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Alcohol
and
Diabetes
Alcohol is everywhere - when the
family gathers, at cookouts, after the softball game, at parties. "What
will you have?" someone asks.
If you have diabetes, what do you say?
It all depends. Start by asking yourself three basic questions:
1. Is my diabetes under control?
2. Does my health care provider agree that I am free from health
problems that alcohol can make worse-for example, diabetic nerve damage or high
blood pressure?
3. Do I know how alcohol can affect me and my diabetes?
If you said "yes" to all three, it's OK to have an
occasional drink. But what does occasional mean?
The American Diabetes Association suggests that you have no more
than two drinks a day if you are a man and
no more than one drink a day if you are a woman.
This
recommendation is the same for people without diabetes.
Your Body and Alcohol
Alcohol moves very quickly into the blood without
being broken down (metabolized) in your stomach.
Within
five minutes of having a drink, there's enough alcohol in your blood to
measure.
Thirty
to 90 minutes after having a drink, the alcohol in your bloodstream is at its
highest level.
Your liver does most of the job of breaking down the
alcohol once it's in your body. But it needs time.
If
you weigh 150 pounds, it will take about 2 hours to metabolize a beer or mixed
drink.
If you drink alcohol faster than your liver can break
it down, the excess alcohol moves through your bloodstream to other parts of
your body.
Brain
cells are easy targets. When someone talks about getting a buzz from alcohol,
this is what they are feeling.
Risk
of Low Blood Sugar
If you have diabetes and take insulin shots
or oral diabetes pills, you risk low blood sugar when you drink alcohol.
To
protect yourself, never drink on an empty stomach. Plan to have your drink with
a meal or after eating a snack.
How does alcohol
add to your chances of having low blood sugar? It has to do with your liver.
Normally, when your
blood sugar level starts to drop, your liver steps in. It goes to work changing
stored carbohydrate into glucose.
Then
it sends the glucose out into the blood, which helps you avoid or slow down a
low blood sugar reaction.
However, when
alcohol enters your system, this changes.
Alcohol
is a toxin. Your body reacts to alcohol like a poison. The liver wants to clear
it from the blood quickly.
In
fact, the liver won't put out glucose again until it has taken care of the
alcohol.
If
your blood glucose level is falling, you can quickly wind up with very low
blood sugar.
This is why
drinking as little as 2 ounces of alcohol (about 2 drinks) on an empty stomach
can lead to very low blood sugar.
When you mix
alcohol and exercise, you increase the risk of going low. This can happen
because exercise helps lower your blood sugar levels.
Let's
say you just played a couple of hard sets of tennis. You have a beer after the
match.
But
in the hours after the game, your body is still working. It is replacing the
energy your muscles used up.
To
do this, it clears glucose from the blood and adds it to the muscles' store.
This is why exercise can cause your blood sugar level to go down.
If you take insulin
or diabetes pills, they too are working to clear glucose from your blood.
Unless
you eat or your liver adds glucose to your blood, you could be heading for a
low blood sugar level.
If
you drink a beer, the alcohol will stop your liver from sending out any
glucose. Your chances of going low are even greater.
Check with your
health care provider to see if it's OK to combine alcohol with your diabetes
medications.
Low blood sugar
when drinking is less of a risk for those with type 2 diabetes who control
their diabetes with meal planning and exercise alone.
Don't Go Low
Follow these guidelines to avoid low blood sugar
levels when you drink:
· Never
drink alcohol on an empty stomach.
· Limit
yourself to 1 drink if you're a woman or 2 drinks if you are a man.
Alcohol affects your body's ability to get over a low
blood sugar level. If you have low blood sugar, you may need to treat it more
than once as time goes by.
If
you've been drinking, check your blood sugar before you go to sleep. Eat a
snack before you retire to avoid a low blood sugar reaction while you sleep.
A
warning: glucagon shots don't help severe low blood glucose caused by drinking.
Glucagon
shots treat very severe low blood glucose reactions caused by too much insulin.
Glucagon
works by getting your liver to release more glucose into your blood. But
alcohol stops this process.
You
need to be able to treat your reaction with a carbohydrate, such as oral
glucose tablets or gels. So you need to avoid letting a low blood glucose level
become severe.
If
you pass out, you will need glucose injected into your bloodstream by a health
care professional.
Heavy
drinking over time can hurt your liver. It won't be able to make glucose as
well. When this happens, your diabetes is harder to control.
Some of the signs
of drinking too much, such as confusion or slurred speech, are similar to the
effects of a low blood sugar reaction or ketoacidosis (most common in people
with type 1 diabetes who have taken too little insulin).
You may be asked
to take a blood or a breath test for alcohol if you have some of these signs.
Don't worry.
Diabetes will
not affect the results of a test for alcohol, even if you are having a reaction
or have a fruity smell to your breath because of high ketone levels.
If you are asked
to take a test for alcohol and you have a choice, choose a blood test. That
way, health care providers can check your levels of glucose and ketones, too.
Beer Belly Blues and
Diabetes
Although an occasional drink may not hurt your blood
sugar control, it can harm your eating plan if your goal is weight loss.
Two
light beers equal about 200 extra calories. Alcohol is called empty calories
because it does not give you any nutrients.
If you are on a low-calorie meal plan, think twice
about adding alcohol. In general, alcohol counts as fat servings (1 drink
equals 2 fat exchanges).
Wise Drink
Choices for Diabetics
Some drinks are better choices
for people with diabetes. Select drinks that are lower in alcohol and sugar.
If
you use mixers in your drinks, choose ones that are sugar free, such as diet
soft drinks, diet tonic, club soda, seltzer, or water. This will help keep your
blood sugar levels in your target range.
Light
beer and dry wines are good choices. They have less alcohol and carbohydrates
and fewer calories.
To
make drinks last longer, try a "spritzer." Mix wine with sparkling
water, club soda, or diet soda. Try a "virgin" Bloody Mary made
without alcohol.
When
Alcohol Is a Poor Choice for Diabetics
Some people with diabetes should
not drink alcohol. Alcohol can make some diabetic problems worse.
If
you have nerve damage from diabetes in your arms or legs, drinking can make it
worse.
Alcohol
is toxic to nerves. Drinking can increase the pain, burning, tingling,
numbness, and other symptoms found with nerve damage.
Some
studies show that even regular light drinking (less than two drinks per week)
can bring on nerve damage.
Heavy
drinking (3 or more drinks per day) may make diabetic eye disease worse. If you
have high blood pressure, you can lower it if you stop drinking alcohol.
Many people with
diabetes have high levels of the fat called triglyceride in their blood. If you
do, you should not drink alcohol.
Alcohol affects
how the liver clears fat from the blood.
Alcohol also
spurs the liver on to make more triglycerides. Even light drinking (two 4-ounce
glasses of wine a week) can raise triglyceride levels.
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