When taking care of my patients with diabetes. I often ask, “do you have a bedtime snack?” This question is very important in management of diabetes. Some of the patients have prediabetes or early diabetes. Some are taking only medicines to manage their sugars. If these patients watch what they eat later In the day, their morning blood glucose can be improved dramatically. In patients who are working on losing weight and improving their sugars, I recommend eating early dinner and skipping bedtime snack altogether. I ask my patients if skipping a bedtime snack altogether is what they would be able to do easily as a lifestyle change? Some of them say it’s very difficult. Then, I recommend snacks like nuts, apple wedges, peanut butter, yogurt, berries, crackers, instead of ice creams and cakes and cookies.
Some of my patients have long-standing diabetes and take insulin, particularly at bedtime. I ask these patients if they feel the need to eat a bedtime snack, in order to take their prescribed insulin. If patients do not feel comfortable going to bed without eating anything, after taking their bedtime insulin due to fear of low blood glucose overnight, these patients could be getting too much insulin. Even in these patients, I try to find out if these patients enjoy their bedtime snacks or looking to do away with them and make changes in the plan accordingly.
Some of my patients take mealtime insulin with their three meals in the day. These patients easily eat a substantial bedtime snack without taking any additional insulin and then wake up with high sugars in the morning. In these patients, sometimes I add additional insulin dose to cover bedtime snack.
A bedtime snack can influence blood glucose and your hemoglobin A1c, without you realizing it. I always encourage talking about bedtime snacks during my patient visits, so I can tailor patient regimen better suited to their lifestyles.