“Alcohol won’t solve your problems, but then again, neither will milk”
I grew up in the UK in the 1990’s. You could still smoke in pubs when I was having my first pint.
My local pub - The Three Blackbirds - was where everything happened. End of work drinks, Christmas Eve drinks, dates, Interviews, birthdays, wakes and anniversaries.
All of my siblings worked there at some point and I knew every single person who walked through the door. That also meant I couldn’t get away with anything. It was a home away from home.
In the UK, Australia and many other parts of the world, the local pub is the centre of the community. Having a beer or wine is a common way to relax and socialise.
So what happens when you have diabetes? Does anything change?
Well, Yes and No.
Enjoying a beer or wine doesn’t mean you‘re irresponsible as a diabetic. Having 15 vodkas does.
It is important to note (as much as I ignore this next comment) - alcohol has no nutritional value whatsoever. Your body will start to process alcohol before food and this leads to lower blood sugars. But the reality is that from a health standpoint, it brings nothing to the table.
Alcohol for a diabetic holds similar risks to a non-diabetic, as well as some more specific threats.
Having a few with your mates is not a risk, and in my humble opinion, is part of growing up and socialising, but having some ground rules will set you up for success.
1) Make sure people who you’re drinking with know you have diabetes and the signs of a hypo, not drunk.
2) Don’t drink on an empty stomach. This is extra important for a diabetic as alcohol will take effect sooner and the impact of too much booze will masquerade a real hypo.
3) Eat carbs when you’re out. Yes, this generally goes against what we say but carbs will soak up the alcohol and mean that your blood sugars are higher as you drink more.
4) Check your blood sugars often. It helps if you have a CGM or FGM but regardless, keep checking.
5) Have some food before you go to bed. This will soften the blood sugar lowering effect of the alcohol and mean you’re less likely to have a hypo overnight.
6) Drink plenty of water when out. I know. Everyone should be, but for a diabetic, dehydration is bad news.
7) Consider less Insulin (basal) the next day, as alcohol often stays in your system for up to 24 hours, and it will continue to lower your blood sugars into the next day.
8) Make sure people always know where you are going. No-one wants to be micro-managed but having some courtesy for your friends and family, and staying safe will keep everyone happy.
9) Always have some fast acting glucose on you. Preferably sweets, not a small bag of sugar.
Drunk or Low
Having a hypo is not a great feeling. The dizzy, disorientating confusion, the increasing sweaty madness that ensues as people ask you seemingly innocuous questions, only to have their head bitten off.
Oh wait, that’s drunk as well!
It’s easy to see why we get the two states confused, and it’s vitally important we can identify which one is which, because the last thing we want to be doing is forcing water down the throat of a diabetic who needs sugar.
It‘s not fun to point out the risks when drinking and being an insulin dependant diabetic, but too much alcohol can lead to blood sugars to drop quickly and alcohol can impair your judgement in treating a hypo.
Getting High On Alcohol
The opposite can also be true, as many alcoholic drinks are accompanied by high sugar mixers.
Many diabetics will choose to drink full sugar mixers with their alcohol of choice. This can be risky as it’s impossible to tell just how much your blood sugars will drop after having a few drinks. Plus, the impact of full sugar mixers can be enormous.
Over time, you’ll be able to assess how much alcohol affects your sugars and whether it’s worth the risk to accompany it with full sugar mixers, or to just have food during and after.
Personally, I don’t have carbs or full sugar mixers when out having a few drinks. I don’t drink so much that it will affect me that much (even if I did, I would have a slice of low carb toast before bed).
Enjoyed responsibly, having a glass of wine or a beer is perfectly safe and many studies suggest it can even be good for you.
One Danish study found that wine in particular was beneficial as it contains compounds that improve blood sugar balance.
Drinking through stress
For many, having a drink after a stressful day is a normal occurrence.
“When my wife was diagnosed with breast cancer shortly after I was diagnosed with diabetes, my drinking increased. Having a few beers most days of the week became normal.
Only when I truly witnessed the strength it took for my wife to manage her own disease, and on top of that inspire others did I begin to slow down drinking and take stock of what was important“.
Trying to have perspective throughout hard times is imperative to holding on to your sanity. Alcohol offers short term relief from stress, but overall will make things worse. Plus, it’s a lot harder to stay disciplined and keep your blood sugars in target range if your drinking. These factors will cause more stress.
Is there a moral to this boozy story?
Not really. Alcohol is a part of many cultures and thus needs to be respected and not abused. Diabetics have more to think about when drinking, so always be prepared and don't go crazy - the consequences can be severe.
Believe the hypo