Most people with diabetes take one or more blood-sugar-lowering medications. Some diabetes medications occasionally reduce your blood sugar to an abnormally low level, a condition known as hypoglycemia. A bedtime snack reduces the likelihood of nighttime hypoglycemia associated with certain diabetes medications. Although not all diabetics need a bedtime snack, it is important to include this in your daily nutrition plan if your doctor recommends it.
Why Bedtime?
Hypoglycemia often occurs during the night because your body is in a fasting state during sleep. Without food intake, your body relies primarily on circulating and stored glucose to maintain your blood sugar level. An imbalance between the amount of glucose available and the amount of blood-sugar-lowering medication in your body may provoke an episode of hypoglycemia. A bedtime snack potentially averts this development; the food you eat before going to bed slowly releases glucose into your bloodstream during the night, helping maintain a normal blood sugar level.
What to Eat
Diabetes professionals have different opinions about the ideal nutritional composition of a bedtime snack to prevent hypoglycemia. Many diabetes specialists recommend solid food that contains both carbohydrates and protein. In some cases, your doctor may advise you to alter your bedtime snack based on your blood sugar level. Talk with your doctor and nutritionist about the best bedtime snacks for your diabetes management plan.
Indications
Nighttime hypoglycemia most commonly occurs in people taking insulin. Hypoglycemia also occasionally develops with certain oral diabetes medications, especially sulfonylureas such as glyburide, glipizide and glimepiride. Your risk of developing nighttime hypoglycemia increases if you skip meals, consume alcohol, exercise late in the day or participate in more physical activity than usual. A bedtime snack helps avert a potential episode of nighttime hypoglycemia in these circumstances.
Warning Signs
An episode of nighttime hypoglycemia often does not cause awakening, which is a contributing factor to the dangerousness of this condition. Some people experience nightmares in association with a low blood sugar level. Other signs and symptoms of nighttime hypoglycemia include soaking night sweats; a headache or confusion upon awakening; and feeling exceptionally tired in the morning. Be sure to check your blood glucose level if you experience any of these symptoms. If you are not currently eating a bedtime snack and experience nighttime hypoglycemia, talk with your doctor about whether you should include one in your nutrition plan.
Complications and Considerations
Nighttime hypoglycemia is a potentially life-threatening medical condition. With a profoundly low blood sugar level, you run the risk of falling into a coma as you sleep. In some cases, hypoglycemic coma leads to seizures and possibly death. If you experience nighttime hypoglycemia despite eating a bedtime snack each night, talk with your doctor about your medications and diet. Do not make changes to your blood sugar management plan unless you discuss it with your doctor.
References
- "Diabetes Self-Management"; Nighttime Hypoglycemia; Robert S. Dinsmoor
- Joslin Diabetes Center: Avoiding Nighttime Lows
- Diabetes.co.uk: Nocturnal Hypoglycemia --- Night Time Hypo
- "The Journal of Clinical Endocrinology & Metabolism"; Nocturnal Hypoglycemia in Type 1 Diabetes: An Assessment of Preventive Bedtime Treatments; Bharathi Raju, M.D., et al.; June 2006
- "Diabetes Care"; Impact of Bedtime Snack Composition on Prevention of Nocturnal Hypoglycemia in Adults With Type 1 Diabetes Undergoing Intensive Insulin Management Using Lispro Insulin Before Meals; Maria Kalergis, M.S., R.D.; January 2003
- "Diabetes Care"; Metformin, Sulfonylureas, or Other Antidiabetes Drugs and the Risk of Lactic Acidosis or Hypoglycemia; Michael Bodmer, M.D., M.Sc., et al.; September 2008
