of candy to see how many carbohydrates are in each piece," Johnson says.
At the Mayo Clinic, pediatric diabetes patients are discouraged from eating candy on Halloween, says endocrinologist Frederick Schwenk.
"From my perspective, there's room for no candy. It's going to make the blood sugar go out of control," says Schwenk, professor of pediatrics at Mayo College of Medicine in Rochester, Minn.
That doesn't mean children should be denied the chance to trick-or-treat. "We suggest in advance that a parent go to a neighbors' houses and provide a non-candy option, like a toy. For very little kids, generally anything put in their bag makes them feel good," Schwenk says.
Johnson suggests parents create a negotiating system for older kids. "Trade five Snickers for downloading five songs on an iPod, or movie tickets."
Pediatric endocrinologist Martha Zeger says younger kids can save their candy for the "Halloween Fairy, who "will magically leave a toy in the place of the candy." Zeger, of Thomas Jefferson University Hospital in Philadelphia, is Zoey's doctor.
Zoey can't resist a little treat. "Milky Ways are my favorite," the fifth-grader says. Her dad, Erik Sayles, says they calculate how much extra insulin she'll need to compensate for the additional carbs.
The key to keep in mind on Halloween, Johnson says: "Before they're recognized as having diabetes, they want to be recognized as children."
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