Halloween is meant to be spooky, but staying on top of your symptoms shouldn’t be scary. For those living with autoimmune diseases, trick-or-treating can feel more like a trick than a treat. Particularly for people living with type 1 diabetes, lupus, inflammatory bowel disease (IBD), or celiac disease, tons of candy and a long night of walking could lead to pain, discomfort or anxiety about managing exacerbated symptoms.

We’ve pulled together a list of tips to make sure you or your loved ones living with autoimmune diseases can stay in control of symptoms while enjoying all that the holiday has to offer.

• For those living with type 1 diabetes, make sure to check candy labels for grams of sugar, carbohydrates, and calories to make sure you know how much insulin you’ll need to balance insulin to carb ratios. 

• With type 1 diabetes, it’s also important to remember that just because a food is sugar-free doesn't mean it also has fewer carbs or calories. Consider foods and drinks that are low-calorie or low-carb to satisfy your sweet tooth without risking an unsafe insulin to carb ratio. 

• If you have Crohn’s disease, the Cleveland Clinic recommends avoiding candies made with sugar alcohols like sorbitol and mannitol, which can make gastrointestinal symptoms worse.

• If you or a loved one lives with celiac disease, check out this list from the Celiac Disease Foundation to learn about which candies are safe and which ones you should avoid.

• If your child lives with type 1 diabetes, consider having a talk about waiting to eat candy until you get home to make sure you can regulate their sugar levels in a safe environment.

• You might also want to keep insulin on hand in case your kids sneak a few pieces of candy while trick-or-treating.

• If you or your child lives with IBD, build in restroom stops to your trick-or-treating route or consider staying close to home in case you need to use the bathroom.

• For children or parents living with lupus, symptoms can appear out of nowhere and can put a damper on the fun. Set expectations together ahead of time for how long you’ll stay out and how many houses you’ll visit.

• They’ve met the tooth fairy—now introduce your children to the treat fairy! To make parting with candy easier, start a new tradition of leaving candy out with a note asking the treat fairy to swap it for a prize. Your kids will get a fun toy, and you don’t have to worry about exacerbated symptoms caused by sugar binges.

• Check out the American Diabetes Association’s Diabetes Food Hub for some sugar-free or low-sugar snacks ideas. You can bake something new together, and enjoy a delicious treat after!

• If your symptoms are too extreme for a big outing on the night-of, consider a family movie night, game night or share a festive dinner together in full costume.

Whether you, your kids, or a loved one live with autoimmune diseases, we hope these tips make for a healthy, happy Halloween!