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Drinking While Diabetic

A guide to safely imbibing, and knowing when to just say no

by <http://diabetes.about.com/mbiopage.htm> a Ford-

You've counted carbs, cut out candy, and even conquered the exchange

system to get a dietary handle on your diabetes, but you'll be darned if

you're going to give up what may seem like one of the few pleasures you

have left -- drinking. Whether it be green beer at the bar on St.

's day, a champagne toast at your daughter's wedding, or a glass

of wine at dinner with friends, alcohol may be the hardest "

<http://diabetes.about.com/library/weekly/aa031201a.htm#*#*> food " for

diabetics to manage because social drinking is such a pervasive part of

our society.

So is drinking acceptable if you're diabetic? The answer is yes, in

moderation, providing that you take the proper precautions. The

<http://diabetes.about.com/gi/dynamic/offsite.htm?site=http://www.diabet

es.org> American Diabetes Association (ADA) asserts that alcohol can be

incorporated into a diet plan, provided that blood sugar control is

already well established and

<http://diabetes.about.com/library/weekly/aa031201a.htm#When to just say

no#When to just say no> other conditions that aren't compatible with

alcohol consumption (such as pregnancy or certain

<http://diabetes.about.com/cs/complications/index.htm> diabetic

complications) don't exist.

How it works

When you drink, your liver stops making glucose so that it can instead

clean the alcohol from your blood. Because glucose production is shut

down, <http://diabetes.about.com/cs/hypoglycemia/index.htm>

hypoglycemia (low blood sugar) becomes a risk for diabetics,

particularly if you drink on an empty stomach or shortly after taking

insulin or glucose-lowering oral medications. And because it takes 2

hours for just one ounce of alcohol to

<http://diabetes.about.com/gi/dynamic/offsite.htm?site=http://silk.nih.g

ov/silk/niaaa1/publication/aa35.htm> metabolize and leave your system,

the risk continues long after you've emptied your glass.

A two drink maximum

For individuals with well-controlled diabetes, alcohol intake should

follow the same guidelines the United States Department of Agriculture

(USDA) has established for the general population. This means a maximum

of two drinks per day for men and one drink daily for women. (A higher

alcohol intake is allowed for most men because

<http://diabetes.about.com/gi/dynamic/offsite.htm?site=http://silk.nih.g

ov/silk/niaaa1/questions/q%2Da.htm%23question16> women have a lower body

fat content and also metabolize alcohol more slowly.)

One drink is defined as:

* 12 ounces of regular beer (150 calories)

* 5 ounces of wine (100 calories)

* 1.5 ounces of 80-proof distilled spirits (100 calories)

[One drink equals 2 fat exchanges; regular beer is an additional 1

starch exchange.]

An ounce of prevention

You need to take certain added precautions when you plan on having a

drink or two:

* Always eat something when you drink. Have a well-balanced meal

before you drink, and snack while you are out drinking. You need glucose

from food, since your liver will stop producing it once you drink

alcohol.

* Carefully check the alcohol level of what you're drinking. Make

sure that mixed drinks are accurately measured, and be sure to account

for added calories and carbohydrates in fruit juices, sodas, and other

mixers. Check the proof of distilled spirits, and the alcohol level of

beer and wines.

* Don't exercise before drinking. Exercise lowers blood glucose

levels, and drinking will reduce them even further. Dancing counts as

exercise, so think about skipping the drinks if you are hitting the

dance floor.

* Be prepared for hypoglycemia. Make sure you have a high

carbohydrate snack available in case your blood glucose levels dip below

65 to 70 mg/dl. Glucagon will not help treat alcohol-induced

hypoglycemia.

* Monitor, monitor, monitor. The best precaution against

alcohol-induced hypoglycemia is to bring along your

<http://diabetes.about.com/cs/glucosemonitoring/index.htm> blood glucose

monitor and check your levels frequently.

Pick your drinking buddies wisely

Make sure at least one friend or trusted companion knows that you are a

diabetic and is aware of what should be done in case of a hypoglycemic

attack. This is extremely important, because hypoglycemia can resemble

intoxication, and others may assume you are drunk rather than suffering

from a dangerous diabetic complication. Your friend should be able to

recognize the

<http://diabetes.about.com/gi/dynamic/offsite.htm?site=http://onhealth.w

ebmd.com/conditions/condctr/db/item%2C106007.asp> symptoms of

hypoglycemia (i.e., confusion, dizziness, shaking, paleness, etc.) and

to get you a snack high in carbohydrates or glucose tablets or gel if

symptoms occur. They should also be prepared to seek immediate medical

attention if you lose consciousness or start vomiting.

After the party

When you go to sleep after a few evening drinks, blood sugar levels may

crash in the middle of the night. As a safety precaution, have a snack

before bed. You should also set the alarm to wake you up after a few

hours of sleep, so you can test your blood glucose and eat something if

required.

When to just say no

Under certain circumstances, alcohol and diabetes don't mix:

* If you suffer from neuropathy, drinking can make it worse. Heavy

or prolonged alcohol use can cause

<http://diabetes.about.com/gi/dynamic/offsite.htm?site=http://thriveonli

ne.oxygen.com/medical/library/article/000714.html> nerve damage (in

diabetics and in non-diabetics), and even moderate drinking can

aggravate existing diabetic neuropathy.

* If you have high triglyceride levels (over 200 mg/dl), you

should also abstain. Alcohol impairs the ability of the liver to clear

fat from the blood, and increases triglyceride production.

* If you have chronic hypertension, limit or eliminate your

alcohol intake. Diabetics are already at risk for

<http://diabetes.about.com/gi/dynamic/offsite.htm?site=http://www.hearti

nfo.org/news2000/diabbp070500.htm> high blood pressure, and alcohol has

been shown to raise blood pressure levels even further. Chronic high

blood pressure can contribute to a host of diabetic complications,

including

<http://diabetes.about.com/library/weekly/library/blNIHkidneydis.htm>

kidney failure, heart disease, and retinopathy.

* A number of diabetes medications and other prescription and

over-the-counter drugs should not be taken with alcohol. Check the

label, and ask your pharmacist and/or physician if you are unsure.

* If you are practicing tight control, you may do better to forgo

the drinks altogether. Tight control and the impaired judgment that

comes with intoxication is a recipe for disaster. In addition, since

tight control means you are fairly close to normal glucose levels,

hypoglycemia may occur more quickly.

And of course, never drink if you are planning to drive any type of

motorized vehicle (automobile, boat, snowmobile, even dog sled!), or if

you are

<http://diabetes.about.com/gi/dynamic/offsite.htm?site=http://silk.nih.g

ov/silk/niaaa1/publication/brochure.htm> pregnant or trying to become

pregnant.

There are other medical conditions which may contraindicate the use of

alcohol, such as liver disease, peptic ulcer, gastritis, and

pancreatitis. Check with your healthcare provider if you think your

medical history may have an influence on your alcohol intake.