Late-evening snacking may worsen nighttime glucose patterns in young children with T1DM. A study published in Nutrition & Diabetes found that small carbohydrate bedtime snacks reduced overnight time in range and did not protect against hypoglycemia.

This randomized controlled crossover trial enrolled 28 children aged 5–8 years with T1DM receiving multiple daily injection therapy. Participants consumed 10 g of carbohydrate as milk, yogurt, or kefir 150–180 minutes after dinner on three separate nights, along with one control night without a snack. Continuous glucose monitoring (CGM) assessed TIR (70–180 mg/dL), TBR (<70 mg/dL), and other metrics for 6 hours post-snack. Trial nights were stopped if glucose rose above 300 mg/dL or fell below 70 mg/dL.

Pre-snack glucose values did not differ significantly across groups (P = .548). Overnight TIR was lower during snack nights (34.7% milk, 38.7% yogurt, 45.9% kefir) than the control night (75.5%, P < .001). TBR remained similar across all conditions (P > .05). Of 112 trial nights, 13 ended early due to hyperglycemia and 3 due to hypoglycemia.

These results indicate that routine bedtime carbohydrate snacks may impair overnight glucose control without reducing hypoglycemia frequency in children with T1DM.