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July 30, 2006

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Question from Fort Wayne, Indiana, USA:

My friend has uncontrolled type 2 diabetes. She was involved in a motor vehicle accident. When she was admitted to the hospital, her blood sugar was 484 mg/dl [26.9 mmol/L]. She is 27 and weighs 108 pounds. Just an hour before the accident, she consumed two shots of alcohol. Her blood alcohol level was 0.26. I am trying to find out if there is any correlation between her extremely high blood sugar and the conversion of the alcohol in her system. Is it possible the high blood sugar could somehow have caused her blood alcohol level to be 0.26 after only having consumed two shots of rum? That seems to be unusually high. Could her uncontrolled diabetes have caused the alcohol levels to accelerate to that degree? She is on glipizide and Glucophage along with sliding scale insulin. We would appreciate any information, as my friend does not remember driving or the accident itself. On the day of the accident, she forgot to take her insulin.

Answer:

The high level is probably the result of being consumed in a short time by a person of small body size. The alcohol is not necessarily converted into glucose. She may have consumed beverages that may have also had high carbohydrate content. In addition, with the sudden stress, stress hormones are produced that actually antagonize the effect of insulin and elevated blood sugars. These include cortisol and glucagon and epinephrine. I would be concerned that her glucose levels are not under good control. This could be answered with the hemoglobin A1c test.

JTL

[Editor’s comment: Please see a recent question on a similar subject.

BH]