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Myth or Fact? “People with Diabetes Cannot Drink Alcoholic
Beverages.”
By A'ishah Khan, Doctor of Pharmacy Candidate, University of Florida College of Pharmacy
Before you answer this, you need to begin by asking yourself
three important questions:
1. Is my diabetes under control?
2. Does my doctor agree that I do not have any health problems which can be made
worse by alcohol?
3. Do I understand how alcohol can affect my diabetes?
If you answered “yes” to all three of these questions, then it
is unlikely that an occasional
alcoholic drink will harm you. One alcoholic drink equals:
1 ½ oz (3 tablespoons) of liquor, such as whiskey, scotch, rum, gin, or vodka
(about 100 calories)
4 oz (1/2 cup) of wine (about 90 calories)
12oz wine cooler (high in carbohydrates, about 240 calories)
Drinking alcohol responsibly is important for everyone, but it
is especially important
for people with diabetes. Four primary concerns with alcohol and diabetes are:
Alcohol can impair memory and judgment causing someone with diabetes to skip
meals and their diabetes medicine.
Alcoholic beverages typically have no nutritional value, are high in calories, and
can impede weight loss or maintenance efforts.
A low blood glucose episode may be confused with being “drunk” or “tipsy” in
someone who has been drinking alcohol. This would delay proper treatment for a
low blood glucose episode.
To begin with, there are several effects of alcohol on glucose
control in people with diabetes.
It depends not only on what you are drinking and how much, but on what you are
eating and
when you last ate.
Normally, when your blood glucose levels begin to drop too low,
your liver will convert stored
starch to glucose. The glucose is then sent out into the blood to help avoid or
slow down a
low blood sugar reaction, giving you time to recognize and treat the low blood
sugar.
Because alcohol is processed in the liver, it can interfere with the liver’s
ability to produce
glucose, which could in turn lead to hypoglycemia with little warning. In
addition, insulin, and
diabetes pills, are broken down by the liver and alcohol blocks this breakdown
making the
dose much more effective so this will accelerate the clearing of glucose from
your blood.
Unless you eat something or your liver sends glucose out into your blood, your
blood sugar
levels could go way down. Alcohol worsens this by preventing the liver from
sending glucose
out into the blood causing your chances of going low to be even greater. In
effect, it’s as if the
alcohol acts as a
(your liver) to pump fuel (glucose).
The following are guidelines to help you avoid low blood sugar
levels when you drink.
medical practitioner
Never drink alcohol on an empty stomach. Alcohol can lower blood glucose levels
even after breakfast, due to several drinks from the previous evening so eating an
additional snack or decreasing your insulin before going to bed may be necessary
Check your blood sugar levels before and after drinking to see how your body
reacts. Because alcohol affects your body’s ability to get over a low blood sugar
reaction, you may need to treat it more than once. Glucagons shots will not work to
treat low blood sugar caused by drinking. So you must treat your reaction with a
carbohydrate, such as oral glucose tablets or gels.
Avoid high sugar mixes and high carbohydrate drinks, such as daiquiri mixes,
margaritas, and slow gin fizzes, which contain sugar or syrup flavorings, juices,
and regular soda.
Your close friends should know that you are on treatment and that low blood sugar
and drunken behavior resemble each other.
To add to this, drinking may result in your judgment being
impaired. Many of the early
warning signs of low blood sugar resemble being “drunk.” Thus, your friends may
mistake low
blood sugar symptoms for effects of alcohol and may not seek help until you lose
consciousness. Your close friends should know that you are on treatment and that
low blood
sugar and drunken behavior resemble each other.
In addition, alcohol still has calories. Remember that fat has nine calories a
gram, about twice
as much as carbohydrates and protein. Well, alcohol, with 7 calories per gram,
has almost as
many calories as fat. In addition, alcohol is called “empty calories” because it
does not give
you any nutrients and counts as fat servings. These extra calories do one thing:
they add
weight, which makes your diabetes harder to control.
Also, some people with diabetes should not drink alcohol because
it can make some diabetic
problems worse. If you have health problems such as pancreatitis, high
triglyceride levels,
gastric problems, neuropathy, kidney disease, high blood pressure, eye disease,
or certain
types of heart disease, you may be advised to abstain from alcohol. If you are
in doubt as to
whether or not consuming alcohol is safe for you, check with your doctor. In
addition, drinking
alcohol has the following effects: It profoundly depresses the production of
white blood cells,
it elevates blood cholesterol, triglyceride, and uric acid levels, it elevates
blood pressure, it
increases the risk of atherosclerosis, it exacerbates psoriasis, which is
already associated
with diabetes, and it inhibits liver function.
Be aware that alcohol can affect your motivation to do even
simple tasks, from folding laundry
to monitoring your blood glucose levels. It’s important for anyone not to drink
so much alcohol
that you lose sobriety. But it’s even more important for someone with diabetes
to remain
sober. In effect, you need to be able to think clearly enough to monitor your
blood glucose
levels and to know what to do in the event of very low blood glucose.
Source: Diabetes In Control