An adult with type 1 diabetes wakes up at night shaking. Which action by the nurse will prevent a hypoglycemic event during the night?

• A. Increase evening insulin dose
• B. Check blood glucose at bedtime and administer a snack if low
• C. Encourage aerobic exercise before bed
• D. Give her a bedtime snack

Answer: (D)

Preventing nocturnal hypoglycemia centers on providing a steady source of glucose during sleep. A bedtime snack gives the body a slow, steady supply of carbohydrates to offset ongoing insulin action overnight, helping keep blood glucose above hypoglycemic levels while the patient is asleep. This direct preventive measure is especially important for someone with type 1 diabetes who uses insulin, because insulin can continue to lower blood glucose even after dinner.

Increasing the evening insulin dose would raise the risk of overnight lows. Checking blood glucose at bedtime and only giving a snack if low is reactive rather than a consistent preventive strategy. Encouraging aerobic exercise before bed can further lower blood glucose and increase the chance of nighttime hypoglycemia. Providing a bedtime snack consistently helps maintain glucose levels through the night, reducing the likelihood of waking with hypoglycemia.