The Effects of Alcohol on Diabetes
Awareness includes knowing when and how to get help
Do you like a beer or two after a long day at work? Or a glass of bubbly to celebrate some good news? Drinking alcohol is a part of many of our cultures, and depending on your relationship with it, can be one of life's pleasures…or one of its pains. April is Alcohol Awareness Month, so this article looks at the effect of alcohol on diabetes, how to spot the signs if you're drinking too much, and how to get help.
Alcohol and Diabetes
Many people with diabetes enjoy drinking alcohol and there is no need to give up unless you want to. Whether you have diabetes or not, healthy (American) guidelines generally recommend a limit of 1 drink per day for women and 2 drinks per day for men. One effect of alcohol on diabetes is hypoglycemia (low blood glucose levels). Drinking alcohol makes these more likely to occur, so the following tips can help reduce the chance of you having a hypo and keep yourself safe whilst drinking:
• Have something to eat before / at the same time as you drink alcohol as drinking on an empty stomach means it will be absorbed too quickly into your bloodstream.
• If you drink more than a few drinks during an evening, you will have an increased risk of hypos all night and into the next day too, as your liver continues to get rid of alcohol. A tip that many find useful is to snack on a starchy food, such as cereal or toast, before going to bed to help minimize this risk.
• Avoid low-sugar (sometimes called ‘diabetic') beers and cider. Although they contain less sugar, their alcohol content is usually much higher.
• Low-alcohol wines are often higher in sugar than ordinary ones, so if you do choose these, just stick to a glass or two.
• Remember that those around you could confuse a hypo with being drunk as, unfortunately, many of the ‘symptoms' are the same! Do let people you are with know that you have diabetes and what help you might need if you have a hypo. Also, make sure you carry some ID to let others know you have diabetes, such as an ID card, medical necklace or bracelet.
So what turns the pleasure and enjoyment of drinking alcohol into alcohol dependence? Alcohol dependence is characterized by at least three of the following signs over a 12-month period:
• A need for markedly increased amounts of alcohol to achieve intoxication or desired effect; or markedly diminished effect with continued use of the same amount of alcohol
• Drinking to relieve or avoid withdrawal symptoms
• Drinking in larger amounts or over a longer period than intended
• Persistent desire or one or more unsuccessful efforts to cut down or control drinking
• Important social, occupational, or recreational activities given up or reduced because of drinking
• A great deal of time spent in activities necessary to obtain, to use, or to recover from the effects of drinking
• Continued drinking despite knowledge of having a persistent or recurrent physical or psychological problem that is likely to be caused or exacerbated by drinking
Dependence on alcohol is extremely common. The World Health Organization estimates that there are 140 million people with alcoholism worldwide. The biological causes are not fully understood, but psychological and social factors such as family history, mental health difficulties, environment, stress, gender, age, and ethnic group can all affect the risk of developing dependence on alcohol.
We know that the physiological effects of alcohol help people to ‘disconnect' from stressful situations, and can be a way of coping with difficult emotions. Consequently, the effect of alcohol on diabetes is not the only thing to be concerned about. There is also the effect on others. Some people with an alcohol difficulty don't realize they have a problem, and that their problem can affect those around them as much — sometimes even more — than the individual themselves.
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Many people say that depression is a side effect or complication of diabetes. Without discounting the association of the psychological condition with the physical one, I'm not convinced that our high and/or unstable glucose levels are directly responsible for that change in our mental state. My belief is that the unrelenting need for self-care, for following the sort of care schedules that can drive licensed, professional caregivers crazy, is what overwhelms us...