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A1c Tip: Staying “In-Range” While You’re Sleeping

Managing your blood sugar during sleep is often key to lower A1c but insulin onboard and light meals at night are required

If you broke your 24-hour day into 3 sections, you’d have 8 hours of dawn/daylight, 8 hours of afternoon/evening, and 8 hours of sleep. 

Now imagine if every night your blood sugars are high, and every morning you’re waking up high. That’s ⅓ of your entire day out-of-range. No wonder you’re struggling to reach that A1c goal! All the testing and counting and dosing during the day can only do so much if you’re snoozing every night with high blood sugars.

“In-Range” off the rails

These are the things that can easily derail your overnight blood sugar goals:

  1. Too little basal / background insulin
  2. Not enough insulin with your last meal
  3. Heavy late-night snacking or bingeing

A night here or there higher than normal is expected — none of us do this perfectly — but if you’re consistently higher than your goal range and struggling to get your A1c down, giving this chunk of time more attention is worth it.

Let’s take a closer look…

Too little basal / background insulin

This culprit is really the easiest to solve because even just an increase of 1 or 2 or 3 units of basal / background insulin can vastly improve those overnight blood sugar levels.

Even if you take 1 dose a day of long-acting insulin, increasing that dose by 1 unit can have a huge impact. 

How do you know if your basal / background insulin needs an adjustment? 

If you are eating a healthy meal for dinner, going to bed with in-range blood sugar, and consistently waking up higher than your goal range, your background insulin dose needs a boost.

On the other hand, if you are regularly eating heavy evening meals like pizza, Chinese food, lasagna, or a burger with fries, you could be experiencing delayed digestion of the carbs because of the high-fat content, which means the next paragraph is for you!

Not enough insulin with your last meal

If you eat dinner at 7 p.m. every night and you’re fast asleep by 9 p.m., it’s very possible that your last meal is being digested after you’re unconscious. 

If you are consistently going to bed with high blood sugars, you know that the amount of insulin you’re taking for dinner isn’t enough.

If you are consistently going to bed with high blood sugars, taking a correction, and still waking up higher than your goal range, your correction dose of insulin may need to be fine-tuned.

Heavy meals translate into long digestion times

On the other hand, what if you check your blood sugar at 9 p.m. and if it’s in your goal-range? Then it’s easy to assume you’re good for the night, but is your meal still being digested?

A meal of lasagna, Chinese food, or pizza is definitely going to affect your blood sugar for up to 6 hours after eating.

Taking a closer look at this means:

  • Improving your dinner meals, making high-carb/high-fat meals a treat instead of a regular choice.
  • Definitely testing before bed but also at 11 p.m. or midnight to see what’s happening while you snooze. 
  • Changing how you dose for dinner or waking up at midnight to see where your blood sugar is at.

This culprit is one of the trickier factors to fix because we don’t eat the same exact thing for dinner every night, right?  But if you can strive to make mostly good choices and test more often before bed, you can probably come up with some more accurate approaches to dosing insulin for dinner. 

Heavy late-night snacking or bingeing

Believe me, I get it: chocolate just tastes better when you’re eating it at 10 p.m., at the end of your day while watching a recent episode of Bachelor in Paradise (shhh…don’t tell anybody I watch this!). But the amount of chocolate I can mindlessly eat when I’m tired and watching TV is a lot more than the amount I would eat at 3 p.m. when my day is still going.

And those late-night habits can turn into a binge-eating cycle if you’re not careful. The guilt from over-eating at night can lead you to skip breakfast and lunch the next day. Then, by the time you get home from work, you’re starving and the binge-eating starts up again.

Nixing a late-night binge-eating habit can be tricky, but it starts in one of three places:

  1. Eating breakfast and lunch even though you feel guilty about binge-eating the night before. This helps you get back onto a healthier eating schedule and prevents that late-night starvation.
  2. Stopping yourself tonight from binge-eating. Just think of it as one night where you resist that urge to overeat those addicting, satiating, heavier treats, and instead make a really healthy meal for yourself…and then go to bed!
  3. Take an entire week (or several!) to think about and look at what’s driving your binge-eating habit. Is it the cycle of starving yourself during the day or is it more emotional? Is there something else in your life that needs your attention that binge-eating is helping to cover-up or avoid?

This habit didn’t start overnight, it took time to develop — which means it will take time to unravel and change, too.

Be patient with yourself! Every day is a fresh start.

 

Ginger Vieira has lived with Type 1 diabetes and Celiac disease since 1999, and fibromyalgia since 2014. She is the author of 4 books: Pregnancy with Type 1 Diabetes, Dealing with Diabetes Burnout, Emotional Eating with Diabetes, Your Diabetes Science Experiment. Ginger creates content regularly for Diabetes Strong, Healthline, HealthCentral, DiabetesDaily, EverydayHealth and her YouTube Channel. Her background includes a B.S. in Professional Writing, certifications in cognitive coaching, Ashtanga yoga, and personal training with several records in drug-free powerlifting. She lives in Vermont with two kiddos and two dogs.

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