My boyfriend has been living with type 1 diabetes for almost 20 years, and we have had many conversations concerning the harmful effects that alcohol can have. He says that clear liquor is the preferred choice for people with diabetes, but I am concerned that he may be consuming too much. We tend to think of ourselves as “social drinkers”, but a few weeks ago, he was seriously injured after losing consciousness for a couple of minutes after a night of heavy drinking. He says it was because he did not eat anything that morning after he took his insulin shot, but I believe the alcohol was a major factor.

I am extremely concerned about my boyfriend’s present health and the irreversible damage that this behavior may be doing to his body. What advice would you give someone with diabetes who insists that a drink every now and then is okay?

I really understand your concern regarding your boyfriend and his heavy alcohol habit. Though we no longer recommend a total ban on moderate drinking for people with diabetes, this does not mean drinking until you get drunk.

In fact, when you have diabetes, you always must be able to think clearly in many situations (like taking your insulin at the right time and the right amount and being aware of not feeling well from a lack of insulin or low blood sugar). When someone is drunk or has a hangover, that person cannot do this, just as you cannot drive a car in a safe way after alcohol use. Recent studies have shown that alcohol’s role in causing low blood sugar depends to a greater extent on the diminished ability to detect low blood sugar than on restraining the liver’s ability to produce glucose (gluconeogenesis).

A safe rule, besides not drinking too much, is to always eat something at the same time that you drink. Remember that it must be “long acting” carbohydrates as the risk of low blood sugar extends into the next day/night. In fact, alcohol containing sugar (like some sweet liqueur and spirits) will initially cause a high blood sugar level for a short time, and after that, a risk of low blood sugar as well. An adult with diabetes can drink moderate amounts of alcohol if he/she eats food at the same time (e.g.1-2 glasses of wine, 1/4 ounce of liqueur) along with food will not increase the risk for low blood sugar the following night/day.

MS

[Editor’s comment: If someone’s use of alcohol repeatedly causes problems with health, employment, the law, marriage, or other relationships, then there’s alcohol abuse. See the quiz at Al-Anon’s website.

WWQ]