New Years Eve is coming, and libations are often associated with this holiday. This would be an opportune time to review the effects of alcohol on diabetes.
ALCOHOL AND DIABETES
Alcohol is absorbed very rapidly and requires no digestion. It is carried in the bloodstream to the liver, where it is processed. The liver removes the alcohol from your system as fast as it can, but the process is slow. The liver can only remove the equivalent of 1 drink per hour. If you drink more than this, the alcohol builds up in the bloodstream and leads to intoxication. Drinking slowly, diluting the drink with a mix, and eating are all ways to slow down the rapid absorption of alcohol and delay its effects.
Under normal conditions, blood sugar levels are not affected by moderate use of alcohol (1-2 drinks per week). However, if an alcoholic drink contains sugar or is mixed with a sugar-containing beverage, the blood sugar may be affected.
The greatest danger for someone with diabetes who drinks alcohol is the increased risk of hypoglycemia. This happens because the liver cannot make any new glucose while it is processing the alcohol. This prevents the body its normal protective mechanism from rescuing itself if the blood sugar level falls while you are drinking. The liver’s ability to release stored glucose into the blood stream after a long period of not eating is an important protection against low blood sugars. Alcohol itself can have a delayed effect on lowering your blood sugar for up to 14 hours. One study showed that young men who drank the equivalent of 4 glasses of wine or 4 beers at 9:00 PM had low blood sugars that persisted until AFTER BREAKFAST THE FOLLOWING MORNING!
Knowing about the effects of alcohol and what to do if you are going to drink alcohol can help you make the right choices. Ideally, if you are under the age of 21, it is recommend that you do not drink. Consider being the designated driver instead. If the blood sugar levels are well controlled, it is okay for an adult to have a moderate amount of alcohol (1-2 drinks per week).
TO DECREASE THE CHANCE OF LOW BLOOD SUGARS:
• Take food with alcohol
• Do not replace food with alcohol
• Set a limit
• Have snacks if you are active
GETTING READY/PLANNING YOUR NIGHT OUT BEFORE YOU GO:
Stick to your usual meal plan during the day . Eating less during the day doesn’t mean you can “save up” for the party. Check your blood sugar prior to going out. This helps you to figure out what snacks you will need for the evening.
Tell at least 1 person (friend), preferably a non-drinker, that you have diabetes , and what to do to treat a low blood sugar (juice, candy, or soda). If you cannot swallow, your friend needs to know to call an ambulance.
WHAT TO BRING ALONG:
• your glucose meter
• identification (medical alert bracelet/necklace, wallet card) that says you have diabetes snacks (juice,
raisins, crackers and cheese)
• fast-acting sugar (glucose tablets, jelly beans, hard candy)
AT THE PARTY
Choose a mix or drink that is sugar-free (diet pop, club soda, soda water, or tomato juice). Sweet wines, liqueurs and regular mixes have lots of sugar in them and may be too much for your insulin to handle, unless you are very active (i.e. dancing).
Sip each drink slowly (to stretch it out).
Alternate each alcoholic drink with a non-alcoholic drink. This gives the body a chance to clear the alcohol out of your system. Try a wine spritzer (½ wine, ½ soda water or diet gingerale). Try to make your own drink, if possible, so that you can control the amount of alcohol in it.
Never drink on an empty stomach.
You need food to absorb the alcohol. Make sure to eat a carbohydrate containing snack (such as crackers or breadsticks), throughout the night and before bed.
Eat extra food for extra activity.
If you are active (dancing, skiing) you will use extra energy, so you need to eat extra carbohydrate-rich foods for each ½ hour of extra activity. Drink lots of water for rehydration if you are really active.
Watch for low blood sugars.
Low blood sugars and intoxication can feel the same. The only way to be certain if you are low is to check your blood sugar. Glucagon will not work with excessive alcohol consumption. Alcohol can add some extra calories to your meal plan. Do not eat less food to account for alcohols extra calories. (This can lead to low blood sugars).
AFTER THE PARTY BEFORE YOU GO TO BED:
Check your blood sugar and have a snack.
Alcohol can cause unexpected changes in blood sugar levels. They may rise initially when drinking, and then may drop several hours later. You must check your blood sugar regularly to know exactly what is going on. It is important to let someone at home know if you have had something to drink, so they can be alert to signs of low blood sugars.
Set your alarm for the usual time . Although it may be tough, it is important to take your insulin and have breakfast, so that you’ll feel good for the rest of the day.
IN THE MORNING:
• Wake up at your usual time
• Check your blood sugar
• Take your insulin
• Eat breakfast
If you are still tired you can go back to bed for a few hours after you have eaten. As tempting as it is to sleep in, not following this routine could be hazardous to your health.