At our last endocrinology visit, the topic of bedtime snacks came up. I don’t normally do a 10:00 or 11:00 pm blood glucose check unless there is a reason to and if I check her at 2:00 am her numbers are usually fine.
But for the week or so before our appointment I checked her right before I went to bed each night. I can’t remember the exact reasons why. I think some nights she was on the low side at bedtime or had had gymnastics or dance. I just know that in my mind each night I thought “I’m up, may as well check.”
Interestingly I found that she was in the 300′s late in the evening every single night. She wasn’t sick and didn’t have ketones. But by 2:00 am she was back in the 200′s and by breakfast was usually in range.
Why the spike?
When Q was diagnosed with diabetes she was only three years old. She began management with MDI. It’s common protocol for these younger children to have snacks (mid-morning, mid-afternoon, and at bedtime) without giving insulin to cover them. The bedtime snack includes at least 5 grams of protein to help keep blood sugars even through the night and extend the carbs.
The endocrinologist asked if Q eats the bedtime snack because she is hungry or if it’s just habit. Does she really need it?
The reality is that we never gave a bedtime snack to her before diagnosis. And now even our three-year-old expects a snack every night along side his sister.
We decided together that we would modify her snacking at bedtime. If she is low (below 80) she’ll get 15 grams of carbs including protein. If she is in range, she can have either a free snack (less than 5 grams of carbs) or she can have a regular snack and get insulin for it at the same I:C as we use for dinner. (There are other contingencies depending on her activity level, etc. that I won’t get into here, but don’t take this as medical advice, always follow your physician’s snacking recommendations for your child.)
She told us about a product called ExtendBars that were developed by an endocrinologist specifically for instances where you want the carbs to last for a longer period and not to spike right away.
Source: www.extendbar.com
Source: www.extendbar.com
I was at Walgreens and spied them in the diabetes section of the pharmacy and picked up a couple of boxes. They were not cheap (but what diabetes-specific product is!). The box was $5.49 for 4 bars, that’s $1.37 each.
Within a week of this appointment and actual purchase, Q was 65 at bedtime so I figured we’d try them out. She ate a Chocolate Delight bar and thought it tasted pretty good. Though she was disappointed she couldn’t also have a glass of milk which she normally gets at bedtime. The bar was 20 grams of carbs, 5 more than we normally give her.
I rechecked her in 25 minutes expecting her to be in the mid-100′s, but she was still on the “too low” side for me to be comfortable at bedtime. I gave her one roll of Smarties (6 grams of carbs) to be on the safe side and to get her quickly back up.
So here’s where it gets interesting.
I don’t believe half the claims I read, especially when it comes to diabetes products. You know, snake oil, cinnamon, and even a special moss which claims to cure it! Would the ExtendBar really keep her even through the night?
| Time | Blood Sugar |
|---|---|
| 7:50 PM | 65 |
| 8:16 PM | 83 |
| 10:34 PM | 145 |
| 2:07 AM | 145 |
| 7:12 AM | 135 |
Talk about stable blood sugars throughout the night. Coincidence? Or did the product work as intended? I will use these bars as we have low blood sugars at bedtime to see if they work this way every time. Wouldn’t that be something to find a food that actually keeps blood sugars stable for nine hours without a post prandial spike?
What I do not like about the ingredient list is the inclusion of sugar alcohols. I try to limit these in Q’s diet so as not to upset her tummy or cause diarrhea. She didn’t seem to have an issue this time.
After purchasing these (with my own money), I actually became in contact with a rep from the company. He offered to send me a few more flavors and the Extendcrisps and ExtendShakes to give a try (at no cost to me).
Q did not like the fruity flavored (apple cinnamon and mixed berry) bars. They were too sweet for her, nor did she like the crisps. We haven’t tried the shake yet. But the Peanut Butter Chocolate and Chocolate bars are a definite hit.
Have we replicated that night of even blood sugars? Yes and no. A few times we have seen even numbers and sometimes we still get a bit of a spike. I have learned that Q needs to be in range at bedtime for these to really be effective for her. If she’s low then they don’t bring her up quickly and I don’t like her going to bed low to begin with. Q often reaches for these for her bedtime snack. In fact I need to add them to my list for my next trip to Walgreens.
Have you ever tried ExtendBars? What was your experience? How do you keep blood sugars stable through the night?
From Extend Snacks’ website: Unlike the high glycemic carbohydrates in most foods that convert to glucose quickly causing blood sugar and insulin levels to spike, Extend Snacks have a unique combination of ingredients with a low glycemic index. So, they break down gradually and releases nutrients into your system more slowly and evenly, to provide you with a continuous source of energy for up to 9 hours.
Giveaway (Entries Now Closed)
One lucky reader of D-Mom Blog will win an ExtendBar kit (similar to what’s shown below) including:
- ExtendBar Delights
- ExtendCrisps
- ExtendShakes
- Blender Bottle
Required Entry:
Enter by leaving a comment telling me what your child’s (or your) favorite bedtime snack is.
Optional Extra Entries:
Tweet about this giveaway including @DMomBlog and http://www.d-mom.com/?p=10227 and leave an additional comment linking to your tweet (click on the timestamp for the link).
Blog about this giveaway linking to http://www.d-mom.com/?p=10227 and leave an additional comment with the link. You can include the badge from the sidebar if you like (optional, but always appreciated).
Read the official giveaway rules. Entry deadline February 11, 2011. US and Canadian mailing addresses only.
Disclosure: When I wrote the first two-thirds of this post, it was before I had any contact with ExtendBar. Only after we had purchased two boxes of bars with our own money did I have contact with ExtendBar and receive a small selection of snacks to try out. I did not receive monetary compensation. Opinions are always my own.
{ 26 comments… read them below or add one }
I heard about these bars from a friend of mine and have been meaning to look for them! We would love to try them. Natalie’s favorite bedtime snack (she only gets one if under 130 BG is good old fashioned crackers with crunchy peanut butter). Now for MY favorite bedtime snack, that would be ice cream (after the kids are in bed)!
Those are some pretty amazing snacks. Morgan loves to eat oatmeal bars. They are the ones that are kinda like fig newtons but they are only about 15g for a bar.
Sam likes sugar free pudding. Hunts has the lowest carbs–15 for chocolate and 11 for vanilla or caramel. Sometimes I add an oreo, depending where his sugar is.
Thanks for the tip, will have to check them out! Jaime is on MDI, so we try to keep her above 150 at night. That being said, we use dannonino yogurts to get her through the night, when necessary. These were always a favorite in our household before diagnosis, they have become the only yogurt I buy now. With just 7g of carbs, they are the perfect size and carb amount for many occasions!
My daughter usually has a small bowl of goldfish crackers or popcorn. We fight lows at bedtime (due to the day’s activities) and then later see that awful spike.
I’ve never heard of these but would love to try them, especially for before bedtime on the days E has Dance class. Thanks for educating us on this product!
My daughter Isabelle enjoys a few graham crackers with a bit of chocolate hazelnut spread ( like Nutella, but found it at the health food store) and a half a cup of whole milk. Seems like a mix of fat, protein & carbs helps to keep things more stable… Have been eyeing the extend bars while waiting in line at Walgreens, but wasn’t sure how tasty raw cornstarch would be in a bar ( I could be wrong , but I believe that is the key ingredient) , but would be glad to give them a try : ) BTW, really enjoy and appreciate your blog!
My son usually gets a gogurt, because they are super easy. He prefers a bowl of ice cream. I have thought of trying these, they are quite expensive though.
I was reading about this on their webpage. I was going to buy some but the price was a little high. My son has never had low blood sugars at night, thank goodness, but he is a snacker. I found some at the local drugstore and bought them last night. I think this is a much better snack than the cereal he always wants. Will let you know what he thinks later. They smell good.
L. is a very hungry girl. Since before her diagnosis at 4 she had nighttime snacks of 30 carbs or more. We often have late night spikes and are often checking her at 11:00 and at 2:00. I feel like each week she needs a different combo of insulin and carbs to have a relatively even night. Our usual snack is cereal if hungry (with a little insulin) or if not too hungry a frozen yogurt squeezie. We look forward to trying out the ExtendBar to see if we can get things a little more even.
Haven’t seen or heard of these . . . . very interesting!
Ellie’s loves to have a wedge of Laughing Cow Cheese with 12grams of Trader Joe’s Everything Cracker.
We no longer do a bedtime snack since he is on a pump but it would be peanut butter and crackers.
Would love to try out these bars!
Great post! Thanks for all the info and for all the BG checks Q:) Very informative!
We tried these right after Sugar’s celiac dx. They were great — pricey, but that’s the case for all GF bars. We stopped using them due to the price…you know…in the old days, before we realized that every GF bar we’d try would cost us well over a buck.
Anyway, we’d love to give ‘em a whirl again.
Why the heck not?
We usually do 2 slices of lunchmeat or 2 slices of deli cheese if we do a later supper. Early supper usually means 70′s by bedtime and then more carbs. I’m going to look for these! I’m sure she’d like the chocolate ones!
I twittered- http://twitter.com/#!/byrdie16/status/33949152182276096
Are these bars like the glucerna brand of bars and shakes, or is there differences in the way each work?
If adam has been running he has a carb free snack like cheese or lunch meat. If he is running low or even if his numbers are good he has a bowl of cereal.
I have not tried these bars, but I am intrigued. It would be interesting to try them on myself. I am often hungry in the middle of the night (I have a very fast metabolism, aided by the fact that I am a runner) and have to get up and eat, and my choices are limited. I might consider trying these!
Favourite bed time snack? Anything with peanut butter!
Joe usually goes without a bedtime snack…or he will do a peanut butter lolli-pop (PB on a spoon) or cheese. I haven’t needed to work in a carb evening snack since he was on MDI.
I’d love to give these bad boys a try Leighann! Great giveaway.
Oooh, I’d love to try these with Adam. Thanks for sharing your experience with them!
My favorite nite time snack is green apples or a cup of milk & graham crackers. I did not know of these bars but I sure am going to try them out. Thanks so much for sharing.
I just heard about these last weekend at a JDRF retreat. I have been looking for them all week and have yet to locate some. I would love, love to win this giveaway! My favorite bedtime snack is cheesesticks.
blogged it:
http://mysweetestboy.blogspot.com/2011/02/couple-great-giveaways.html
My daughter usually eats cereal with milk at bedtime. But we are curious about these bars as she usually spikes around 1 am. Thanks!
I’m a big fan of Extend Snacks… they really do work…
Oh, and my favorite bedtime snack is now the PB Delight ExtendBar.