Bedtime snacks are important for blood sugar control for children with type 1 diabetes. A snack that includes carbohydrate and protein helps to keep up your child's blood sugar level through the night. A typical bedtime snack should include 15 grams of carbohydrate and 7 to 8 grams of protein. This amount can change based on your child's age, blood sugar levels, and activity throughout the day.
Examples of foods containing 15 grams of carbohydrate and 7 to 8 grams of protein include:
1 slice of bread plus 2 Tbsp peanut butter
1 6-inch tortilla plus 1/4 cup grated cheese
6 saltine crackers plus 1 string cheese
3 cups popcorn plus 1 oz of meat or 1 egg
12 small pretzels plus 2 Tbsp sunflower seeds
3/4 to 1 cup cereal plus 1/4 cup peanuts
5 vanilla wafers plus 1 cup milk*
8 oz of no-sugar-added yogurt*.
*Yogurt and milk provide about 15 grams of carbohydrate as well as protein.
It is good to choose a solid food at bedtime. Solid foods will churn around in the stomach before passing to the intestine where most food is absorbed. Milk or yogurt alone might pass quickly through the stomach, but milk and cereal or yogurt and crackers might pass through more slowly. Adjust carbohydrate amounts based on what the blood sugar is at bedtime. Here are some guidelines to follow:
At bedtime, if your child's blood sugar is:
150-200 mg/dl (8.3-11.1mmol/L): Give your child 15 to 20 grams of carbohydrate and 7 to 8 grams of protein.
100-150 mg/dl (5.5-8.3 mmol/L): Give your child 25 to 30 grams of carbohydrate and 7 to 8 grams of protein.
100 mg/dl (5.5 mmol/L): Give your child 30 to 45 grams of carbohydrate and 7 to 8 grams of protein.
Children who have had an active day should have a bedtime snack no matter what their blood sugar level.
I agree with the premise, but the amounts have to be individualized beyond what can be given in an article.
The definition of active day.
The definition of child.
How many pounds kid can take 25-30 grams of carb and 8 grams of protein at night & not be 300 the next morning?
Is there a pump attached? a CGM attached?
Additionally, we need a meter that measures the energy expended!
Not easy to agree. It’s an algorithm in need of further parameters - more definition.
Well, I don’t have kids, I’m sure the needs for them is going to be different than it is for adults but in general I’ve found that eating before bed is a bad idea. It tosses my morning numbers out of wack and diminishes the quality of my sleep. I don’t count my macro-nutrients but I imagine I probably eat about 15-20 grams of carbs in a day (not counting the occasional Dex4s) I certainly can’t see eating that amount in one sitting with a bg of 200!
So from my experience I’d say I disagree, however if you are a parent I’m sure having your child not wake up in the morning due to an extreme hypo is a pretty terrifying prospect. So it may be worth trying.
I have a 5 year old son and we make sure he has a bed time snack to help him through the night. But of course, it all depends on his BS at bedtime and our target ranges throughout the night and for the morning. His favorite snack of choice is yogurt. We also allow him to have milk every night. I would not follow the guidelines stated above (1-3). I really believe it is depends on the child and their target ranges.
Honestly, the scales that are given look like advice that was given when kids were on 2 shots of NPH and sliding scales of regular insulin a day.
I think the article needs to be updated, as any parent of a CWD knows, what works for one may not work for another. The carb amounts look huge to me, but we’ve been using basal-bolus insulin for the past 8 years, I haven’t had to think too much about preventing a nighttime low due to peaking NPH in quite a while. . .
If this info is being provided by your Dr’s group, I’d ask them to check where they got it from, I think they could be circulating information that is a bit out of date considering how most people are treating their D today.
It may work for some, but I think for the majority of CWD, a night time snack is more of an option, not a requirement given the new(er) insulin regiments.
My daughter is 2 years old on MDI, and she MUST have a bedtime snack. Depending on her reading before bedtime is how we decide what she can have. If she is on the higher side we stick with a 4-6 carb sugar free Popsicle and 4oz of milk, whereas if she is on the lower side we use carb smart ice cream, or a 12 carb chocolate bar with 4oz of milk (her dr. balks a little b/c that is over 15 carbs, but she still wakes up between 100-150 where she should be). Without her snack she will bottom out about 4am. She is a funny child b/c if we test her in the night b/tw 12am and 4am she runs high 250-400, but drops early morning to her normal range. Without the snack she once woke us up at 4:30am with a glucose reading of 45 (scary). I will say the list contains Vanilla Wafers which even 2 will send her high so I am not sure how great the food suggestions are. I think this advice is for young children or toddlers.
I always have a bed time snack before bed and I’m 18 (tomorrow :D) and 140ish pounds. If I don’t have around 40 grams of carbs before bed, I’ll drop to somewhere in the 40-50s during the night. I know people would say “lower your basal” but I need that much throughout the day, or I would need to take about twice the amount of fast acting that I am now. (I tried it once, lowered my basal from 28 to 24… I still needed 20 grams of snack before bed, but my I:C for meals went from 1:10 to about 1:6.) I found that eating a large snack just makes things easier
It’s up to the individual childs needs. My kids, when they were still in toddlerhood, would wake up extremely high if given a night time snack when their BG was above 150 before laying down. BUT, they required almost no insulin during the day aside from a miniscule amount of ultralente that was administered in the morning. That worked till about age 4, then all bets were off, that’s when their daytime insulin requirements started rearing their nasty heads.
I always suspected that their pancreas’s, for what ever reason, worked a little bit during the day, and not at all in the overnight. If they were D’xed today at their ages, it would have been something else to have put a CGMS on them so I could see what they were doing overnight. I also have thought, for a very long time, that kids D’xed at such young ages, if they start insulin therapy early, it somehow helps extend their “honeymoon” period. None of this I can substainiate with research or anything like that, just my own thoughts and experiences.
I hope your daughter continues to have ease in getting a high overnight BG down, mine would do that all on their own during the daylight hours, never overnight, and it only lasted for a little while, wish it was still happening today. . .
