I am an 18 year old with type 1 diabetes diagnosed two months ago, and I used to drink alcohol about once a month, but haven’t since my release from the hospital. My sugar is now under good control, and I am leaving for college in two weeks. I read about a two beer limit, but could I safely have four beers at night? I know I should stay awake for two hours after I stop drinking, and will check my sugar frequently. How do I account for the carbs in beer as opposed to hard liquor?

In order to anticipate the effect of an alcoholic beverage on your blood sugars, you have to keep in mind the kind of response it will induce. First, a beer or other beverage will have some carbohydrate and raise your sugars acutely (within the first two hours). However, after four hours, there is a pharmacologic effect of the alcohol that decreases your blood sugar by decreasing your liver’s glucose output. This will frequently cause low blood sugars during the night, as most drinking is in the evening.

The number of beers/drinks you consume is an important issue. First, the more you drink, the larger the above effects. Second, if you become intoxicated, you will have difficulty deciding whether you are suffering a low sugar versus being under the influence of the alcohol. My advice is to go slow and be in control.

JTL