What is a safe approach to nocturnal hypoglycemia prevention in a patient with type 1 diabetes?

• A. Increase evening insulin dose
• B. Skip dinner
• C. Give a bedtime snack
• D. Monitor blood glucose periodically during the night

Answer: (C)

A bedtime snack provides a small, steady source of glucose during the overnight fast, counteracting the continuous action of basal insulin in type 1 diabetes. By supplying slow-digesting carbohydrates (often with some protein or fat), it helps keep blood glucose from dropping too low during the night without causing a rapid rise or a large rebound later. This preventive approach directly reduces the risk of nocturnal hypoglycemia.

Increasing the evening insulin dose would raise the chance of overnight lows. Skipping dinner removes carbohydrate intake and can worsen overnight lows if insulin is continued. Monitoring during the night is helpful for detecting lows, but it’s reactive rather than preventing them; it doesn’t stop hypoglycemia from occurring.