Is a bedtime snack really an effective way to manage hyperglycaemia?
A systematic research review led by IHMRI affiliated researchers has found that there is no sufficient evidence to support consuming a snack before bed for glycaemic control with Type 2 diabetes.
A bedtime snack is often prescribed as a potential strategy to reduce morning hyperglycaemia in Type 2 Diabetes and is a common strategy reported in popular media. Elevated glucose concentrations can occur when a person living with diabetes wakes up in the morning after a period of fasting whilst asleep.
Dr Lauren Roach who authored the review, says “the theory behind this strategy is that by ingesting a bedtime snack you are reducing the overnight fasting window, which could in turn mitigate fasting hyperglycaemia.”
However, this recommendation has been challenged by Dr Roach and supervisor Dr Monique Francois. After reviewing the results from 16 studies investigating the impact of a bedtime snack, they found that there is little evidence to support its efficacy.
“Although a bedtime snack is commonly recommended for people with type 2 diabetes, we were interested to find that the evidence to support this recommendation is lacking. Many studies we reviewed did not compare a snack to a no snack control and so we are unable to say whether a snack improves fasting hyperglycaemia compared to not eating at all,” said Dr Roach.
“There is some evidence to support having a protein-based snack (e.g. eggs) before bed compared to a carbohydrate-based snack (e.g. flavoured yoghurt) for improved fasting glucose, however, neither of these improved fasting glucose levels more than not having a bedtime snack at all.”
A growing health burden
Type 2 Diabetes is the most common form of diabetes in Australia and impacts around 4.9% of the population. This chronic condition occurs when the body becomes resistant to the normal effects of insulin and gradually loses capacity to produce enough insulin in the pancreas.
Whilst there is no cure for type 2 diabetes, it can be managed through medication and lifestyle-based interventions, such as a healthy diet and exercise. However, if not managed correctly it can lead to uncontrolled blood glucose concentrations and increased risk of complications such as blindness, amputation, and cardiovascular disease.
“Type 2 diabetes forms a significant and growing health risk to our community and is a known risk factor for cardiovascular morbidity, which can reduce your life expectancy by 5-15 years,” said Dr Roach.
For World Diabetes Day, Diabetes Australia have released a report which has highlighted the spiralling impact of diabetes on Australia.
Where to next?
Dr Roach noted that future well-designed, longer randomised controlled trials are needed to investigate different bedtime snacks for hyperglycaemia. Specifically, trials that use whole foods that people will realistically eat before bed, and studies that include people that are treated with insulin.
“This will strengthen the evidence base and help clinicians make recommendations in clinical practice.”
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