From the Guidelines
For insulin-dependent diabetics with blood sugar levels lower than the target before bed, consuming 15-20 grams of glucose is the most effective treatment to raise blood glucose levels quickly. According to the study by Franz and Associates 1, glucose is the preferred treatment for hypoglycemia, and ingestion of 15-20 grams of glucose is effective in treating hypoglycemia. The study also notes that any form of carbohydrate that contains glucose may be used, but glucose is the most effective in raising plasma glucose levels.
Some key points to consider when treating hypoglycemia before bed include:
- Checking blood sugar levels before treating to confirm hypoglycemia, typically below 70 mg/dL
- Aiming for 15-20 grams of glucose to raise blood sugar levels quickly
- Avoiding foods high in simple sugars alone, as these can cause a rapid rise followed by a drop in blood glucose
- Considering a small snack containing both carbohydrates and protein, such as a small apple with peanut butter or a small bowl of yogurt with berries, to provide a more sustained release of glucose throughout the night
It's also important to note that the initial response to treatment for hypoglycemia should be seen in 10-20 minutes, but blood glucose should be evaluated again in 60 minutes, as additional treatment may be necessary 1. Additionally, individuals with type 1 diabetes should continue insulin during acute illnesses and test blood glucose and blood or urine ketones, drink adequate amounts of fluids, and ingest carbohydrate to prevent diabetic ketoacidosis 1.
From the Research
Managing Low Blood Sugar Before Bed in Insulin Diabetics
When blood sugar levels are lower than the target before bed, it is essential to consume a snack that will help stabilize blood glucose levels throughout the night. The following options can be considered:
- A small serving of carbohydrates, such as crackers or toast, with a protein source like cheese or peanut butter 2
- A glass of milk or a small serving of yogurt with some carbohydrates like fruit or granola 3
- A small snack that combines carbohydrates and protein, such as a handful of trail mix with nuts and dried fruit 4
Choosing the Right Snack
The key is to choose a snack that will provide a steady release of glucose into the bloodstream, rather than causing a rapid spike in blood sugar levels. Some options to consider include:
- Whole grain crackers with cheese or peanut butter 5
- A small serving of fruit with a handful of nuts or seeds 6
- A small serving of yogurt with some honey or maple syrup and a sprinkle of granola 3
Important Considerations
It is crucial to monitor blood sugar levels after consuming a snack to ensure that they are within the target range. Additionally, the type and amount of snack consumed may need to be adjusted based on individual factors, such as the type of insulin being used and the presence of any other health conditions 2, 4.