Diabetes Month Tip of the Work Day--Part Two

Question

What about alcohol? I've gotten a lot of different "opinions" on this one.

Answer

You've probably gotten a lot of different opinions on this one because a) the consumption of alcohol has a huge social/societal component to it, and many of us in healthcare let that color our answer, sometimes more than we should and b) people with diabetes have a lot of things to consider before they take that first drink. I've included a list of considerations below.

*Moderate drinking to maintain good health is defined as no more than two drinks maximum for a larger person and one drink a day for a smaller person.  

1. Is my blood glucose level in what I consider good control or poor control?
1. For people that already have blood sugar levels well above goal or tend to “swing” wildly; you probably shouldn’t add empty calories and extra carbohydrate into that mix.
2. Do I have any other conditions that do not mix with alcohol?
1. Many people with diabetes have other conditions like kidney disease, neuropathy, congestive heart failure, etc that are aggravated by alcohol consumption and might be better off avoiding it.
3. Do I take any medications that do not mix with alcohol?
1. Again, many people with diabetes will taking other medications that do not mix well with alcohol.  Ask your provider or pharmacist about your medications if you can, as the internet might give you a lot of seemingly conflicting information too.
4. Do I have access to food for when I take that first drink of alcohol?
1. Our bodies engage in many wondrous complex regulatory processes, including a process called gluconeogenesis, which allows the liver to store glucose and release glucose into the bloodstream when your blood glucose levels drop.  Alcohol can hinder that same process and cause the blood sugar to drop if you drink on an empty stomach.  
2. On a related note, if you have diabetes and are going to be drinking with friends or family, make sure they know that you need to eat with alcohol.  That way if your food intake is delayed, and you become “wobbly,” your friends can remind you to check your glucose instead of just assuming you are tipsy. Keep easily chewed and swallowed carbohydrate sources with you, and make sure you are wearing your medic alert bracelet or necklace.
5. How many extra calories and carbohydrate grams am I getting?
1. Most alcoholic beverages do not have a label on them to tell you this—so again, yay for the internet (calorieking.com) and smartphones to help you figure this information out. Again, planning ahead before you go out to a place that doesn't have good internet service is a good idea.
2. In general, dry red wines and lite beers have only 2-4 grams of carbohydrate and distilled liquors (like vodka) have none. You still have to count the calories though.
3. Mixed drinks (like margaritas) will often have the most calories and carbohydrates.
6. What is my past experience with alcohol/can I truly moderate my drinking?
1. Have you had trouble stopping after one or two drinks in the past?  Did a fun night of drinking result in a hospital visit?  Probably not a good idea for you personally to be drinking then.

Se you tomorrow for some information about exercise!