Got questions about navigating life with diabetes? Ask D'Mine! Our weekly advice column, that is — hosted by veteran type 1, diabetes author and educator Wil Dubois. This week, we're talking more with "Uncle Wil" about drinking alcohol with diabetes (!), and some issues on pen needle re-use and burning calories, even while watching TV.

{Got your own questions? Email us at AskDMine@diabetesmine.com}

 

Amanda, type 1 from Washington, writes: I read with great interest your advice on teen drinking, and I have a related question for my "Uncle Wil." As a young person, I often find myself in social situations where drinking is almost required to fit in. I don't really care to get drunk myself, but it's hard enough fitting in with diabetes as it is -- I don't want to look like a prude. What can I do? And I know I can count on you not to tell me to just be myself and not worry about what other people think. That's not realistic. Got any tips for your niece who doesn't want to get too tipsy?

UncleWil@Ask D'Mine answers: Like an orgasm during bad sex, fake it. (I hope to hell you're 18, or I could go to jail for writing that.) Look, it's easier than you'd think to pretend you're drinking when you're really not, because people pay a lot less attention to other people than you think they do. So long as you have something in your hand that looks like a drink, you're good to go. Your options for fitting in include "nursing" a drink for hours, or going to the can to dump most of a drink down the toilet and get a "refill," or drinking a diet soda and pretending it's full of vodka when it isn't. A paper umbrella or a lime is good mixed-drink camouflage for diet soda. I bet you could even smuggle an alcohol "free" beer into the kegger in your bra along with your insulin pump.

If you're at a bar or a night club scene, you have the option to choose drinks that have less alcohol over drinks that have more. Betcha didn't know that even beer can run the gauntlet from almost no alcohol by volume, to as much as whiskey. For instance, Bud 55 has 2.4% alcohol, while Sam Adams Triple Bock has 17.5% alcohol. That means you'd have to drink seven Bud 55s to get as much alcohol as you'd get out of one Sam Adams Triple.

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Worried that people will ask why you're drinking a light-weight beer? I doubt very much that will happen, but your cover story is you're watching your weight. Bud 55 is low in calories, too. (Check out this site, which is slightly anti-drinking, but has the best beer database I've seen.) Brewskies actually range from a low of 0.4% alcohol for O'Dule's up to 32.0% for Tactical Nuclear Penguin, with a common range being between 3-10%.

Choice matters.

I'm more of a wine and whiskey guy myself—not generally at the same time of course—but suddenly I'm having an odd urge to try a Tactical Nuclear Penguin! While I'm at the bar, can I get you another faux rum and Coke?

Riva, type 1 from New York, writes: OK, got the HumaPen Luxura, got the cartridge in, it's a beautiful color and feels nice in my hand, but taking the pen needles off and on for each shot is driving me mad. It makes the whole insulin pen thing seem as laborious as vial and syringe. Really, do I have to do this? I know the theory is air bubbles will form in the cartridge if you don't. Really? I only dose on average between a half and 3 units anyway. What does the master say?

Wil@Ask D'Mine answers: I use a single BD Nano needle all day long on my Luxura. Who the hell has time to change the stupid

things? They hold up just fine, and I take at least five shots a day with it, sometimes more.

Yes, you'll get some bubbles leaving the needle on, especially if you make a lot of changes in altitude or temperature during the day. So what? If you angle the pen so the bubbles float upwards towards the plunger, and aren't near the needle hub, it won't affect the dose. I tap the bubbles to the top about once a week and shoot 'em out. Just so they won't mess with me.

In theory, the air in the cartridge can degrade the insulin a bit, but I've not experienced this. It doesn't affect us when we "inject" air into vials, right? So I'm thinking that's an urban myth created by the people who want to sell us more needles.

Oh, but do please take the time to re-cap the needle with the little inside cover. Without that, sometimes the pens can syphon dry. Removing the needle sheath for a shot and putting it back on only takes a sec. (I pull mine off with my teeth and hold it there while I shoot.)

Now if we can just get BD to flavor that needle sheath...

 

Kevin, type 2 from Montana, asks: How many calories a day do I have to cut to lose weight? I know food labels are based on a 2,000 calorie a day diet. Do I need to cut to 1,500 or to 1,000 to lose weight?

Wil@Ask D'Mine answers: Little known fact: Even sitting on your bum [W1] in front of the TV takes a boatload of energy. Medically, this is called your basal metabolic rate, or BMR, the amount of fuel needed to keep your heart beating, lungs breathing, your kidneys filtering, and pancreas pumping.

It's a stunning percentage of your daily calorie intake. For instance, mine is 1756. That means it takes a hair over 1700 calories for me to sit in front of my computer raising my whiskey glass to my lips. That only gives me a spare 249 calories to play with when looking at the standard 2K a day diet, even if I hardly move.

You can check your own BMR here.

The lesson here is that our margins are very thin indeed, and that we need quite a few more calories than you'd think just to breathe. So assuming that you're not gaining weight right now, the answer is that you only need to cut a few calories to lose weight. That forces your body to burn some fat. In fact, if you eat only ten fewer calories a day than your body burns, you'll lose a pound in a year. What's ten calories?

Half a single Nacho Cheese Dorito.

Two baby carrots.

Three-quarters of a Zesta cracker.

Two Ghirardelli chocolate chips.

It doesn't take much. What? You want to lose more than a pound next year? OK, cut 100 calories a day instead and you'll drop ten pounds. All ya gotta do is cut 10 chocolate chips and five Doritos a day, and ya got it made.

 

This is not a medical advice column. We are PWDs freely and openly sharing the wisdom of our collected experiences — our been-there-done-that knowledge from the trenches. But we are not MDs, RNs, NPs, PAs, CDEs, or partridges in pear trees. Bottom line: we are only a small part of your total prescription. You still need the professional advice, treatment, and care of a licensed medical professional.

 
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This content is created for Diabetes Mine, a consumer health blog focused on the diabetes community. The content is not medically reviewed and doesn't adhere to Healthline's editorial guidelines. For more information about Healthline's partnership with Diabetes Mine, please click here.