Diabetes Viewpoints

Salud!
Why you have to take alcohol seriously when you have diabetes.

By Manny Hernandez

A holiday, a Friday, a celebration … there are many reasons why some of us choose to have an alcoholic drink. However, having diabetes means you need to take alcohol more seriously than those without diabetes.  As a friend of mine who lives with diabetes told me, “Having diabetes doesn’t prevent us from having fun. We just need to plan a little more.”

In most of the Latin American countries, a “drinking culture” (if there is such a thing) has very strong roots. Lots of people drink a lot and very regularly. Venezuela, where I come from, ranked second worldwide in Scotch whisky consumption after Scotland (a dubious honor, of course)! This results in strong social pressures that only add to the problem. This becomes more of an issue when you have diabetes, because alcohol typically affects blood sugar levels in a fairly visible way.

What things do I do to avoid unpleasant surprises in connection with alcohol?
I love having a glass of wine or two. Or a beer, to wrap up a long week.

If your diabetes is in control, consuming alcohol moderately (no more than two daily portions of alcohol for men and one portion for women) is not necessarily a problem. However, if you happen to have many low blood sugars or experience hypoglycemic unawareness, it is dangerous to drink alcoholic beverages, since alcohol can produce drops in blood sugar.

To make things more interesting, not all alcoholic drinks have the same effect and the same drink can have different effects in different circumstances.

For example, if you drink a piña colada or a Margarita prepared using margarita mix off the shelf, you will find the opposite effect from what alcohol normally causes to blood sugars. Due to their high carb levels, these drinks can have an impact similar to having a regular soda. It is because of this fact (and because I also like them better) that I personally prefer wine or light beer when I am having a drink.

If you have even a single alcoholic drink without eating, there is a great chance that you will make most people around you think you are drunk, even though that may not be the case. Why? Because when you have diabetes and drink on an empty stomach, this can cause severe blood sugar drops and hypoglycemic episodes can be confused with drunkenness.

The biggest danger of severe low blood sugars caused by excess alcohol or drinking without eating enough is that they cannot be treated using glucagon (if you were to lose consciousness) - only consuming carbohydrates. So, if you pass out with a low blood sugar caused by drinking alcohol, the only way to get your glucose levels back in shape is through an IV. Not fun…

If you want to have a drink occasionally, simply remember to ALWAYS test your blood sugar before you drink, while you are drinking (if you have more than one drink), after you drink, and before you go to bed. Also, remember to pop in a snack before you fall asleep to avoid overnight low blood sugars.

So, if your partner asks you to please avoid that extra drink, you know why they are telling you. Don’t argue … it’s not worth the trouble. Just change it for something else that won’t impact your glucose as much. You can still have fun!

Disclaimer
dLife's Daily Living columnists are not all medical experts, but everyday people living with diabetes and sharing their personal experiences. While their method of diabetes management may work for them, everyone is different. Please consult with your diabetes care team to find out what will work best for you.