Diabetes Type 1 and Alcohol

What is type 1 diabetes?

Someone is said to have type 1 diabetes when the person’s body is unable to produce the required insulin (a hormone which helps the glucose in the blood to get into the cells for us to have some energy) the body needs to control blood glucose. However, it is possible to manage type 1 diabetes by taking insulin everyday to keep blood glucose level in check.¹

Usually, the immune system (the system that fights infection) of a person with type 1 diabetes begins to attack cells in the pancreas, which is responsible for producing insulin. Since the cells of the pancreas are being destroyed, the production of insulin diminishes or stops. Consequently, without insulin, glucose will not get to the cells where it is used for energy, making the glucose level in the blood high.²

The effects of alcohol on blood sugar levels

One of the important functions of the liver is to regulate blood sugar levels. Taking alcohol impacts this liver function and hinders its abilities to regulate glucose release into the blood. Also, when you take alcohol, the secretion of insulin increases in your body, making your blood sugar low. This is also called hypoglycaemia. Hypoglycaemia results in fatigue, lightheadedness and other associated alcohol problems. Therefore, excessive drinking is dangerous especially for persons with diabetes. For persons with  medications that can cause hypoglycemia, taking alcohol will make the medicine less effective as well. 

Drinking on empty stomach can lead to hypoglycaemia

You can be at risk of hypoglycaemia when you drink alcohol on an empty stomach, as it allows the alcohol to pass directly into the bloodstream.³ It also hinders the liver from performing the function of releasing glucose into the blood as it is supposed to. Notably, heavy and binge drinkers are more likely to suffer from this condition because they mostly drink on an empty stomach. 

Moderate drinking with a meal raises blood sugar

Having a meal with a drink can help to reduce the spike in the blood sugar levels the alcohol might cause. According to a study, taking moderate alcohol and a meal neither increased nor decreased the blood sugar level in diabetic patients.⁴

Is it safe to drink when you have type 1 diabetes?

If you have type 1 diabetes, it is okay to drink alcohol but not in excess. Excessive drinking of alcohol may lead to hypoglycemia for as long as 24 hours. Also, it is unsafe to drink alcohol on an empty stomach when you have type 1 diabetes, and it is important to check your blood sugar regularly.

Drinking in moderation is usually safe if you regularly take your insulin

It is safe to drink in moderation on insulin, but you must monitor your blood glucose levels. However, it is advisable not to drink more than 14 units a week to reduce alcohol-associated risks, such as blood sugar reactions. Although alcohol and insulin do not interact directly, the possible reaction involves how the body handles the blood sugar after drinking and if the diabetes treatment will become complicated. 

Be careful when drinking alcohols containing sugars

Alcohol is derived from sugar and starch, which translates to a high-calorie content; therefore, taking alcohol increases sugar intake. When you take alcohols containing sugar - such as beer, sweet wine and cocktails - you are further increasing your sugar consumption. Excessive sugar intake leads to obesity, diabetes, cancer and heart disease.

Hypoglyceamic unawareness

This is a term used to describe a situation where a person is unaware that their blood glucose is low and may not know that they should treat it. When you are unaware of your blood sugar level, you put yourself at risk of having severe low blood glucose reactions. Hypoglycaemic unawareness may cause death in sleep or affect critical tasks such as driving. It is vital to check your blood glucose levels regularly or speak with a health care provider to provide guidance on how to raise your blood glucose target to reduce the risk of hypoglyceamia.

If you’re worried about your or your loved one’s alcohol intake

If you are worried about your alcohol intake, it is a good sign that you are ready to get help. Firstly, you need to see your GP to discuss available treatment or services. The GP may assess your alcohol intake to determine how to help you get better and check if the drinking level has reached a dangerous stage. There are also a number of support or charity groups which can support and give counselling for your drinking habits. 

On the other hand, if you are worried about a loved one’s alcohol intake after you have noticed some signs such as incessant drunkenness, sleep problems, lack of control over alcohol intake, depression and anxiety, it is best to talk to them about it. While this might be tricky or sensitive, alcohol dependence may affect the person’s mental or physical health. You can talk to them when you see that they are in a good mood or in a comfortable and safe place. Begin the discussion with positive words and supportive language. At this point, do not be judgmental and avoid criticising or using labels. 

Summary

Heavy alcohol consumption can cause or aggravate type 1 diabetes. Therefore you need to take caution about how much you drink to prevent alcohol-related disease.