How Social Drinking Imapcts Diabetes

People with diabetes should be particularly concerned about drinking, because alcohol can worsen some of the complications of diabetes. First of all, alcohol impacts the liver in doing its job of regulating blood sugar. Alcohol can also interact with some medications that are prescribed to people with diabetes. Even if you only rarely drink alcohol, talk to your doctor about it so that he or she can prescribe medications appropriately.

The Physiological Damage caused by Alcohol that makes it a health risk in Diabetes.

Our liver is the organ that makes glucose from the food/drink (Glucogenesis), stores it as glycogen, and then breaks it down (Glycogenolysis) providing energy & fueling cells when you are not eating. The liver is also responsible for cleansing the body of toxins, hence does not recognize alcohol as food. Instead, it sees it as a drug and a toxin. When alcohol is in the system, the liver changes gears and begins to detoxify in an attempt to get rid of the alcohol. In a non-diabetic individual, the body regulates these processes smartly, and maintains the glucose levels in a narrow range. However, in a person with diabetes, this function is compromised making the body go into a state of dangerously low glucose levels called Hypoglycemia. Unfortunately, the liver cannot do both jobs - detoxification and secreting glucose at the same time.

On an average, the liver can only break down one drink of alcohol per hour. So when you drink alcohol, your liver has to work hard to remove it from your blood instead of working to regulate blood glucose, thus decreasing the liver's capacity to make new glucose. Since the blood glucose is already low, consuming alcohol with diabetes, further aggravates the hypoglycemia which could lead to more serious issues like seizures, coma, or even death.

Consuming Alcohol with a Meal

If you have a meal rich in carbohydrates and consume alcohol at the same time, there will be an exaggerated response in insulin or acute insulin sensitivity. This means the cells start absorbing sugar from the food more rapidly than normal leading to a significant reduction in both glucose and insulin levels eventually resulting in hypoglycemia due to decreased gluconeogenesis.

Varied effects of Alcohol based on the quantity and time of consumption

Alcohol has different effects, based on when and how it is consumed - on an empty/full stomach, the sugar content of the mixer (juice/soda) and the percentage of mixer used in dilution. alcohol consumption can lead to reactive hypoglycemia.

Heavy Drinking

Alcohol consumption can not only interfere with blood sugar but also with the hormones needed to maintain healthy blood sugar levels. Heavy drinking can lead to higher rates of insulin resistance and unpredictable glucose regulation and reduce the overall effectiveness of insulin over time.

Binge Drinking

Binge drinking is when a person consumes large quantities of alcohol in a very short time duration For example, having 4-5 drinks within 2 hours is considered binge drinking and can lead to lasting impairment of metabolic fitness and putting the individual at a very high risk of Type-2 Diabetes.

Can Alcohol interfere and react with any medications I'm taking?

• ‍Diabetes Medication : There are certain pills for diabetes, such as sulfonylureas, that work by telling the pancreas to keep making insulin all the time. Normally this is a great thing, but if you aren’t eating anything or if your liver isn’t making any glucose because it is busy cleaning out the alcohol, your blood sugar can drop. Unless you are eating food, the insulin continues to be produced andcauses your blood sugar to plummet. This can happen very quickly if appropriate actions are not taken.

• ‍Other Medications : Alcohol should not be ingested if you are on antihistamines, beta blockers, antidepressants, pain medications, or antibiotics. Talk to your doctor about your medications and their interactions with alcohol.

Do's and Don'ts of Alcohol Consumption when you have Diabetes

         DO’S

• Check your sugar before drinking, while drinking, and after drinking.
• Look at the label to know the amount of alcohol and nutritional content of each beverage.
• Sip your beverages very slowly and keep yourself well hydrated by drinking plenty of water.
• Eat well before and during drinking or carry a snack with you, as food will slow the effects of alcohol.
• Be honest with your doctor and health coach about what you are drinking and how often.

        DONTS’

• Do Not drink if your blood sugar level is not under good control - or is too high or low - or is unstable (rising and falling quickly).
• Do Not count alcohol under your daily carbohydrate count
• Do Not participate in any physical activities while drinking without eating, as they may lower your blood sugar even more
• Do Not drink on an empty stomach. The stomach will absorb alcohol faster this way
• Do Not adjust or omit your medications without talking to your doctor

Bottom Line

From the point of view of effective diabetes management and knowing the metabolic effects of alcohol on blood sugar regulation, it just makes sense not to consume alcohol at all. But if you absolutely must drink to enjoy a rare social occasion or celebration, make sure you choose a low carb drink and remember to monitor your blood sugar levels. While there are some alcoholic beverages that are better than others, just remember that regardless of their carb content, all alcoholic drinks contain empty calories and are considered toxic by your body. Taking charge of your health should always be your number one priority. Read more about medications for diabetes.