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Alcohol and Diabetes
As a person with diabetes youre used to watching what you eat, being physically active, checking glucose levels and in some instances, giving up or drastically reducing, things you love. One of the toughest things for some people with diabetes to get a handle on is alcohol -- whether its an occasional beer with friends on Friday, a champagne toast at a celebration or a glass of wine at dinner with friends. Alcohol can be one of hardest "foods" for people with diabetes to manage because social drinking is such an omnipresent part of our culture.
Alcohol is produced by the fermentation of yeast, sugars, and starches which basically means carbs and more carbs.
Alcohol affects every organ in the body. It is a central nervous system depressant that is rapidly absorbed from the stomach and small intestine into the bloodstream. Within five minutes of having a drink, there's enough alcohol in your bloodstream to measure.
Alcohol is metabolized in the liver by enzymes. The liver treats alcohol as a toxin and works to rid the body of alcohol as quickly as possible. However, the liver can only metabolize a small amount of alcohol at a time, leaving the excess alcohol to circulate throughout the body. If you drink alcohol faster than your body metabolizes it, the excess alcohol moves through your bloodstream to other parts of your body, particularly your brain, causing the buzz". The intensity of the effect of alcohol is directly related to the amount consumed.
When blood sugar levels drop, the liver usually begins to produce glucose from stored carbohydrates to compensate. But drinking alcohol blocks the liver's ability to produce glucose. The liver will not produce glucose again until the alcohol has been processed and cleared from the body.
Some people who have diabetes can safely drink moderate amounts of alcohol, but for others any amount of alcohol intake can have negative health consequences.
There are some circumstances under which diabetics should not drink alcohol in any amount. The key for those with diabetes is to understand what conditions can be worsen if they consume alcohol.
Three basic questions to ask yourself before you drink alcohol:
Is your diabetes under control?
Do you have health problems that alcohol can make worse, such as diabetic nerve damage or high blood pressure?
Do you know how alcohol can affect you and your diabetes?
Its smart to talk with your doctor if you are overweight or have high blood pressure or high triglyceride levels before drinking alcohol. If you are in doubt about whether drinking alcohol is safe for you, or your condition, check with your doctor.
Effects of Alcohol on Diabetes
Beyond all the health and safety concerns about alcohol, if you have diabetes and are on diabetes medications that lower blood glucose, you need to practice caution. The action of insulin and some oral diabetes medications such as sulfonylureas and meglitinides is to lower blood glucose by making more insulin.
Drinking alcohol can cause a dangerous low blood sugar because your liver has to work to remove the alcohol from your blood instead of its main job of regulating your blood sugar. Alcohol can also cause hypoglycemia for 24 hours after drinking.
So, if you want to drink alcohol, eat before you drink and be sure to check your blood glucose levels periodically. You should also check your blood glucose before you go to bed to make sure it is at a safe level between 100 and 140 mg/dL. If your blood glucose is low, eat something to raise it.
The symptoms of too much alcohol and hypoglycemia can be similar sleepiness, dizziness, and disorientation. You do not want anyone to confuse hypoglycemia for drunkenness, because they might not give you the proper assistance and treatment. The best way to get the help you need if you are hypoglycemic is to always wear a medic alert I.D. identifying yourself as a person with diabetes.
Other Effects of Alcohol on Diabetes
Beer and wine contain carbohydrates and may raise blood sugar.
Alcohol stimulates your appetite, which can cause you to overeat and may affect your blood glucose levels.
Regular consumption of alcohol may increase triglyceride levels.
Alcohol may increase blood pressure.
Diabetes and Alcohol Consumption Dos and Don'ts
People with diabetes should follow these alcohol consumption guidelines:
Drink only when and if your blood glucose is under control.
Wear a medic alert bracelet that notes you have diabetes.
Test blood glucose levels before drinking alcohol.
Drink alcohol with a snack or meal. Some good snack ideas are pretzels, popcorn, crackers, fat-free or baked chips, raw vegetables and a low-fat yogurt dip.
Have a no calorie beverage like water at your side to quench your thirst.
Limit alcohol consumption to one or two drinks in a one-day period. (Example: 5-ounce glass of wine, 1ฝ ounces (shot) of liquor or 12-ounce beer).
Avoid mixed drinks with fruit juices or sugary sodas, sweet wines (muscato or ice wines), or cordials (Drambui, Galliano, Contreu).
Try wine spritzers to decrease the amount of wine in the drink.
Use calorie-free drink mixers: diet soda, club soda, diet tonic water, or water.
Be prepared always carry along glucose tablets or another source of sugar. Glucagon shots will not work with hypoglycemia caused by alcohol.
Don't mix alcohol and exercise physical activity and alcohol will increase your chances of getting a low blood sugar. Because exercise and alcohol can decrease blood sugar levels drinking alcohol immediately following exercise is not recommended.
The symptoms of too much alcohol and low blood sugar can be very similar, i.e. sleepiness, dizziness, and disorientation. You don't want others to mistakenly confuse hypoglycemia for drunkenness. Alcohol and diabetes is another reminder that it's always a good idea to wear a diabetes medical I.D.
The symptoms for alcohol intoxication and hypoglycemia are similar. Symptoms may include fatigue, disorientation, and dizziness. To ensure proper medical care for hypoglycemia, a person with diabetes should carry a card or wear an identification bracelet or necklace indicating that he/she has diabetes.
When Drinking Is Harmful
Drinking alcohol can be contraindicated if diabetics have the following conditions:
Diabetic neuropathy - Alcohol can damage nerve cells; even light drinking can cause nerve damage. For diabetics with nerve damage drinking can increase the pain, numbness, tingling or burning sensation associated with diabetic nerve damage.
Diabetic eye disease - For diabetics with eye disease symptoms, heavy drinking (more than 3 drinks per day) can make the condition worse.
High blood pressure
High levels of triglycerides
For diabetics trying to control weight gain, drinking alcohol is not a wise choice. Alcohol quickly adds calories to the diet without adding any nutritional value. Even two light beers can add 200 calories.
For type 2 diabetics, who control their diabetes with diet and exercise, rather than medication, drinking alcohol is less of a risk factor for low blood sugar.
If you choose to drink alcohol, only drink occasionally and when your diabetes and blood sugar level are well-controlled.
Updated June 13, 2013
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