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Advice and Information
Alcohol: what you need to know
Alcohol has been classed as the fifth most harmful drug in the world. Why? Alcohol is strongly linked with harm to our physical health and our social wellbeing. A recent study found that it actually shrinks your brain.
The Boston School of Public Health published its Framingham study of more than 1,800 adults in Archives of Neurology. The study found that people who drank more than 14 standard drinks a week, or more than two a day, had a significant reduction in brain size. This finding was worse in women than men.
The recently released National Health and Medical Research Council guidelines state that both men and women should limit their drinks to two standard drinks a day. This is the recommendation for all adults, not just people with diabetes. People under 18 are advised not to drink, as well as pregnant or breastfeeding women.
A standard drink contains 10g of alcohol.
So how do you keep your diabetes in check when you drink alcohol? I asked some young people with type 1 diabetes about their experiences. Here are their stories (names have been changed):
Mick is 18 and likes to drink on the weekends with his mates. To help manage his diabetes, he eats extra carbs and only has an insulin bolus for half of what he eats. Most times he drinks, he’ll have about 10 standard drinks. His BGLs the next day are usually high. Through the night, he has a “wingman” – the designated non drinker for the night. This friend also knows how to help Mick do a blood glucose test. Mick doesn’t test his BGL before sleeping off the drinks (this is not recommended – see Alcohol tips for type 1).
Adam is 18 and says he isn’t much of a drinker. On the odd occasion he does drink alcohol, he checks his BGLs before eating, drinks with dinner and tests again before going to bed. He does not take any extra insulin for any carbs in the drinks. It is not generally recommended to give short-acting insulin for alcohol due to the risk of hypos.
At a recent Young People’s Group day in Sydney, members of the panel were asked about how they dealt with alcohol and their other experiences managing diabetes. They said:
“If I’m tired, drunk or fatigued, the symptoms of hypos are confused. We must all be careful and pay attention. Do a blood check when you feel odd. That way, you can treat it or rule out diabetes as the reason you don’t feel right.”
“I don’t have many nights out where I’m drinking but when I do, I take my meter with me to check my level. I eat some carbs before I drink and tend to drink low carb beer or red wine.”
“I would find when I drank that my sugars would be high on the night but quite low in the mornings. I would wake up with a ‘hangover’ feeling that was actually a hypo. These days I limit myself to a couple of glasses of wine.”
Alcohol tips for type 1
Check your BGL before going to sleep, even if you get your “wingman” to help. The test will let you know if you need extra carbs to help prevent an overnight hypo. Remember that while alcohol is being processed by the liver (approximately one standard drink per hour), it won’t be able to release its emergency store of glucose, so that if you have a hypo and don’t treat it, it can become a severe hypo.
It is important to test BGLs before bed and have a snack containing carbohydrate without a short acting bolus of insulin for it.
It is safer to have alcohol when you have had some carbohydrate foods or with a meal.
Carrying hypo treatment is essential if you are drinking alcohol. Because alcohol can make it harder to recognise and manage a hypo, it is important to have a meter handy to check your BGLs regularly.
Have someone with you who knows how to help if a hypo occurs. Hypos can occur even up until lunch time the next day. It is important to discuss insulin adjustments and drinking alcohol with your healthcare team.
Drinking alcohol needs careful management and knowledge of the possible consequences. Discuss it with your doctor or Diabetes Educator.