(Spoiler: The answer is yes.)
A colleague of mine recently contacted me for an article she’s writing on myth-busting some misconceptions of having diabetes and seasonal treats and candy, a concern for many struggling against diet culture and the food police, especially with Halloween coming up.
I wanted to share my thoughts on some of the common challenges and questions I encounter on a regular basis here, too.
It’s absolutely a myth that people with diabetes can’t eat candy. It’s also a myth that sugar-free, modified, or substitute versions of these foods are required if you have diabetes. It is true that candy contains carbohydrate (usually in the form of sugar) and will have an impact on blood sugar levels. But our bodies need carbohydrate throughout the day, and candy can be a delicious, festive, and enjoyable source of it. Rather than trying to strictly avoid candy and sugar, it’s helpful to not label foods as off limits. Instead, get curious around what impact these foods are actually having on your blood sugar management and respond appropriately.
Physiological and psychological deprivation can leave us vulnerable to less mindful eating patterns, eating that feels uncomfortable, or binge eating (where we're eating large quantities, often at a quick pace, resulting in physical discomfort and emotions like guilt and shame). Sometimes special occasions like Halloween or parties can feel like a time of feast or famine, where we're either going to have a lot of candy or try to resolve to have none at all. I encourage checking in with your body at and before social events to see where hunger levels are and what the body is asking for and practicing intuitive eating principles. If this feels difficult, processing upcoming events and special occasions with your registered dietitian can be helpful.
Diabetes Management: Safety and Physiology
When we're eating candy, it's helpful to be curious rather than judgmental around the impact the candy is having on blood sugar. Any food with carbohydrate is going to raise blood glucose, including candy and sweets. In terms of safety, self-monitoring our blood glucose levels and adjusting any medication doses if appropriate (per the recommendations of the treatment team) is the best recommendation, even if we're feeling vulnerable about or disappointed in how our food choices went. When I see clients struggle with feelings of guilt around eating candy, I often also see a pattern of wanting to avoid checking BG or ignoring that the candy happened at all.
Our bodies digest the food we eat and turn carbohydrates into glucose. Glucose circulates in our blood and fuels our cells' daily activities and functions. Having diabetes means that we're either experiencing insulin resistance or our pancreas is having a difficult time producing insulin to match the carbohydrate content of the food we're eating and the amount of glucose circulating in our blood rises above normal levels.
Our bodies utilize all carbohydrate sources for glucose, whether it comes from a bowl of cereal, a piece of whole-grain bread, pasta, or candy. When we're talking about the difference in perception between "healthy" and "unhealthy" or "allowed" and "not allowed" foods, we're often talking about a difference in fiber and added sugar. It is true that candy is not high in fiber and does contain added sugar, but this doesn't mean it's off-limits or that we need to be rigid in avoiding it. What we want to do is meet our body's nutrition needs (including fiber, protein, fat, and carbohydrate, along with micronutrients) and utilize diabetes-management tools such as medications, insulin, physical activity, and eating patterns to support keeping our blood glucose in or as close to goal range as we can.
It isn't about perfection in the moment, but managing patterns.
Safety with diabetes management usually involves preventing significant short-term dips (lows/hypoglycemia) and elevations (hyperglycemia) in blood sugar and reducing risk for long-term complications by aiming for overall patterns close to normal BG ranges. This is going to be pretty individualized, especially for people with type 2 diabetes, because the degree of insulin resistance and your own body's production of insulin in response to carbs consumed will be different for everyone. Instead of approaching an eating opportunity with a restricted mindset ("I can only have this much..."), feeling conscious and in control of the portions we're eating is the goal. It's a good idea to know the symptoms of hyperglycemia and have your BG monitoring supplies on hand so you're not caught off guard or unable to treat an episode of high blood glucose.
Portion Sizes and Intuitive Eating Principles
Sometimes with diabetes, the message can feel like “all foods fit, but just in smaller portions.” Larger portions of carbohydrate will bring blood sugar levels higher, so what we’re eating does play a role in the numbers we're seeing as we monitor DM control. However, I really encourage listening to body cues (hunger, satisfaction, enjoyment) rather than external rules around portions to help make decisions here.
I like to frame decisions around portion size not as a reflection of willpower and self-control, but as an opportunity to check in with what we're asking the food to do and how our body is responding. Are we asking candy at a Halloween party to meet the hunger needs of a full meal? Is candy serving as a dessert or snack that's eaten for taste and pleasure rather than to satisfy hunger pangs?
If we're really hungry because we haven't had enough to eat yet, or have been "saving up" anticipating a party, it makes sense that our appetites wouldn't be satisfied with meager portions. If struggling with portion sizes feels challenging, reflect on why you're eating in the moment (hunger, anxiety, social cues, boredom), and if it's meeting the need you're asking it to fill.
I don't have specific candies or brands I recommend (no top 10 lists of best Halloween candies for managing T2DM here); instead, I encourage clients to stay attuned to what tastes good and choose foods they like. For example, a past client described choosing Fig Newtons frequently because she felt they were a healthier, safer choice (not really a candy, not really a cookie), but when we started to explore what was going on with her blood glucose data, she was having more significant highs after that food than she was experiencing after eating her true taste preference, which was a chocolate candy bar. Her own body's response gave us the information to challenge previously held conceptions around which foods should be "allowed" as choices.
Challenging Diet Culture, Now and In the Future
Especially with Halloween coming up as the start of a holiday-filled end of the year, I encourage clients to keep two ideas in mind:
- First, in social and family settings, we're often serving as role models for kids that are present, whether we intend to or not. Demonstrating comfort with food choices and avoiding self-judgment or harsh language (like "I'm being so bad,") can help kids build their own confidence in making choices around food and listening to their bodies and hunger cues.
- Second, we'll have more eating opportunities coming up in the near future. If a party or social event didn't go the way you'd hoped, you can reflect on your experience (again, processing this with a registered dietitian can be helpful) and consider how you'd like upcoming eating opportunities to be different.
It's not about being harsh or judging how perfectly a given moment with food went, but about listening to what's working and feeling comfortable for your body and what's not supporting eating and diabetes management goals.
Food choices aren't moral choices.