When I was diagnosed with diabetes at the age of 13, the nutritionist introduced me to the idea of a bedtime snack. Previously, dinner was always the last thing I ate before bed. My parents and I were instructed that I needed a snack with both carbohydrates and protein at bedtime. I remember that a turkey sandwich was specifically recommended!
Back then, my insulin regimen included NPH and Regular insulin, thus, the nighttime snack was helpful in keeping away hypoglycemia brought on by unpredictable insulin spikes. Nocturnal eating became a regular part of my new diabetic life. I specifically remember getting up in the middle of the night with low blood sugar (apparently the bedtime snack didn't always work) and eating half of the snack foods in the kitchen. What had previously been unthinkable to me, that is eating between dinner and breakfast, suddenly became an expected part of my daily routine.
When I started pumping (two years ago next week!) I was excited to rid my life of long acting insulin. I'd been splitting my dose of Lantus into two daily injections, to better manage its effectiveness, for a couple years. The pump gave me the opportunity to eat when I wanted instead of on the schedule of my insulin doses. That meant, I would be able to skip the bedtime snack! However, I found that a lot easier said than done. I'd gotten so used to eating something before bed, that my body automatically signed hunger as soon as I started my bedtime routine. I tried to convince myself it wasn't real, but more often than not, the habit of snacking won out.
Then, I got pregnant and my healthcare staff again advised a bedtime snack. Through the sleeping hours is the one segment of the day that usually doesn't require a higher basal rate in pregnant women. Nocturnal hypoglycemia is common and thus the bedtime snack is important. So, I embraced eating before bed again.
Now that I'm nearing the end of my breastfeeding and focusing on getting in shape before it's time for our second child, I'm looking at ways to cut back on calories. Those superfluous bedtime snacks seem like an obvious choice. However, an even more convincing reason to stop eating before bed is that it greatly improves my blood sugar control.
See, we usually eat dinner around 8:00 p.m. What with us getting home at 6:00 p.m. and all of our evening chores plus Sienna's dinner, bath, and bedtime routine to accomplish, it's actually not unheard of for Dennis and I to sit down to eat closer to 9:00 p.m. I used to actually eat another small snack less than 2 hours after dinner! How silly!
When I discussed this dinner and snack timing with my endocrinologist lately, he commented that he'd like to see me deliver my last insulin bolus at least a couple hours before going to bed. I understood the logic: that way I could test my blood and be able to better estimate what my blood sugar would do through the night based on my dinner and the insulin left on board. When I eat just as I'm going to bed and bolus for that meal, I could very well over or under bolus and not know it until the morning (if Sienna lets me sleep through the night!)