Happy St. Patrick's Day! Are you wearing green? Better yet, are you heading out to the bars after work to partake in a little St. Patrick's Day celebrating? If you're a PWD, you might want to take a few minutes to take a look at your "diabetes plan" to make sure you're set -- assuming you have a plan that actually addresses "the drink."
Even if you're not going out tonight, preparing your diabetes management plan for alcoholic beverages is very important. Alcohol, like most things with diabetes, is very dependent on the individual. Generally speaking, drinking in moderation is the keyword. I'm a California wine gal myself, and lots of it, although "lots" means maybe two or max three glasses these days. I also enjoy the odd effandvee (Fresca & Vodka) now and then -- no carbs, no headache ;) In order to find out what everyone else is doing, Allison and I invited the community over at TuDiabetes to chime in with some of their thoughts and tips on handling alcohol with the big D.
The low-sugar or diet variety of alcoholic beverages were the most common suggestions. Dry red wine was mentioned by several people as a reliable alcoholic drink. Suzanne, a PWD with type 1, says, "I only drank dry red wine since getting on a pump. I always drink it with a meal as I do notice it makes my sugar drop somewhat." Dino's drink of choice is Jack Daniels and Coke Zero, while Gerri also drinks dry red wine (never more than two glasses, she says), and sometimes she has distilled liquor. But she avoids mixed drinks and beer.
Michael Park, a 25-year-old type 1 diagnosed at age 7, says his "medical education" about alcohol was very limited. "The doctors and nurse educators shied away from the booze issue with young teens - I see this as a somewhat negligent healthcare tactic." He says in his experience, "if I drink to excess, I run my sugars high before bed. I am comfortable going to bed with sugars are 10 (180) or slightly higher. Like all beverages, I lean toward sugar free like my standard Rye and Diet." Michael adds that when eating while drinking, he does half-boluses, since, as Michael points out, "the more liquor you have in your system, the more sugar lowering effect there is."
It's also important to have an emergency plan in case the alcohol drops you too much overnight. When Kate, a type 1, was in her early 20s, she had several seizures after drinking, including a time she had a seizure after a night out as a newlywed! According to the ADA, glucagon won't help a low blood sugar from alcohol. You need to ingest glucose or someone needs to call 911 to get an injection of glucose.
No matter what you're drinking, testing your blood sugar is crucial! There's no way to know what your particular drink and food combo is doing unless you get out the meter and test frequently. Even if you're comfortable with your "drink of choice," it's important to test frequently as other variables, like food and exercise (for instance, if you're partying at a club!) can drop you or raise you unexpectedly. Monitoring using a CGM is helpful, but remember that the CGM usually has a delay and your blood sugar could drop rapidly. (Not to mention that we sometimes leave those devices home on special occassions.)
Colleen says, "Whether it's one drink or three, I always make sure to test and test often! If my [blood sugar] starts to slide down I'll have a snack, especially before bed. If I've had more than one drink, I'll usually have a good carb snack before bed and make sure to keep my meter and juice box close by. As I currently live alone, I don't usually have more than two drinks unless my boyfriend is visiting and can keep an eye on me to make sure I don't go low overnight. My CDE also suggested setting a temp basal for more than one drink--in my case turning it off for perhaps 4+ hours, depending on how much alcohol and how carb-heavy the drinks are. I've only tried this a few times so far, but it has seemed to work well."
There was some debate between some of the people with type 2 about whether or not you can drink alcohol while on pills.
Moderate alcohol consumption (about 1-2 drinks) may be appropriate, but like they say: it's best to check with your doctor to make sure you understand the risks and can keep an eye out for any side effects that may occur.
Like anything else in our never-ending struggle to stay on top of our diabetes management, it's important to stay educated. Michael adds, "To those parents who might be reading this - diabetes or not, kids will be kids. Assume that your kids will rebel against you and make sure they understand what effect that rebellion will have on their sugars!" Very wise words, for anyone at any age! Especially on March 17, celebrated each year with lots of flowing (and often green) alcoholic drinks.
Got more thoughts or tips on best practices for diabetes & drinking? Share them below, and/or with the rest of the TuDiabetes community here. Thanks, everyone!