Is being a teetotaler the best choice?
I was wondering if alcohol affects other type 1 diabetics like it does me. I abstained for several years, but decided that I wanted to drink a glass (or 2) of wine occasionally. I’ve never smoked, did drugs or gambled in my life, so I thought, “gee whiz, I deserve an adult treat once-in-awhile”. On one hand, it’s calming to my constant worrying mind, but it can be like playing Russian Roulette. My blood glucose sometimes becomes more unpredictable and drops dangerously low. I’ve had Type 1 for almost 28 years. Could this be happening because of how long I’ve had Type 1?
Low blood sugar is a pretty normal reaction to alcohol for someone on insulin. Of course there’s a lot of uncertainty: different alcohol (wine vs beer vs mixed drinks) affects each individual differently. However, as your liver processes the alcohol, it disrupts its ability to regulate your blood sugar levels, which can cause lows.
I have type 1 friends who have chosen all different solutions to this, I think the key is finding what works for you and finding ways to mitigate it so it becomes an acceptable risk. One of my type 1 friends did warn me off of wine, because if she drinks it in the evening she almost inevitably has a bad overnight low.
From the Joslin Diabetes Center website: “Patients who are counting carbohydrates may be better off not counting the carbohydrate in alcoholic beverages since the alcohol will lower their blood glucose. However, you should count the carbohydrate in very high carbohydrate alcoholic drinks like those with mixers, fruit juice, or regular soda,” advises Staum. And of course, those people on insulin should be especially careful about having alcoholic drinks only with a meal or snack that contains carbohydrates to reduce their risk of low blood glucose.”
I enjoy wine, beer, & etc., when I feel like it, just like I enjoy ice cream cake, Chinese food, and pizza once in a while as well. I have found that alcohol, just like mixed carbs or high fat carbs, takes practice and more testing.
so if you want to enjoy your wine, test more, make more observations, and for example, have your meal and wine at lunch so you can get more observations in, and so you know better what’s going to happen over the 4-5 hours afterward.
if it’s too much trouble, or if you don’t like testing more or making your own decisions on insulin, then maybe you shouldn’t. it’s really up to you.
I have one drink, a day or two each week, regularly relaxing with friends or family. The best approach is to pick 2-3 drinks you like best and do some experimenting, one at a time. It’s easiest to pick things that are kind of measured out and carb-predictable, such as a bottle of beer, a glass of wine, or a mixed drink such as Diet Coke & Rum. If you start getting into margaritas or juice-based cocktails, the sizes and resulting carbs can really vary and throw you off, so you have to do your best guess with those. For me personally, I dose myself for any carbs in the drink up front, then about 3 hours later my BG starts to drop so I set a temporary basal rate for the next few hours. If you do not use a pump, you can always have a carby snack a little later to offset the BG decrease. The effect varies from person to person, but once you get it down for you, it’s pretty consistent. I recommend only one drink per night, because you need to keep your wits about you and avoid intensifying that effect to where it becomes problematic.
Thank you cmanton, it’s great (and very helpful) to read some advice from you and your friends with Type 1 Diabetes (why do I give this condition such importance that I capitalize it…?) LOL! Yes, wine does seem to affect me much more than any other alcoholic beverage. I’m not sure if it’s the sulfites, yeast, how easily it goes down…etc. My endo actually recommended trying a drink with vodka. Hm, don’t know how I’d handle that. I think your friend’s situation closely mimics my own. Thank you so much for sharing that with me.
Hi Joe, I have noticed that you are very knowledgeable on this site and give great advice. I think that, once again, I will become a teetotaler because I deal with so much already. Alcohol calmed my racing mind but it was my racing mind that kept on top of things and helped me be a “problem solver”. Thank you for your honest advice.
Hi angivan, you’re right about keeping my wits about me and avoiding “intensifying the effect”. I become much more lackadaisical in my type 1 control when I have imbibed (even though it helps calm my mind). I’ve been told that I should get back into yoga and some “gentle” jogging to help alleviate the emotional stress. Now that our intense heat and humidity is lessening in Minnesota, I’m definitely going to give them both an honest try.
Thank you all for your awesome advice. I take it seriously since you all understand this “condition”. Debra
I agree that everyone is different. I also want to be clear that binge drinking is not healthy nor safe for anyone, particularly diabetics. However, we can enjoy alcoholic beverages, in moderation, with some planning, experience, and education.
I recently got my first CGM, and it has made enjoying the finer things in life (alcohol, pizza, ice cream) more enjoyable. Although initially I get constant feedback from the CGM telling me my BG is too high, it helps be manage the situation better on the next attempt. And even better, I no longer feel deprived of foods or drinks that are “off limits”.
But, this is about alcohol. Here are the results of my personal experiments, and the tips/tricks I have developed to manage enjoying adult beverages with less anxiety:
I have found that (in moderation) alcoholic drinks that have 10-15g carbs or less per serving do not disrupt my BG drastically. If I have wine (~5g carbs/serving approximately), light beer (~5g carbs/serving), or liquor drinks without additional carbs, in excess (>3 in a day/night) i will experience a drop in my BG within the next few hours AND I am more likely to drop over the next 24 HOURS.
I manage by 1) eating before/during drinking 2) not bolus-ing for the carbs and sticking to lower-carb options 3) snacking before I fall asleep 4) occasionally decreasing my basal insulin the next day, and last but not least – CHECKING MY CGM EARLY AND OFTEN. I also aim to fall asleep with a higher target BG than usual (150-200) and setting my CGM low alert a little higher (90 instead of 80) than usual in case I do start to drop while i am drinking or in my sleep. Also, I am never drinking alone. I am always with a friend who knows what to do in an emergency, should one happen despite all my careful planning/preparation.
I definitely recommend testing one drink at a time, and watching what happens to your BG either with hourly finger sticks, or even better, on the CGM. That way, you can better understand how your body reacts and you can develop your own strategies.
Hi, Cetall, I will be honest enough to admit that a glass of wine (or iced vodka) helps me to self medicate. I was a teetotalor for over 10 years, but I really wondered about the meaning of life and how I can survive (and thrive) on this primitive planet with this illness. My hyper vigilance about my illness and worry about the world in general makes my life (sometimes) uncomfortable. I sometimes worry about becoming overly judgmental of others by abstaining from everything that is considered “unsavory”. I thank you for your honest and fair opinion. Thank you and I wish you the very best! Debra
I don’t drink much. If I drink a beer, I usually take an hour to finish it, if I finish it at all. How much wine do you drink? There isn’t really that much sugar in wine and alcohol. I think maybe you miscalculate your insulin or food when you drink. Different things can happen from changes in your emotions, too. i have no sense of taste, or smell and have a problem eating enough sometimes, so my “adult treat” is marijuana, because it gives me an appetite and has no carbs.