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guide to alcohol and diabetes

Ultimate Guide to Alcohol and Diabetes

19/6/2016

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If you are reading this post then it's likely you may be concerned about how alcohol negatively affects your diabetes. The topic of alcohol and diabetes is undoubtedly an area of interest and concern for many people living with diabetes and perhaps their loved ones too. In this post, we aim to answer many of the questions you will have about this important topic and then outline steps you can implement to ensure your choice to consume alcohol is not overly risky to your health.
Many people enjoy to relax by enjoying a cold alcoholic beverage, and people living with diabetes are no exception to this rule. And let's not forget that many people develop diabetes well into adulthood, so habits involving alcohol consumption have been well established by this point.
Discovering you suffer from diabetes may seem like a death sense for your social life, but we assure you this is not the case.
What does alcohol contain that affects diabetics?
Not all alcoholic drinks contain carbohydrates. However, some alcoholic drinks do contain carbohydrates. Many alcohol producers provide inadequate labelling when it comes to the number of carbohydrates their products may contain. Thus, we advise you to consult the Internet before you choose to purchase a brand of alcohol you are unfamiliar with. This ensures you do not choose an alcoholic beverage high in carbohydrates.
Beer has a tendency to increase sugar levels. This is especially the case if you drink more than one or two pints. In contrast, wine tends to contain less carbohydrates than popular beers. This means wine has less of an effect on blood sugar levels than beer. Spirits contain a negligible amount of carbohydrates and therefore, should not push blood sugar levels up. If you consume spirits with a mixer, you will need to consider the number of carbohydrates contained within that mixer and the effect this could have on your blood sugar levels.
Can people with diabetes drink alcohol?
Although people who live with diabetes are able to safely drink alcohol, you still need to be mindful of the amount of alcohol you can safely consume. If you have been diagnosed with diabetes later in life, it's essential you realise your diabetes now imposes set limits when it comes to the amount of alcohol you consume.
When you suffer from diabetes, there are some additional risk factors you really must be aware of which we outline below.

Risk factors when people with diabetes drink alcohol
Health problems arising from mixing alcohol with diabetes range from minor to severe, depending on the health condition of the diabetic person concerned. Whilst people suffering from both type I and type II diabetes may safely consume alcohol, there does exist some increased risk factors you must be aware of. Below we outline five major risk factors and then outline several measures you may take to mitigate these risks to safe levels.
Risk #1: Low blood sugar
The most serious risk factor when you consume alcohol is that you could 'bottom out' with a low blood sugar. Many people may assume alcohol increases blood sugar levels when the reverse is true. Normally, when your blood sugar is low, the liver raises your blood sugar by releasing glucose via its glycogen reserves. However, alcohol prevents the liver from performing this essential task. This risk is also complicated when certain diabetes medications such as sulfonylureas and meglitinides are consumed with alcohol. This is because, like alcohol, these medications also lower your blood sugar levels by increasing the secretion of insulin. This may result in hypoglycaemia.
Alcohol is thus similar to insulin in the way it affects the blood. This is because alcohol can stop the liver from being able to raise blood sugar levels. One of the liver's key functions is to produce glucose. This glucose provides essential energy needed to sustain life. However, the liver is also responsible for metabolising alcohol. When you consume more alcohol than your liver is able to metabolise, the excess alcohol enters your blood and moves into all areas of the body.
Since the liver knows alcohol is toxic to the body, it prioritises the metabolization of alcohol. Whilst the liver is attempting to metabolise all of the alcohol in your blood, its capacity to release glucose is restricted. This results in a drop in glucose levels. This may develop into a life-threatening condition known as hypoglycaemia.
Therefore, many people living with diabetes find that after drinking alcohol their blood sugar levels begin to drop. When you suffer from diabetes, it's important to recognise when you are experiencing low blood sugar and ensure you correct this by eating a starchy snack.
If you live with diabetes and drink alcohol, it's also essential you test your blood sugars (glucose) at frequent intervals, particularly before, during and after you consume alcohol. A blood sugar level considered safe is between 100 and 140 mg/dL.
Alcohol can induce hypoglycaemia up to 12 hours following the consumption of just a few alcoholic drinks, so these risks continue even when you’ve ‘sobered up’.
It’s thus vital that you are able to recognise the symptoms of low-blood sugar/hypoglycaemia.
The symptoms of hypoglycaemia include:
  • Drowsiness
  • Disoriented
  • Feeling dizzy
Unfortunately, many of hypoglycaemia’s symptoms are similar to those experienced when you are drunk. This may cause you or your friends to dismiss these symptoms, concluding you are simply drunk. Again, to combat this confusion, we urge you to take your blood glucose count at regular intervals and inform your friends of this risk.
Risk #2: Weight gain
Another risk factor when you consume alcohol is excess calories. Simply because an alcoholic drink does not contain carbohydrates is not a green light to drink as much as you wish. One pint of beer may contain the same number of calories as one slice of pizza. This is particularly a risk factor for those of you who live with type II diabetes. Many people living with type II diabetes are also overweight. Weight gain increases both triglycerides levels and high blood pressure.
Risk #3: Organ damage
Alcohol is also capable of damaging major organs such as the heart, liver, pancreas and stomach. Since people with diabetes are more susceptible to organ damage, you may want to limit your alcohol intake for this reason alone.
Risk #4: Neglecting your medications
When you are drunk, you must consider whether you will be in a fit state of mind to look after your insulin pen, your glucose metre and your medication. Remember that only a small amount of alcohol is required to seriously affect a diabetic’s cognitive state.
Risk #5: Long-term risks for heavy diabetic drinkers
Additional risks associated with heavy alcohol use and diabetes include:
  • The onset of acute pancreatitis. This further hinders the pancreas' ability to produce insulin
  • Damage of nerve cells already adversely affected by diabetes
  • Eye disorders such as glaucoma
  • The onset of diabetic ketoacidosis

6-step plan to reduce these risks
Below we outline six steps you may take to reduce the above risks when you choose to consume alcohol.
Risk mitigation factor #1: Eat starchy foods before you drink
Eating something before you drink alcohol will slow down the digestion and absorption of alcohol. Remember that alcohol decreases blood sugar levels, so it's important to slightly increase your blood sugar levels by eating starchy foods during and after you've drunk alcohol. We urge you to never drink alcohol on an empty stomach.
Good snacks to eat while you are drinking alcohol include:
  • Popcorn
  • Vegetables
  • Pretzels
  • Baked potato crisps
Never drink alcohol where food is not readily available. It's also essential you eat something before you go to bed. This ensures your body has enough glucose available whilst your liver metabolises the alcohol in your blood.
Risk mitigation factor #2: Let people around you know that you have diabetes
Let people know you suffer from diabetes. Or more importantly, tell your friends what to do if something goes wrong. This lets them react accordingly if something bad does happen to you. This information also allows your friends to tell medics that you have diabetes so they know how to treat you correctly.
Furthermore, we recommend you always carry some kind of ID on your person that states you are a diabetic, such as a card, necklace or bracelet. Also, inform security and bar staff that you suffer from diabetes. Otherwise, if you pass out due to low blood sugar, people may conclude you are 'just wasted' due to the alcohol. Informing people of your diabetes helps to reduce this risk. Be careful not to separate from your group of friends in case you pass out and require their assistance.
Risk mitigation factor #3: Drink within the Government's recommended limits
If you are a man or a woman, the Government recommends you do not consume more than 14 units of alcohol a week. If you wish to consume 14 units, you are urged to spread these units over three or more day. The guidelines also recommend you do not consume more than 2-3 units of alcohol a day.
Risk mitigation factor #4: Never be overconfident with your ability to drink alcohol
Unfortunately, even if you are careful about regulating your blood sugar, mixing diabetes and alcohol can always present unpredictable medical conditions. Thus, risks are increased when you are overconfident about your ability to mix alcohol with your diabetes. This over-confidence may mean you are not vigilant because ‘you've done this before many times over.’ Unfortunately this over-confidence could induce a life-threatening low blood sugar if you are not ultra-careful when you drink alcohol.
Risk mitigation factor #5: Monitor your blood sugar even once you’ve gone to bed
Once you've drunk alcohol, your blood sugar levels may crash many hours after you have last consumed alcohol. This could occur when you are asleep, a condition known as nocturnal hypoglycaemia. We thus recommend you wake up during the night in order to monitor your blood sugar levels. This prevents a dramatic crash in blood sugar levels whilst you are asleep. Because you are asleep, this crash may go undetected which could be fatal. Set your alarm to ensure you awake to conduct your blood count. We recommend you test your blood sugar levels at two hour intervals. If your blood sugar levels drop, get out of bed and make yourself a starchy snack. This may seem inconvenient but implementing this routine could save your life.
Also, ensure you eat breakfast in the morning.
Risk mitigation factor #6: Drink alcoholic beverages that are low in sugar
We recommend you stick to light beers or dry wines because they contain less alcohol and sugar than heavier beers and sweet wines. If you use a mixer, use diet coke or diet lemonade.

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    Paul Clarke

    With thanks to Paul who is an Addiction worker and Blogger at ADT Healthcare in the UK

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