Diabetes may make you give up some things you like. Is drinking alcohol one of them? Can you drink safely, and if so, how?
There are reasons to drink. Many studies show that moderate drinking reduces the risk of getting Type 2 diabetes and the risk of dying of heart disease. Moderate is defined as two drinks a day for men 65 and under and one for women or men over 66. (A drink is considered to be 12 ounces of beer, 5 ounces of wine, or 1.5 ounces of spirits.) More than that seems to erase the health advantages and cause other health problems.
Drinking wine, beer, or stronger spirits has a long tradition in many cultures and families. You might like the way it feels; you might want to be sociable; you might want to forget your cares. If you forget about diabetes, though, there can be serious consequences.
Low blood sugar
The big concern is that alcohol can drive your sugar level down too much. Researchers in Sweden found that alcohol increases circulation to certain parts of the pancreas and causes more insulin to be secreted.
At the same time, the liver is distracted by the need to process alcohol and doesn’t release glucose when glucose levels are going too low. The result can be severe hypoglycemia.
To avoid hypos, the American Diabetes Association (ADA) counsels, “Women should have no more than one drink per day. Men should have no more than two drinks per day… Practice caution when drinking.”
Limiting drinking can be done by sipping slowly. “Savor it and make it last,” says the ADA.
There are some additional ways to make drinking safer. Test your sugar before you start to make sure your glucose is high enough. Do not drink on an empty stomach. Always have food when you drink, especially if you are on insulin, sulfonylureas (brand names Orinase, Tolinase, Diabinese, Amaryl, Glucotrol, Glucotrol XL, Diabeta, Micronase, and Glynase), or meglitinides (Prandin, Starlix).
Because of its effect on the liver, alcohol can make sugar go low for a full 24 hours. Test sugars frequently after you drink.
The ADA warns people not to go sleep with a blood sugar below 100 if they have been drinking. If your glucose goes below 100 before, during, or after drinking, eat something.
Sugars can also go up, because alcoholic drinks such as beer and sweet wine contain a lot of sugars. ADA suggests light beers instead of regular and mixing drinks with sugar-free mixers like club soda.
Making bad decisions
Alcohol can hurt you in other ways. It’s a gateway to more dangerous drugs and to doing stupid things that can make you sick or get you killed.
Alcohol can dim your perception that you’re going low. It can cause you to eat more than you want or eat things you normally wouldn’t. It can lull you into skipping checking your glucose when you really should check, or it can make you physically unable to test. It can interact with your medications.
Drinking makes driving and sometimes other activities dangerous. It leads you to say “yes” when you would be better off saying “no.”
Some of these risks can be avoided by remembering to eat and having a levelheaded friend or loved one with you to back you up. Of course, you’ll need to listen to your friend’s advice.
Other important safety tips
• Hydrate — drink water, iced tea, or diet soda between or with drinks.
• Wear an I.D. that notes you have diabetes and have friends with you who know about your diabetes. This matters because the symptoms of low blood sugar — including sleepiness, dizziness, and confusion — resemble being drunk. People have been hauled to jail and some have died because their hypoglycemia was mistaken for drunkenness.
• Do not drive or think about driving for at least several hours after you drink alcohol. You don’t want to drive drunk or go low behind the wheel.
Some people highly value the social lubrication that alcohol provides. If you’re one of them, you may not want to give up drinking, but please do it carefully. If you remember to eat, test, and moderate intake, you can drink safely and have some fun without obsessing about it.
Living with diabetes can cause occasional, justified bouts of anger, but there’s a constructive way to deal with the experience, says Type 1 veteran Scott Coulter. Bookmark DiabetesSelfManagement.com and tune in tomorrow to learn more.
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