Alcohol and diabetes
In Australia, the legal drinking age is 18 years of age.
In order to use alcohol wisely and safely, it is important
to understand how your body handles it. Alcohol is absorbed very rapidly and
requires no digestion. It is carried in the bloodstream to the liver, where it
is processed (detoxified). 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, which leads to intoxication (drunkenness). Drinking
slowly, diluting your drink with a mix, and eating are all ways to slow down
the rapid absorption of alcohol.
Under normal conditions, blood glucose levels are not effected
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
glucose may be effected.
The greatest danger for someone with diabetes who drinks
alcohol is the increased risk of developing hypoglycaemia (low blood glucose).
This happens mainly because the liver cannot make new glucose while it is
processing alcohol. This prevents the body’s normal protective mechanism from
kicking in if the blood glucose level falls while you are drinking. The liver’s
ability to release glucose into the blood stream when you haven’t eaten for a
while is an important protection against low blood glucose. Alcohol can have a
delayed effect on lowering your blood sugar for up to 14 hours.
Knowing about the effects of alcohol and what to do if you
are going to drink can help you make the right choices. Consider being the
“designated driver”! If blood glucose levels are well controlled, it is okay
for an adult to have a moderate amount of alcohol (1–2 drinks per week). If you
have any questions or need help planning for a special occasion, your doctor,
nurse or dietitian is available to help you.
Remember: being responsible doesn’t mean you can’t have a
good time!
TO
DECREASE THE CHANCE OF LOW BLOOD GLUCOSE LEVELS:
- 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.
Remember your food/insulin balance!
- Check your blood
glucose 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 glucose (juice,
lollies, or lemonade). If you can’t swallow, your friend needs to call an ambulance.
WHAT
TO BRING ALONG:
- your
glucose meter
- identification
(medical alert bracelet/necklace, wallet card) that says you have diabetes
- snacks
(muesli bars, crackers and cheese)
- fast-acting
sugar (glucose tablets or jelly beans)
AT THE PARTY
- Choose a mixer or
drink that is sugar-free
(diet soft drink, club soda, soda water).
Sweet wines, liqueurs and regular mixers 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, clubbing) 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 drunkenness can feel the same. The
only way to be certain if you are low is to check your blood glucose. Glucagon
will not work with excessive alcohol consumption.
- Alcohol can add
some extra calories to your meal plan.
Do not eat less food to make up for the extra calories. (This
can lead to low blood glucose levels).
You
don’t want to drink too much, but if you do…
…make sure someone stays with you who can help you check
your blood glucose levels every 3–4 hours and help you decide what to do if
your blood glucose levels are low. Alcohol can have a relaxing effect and dull
your judgement. Be sure to take your meals/snacks on time. If you are not
careful, you could go unconscious!
AFTER THE PARTY
BEFORE
YOU GO TO BED:
- Check your blood
glucose levels and have a snack.
Alcohol can cause unexpected changes in blood glucose
levels. They may rise initially when drinking, and then may drop several hours
later. (Alcohol has delayed effects on lowering blood glucose, even up to 14
hours after drinking). You must check your blood glucose 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 that they can be alert to signs of low blood
glucose levels.
- 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
glucose
- Take your insulin
- Eat breakfast
If you are still tired you can go back to bed for a few
hours. As tempting as it is to sleep in, not following this routine could be
hazardous to your health.
ONE
DRINK EQUALS:
- 45
mL hard liquor = 1 shot
- 360
mL beer = 1 bottle/can
- 150
mL wine = 1 glass
For more information:
Diabetes
Australia: Alcohol information
NDSS: Alcohol fact sheet
This page was developed with thanks to the BC Children’s
Endocrinology and Diabetes Unit: http://endodiab.bcchildrens.ca