Alcohol, even in small amounts, is harmful to health, with and without diabetes. Alcohol is a drug i. H. it can be addictive. In particular, if you are under the age of 18, there are also legal provisions on the purchase and consumption of drinks and food that contain alcohol. Alcohol may not be served to people under the age of 16. The same legal provisions apply to people with diabetes. Because of the increased risk of severe hypoglycaemia, you should also note the following things.
What does alcohol do to your body?
After drinking alcohol, part of the alcohol immediately enters the bloodstream of your body via the mucous membranes and is distributed throughout the body. Each of your organs is exposed to alcohol and can be damaged as a result. The function of the brain and liver in particular is noticeably impaired. As a result, the blood or Tissue sugar directly affected.
What happens in the brain ?
Alcohol impedes the connection between nerve cells. It can cause fatigue, silliness, talkativeness, however
also speech or perception disorders, up to aggressiveness. Even after a beer, distances are often misjudged, coordination of movement deteriorates, and reactions slow down.
What happens in the liver and stomach?
In addition to many other tasks, the liver has the function of keeping your blood sugar levels in balance.
The body stores its sugar reserves (glycogen) in the liver and constantly releases some of the sugar (glucose) into the body
bleed to keep blood sugar constant. Alcohol is broken down by the liver, which can take some time
(approx. 0.1‰ per hour). Until then, the alcohol blocks the release of glucose from the sugar stores. Alcohol also delays gastric emptying, causing carbohydrates to enter the bloodstream more slowly. The result is an increased risk of hypoglycaemia (also up to 36 hours later).
Your stomach also reacts to alcohol by irritating the stomach lining. This can make you nauseous or make you vomit.
The emergency syringe (GlucaGen HypoKit), the emergency pen Ogluo and the nasal powder (Baqsimi) are not effective enough for severe hypoglycemia caused by alcohol.
If I want to drink alcohol, what can I do to avoid hypoglycaemia?
- Alcohol in moderation means: up to 10 g alcohol per day for adult women (equivalent to 250 ml beer or 125 ml wine) and up to 20 g alcohol per day for adult men (equivalent to 500 ml beer or 250 ml wine)
- Never drink alcohol on an empty stomach, but take it with a meal containing carbohydrates
- the CU from alcoholic beverages (e.g. beer, wine, cocktails, liqueurs, punch) should not be covered with insulin because of the risk of hypoglycaemia despite the carbohydrate content
- if you drink alcoholic beverages without carbohydrates, you should also eat: 10 g of carbohydrates per drink (e.g. 10 pretzel sticks, a handful of potato chips approx. 35 g) without insulin administration
- there is a double risk of hypoglycaemia during and after physical activity such as dancing, bowling or sports;
- Eat more sports carbohydrates: at least 20-40gcarbohydrates if you consume alcohol, the evening basal insulin dose or basal rate should be temporarily reduced by up to 50% (possibly stop AID mode)
- the insulin dose may also need to be reduced the following day
- Hypoglycaemia can occur up to 36 hours after alcohol consumption (often in the morning or midday after drinking alcohol)
- if you have drunk alcohol, the blood or tissue sugar should be above 250 mg/dl (14 mmol/l) before bedtime
- If your values are below 250 mg/dl (14 mmol/l), you should eat additional carbohydrates, for example:
- below 100 mg/dl (5 mmol/l) at least 25gcarbohydrates
- below 150 mg/dl (8 mmol/l) 15gcarbohydrates
- below 250 mg/dl (14 mmol/l) 5gcarbohydrates
- correction should be made to the target of 250 mg/dL (14 mmol/L), but only if glycemic control (eg, by friends, siblings, parents) occurs over time
- remember: higher blood or tissue sugar levels harm you less in this situation and are not nearly as threatening as hypoglycaemia caused by the influence of alcohol
- check blood sugar again at night after drinking alcohol (set an alarm clock); Inform parents or friends so they know; they should know that the emergency injection does not work
- Relatives and friends should call the emergency doctor or the fire brigade on tel. call 112
- Nevertheless, be careful with blood sugar values of over 300 mg/dl (16 mmol/l): test ketones!
- eat a carbohydrate-rich meal before drinking alcohol and inject insulin for it
- drink no more than two standard glasses
- do not inject insulin for beer, wine, cocktails, liquor, shots, etc
- before going to bed, your blood sugar should be above 250mg/dl (14 mmol/l)
- Reduce but DO NOT eliminate basal insulin or basal rate
- Stop AID mode if necessary
- have good friends with you who can help you
