Diabetes and Drinking
You are at a holiday party. Everyone around you is drinking, but you have diabetes. Is it safe for you to consume alcohol? The danger is not what most people think – high blood sugar. Instead, alcohol mixed with diabetes medication, either insulin or certain pills, can lead to dangerously low blood sugar levels (hypoglycemia). Since low blood sugar produces symptoms similar to intoxication, you may be fooled into thinking you are slightly drunk when in fact you may be headed for a severely low blood-sugar reaction.
But it is OK for someone with diabetes to have a drink or two at a party if they take proper precautions. The American Diabetes Association suggests not more than one “serving” per day for women, and two for men. A “serving” is one beer, 4 ounces of wine, or 1.5 ounces of distilled spirits. So what happens if you have diabetes and you drink? Normally, your liver produces a steady supply of glucose, especially at night, when you are not eating. If you have diabetes, you take insulin and/or oral medications to lower the sugar levels in your blood. So there is a balance: The liver produces glucose and the medication keeps it at a safely low level.
But when the liver senses alcohol, it shifts function and attempts to detoxify your body by removing the alcohol from the bloodstream. Meanwhile, it is not producing sugar. So if you are taking medication to reduce your glucose levels while the liver is not producing any, you may reach dangerously low levels.
The liver can work from eight to 12 hours ridding your body of alcohol. Since these hours normally are the ones following an evening affair, your blood sugar may drop very low while you are asleep. You would recognize and treat the symptoms if you were awake, but perhaps the symptoms would not wake you, particularly after a long, tiring party at which you’ve had a drink or two.
Here are some rules to improve your chances of safe drinking:
First, at a party, always make sure someone is aware that you have diabetes and knows how to recognize hypoglycemia and help you treat it by giving you carbohydrates. Tell them not to assume you are a bit drunk, but rather know that you are having a low blood-sugar reaction. They must be told that if you appear ill or begin vomiting, you will need medical help. If you become unconscious, they should not try to feed you. Instead, they should seek medical help immediately.
Never drink on an empty stomach. Take your drink with a meal, or with snacks containing carbohydrates, such as pretzels or crackers. Prepare your own drinks, if possible, so you know how much alcohol you’re getting. Most important, drink slowly!
Avoid sweet liqueurs, drink mixes, juices or regular soda. Instead, mix drinks with diet soda, club soda or vegetable juice. But locate fruit juice and regular soda so you can reach it quickly if you need a quick carbohydrate boost.
Choose light beers over regular beer. Drink water or a non-caloric beverage between alcoholic beverages. Carry a quick-acting carbohydrate, such as three glucose tablets or candy.
Monitor your blood sugar every few hours, especially if the party includes increased physical activity, such as dancing, playing sports or swimming, that can further lower your blood sugar. Remember that even one drink may affect you differently than people without diabetes, so always have a designated driver lined up.
Have a snack before getting into bed, even if your blood sugar is slightly high. Set the alarm clock to ring halfway through the night, or have a family member wake you, to check your blood sugar. Eat a carbohydrate-containing snack if blood sugar is below 100mg/dl.
