For many patients it is good practice to eat consistently. That translates into eating about the same amount of carbohydrate at meals and eating on a schedule. But suppose your schedule requires that you eat dinner about 8:30 or even later every night. Will that affect your blood glucose control adversely?
That’s a definite maybe! If you are a lean type 1 or type 2 and you aren’t overindulging in fats the answer is probably not. Rapid acting insulin works over a four-hour period, whether you inject it at 2 a.m. or 2 p.m. In fact, later evening (9 p.m. to midnight) repasts parallel a period of increased insulin sensitivity in many folks. That means your insulin will work better and more glucose per unit of insulin will move into the muscle cells.
But some health care providers do suggest that their patients try to limit late night indulging and schedule dinners earlier in the evening. Their rationale has to do with the eating patterns of many overweight people, especially Americans. Often later night eaters take in few calories during the day and are famished when they sit down for dinner.
This creates a situation ripe for overindulging. Without any food through the day, a 5 p.m. snack becomes a high calorie smorgasbord. When followed by a full sit down dinner around 8 p.m., it more than makes up for the calorie restraint during the day.
Now things really start to snowball because people with type 2 have a number of things going against them. High overnight output of glucose from the liver coupled with the common lack of physical activity at this time of day puts people at risk for elevated a.m. glucose readings. Add to this the use of oral medications that do not adjust to the size or composition of meals and the situation is ripe for an unwanted bump in A1C.
We aren’t suggesting that people give up eating with their families or try to change the mores of whole cultures where the dinner hour doesn’t begin until the last ray of sunshine has been long drained from the sky. But if eating a bit earlier will help rein in the hungry horrors, and that is an option for you, you may want to give it a try.
If late night meals are a permanent fixture in your life, work on making them heavy on the vegetables and light on the fat and starch. Whether you eat at 5 or 9 p.m. you can still have great blood glucose control.