Systematic literature review: should a bedtime snack be used to treat hyperglycemia in type 2 diabetes?

Background Consuming a bedtime snack is often recommended for people with type 2 diabetes. Objective This systematic review aims to evaluate the evidence from intervention studies to determine whether consuming a bedtime snack improves fasting hyperglycemia and/or overall glycemic control in individuals with type 2 diabetes. Methods PubMed, Medline (EBSCO), Cochrane Library, and CINAHL Plus (EBSCO) databases were searched until 20 July, 2022. We included prospective studies in people with type 2 diabetes or prediabetes that included the intervention of a bedtime snack, consumed >30 min after dinner and Results The systematic review included 16 studies. There was no consistent relationship between consumption of a bedtime snack and improved glycemic control, especially when a no-snack control was included. Of the 4 studies that included the use of corn starch, a low dose seemed to have benefits over high-dose corn starch in terms of improved nocturnal and fasting glucose concentrations. Conclusions Current advice to consume a bedtime snack is based on a limited number of intervention studies that often do not include a no-snack control, nor have used a feasible bedtime snack option that could be translated into everyday clinical practice. Further research is needed in type 2 diabetes patients treated with or without insulin. This review was registered at the Prospective Register of Systematic Reviews (PROSPERO) as CRD42020182523.

Automated summary

This systematic review evaluated the relationship between consuming a bedtime snack and glycemic control in individuals with type 2 diabetes. The review included 16 studies and found no consistent evidence supporting the benefits of consuming a bedtime snack. Further research is needed to explore the effects of different types and dosages of bedtime snacks in patients with and without insulin treatment.