An Ounce of Prevention
How to Stay Safe When You Drink Alcohol
You need to take certain added precautions when you plan on having a drink or two:
- Always eat something when you drink. Have a well-balanced meal before you drink, and snack while you are out drinking. You need glucose from food, since your liver will stop producing it once you drink alcohol.
- Carefully check the alcohol level of what you're drinking. Make sure that mixed drinks are accurately measured, and be sure to account for added calories and carbohydrates in fruit juices, sodas, and other mixers. Check the proof of distilled spirits, and the alcohol level of beer and wines.
- Don't exercise before drinking. Exercise lowers blood glucose levels, and drinking will reduce them even further. Dancing counts as exercise, so think about skipping the drinks if you are hitting the dance floor.
- Be prepared for hypoglycemia. Make sure you have a high carbohydrate snack available in case your blood glucose levels dip below 65 (3.61 mmol/l) to 70 mg/dl (3.89 mmol/l). Glucagon will not help treat alcohol-induced hypoglycemia.
- Monitor, monitor, monitor. The best precaution against alcohol-induced hypoglycemia is to bring along your blood sugar testing supplies and check your levels frequently.
Pick Your Drinking Buddies Wisely
Make sure at least one friend or trusted companion knows that you have diabetes and is aware of what should be done in case of a hypoglycemic attack. And make sure they remain sober enough to do so. This is extremely important, because hypoglycemia can resemble intoxication, and others may assume you are drunk rather than suffering from a dangerous diabetic complication. Your friend should be able to recognize the symptoms of hypoglycemia (i.e., confusion, dizziness, shaking, paleness, etc.) and to get a source of fast-acting sugar, such as juice, soda with sugar, or glucose tablets or gel if symptoms occur. They should also be prepared to seek immediate medical attention if you lose consciousness or start vomiting.
After the Party
When you go to sleep after a few evening drinks, blood sugar levels may crash in the middle of the night. As a safety precaution, have a snack before bed. You should also set the alarm to wake you up after a few hours of sleep, so you can test your blood glucose and eat something if required.
When to Just Say No
Under certain circumstances, alcohol and diabetes don't mix:
- If you suffer from neuropathy, drinking can make it worse. Heavy or prolonged alcohol use can cause nerve damage (in people with and without diabetes), and even moderate drinking can aggravate existing diabetic neuropathy.
- If you have high triglyceride levels (over 200 mg/dl or 11.11 mmol/l), you should also abstain. Alcohol impairs the ability of the liver to clear fat from the blood, and increases triglyceride production.
- If you have chronic hypertension, limit or eliminate your alcohol intake. People with diabetes are already at risk for high blood pressure, and alcohol has been shown to raise blood pressure levels even further. Chronic high blood pressure can contribute to a host of diabetic complications, including kidney failure, heart disease, and retinopathy.
- A number of diabetes medications and other prescription and over-the-counter drugs should not be taken with alcohol. Check the label, and ask your pharmacist and/or physician if you are unsure.
- If you suffer from hypoglycemic unawareness, you may do better to forgo the drinks altogether. People with this condition may not recognize a low blood sugar until it is too late. Adding alcohol to this mix may serve to further this impairment.
And of course, never drink if you are pregnant or trying to become pregnant.
There are other medical conditions that may contraindicate the use of alcohol, such as liver disease, peptic ulcer, gastritis, and pancreatitis. Check with your healthcare provider if you think your medical history may have an influence on your alcohol intake.
Reviewed by Francine Kaufman, MD. 4/08
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