Impact of different protein composition of bedtime snack on prevention of nocturnal hypoglycemia in older patients with type 2 diabetes mellitus
Objective To evaluate the impact of different protein composition of bedtime snack on prevention of nocturnal hypoglyce-mia in older patients with type 2 diabetes mellitus,and to provide reference for glucose management in this population.Methods Three hundred older patients were randomized to one of two groups,with 150 in each.Their glucose level at bedtime(22:00)was measured using a continuous glucose monitoring system and if it was between 4.0 and 5.6 mmol/L,9 g of low-protein biscuits(containing 1.3 g protein)were given for the control group,while high-protein substitutions(20 g of milk powder dissolved in 100 mL of water containing 6.6 g protein)were given for the intervention group.The incidence of nocturnal hypoglycemia and the next-day glucose levels were compared between the two groups.Results The incidence of nocturnal hypoglycemia was 3.75%in the in-tervention group and 12.50%in the control group,showing significant difference(P<0.05).The mean amplitude of glycemic ex-cursion,time in range,time below range,as well as the rates of these parameters during the target range were significantly better in the intervention group compared with the control group(all P<0.05).Conclusion Consuming a high protein bedtime snack can effectively reduce the incidence of nocturnal hypoglycemia in older patients with type 2 diabetes and improve next-day glycemic con-trol.
older patientsdiabetesnocturnal hypoglycemiabedtime snackglycemic controlproteinnutrientsdietary care