My best friend has had type 1 diabetes for almost 15 years. While many people have tried to remind her of the importance of testing/monitoring her blood sugar levels on a regular basis, she will admit that she has only checked her blood levels a handful of times over the past few years. Over the last two years, almost every weekend, she drinks about five or six beers every Friday and Saturday night. Could that be affecting her body in any major way? Also, she has been on three medications for kidney/bladder infections. Is that related? Can you give me some advice to help my friend?

The fact that your friend does not check her blood sugars is a very bad prognostic sign for her long-term wellbeing. The standard of care for patients with type 1 diabetes is to take three or four insulin injections per day or use an insulin pump. Blood sugar monitoring should be performed at least four to six times per day. The monitoring allows feedback to determine if the insulin dose is accurate. In addition, it allows for daily adjustments that keep blood sugar control on target. That fact that she drinks on weekends cannot help keep her blood sugars in good control. The amount she drinks has a complex effect on her blood sugars. It makes her at risk for both high and low blood sugars. If you have an impact on your friend, I would have a heart-to-heart talk with her about looking into better self-care. Diabetes is the most common cause of kidney failure, blindness, and non-traumatic amputations. If she is not monitoring, she is at risk for these complications. The poor blood sugar control she has contributes to frequent infections, including bladder infections.

JTL