Tips for Staying in Control While Consuming Alcohol

Alcohol plays a significant role in many rituals and celebrations. All weddings, for example, alcohol often flows freely for hours on end, beginning with cocktail hour and continuing through the formal champagne toast and beyond. Drinking too much alcohol is not healthy for anyone, and it can have the serious consequence of hypoglycaemia (low blood glucose).

Alcohol can cause hypoglycaemia because it interferes with the release of glucose by the liver. Normally, the liver releases glucose into the bloodstream when blood glucose levels drop, but when the liver is breaking down alcohol, that function takes precedence. Because all this potential for alcohol to cause low blood glucose, and because it takes the liver about two hours to process the alcohol from one drink you should increase the frequency of your blood glucose monitoring after drinking for about two hours per drink. Monitoring more frequently is also prudent because the intoxicating effects of alcohol car make it harder for some people to detect hypoglycaemia.

Even after your liver has finished processing your drink, however, your risk of hypoglycaemia is still higher than normal for up to 36 hours after drinking. This is because while your liver was breaking down the alcohol, it was not only not releasing glucose but it was also not adding to its stores of glycogen (a storage form of glucose). The end result is that drinking alcohol can lead to low liver stores of glycogen, and if that happens, a shot of glucagon will not raise blood glucose levels.

It is also worth noting that alcoholic beverages can raise blood glucose levels if they contain carbohydrate. Drinks that typically contain carbohydrate include beer, sweet wine, frozen drinks, and cocktails that are mixed with juice or soda.

It is a good idea for anyone with diabetes that would like to drink alcohol to talk to his health-care provider about it, particularly since the effects of some drugs can be magnified or diminished by mixing them with alcohol, even if the medicines were not taken at the same time as the drink. Certain complications of diabetes and coexisting conditions, such as retinopathy, high blood pressure, and high triglyceride levels can also be aggravated by alcohol consumption. People who have neuropathy are strongly discouraged from drinking, because alcohol can accelerate the progression of nerve damage.

Acute alcohol consumption improves insulin action without affecting beta cell secretion. That was the finding of Italian researchers who suggest this effect may be partly due to the inhibitory effect of alcohol on lipolysis, or the splitting up or chemical decomposition of fat. In their study, alcohol significantly increased insulin sensitivity in both groups.

In addition, alcohol reduced free fatty acid by 17 percent in control subjects but significantly decreased free fatty acid by 23 percent in type 2 volunteers.

If you decide to drink at a special occasion, don't do it on an empty stomach (since that raises the chances of your developing hypoglycaemia) or if you already have low blood glucose. Even if your blood glucose level is in an acceptable range, have some food with your drink.
Dr. R.M. Antuña de Alaiz
Educational Treatment Unit
education > taking control over your diabetes