Whenever I see a thread about people asking if they should eat before going to bed, the general answer is "No, and if you do, your basal is too high"
I have had diabetes for almost 13 years now, and have been on MDI for all of it. I was put on Lantus when it first came out. I have also been told time and time again by my doctor that I should ALWAYS eat a snack before bed to avoid lows.
So last night I decided to test to see if I really needed a snack. I have had a few random highs in the mornings for the past week, so maybe the snack was causing it. I took my 28U at 10:30 and started to get ready for bed. My BG was stable (127-123 one hour apart). After I brushed my teeth, showered, ect. I grabbed some glucose tabs, a snack, and my kit and went to bed at around 11:00. I usually will wake up when low so I didn’t feel the need to set my alarm or anything (and besides, its Saturday, who wants to wake up on a Saturday?).
I didn’t even get a chance to go to sleep. At 11:27, one hour after I took my Lantus, I’m at 55. That’s the kind of drop I would expect to see from my Humalog, not my 24 Hr basal! So I took 3 glucose tabs, ate my usual 30g snack, went to sleep, and woke up at 9:30 with a BG of 113.
Ok story time over, Do you think that bedtime snacks are necessary for people like me? It almost seems like my Lantus acts like Humalog for the first couple hours after injection. Or is my Lantus just way too high?
28 Units seems like a lot to me. I was only taking 15 units when I was on it (I am on the pump now), but everyone is different. I used to snack before bed, but now that I am on the pump, I don’t have to and my BS is so much better regulated. Maybe you should check into getting the pump?
As much as I would like it, I just cant afford it. $1200 after insurance is still way too much
Hey TimmyMac,
I always have a little nibble before I go to beddy byes at night - usually abit of cheese and a cracker or two. Depends on what my blood glucose is at the time. I was using an insulin pump for almost 3 years - and am now on a break from it - to see if I can control my diabetes as well as I seemed to be doing with the pump. I went to the pump, only because of having lows at night and upon waking, even with tweaking of Lantus shots to every 12 hours, I just didn’t seem to win. Since going on the pump, and sort of reeducating my brain with how insulin works (I should know better having been diabetic for 43 years - huh? ) - I find right now - with my Lantus shot and having a snack (didn’t do this before) - no night time sweats/lows - waking up like a space cadet.
Helen - everyone is different in how much Lantus / Levemir they take like you say. I met up with a young man last month at a diabetic meeting that I help run here in Montreal - he’s taking 54 units of Levemir at night time. I went - woah! More because he’s has lows alot, at night/morning. I told him to talk to his doctor about going to 2 shots - and asking him about taking a smaller shot at night. That’s what I do for keeping my BG’s on a steady keel. I take 8-10 units of Lantus at night - and depending on my activity the next day - between 8-12 units of Lantus. I admit - with a pump - it is easier to tweak our basal rates - but with patience/time - we MDI’s can do it just as well.
BTW, TimmyMac - have you ever tried Levemir - I wrote a blog about it this week - as I wanted to switch over to it - but after a week - am back to Lantus - better control with my BG’s - and no allergic reaction - you can check it out at this link - advise/comments much appreciated. Diabetes is always such a roller coaster ride! Whoo! Whoo!
Yeah - $1,200 is still alot of $$$'s. My insurance company only covered 80% of the purchase of my pump ($6K CDN) - so I had to dig into my mattress to pay the extra (e.g. had to cut back on things). If I lived in the province of Ontario which is next door to where I live (Quebec) - there they pay for your pump and up to $2,500 CDN a year for supplies - not a bad deal if you live there and need to go on a pump.
I usually have a bedtime snack. (one carb serving plus a protein).Last night I skipped it after eating too much at a wedding reception. And my morning fasting was 156 instead of its usual 118-125. So my snack probably prevents a low which causes a rebound high in the morning. And I take 10 units of Lantus every morning. When I took it at night I would be in the 60s in the morning.
I was told to have a snack before bed when I was on 10 units of my levemir and it did the trick but now I am taking 9 units I find that I dont need a snack and if I go to sleep at a good number I will wake up at the same number most of the time.
Just see what works for you.
let me tell you about my experience with Lantus and why I am no longer using it. I was put on it and was doing it for a couple weeks. First off it did not keep me at a good level during the day–kept being high. So at night I would be 220-275 before bed. So I take my Lantus and I would wake up at 20-40 the next day. Who eats a snack when they are that high? Who thinks to eat a snack at that number? So I quit taking the Lantus and went back to my normal R and N. I generally don’t wake up like that now. Especially if I am high before going to bed. The dr’s office said it needing “tweaking”. I said I don’t have time for that and am not doing it with these results. Best of luck to you but I am glad to know I am not the only one who had problems with that. And Lantus it not supposed to peak that much…right!
Thank for the replies, I guess eating a snack is needed for some people angrily glares at responses on another form I guess i could try Levamir, but I’m still a few months away from my next doctor appt. I might forget to ask by then =)
@ anna, wow that is a good deal, I wish I lived in Ontario then. But no, I’m all the way down here in Virginia
When i was younger i almost always had to have a glass of milk just before i went to bed to keep my BG stable… i usually eat a snack just before bed just cause i want a snack, but i don’t HAVE to. (I bolus for the snack most of the time)
I’d say look into lowering your Lantus… if i knew anything about it, which i don’t, so i’ll leave that to the Lantus guys. 
I don’t really like the idea of NEEDING a bed time snack, but some people do… i’m just not one of them.
I’ve been told both, eat a snack, shouldn’t have to eat a snack.
My Lantus dosage issue is the one major difficulty that might drive me towards a pump. My Lantus dosage has recently ranged from 9 to 12 units trying to work out 10 pm to 10 am kinks that don’t seem to want to be worked out. Part of my issue is that I get up, eat breakfast, and leave for work between 5 am and 6 am.
I almost always enjoy a snack before bedtime. It’s usually an apple & cheese, something light with a bit of carbs and fat.
You might want to do some more overnight testing to see if you are consistently having overnight lows or if it was just that one night…
Personally, I’ve found that Lantus is not always absorbed as evenly as it’s supposed to be. I’ve found that it usually peaks in the early morning ~ anywhere from 2-7 hours after I’ve taken it…so I ended up decreasing from 24 -16 though will go back to 20 units if I’m not exercising regularly. Since decreasing it, it still peaks, but not as much (like a 10-15 pt drop) but not crashing into the 30-40 range like I had been.
One of the things I discovered was that cutting back on the lantus really helped to get rid of some unexplained highs in the morning that tended to persist till late morning. Now when I wake up in range, the rest of my day goes a lot better.
Also I don’t eat bedtime snacks…but then I usually don’t eat dinner until 9pm give or take an hour…
I had more stable BG when I changed to Levemir. Lantus had peaks & valleys that resulted in bad lows. I take split doses of Levemir. One right before bed (I have dawn phenomenon) & another in the morning. Smaller doses of insulin act more predictably. It takes about 2 hours for Lantus to start working for most people.
If your basal dose is correct, bedtime snacking shouldn’t be necessary. I think the night snacking recommendation started from the days of NPH, which acted unpredictably. Eating 45 carbs before bed & waking at 113 does make it seem that your Lantus dose is higher than it may need to be.
I always have a snack before bed and i did it while i was on MDI’s ad now with the pump. it works for me with less lows especially on my cardio night workouts. i do 2 gram crackers with teaspoon of crunchy peanut butter and 8 oz of skim milk
This is the problem with Lantus. You are committing to a specific basal rate that chances are you do not need during sleeping hours. I woke up with lows just about every night I did not eat a snack when on lantus. For example, I took 20 units of lantus at 10pm. That equals about .83 units per hour. It says it doesnt peak, but thats BS, at least with my physiology. Now, on the pump, I take .60 units per hour during sleep hours. rarely do i go low at night.
Since she can be lower or higher at bed on tested basals (her blood sugars fluctuate a great deal during the hours of 6pm to 2am, very steady during the day), we give her a snack to bring her up to about 120. She is on a pump. Likewise, we use temp basals to adjust during the evening hours quite a bit. Once she is a fully grown adult, I hope for more stability at night.
I always took my lantus in the a.m… I found that it had a little peaking going up about 11:30 then it smooth out for the rest of the day.
Also if you feel that you are going low as a result of the Lantus. Perhaps your dose is a little to high. Experiment and see what happens. Good Luck to you.
Do you know how to do basal testing? You should be able to take your Lantus, not eat or take fast acting insulin & not go up or down by more than 30 points during the test period. When I was on Lantus, I only took it once a day not realizing a lot of people do better splitting it. I know I was taking too much & always woke up low but if I cut back, I ran high all day. I now take Levemir & do much better on it. I also know how to do basal testing now! If you have your basals set correctly, you shouldn’t have to snack. If you want to snack, that is different but you really shouldn’t have to eat to your insulin.
My DR told me that, if I was at 100 or pretty near, I should eat a snack like 1/2 sandwich. So, if I am at 110, I will have a snack and then I usually wake up with a good number. Now that I am on the pump, it is just as easy to lower the basal after lows happen more often in the a.m.
Hope this helps.
Lois
You don’t have to take your basal insulin only at night. You can take it anytime during the day-- as long as it’s the same time of the day. At least thats what the researchers in my study told me.