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.
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?
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
- Blender Bottle
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.