In a nutshell
This study examined the effectiveness of bedtime snacking in reducing the risk of low blood sugar at night in type 1 diabetics.
Some background
Hypoglycemia (low blood sugar) can occur at night, whereby the blood glucose levels drop below 3.9 mmol/L while sleeping. In non-severe hypoglycemia, the individual awakens themselves to take the corrective action. A bedtime snack comprising of carbohydrates and proteins is believed to reduce the risk of experiencing hypoglycemia at night. However, the effectiveness of this is uncertain.
Methods & findings
This study aimed to determine whether bedtime snacking is associated with a lower risk of non-severe night time hypoglycaemia. Bedtime snacking was defined as dietary intake 3 hours after dinner meal at 18h30. Night time hypoglycemia was defined as blood glucose <3.9 mmol/L for 15 consecutive minutes. This study involved 100 adults using multiple daily injections or an insulin pump. Each adult wore a continuous glucose monitor (a device with a part beneath the skin to measure sugar in the blood) for 72 hours to detect hypoglycemia. Each adult also kept a food diary during that period. Results from all patients were put together to give a total of 282 nights.
Patients ate a bedtime snack 63% of the time and injected rapid-acting insulin 23% of the time. Hypoglycemia occurred on 28% of nights.
When patients ate carbohydrates as a bed-time snack and followed this with a rapid-acting insulin, each 5g increase in the amount of carbohydrate was associated with a 16% increase in the risk of experiencing low blood sugar during the night. When patients ate carbohydrates as a bed-time snack but did not follow this with a rapid-acting insulin, each 5g increase in the amount of carbohydrate was associated with an 8% increase in the risk of high levels of blood sugars during the night.
When patients ate protein as a bed time snack and did not follow this with a rapid-acting insulin, every 2g increase in protein was associated with a 12% decrease in the risk of experiencing low blood sugar during the night.
The bottom line
This study concluded that overall, bedtime snacking is not associated with a lower frequency of hypoglycemia while sleeping.
The fine print
Others factors that can affect blood glucose levels were not taken into account. These factors include the nutrient composition of dinner and the insulin dose.
What’s next?
Consult your physician about the various options available to reduce the frequency of hypoglycemia while sleeping
Published By :
Diabetes Research and Clinical Practice
Date :
Dec 01, 2014
