Hallee Acquanita
MS, RDN, LDN, CDCES
There is a lot of information and ideas on whether people with diabetes should eat snacks or should not. But, there are many factors that can affect whether or not a snack may be a good idea for you.
What Time is the Snack?
Primarily, if you are ever having hypoglycemia or low blood sugar, a snack is necessary to bring blood glucose up to a safe level. Typically, a low blood sugar is less than 70mg/dl. The “Rule of 15” has become standard for the treatment of low blood sugar: Eat 15 g of quick-acting carbohydrates and wait 15 minutes for blood sugar to rise to a safe level. Treatment may be repeated as needed. A snack may also be needed with exercise depending on the type and risk for hypoglycemia.
Eating a snack at other times of the day other than snacks deemed necessary has long been debated by the diabetes community. Many recommend for maintaining blood sugar and satiety that people should eat every 3 to 5 hours. When blood sugar drops, it signals more energy is needed and we may become hungry. After a balanced meal, insulin levels in the body typically take about 3-5 hours to bring our blood sugar back to pre-meal levels. So, if you will be going longer than 5 hours without a meal, you may want to consider adding a snack. However, there is a need for further research on meal frequency and how to best incorporate snacks.
Those in favor of intermittent fasting will point to the fact that continuous glucose excursions will lead to increased insulin levels in the blood, which in turn increases insulin resistance and fasting glucose, and may promote weight gain. More research needs to be done for conclusive evidence but correlations have been made that decreasing the window of time when one eats, including snacks, may aid in weight loss, improve fasting blood sugars, and decrease the risk of cardiovascular disease.
Eating a snack at bedtime should also be considered. The Dawn Phenomenon is a natural rise in blood glucose levels that happens in the early morning due to the release of hormones to start waking up for the day. For those with diabetes, there may not be enough insulin available to counteract the rise in blood glucose leading to elevated fasting blood glucose. In a systematic review of over 16 different studies, there was no clear consensus on whether eating a bedtime snack is more preferable than not eating a bedtime snack for managing blood glucose levels, including fasting blood glucose levels, in those with type 2 diabetes. It is common to hear that not having a snack can lead to low blood sugar during the night. However, if diabetic medications are causing low blood sugars overnight, they may need to be adjusted with the help of your healthcare provider.
Also, following a typical routine or schedule may also help with blood sugar management. Studies show that following a routine eating schedule may make blood sugar management easier compared to no eating routine3. Overall, The timing of a snack can have a significant impact on blood glucose levels, and it is important to consider when planning a snack.
What is in the Snack?
The composition of a snack can also impact overall nutrition quality and how blood glucose reacts. Including high-fiber carbohydrates in your diet has been found to be helpful in managing blood glucose levels. Fiber is a type of carbohydrate that does not fully digest and therefore does not cause a large glucose response. Fiber is found in plant foods such as whole grains, fruits, vegetables, lentils, nuts, and seeds, and including them as part of a snack can increase daily dietary fiber intake, which is correlated with better blood glucose levels overall.
Pairing protein, such as lean meats, eggs, and low-fat dairy, with carbohydrates slows digestion and the glycemic response of the carbs, leading to blood glucose levels not rising as high and not dropping as quickly. Dietary fats, such as avocado and nuts and seeds, also have the ability to do so, but protein-based snacks may provide more satiety. Choosing snacks that include high-fiber carbohydrates, lean protein, and high-quality fats may lead to a more satisfying snack and prevent blood sugars from rising quite so high.
What about a Sweet Treat?
Sweets have long been considered a big no for people with diabetes. But, due to advancements in diabetes management, dessert can definitely be included in a well-rounded nutrition plan. However, moderation is important and you may consider choosing a sweet treat that is high in fiber or pair the simple sugar with protein or fat for less of a blood sugar spike.
Ideas for foods that may make a great snack option include:
The Big Picture
If you want to regularly eat snacks, then eat them, if you don’t, don’t. There is not enough research currently to definitively say eating or not eating snacks is best for managing diabetes. Eating in a way that you find satisfying, works with your schedule, is compatible with medications, provides adequate nutrients, and still leads to successful blood sugar management is what is important to any nutrition plan. This can be challenging to navigate, so working with a Registered Dietitian knowledgeable about diabetes can be a great resource for evidence-based nutrition advice. The Certified Diabetes Care and Education Specialist (CDCES) means they have advanced specialized training in diabetes care and are knowledgeable on the other factors of diabetes that may impact diet choices.
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