Alcohol and Diabetes
Alcohol and diabetes
When you drink alcohol, your liver decreases its ability to release glucose so that it can clean the alcohol from your blood. Because glucose production is shut down, hypoglycaemia [low blood sugar] becomes a risk for people with diabetes, particularly if you drink on an empty stomach or shortly after taking insulin or glucose-lowering tablets. It takes two hours for just one ounce of alcohol to metabolise and leave your system so the risk continues long after your glass is empty. Even modest amounts of alcohol can have this effect.
Research carried out at the Royal Bournemouth Hospital [Diabetes Care, July 2005] showed that alcohol has been implicated in up to one fifth of hospital visits for hypoglycaemia, low blood sugars. The researchers investigated the effect of evening alcohol in 16 people with Type 1 diabetes who had normal hypo warnings and who drank alcohol on a regular basis. The participants were evaluated with continuous blood glucose monitoring on two occasions – after taking orange juice and vodka or just orange juice followed by the same meal and same dose of insulin. The participants experienced 1.3 episodes of hypoglycaemia per day during the 24 hours after the alcoholic drink compared to 0.6 episodes after a non-alcoholic drink. The researchers suggest that this research may encourage people to be more ‘proactive’ in adjusting their insulin appropriately if they are drinking alcohol.
Facts about alcohol and diabetes:
- Alcohol lowers blood glucose levels so increases the risk of hypoglycaemia (low blood sugars) not just while drinking but also over the next 24 hours or longer.
- Alcohol impairs judgement, so you may not realise that you are hypo and will not treat it with sugary food. You may also be mistaken for being drunk by others around you and so they will not offer help. Both of these situations could lead to severe hypoglycaemia.
- There may be carbohydrates in the alcoholic we drink may but these do not offset the blood sugar lowering effect of the alcohol, so they should not be counted as part of your overall carbohydrate consumption. (Remember that while Pils is a low sugar lager, it has a higher alcohol content, so it is not a good drink for people with diabetes.)
Having diabetes does not mean that you cannot drink but there are some golden rules that people with diabetes should follow:
- Only drink in moderation – sensible advice whether or not you have diabetes.
- Learn by experience how alcohol affects you – everyone is different.
- Take the appropriate steps to prevent a hypo and if necessary lower your insulin dose at the meal prior to going out for a drink.
- The best time to drink alcohol is with a meal. If you are not having a meal with your alcohol, then it is a good idea to nibble carbohydrate [eg crisps] throughout the evening.
- Never drink alcohol before a meal.
- Carry out more blood glucose tests to check for hypos for at least the next 24 hours after drinking alcohol.
- Have an extra bedtime snack before going to bed. Remember that alcohol could lower your blood glucose during the night while you are asleep, resulting in a night hypo. The alcohol may also make you sleep more soundly so that the hypo warnings may not wake you.