1. Get the Diabetes Forum App for your phone - available on iOS and Android.
    Dismiss Notice
  2. Guest, we'd love to know what you think about the forum! Take the Diabetes Forum Survey 2021 »
    Dismiss Notice
  3. Diabetes Forum should not be used in an emergency and does not replace your healthcare professional relationship. Posts can be seen by the public.
    Dismiss Notice
  4. Guest, stay home, stay safe, save the NHS. Stay up to date with information about keeping yourself and people around you safe here and GOV.UK: Coronavirus (COVID-19). Think you have symptoms? NHS 111 service is available here.
    Dismiss Notice
Dismiss Notice
Find support, ask questions and share your experiences. Join the community »

Bedtime Snacks

Discussion in 'Type 1 Diabetes' started by Diabetes Yoyo, Apr 7, 2014.

  1. Diabetes Yoyo

    Diabetes Yoyo Type 1 · Member

    Messages:
    13
    Likes Received:
    25
    Trophy Points:
    53
    In this article I would like to emphasise the importance of evening snacks for type 1 diabetics. In the past I never had an evening snack and often woke up with high sugar levels or had hypos during the night. My sugar levels were erratic and I was confused. Over the time that I have spent in Malta and have had regular visits to the doctors, I came to a realisation that evening snacks are good for type 1 diabetics. In fact, a couple of doctors have suggested to me that even if my sugar levels are high before bed, I should still have a snack. The reason for this is apparently that your body is like a fridge and if there is no food available in the body, it goes to the fridge and gets some stored food/glycogen. This is in a way concentrated food.

    Glycogen was discovered by Claude Bernard. His experiments showed that the liver contained a substance that could give rise to reducing sugar by the action of a “ferment” in the liver. Glycogen is stored in the liver and muscles and functions as the secondary long-term energy storage. Glycogen forms an energy reserve that can be quickly mobilized to meet a sudden need for glucose. The most common disease in which glycogen metabolism becomes abnormal is diabetes, in which, because of abnormal amounts of insulin, liver glycogen can be abnormally accumulated or depleted. Restoration of normal glucose metabolism usually normalizes glycogen metabolism, as well.
    I think glycogen plays an important part in diabetes management; if you are on a wrong dosage of insulin or if you are under a lot of stress in my experience your sugar levels can fluctuate for unexplained reasons and it looks like glycogen is the culprit.

    Over the last couple of months, I have started eating evening snacks. What I have found out is,

    1. even if your evening and morning readings are high, still have a snack and wait for a couple of days for your body to adjust
    2. check your sugar levels at 3am to make sure that you do not get hypos while sleeping
    3. check your sugar levels at 5/6am to make sure, your evening insulin gives you a good reading in the morning. If it is still high increase your long acting insulin, you need to consult your doctor regarding dosages and the time you take the long acting insulin. I found reducing my long acting insulin to once a day helped me a great deal, as mentioned before I only take 16 units of Lantus at 11am.

    I have found out that changing your evening insulin can also alter your short acting insulin ratio, however before making any changes to your ratio allow a couple of days for your body to adjust.

    I am a fan of evening snacks, but a 2003 study published in the Diabetes Care journal suggests that people with diabetes, who have blood glucose levels over 180 mg/dL before bedtime should not eat a bedtime snack; but those with blood glucose levels below 126 mg/dL at bedtime should have a snack (roughly 15 grams of carbohydrates and 100 calories) to prevent late-night lows. In general, a diabetes-friendly snack should contain 15 to 30 grams of carbohydrates and between 100 to 200 calories[2] In a way, this contradicts my findings above, but in my experience the best snacks are a little bit of carbs (10g) and other items such as protein and fats. The reason for that is that if you eat a bread with some cheese and tomatoes for example, it sometimes gives a peak after an hour of eating. This is because the long acting insulin does not necessarily cover the carbs if sugars are being released to the blood stream quickly. So, avoid any sugary/high carb foods to avoid high sugar levels during night. You can find some tasty sugar free snacks through Google search such as this website. Having said that if you exercised during the day, or if your sugar levels are below 10 mmol/L you may want to eat a bread with some protein/salad.

    A study also found that people with liver disease can benefit from Late Evening Snacks. They could improve energy malnutrition, correct amino acid imbalance, and ultimately may improve glucose intolerance in patients with liver cirrhosis.[3]

    Personally, my sugar levels seem to be better controlled when I avoid eating snacks during the day. However, if I fancy a snack, my body seems to be tolerating up to 20g carbs snack 2 hours after eating. Especially if the meal intervals are longer than five hours or if you exercised during the day snacks can be good. I found out that if I walk up to an hour, my sugar level generally goes down 10 hours later. This is strange as I never noticed this before, but only a few months ago. So, snacks should help you avoid evening hypos. We all know how horrible they are.

    In addition, I feel that eating evening snacks has had a positive impact on my day time blood sugar management. A couple of years ago, I could not have imagined that my sugar levels would be under control or I would understand why they went up or down. Since I have found out that the best way of managing my diabetes seem to be eating an evening snack, getting your long acting insulin amount correct, find out your ratio and avoid stress. I have also benefited significantly from reducing my long acting insulin to once a day and keeping short acting intervals to 5 hours, as otherwise insulin would overlap and be hard to measure and control.

    Over the years, I have also found it quite hard to fall asleep. Apparently tryptophan type of foods as a bed time snack are really good and aids your body with avoiding depression and help falling asleep.[4]

    In conclusion, I would recommend evening snacks on a daily basis, but increasing the amount up to 20g carbs depending on exercise during the day.

    Hope you found this article helpful, and hope that evening snacks will avoid your hypos and will give you a better control over your sugar levels.

    The above writing is based on my experience with type 1 diabetes. Always consult your physician before making any changes to your diabetes management plan.

    You can also follow our journey on Twitter.

    [1] http://en.wikipedia.org/wiki/Glycogen
    [2] http://www.sparkpeople.com/resource/health_articles.asp?id=1588
    [3] http://www.ncbi.nlm.nih.gov/pubmed/12957206
    [4] http://www.lifescript.com/diet-fitness/articles/archive/diet/eat-well/bedtime_snacks_that_help_you_fall_asleep.aspx & http://en.wikipedia.org/wiki/Tryptophan
     
    #1 Diabetes Yoyo, Apr 7, 2014 at 1:08 PM
    Last edited by a moderator: Apr 15, 2014
  2. hale710

    hale710 Type 1 · Well-Known Member

    Messages:
    2,903
    Likes Received:
    1,082
    Trophy Points:
    178
    Some of this is true yes, but if you BG is not low at bed time it's not necessary for EVERYONE to snack. If I have a snack I wake up high. If I don't, I stay steady.

    Everyone's body is different. It's great that it works for you, but it's not a blanket rule


    Blogging at drivendiabetic.wordpress.com
     
    • Like Like x 5
  3. michaeldavid

    michaeldavid Type 1 · Well-Known Member

    Messages:
    387
    Likes Received:
    109
    Trophy Points:
    83
    Claude Bernard effectively used to torture animals, incidentally.

    "Bernard was quite explicit in his determination to pay no attention to the pain his animals suffered".

    - Bad Medicine, David Wootton (page 185).
     
    • Like Like x 2
    #3 michaeldavid, Apr 7, 2014 at 1:31 PM
    Last edited by a moderator: Apr 7, 2014
  4. Auckland Canary

    Auckland Canary Type 1 · Well-Known Member

    Messages:
    286
    Likes Received:
    622
    Trophy Points:
    133
    I think it would be advisable if you stopped posting generic "one size fits all advice here". This is not true for me and would probably cause control issues for many other Type 1's as well. Diabetes is a very specific and individual condition and especially for those recently diagnosed you may be causing confusion to them with this type of post.
     
    • Like Like x 7
  5. Diabetes Yoyo

    Diabetes Yoyo Type 1 · Member

    Messages:
    13
    Likes Received:
    25
    Trophy Points:
    53
    Hi, these writings are based on my own experiences and struggle over the last 15 years with type 1 diabetes People should always consult with their doctor for any changes to their diet and so on.
     
    #5 Diabetes Yoyo, Apr 7, 2014 at 2:25 PM
    Last edited by a moderator: Apr 7, 2014
  6. hale710

    hale710 Type 1 · Well-Known Member

    Messages:
    2,903
    Likes Received:
    1,082
    Trophy Points:
    178
    You start by saying you want to emphasise the importance of it though. That makes it sound like something we should all be doing.

    I know you mean well, it's just a case of being careful with the wording :)


    Blogging at drivendiabetic.wordpress.com
     
    • Like Like x 7
  7. noblehead

    noblehead Type 1 · Guru
    Retired Moderator

    Messages:
    23,618
    Likes Received:
    19,618
    Trophy Points:
    278

    I'm pleased you've made that quite clear Diabetes Yoyo.

    When I was on fixed insulin doses (twice daily injections) there was a need to snack between meals and before bed, however since changing to basal/bolus the need is not there unless my bg is running low. I eat my evening meal between 6-7pm and don't eat again until 6.00-6.30am, provided my bg is within range at bed I don't snack and don't see the need to, if I were to have a 20g snack without insulin I'd be guaranteed to wake up in double figures.
     
    • Like Like x 5
  8. phoenix

    phoenix Type 1 · Expert

    Messages:
    5,672
    Likes Received:
    3,674
    Trophy Points:
    178
    Your reference to the 2003 paper actually goes to one on evening snacks for people with cirrhosis of the liver but I think I've found the correct one. That paper actually has no significance to most of us here since the long term insulins used were NHP, or Ultra lente, insulins that don't have a flat profile. The purpose was to find at what level it was a good idea to take a snack,to prevent night time hypos. Basically the snacks resulted in higher overall average glucose levels. It was suggested that snacks weren't necessary at higher levels but were at lower levels. http://care.diabetesjournals.org/content/26/1/9.full
    The difference is that the modern basals have a much flatter profile Personally, I'd rather avoid this extra glucose because all it would do is raise my blood glucose level and it would stay up.
    The whole purpose of a basal is to deal with and inhibit glucose released from the liver so if it's right then you shouldn't need a snack
    (unless very low and/or you've had exercise that is likely to lower levels further; in my case this usually kicks in at 5hours post exercise, we're all a bit different)

    Absolutely you need to test to find out what is happening overnight if there is a big rise or fall though it might be difficult to adjust basal to suit, especially if taking it just once a day.
    If you find that you find that you can't get your basal right and you find that a snack helps then fine, it's great that it works well for you.
     
    • Like Like x 2
  9. Diabetes Yoyo

    Diabetes Yoyo Type 1 · Member

    Messages:
    13
    Likes Received:
    25
    Trophy Points:
    53
    Hi, my basal might not be right. I am on 16 units of Lantus but the suggested amount is 12. This is another subject that I should investigate further :). Thx
     
  10. Jaylee

    Jaylee Type 1 · Moderator
    Staff Member

    Messages:
    14,732
    Likes Received:
    11,259
    Trophy Points:
    298
    The effects of all that cheese before bedtime on the dream subject matter may be a good investigation too...!
     
    • Like Like x 3
  11. Diabetes Yoyo

    Diabetes Yoyo Type 1 · Member

    Messages:
    13
    Likes Received:
    25
    Trophy Points:
    53
    possible
     
  12. Jaylee

    Jaylee Type 1 · Moderator
    Staff Member

    Messages:
    14,732
    Likes Received:
    11,259
    Trophy Points:
    298
    Your pretty wordy in your posts.. I'm figuring you must be an accomplished touch typist? :cool:
    I fancy these talents coupled with the effects of the cheese, you could deliver a plot for a David Cronenberg movie..
     
  13. Diabetes Yoyo

    Diabetes Yoyo Type 1 · Member

    Messages:
    13
    Likes Received:
    25
    Trophy Points:
    53
    I think not many people liked this post. In summary the post is about; I found it useful to eat 10g carbs before bed, and if I exercised 20g carbs.
     
    • Like Like x 2
  14. Julie1471

    Julie1471 Type 1 · Well-Known Member

    Messages:
    504
    Likes Received:
    409
    Trophy Points:
    103
    I have never snacked at night time since starting basal/ bolsus injections, I only snacked when on 2 injections morning and evening. So not in years. And also I think you need to think about your posts as they can't all be taken as red and diabetes is not a one size fits all. So what you post won't fit all. Maybe impart advice on certain posts, rather than a blanket post. You've been diabetic for 15yrs, some here a lot longer, you've found what works for you, but it won't work for every one.
     
    • Like Like x 3
  15. Jaylee

    Jaylee Type 1 · Moderator
    Staff Member

    Messages:
    14,732
    Likes Received:
    11,259
    Trophy Points:
    298
    I can appreciate you have clearly taken the trouble to share your personal observations which work for you.
    Don't be disheartened. The target audience is just a little too diverse.. I dont agree with everything on here but that's not to say i wouldn't give something a try under controlled circumstances...
    It's all "food for thought".. :cool:
     
    • Like Like x 9
  16. Jaylee

    Jaylee Type 1 · Moderator
    Staff Member

    Messages:
    14,732
    Likes Received:
    11,259
    Trophy Points:
    298
    Yep, i remember those days...!
     
    • Like Like x 3
  17. Julie1471

    Julie1471 Type 1 · Well-Known Member

    Messages:
    504
    Likes Received:
    409
    Trophy Points:
    103
    For me Jaylee it was many years ago, as I was one of the first on insulin pens in my area, and my parents had to buy it. And it was steel. And my carb & cals book was massive and in different colours red =no , yellow= every so often/ treat ,green= every day = ok
     
    • Like Like x 3
  18. Diabetes Yoyo

    Diabetes Yoyo Type 1 · Member

    Messages:
    13
    Likes Received:
    25
    Trophy Points:
    53
    thank you, my aim is just to help even if it is just one person. if people have good controlled sugar levels, they should ignore my text. If they cannot control, they can read and discuss with their doctor.
    Thank you for your comments, ii is good to hear that you are having good control even without an evening snack.
     
  19. Jaylee

    Jaylee Type 1 · Moderator
    Staff Member

    Messages:
    14,732
    Likes Received:
    11,259
    Trophy Points:
    298
    I was diagnosed in 76.. In 92 i was offered the pen system due to my "irregular lifestyle". (I'd just spent 3 years in a dance college.)The pen, which as you know involved a new more flexible regime..
    I was given an A4 sized glossy publication folded into a 3 page leaflet with a wave graph showing how the basal & bolus insulin worked in conjunction with meals, then sent on my way.. Being the "only gay in the village" at that time i had to make the rest up as i went along...
     
    • Like Like x 2
  20. Julie1471

    Julie1471 Type 1 · Well-Known Member

    Messages:
    504
    Likes Received:
    409
    Trophy Points:
    103
    I was lucky a whole load of us were trained to use them at Farnbrough hospital in Kent. But I loved it, when I first started it, but things move on I was offered a cell transplant and came back with can't I try a pump, I am now on a pump but visit a different hosp, due to funding in my area. But I would not give it back I have the odd blip, and I've been told of by my DSN as I want my numbers perfect. But it's changed my life so much. In the few months I've had it.
     
    • Like Like x 6
  • Meet the Community

    Find support, connect with others, ask questions and share your experiences with people with diabetes, their carers and family.

    Did you know: 7 out of 10 people improve their understanding of diabetes within 6 months of being a Diabetes Forum member. Get the Diabetes Forum App and stay connected on iOS and Android

    Grab the app!
  • Tweet with us

  • Like us on Facebook