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Don't drink and hypo (alcohol and DM)

Alcohol and Diabetes. Is it off limits?

When it comes to diabetes, alcohol consumption is a big topic of controversy. Is it okay? Is it not okay? And why or why not?

First and foremost, I’d like to say that it is important to consult your clinician regarding any alcohol use. That being said, I am personally a firm believer in the “everything in moderation” philosophy when it comes to my diabetes. I don’t like being told that I “can’t” do things or am restricted by my diabetes in any way. I especially don’t like being told I shouldn’t do things without being given an explanation as to why. I also try to avoid this with my patients as much as possible…

With that in mind, there are many things to consider regarding blood sugar control if you do choose to drink alcohol from time to time. First, understanding how alcohol affects your body and therefore your blood glucose (BG) level is imperative. There is a common misconception that alcohol causes hyperglycemia due to its high sugar content, however it is frequently the opposite. Alcohol has been known to cause very serious hypoglycemic events. Why?

The liver’s job is to regulate BG levels by releasing “emergency stores” of glucose when our BGs drop below certain levels. The liver’s other job is to process alcohol. High ingestion of alcohol can therefore block the liver’s production of glucose (the liver is too busy processing the alcohol to make new glucose stores). Therefore, when someone is on insulin or an insulin stimulating agent like a sulfonylurea (glipizide, glimepiride, etc.) they can experience very severe lows up to 24hrs after alcohol ingestion. Additionally, if you are taking medications that are processed by your liver, drinking alcohol can increase your risk of liver damage.

Now, if you are thinking about using alcohol to lower a high BG (I know some of you are…). Don’t! Alcohol’s effect on BG levels is UNPREDICTABLE. It therefore should not be used in this way!

Here are some sipping tips…NEVER drink alcohol on an empty stomach. This increases your risks of lows while drinking. If you do decide to drink alcohol, make sure that you have not skipped any meals and do not plan to skip them the following day (remember alcohol can affect your BGs for up to 24hrs). Also, moderate! One drink of alcohol/day may be okay, but more than one could put you at serious hypo risk. It is recommended that women should not have more than 1 drink of alcohol/day and men 2 drinks/day.

So, drink slowly! It’s not a race! Make sure to test your BG before, during, and after you drink alcohol. Do not go to bed with a low BG. Also, keep in mind that the symptoms of hypoglycemia can easily be confused with the symptoms of alcohol intoxication (confusion, fatigue, dizziness). It is always a good idea to wear a medical alert bracelet while drinking that way if you do have a hypo event, you will not be perceived as drunk, but will instead receive proper medical attention. Avoid mixed drinks high in sugar (opt for low carb or diet mixers). And lastly, DON’T DRINK AND DRIVE.

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