Ok, you have diabetes, so make sure you eat a snack at night, right?

Well, as a wise woman once said, the correct answer to every question is- it depends! (try it out- it works remarkably well for most questions)

First, to understand an issue, you need to understand it's origins. So where did the concept of a bedtime snack for diabetics come from? Well, the earliest diabetics were treated with insulin, and of course the danger of taking insulin is that it can cause your blood sugar (glucose) to drop too low. Since our brains run on glucose, our brains may 'shut down' if they run low on fuel. And since we don't come with reboot switches, this is really dangerous.

So two major issues with early insulin treatment were: 1- eating snacks during the day to prevent getting horizontal; and 2- eating a snack before bedtime to prevent staying horizontal. Both of these issues were exacerbated by the fact that early insulin didn't come from people, but from pigs (not sure if this caused a problem for muslim diabetics).

Now, I don't know much about pig's blood, although it doesn't do much for decor on prom dresses. But of course common sense says that piggy insulin won't work the same way as human insulin. And so, the early insulins were more likely to cause low blood sugar due to sporadic release in the blood. Hence early diabetes treatment included a bedtime snack.

Fast forwarding to today, we have ingeniuosly engineered insulin which is not only of human insulin form, but we also have slow, reliable release forms of insulin like detemir/lantus/glargine, which won't cause unpredictable drops in blood sugar. And there are now medicines which increase insulin sensitivity, so many diabetics do not need insulin early in their treatment. So, for patients not on any insulin or hypoglyemic medicine, there is no need for a bedtime snack.

Who needs a bedtime snack? It depends. Type I diabetics and diabetics on shorter acting insulins may need it if their sugar runs low in the morning. But diabetics on lantus or not on insulin have no reason to eat before bed. Unless of course you like a late snack. In that case, make sure the stash under the bed is a box of trail mix, not a box of twinkies.