NNUH to launch new ‘bedtime snacks’ initiative for patients with Diabetes

Norfolk and Norwich University Hospital has launched a new ‘bedtime snacks’ initiative to aid inpatients with diabetes. This follows research showing that snacks before bed can reduce the number of hypos or low blood sugars people with diabetes have overnight which then shortens their hospital stay.

A trial was launched in 2014 providing evening snacks to patients with diabetes to help patients avoid hypoglycaemia (low blood sugar) which has in turn reduced length of stay for patients with diabetes. Hypos can be unpleasant, and sometimes frightening, they can also delay a patient’s recovery and affect someone’s overall management of their condition. The trial was so successful it will now be rolled out across all wards within the hospital.

The trial, starting as a pilot study, offered a 20g carbohydrate snack to all patients with diabetes on Langley, Docking and Cringleford ward in order to avoid incidents of hypoglaecemia, known as hypos. Patients were offered a choice of a banana, two digestive biscuits or yoghurt to eat before bedtime.

Dr Frankie Swords, Consultant in endocrinology at the Norfolk and Norwich University Hospital, said: “We know that all patients with diabetes have an increased length of stay but we’ve shown that the patients with good control throughout their admission have the lowest excess length of stay in hospital.

“The hypo snacks trial aimed to reduce the number of hypos that patients experience and in turn reduce the time they need to spend in hospital. The snacks were scheduled at bedtime because controlling blood sugars overnight is particularly difficult for patients in hospital and overall 64% of hypos at the NHUH occur at night time.

“After the trial the number of patients who had good blood sugar control throughout admission increased by 33%, so more people were brought into the lowest length of stay group. We also know that patients who did not have good glycaemic control had a length of stay which was one day longer than the average length of stay for the good control group.”

After running the trial, there were 101 fewer hypos per month in just three wards. The other results were as follows:
• 64 less night time hypos
• 33% fall in number of hypos (308 to 207)
• 38% fall in severe hypos (115 to 72)
• 33% fall in night time hypos (196 to 132)
• 33% fall in severe night time hypos (65 to 44)