Drinking and diabetes
You probably read or heard a lot of things about drinking and diabetes. I wanted, however, to write an article about it to share my personal experience with that subject since it took me a while understanding what my body needs when drinking alcohol.
When you think about university, sure you think about books, libraries, and midterms, but you also think about alcohol. I would say that for me, the period where the subject of diabetes and drinking would apply the most would be when I was in college! Sure I am still drinking from time to time now, but let’s say that drinking wine from time to time is far different than drinking beer during frosh week. When I started university, I didn’t think that I would be going out that much but I did, so that meant beer, beer and beer! The thing about beer is that it has carbs so you need to be careful when drinking too much! I look back at those times and I think: damn those were good times, but I also think: how the hell did I manage my diabetes during those times!! I used to go out and drink, put insulin only once and then didn’t even bother putting more afterwards. I would also eat late at night (oh those good late night meals) and I would put the same determined amount of insulin that I used to put every time, without even calculating the carbs, and then I would go straiiight to bed! I would have hypos the next day and I would just drink juice every time I had them. Sometimes I look back and wonder how I was managing everything this way and I can’t even understand, even now! I don’t want to regret what I was doing, but I am just thankful that nothing serious happened to me. Back then, it was easier for me because I was still feeling my hypos really strongly, but even so, I am still very thankful!
In my opinion, we all need a little phase to go crazy, not worrying about this disease that is on our mind 24/7. However, the key to alcohol consumption while having diabetes is moderation. I am not saying you can’t drink, but just be careful about the amount that you are taking, and it is also important to have someone with you who knows that you have diabetes. When I used to go out in college, I had close friends who knew I had diabetes, but I don’t think they knew what were the signs of hypos and what they would have to do if I go very high or low. Fortunately, they didn’t have to react to any incident, but now when I go out, my friends around me, or even my boyfriend, know the symptoms and always keep an eye on me and my Dexcom to see where my numbers are heading. Being drunk and being low almost feel like the same thing, so it is important that you check your BG level often because sometimes you would think that you are tipsy but really, you’re just low! It is also important to eat something before drinking, that way you won’t get drunk too fast and your inhibitions won’t be lowered too fast.
Drinking and hypoglycemia
Why does alcohol bring the blood sugar down? Well if I can summarize everything in a sentence, I would say that when you drink alcohol, your liver is too busy filtering your drinks and it doesn’t secrete the same amount of glucagon as it would usually do into your blood. In my case, I get a lot of hypos a couple of hours after drinking, and especially the next morning. I get more hypos if I go out dancing since it is like exercising. That’s why it’s important to adjust your insulin accordingly to what you are drinking, and to what you are doing. I used to drink alcohol with juice and wouldn’t put insulin for my drinks because I was dancing. To be honest, I don’t know how that worked out because I would only check my BG the next morning (I still can’t believe how I did that!!) buuut now that I am more responsible and that I have my friend Dex with me, I put insulin when drinking fruity drinks, but I put a little less if I might be dancing. This reduces the chances of hypoglycemia.
An important thing to do also is to keep juice boxes and candies on your night table when you go to sleep after a night of drinking since the hypo effect can happen overnight, so it is better to keep something close to you. Oh and keep a LOT of water too to stay hydrated!
I have an insulin pump so I also set a temporary decrease in my basal insulin overnight to reduce the risks of hypos. I also put my Dexcom alarms really loud because we tend to have a deeper sleep when we have alcohol in our system. For those who don’t have a Dexcom, just make sure to check your BG level right before going to sleep!
What to drink
It is important to know how every kind of drink can affect the blood sugar. For me, I don’t drink strong alcohol anymore. I feel like I get sick right away so I try to avoid that, but just know that this kind of alcohol (vodka, rhum, tequila, etc.) doesn’t have carbs, but it’s the kind of alcohol that tends to get you drunk faster so be careful when drinking that (remember, the key is moderation), and unless you drink it with juice or in a drink, you don’t need to take insulin for strong alcohol, like when taking a shot.
Beer can be kinda tricky because it depends if you’re having one beer, or if you’re drinking beer while let’s say you’re playing beer pong. I calculate 10g of carbs for one beer, and I put insulin right before drinking, and sometimes I know that I’m going to have 3 beers so I calculate my insulin for 30g. However, each time is different because it all depends if I’m eating, on my BG at the moment, on how long I am going to drink. You just have to work by error/trial.
Now my favorite drink: wine! I almost don’t drink anything else than wine now. It gets me in that happy, laughing mood, while being aware of what’s going on around me and aware of some low or high symptoms. I used to put insulin when drinking wine but I don’t anymore (I listened to my nutritionist) because I was always going low 2-3 hour after drinking wine. My BG level usually stays in a normal range now, except if I have a lot of insulin on board, but my candies are always here to help me when that happens!