I am 77 years old and was diagnosed with type 2 diabetes 20 years ago. I drink two drinks of vodka and water per day. At family gatherings where I consumed more than my usual two drinks, is it possible that my blood sugar got so low that I might have had blackout periods?

Yes. Alcohol has a rather complicated effect on blood sugars. First, it has the effect of raising blood sugars as a result of the beverage with which it is consumed. If you leave out the carbohydrates and use only water, there are no real carbohydrates there. However, after about three or four hours, the pharmacoloic effect of the alcohol has the effect of decreasing the liver’s production of glucose. The magnitude of the effect is proportional to the amount of alcohol consumed. Some of my patients have had severe hypoglycemic effects with alcohol. The hypoglycemic episodes are likely to be more severe with insulin and sulfonylureas as these medications increase insulin levels.

JTL