See Tino's Diabetic Supplies Website.
ALCOHOL AND DIABETES... considerations
Part of this information was condensed from the Good Health Eating Guide (Canadian Diabetes Association) by:
Tino Montopoli, B.Sc.Phm., Certified Diabetes Educator. (You can reach Tino at STUTT'S PHARMACY, 5344 Main St., ORONO,
905-983-5009 OR at 1-888-678-8887)
A recent study at the University of Wisconsin (JAMA Jul 99 Vol 282 No 3) has shown that light to
moderate (1 to 2 servings per day) alcohol consumption may reduce the risk of coronary heart disease in patients
with Type 2 diabetes by 80%. While this statistic is very impressive it is suggested that one should discuss with
their physician, the issue of drinking alcohol because of individual variations in the disease process. I thought a
discussion of some of the considerations and precautions would be helpful in understanding other issues
concerning alcohol consumption.
Alcohol in any form (wine, beer, hard liquor) may cause a low blood sugar reaction (less than 4.0mmol/l)
which is also called hypoglycemia. This is a serious problem and needs to be treated right away. The way you act
when you have low blood sugar could make people think you’re drunk. In this situation, you might not get the
help you need. It is advisable to tell a friend you have diabetes. Also tell your friend how you feel and act when
you have a low blood sugar reaction and what to do if you need help.
LOW BLOOD REACTION IS TREATED WITH 15 GRAMS OF GLUCOSE OR SUGAR . SOME EXAMPLES ARE -3 BD GLUCOSE TABLETS, 1/2 CUP FRUIT JUICE, 1/2 CUP REGULAR SODA POP, 3 CANDIES, 3 TEASPOONS OF TABLE SUGAR, HONEY OR SYRUP.
To avoid a low blood sugar reaction it is best to have an alcoholic drink with food. NEVER DRINK ON AN
EMPTY STOMACH. If you want to drink before dinner, have an appetizer like bread sticks, bread or crackers.
Remember to include the food you eat before or with your drink as part of your meal plan.
Also remember that alcohol has calories. If you are trying to watch your weight, you should know that alcohol
adds extra calories to your diet.
one regular beer === 1 slice bread + 2 fats===150 calories
one light beer ==1/2 slice bread + 2 fats===112 calories
4 oz dry wine === 1 & 1/2 fats === 63 calories
1 fat choice = 1 teaspoon butter = 1 teaspoon margarine = 1 teaspoon vegetable oil
If you treat your diabetes with pills such as glyburide (Diabeta), gliclazide (Diamicron), tolbutamide (Orinase),
chlorpropamide (Diabenese), acetohexamide (Dimelor) or any other member of the sulfonylurea family, there is a
possibility of a reaction with alcohol which may result in flushed skin, sensation of warmth, giddiness, sweating,
dizziness, nausea and vomiting. The above reactions are more commonly found in those who take
chlorpropamide & alcohol, but may occur with the others listed above. If you experience this reaction, you should
avoid alcohol.
Other tips and precautions...
DON’T DRINK AND DRIVE
wear ID or Medic Alert bracelet
never drink alcohol on an empty stomach
drink in moderation
test your blood glucose before & after consumption of alcohol (with a blood glucose meter)
bring your own snacks in case none are available
bring your own glucose tablets or candies or juice in case of a low blood sugar reaction
stick to your usual meals & snacks & insulin/medication schedule
tell a friend you have diabetes
avoid liqueurs (too sweet) and sweet wines and watch what is mixed into (mixed drinks)
if you’re going to be active during your night out (eg dancing, skating etc), you will use up extra energy
which can lower your blood sugar. You might need extra food for this.
Knowing about the effects of alcohol and what to do if you’re going to be drinking alcohol can help you
make the right choices. A doctor, nurse educator or dietitian can always answer any more of your questions and
help you plan for alcohol consumption. Have a good time!
WINE AND DIABETES
by Dr. Larry Anderson in BC Wine Trails
Diabetes Mellitus is a disease which is caused by the lack or insufficient supply of insulin in the body.
This leads to high blood sugar levels and these high levels cause damage to the blood vessels. The damaged
vessels then develop arteriosclerosis and, depending on the organ site, the various signs and symptoms will
occur. If the organ happens to be the heart, then the disorders resulting from atherosclerosis in the heart are
angina, heart attacks and death.
As far as we know, diabetes has been with the human being from the beginning of time and there have
been various remedies to try and counteract this disorder. There are records indicating the use of small
amounts of alcohol to help control diabetes in the early Roman period.
There have been a number of studies over the last several years indicating that individuals who drink
small amounts of wine are the people least likely to suffer diabetic complications. In a study published in 1990
it was said that, “Alcohol is known to induce low blood sugar.” This reducing of the blood sugar reduces the
damage to blood vessels and thus has a beneficial effect.
In a study in 1992 of 1,000 British women it was noted that the women who drank small amounts of
alcohol had lower peak levels of insulin. It is known that high peak levels of insulin can cause an increase in
blood fat and cholesterol levels and may play a role in increasing heart attack risk. It is also thought that
alcohol metabolism does not involve insulin and so diabetics can drink dry table wines safely.
The recent Danish study has indicated that the use of moderate amounts of alcohol may prevent the
onset of diabetes and so individuals who are drinking in moderation may not develop diabetes even if they
have the genetic predisposition. Furthermore, as a result of the well published studies indicating that
drinking in moderation reduces the incidence of heart attacks by fifty percent it is probably a beneficial
strategy that individuals with diabetes who have a high likelihood of developing heart disease may reduce that
high incidence by consuming small amounts of alcohol.
There begins to accumulate more evidence that drinking in moderation may reduce the likelihood of the
development of diabetes and even if an individual has diabetes they may receive some cardioprotective and
treatment value from consuming alcohol in moderate amounts. When Dr. Renaud indicated, “there is no
other drug that is so efficient at preventing heart attacks as the moderate intake of alcohol,” he may have
been also talking about the possible benefits of moderation of alcohol consumption in diabetics.
In summary, there is reason to believe that the consumption of wines in moderation will benefit most organ
systems. In particular, as I have outlined above, it may be valuable in preventing the onset of diabetes and it
may also play a role in the reduction of high blood sugar levels and may be helpful in the ongoing
management of the diabetic patient.
It should also be said, however, that any patient should discuss these issues with their physician in order to
deal with what might be described as individual variation in the disease process and in the treatment
protocols that would be most valuable for that particular individual.
Drinking and DiabetesDo They Mix?
Information provided by the Canadian Diabetes Association
Is it wise or safe for a person with diabetes to drink?
This is a question often asked and the answer is... It depends. It would appear under normal circumstances that blood sugar levels will not be affected by the moderate use of alcohol when diabetes is well controlled. The key words are "under normal circumstances", "moderate use" and "well controlled". Be sure you know exactly what they mean.
Discuss with your doctor
Whether or not to use alcohol is a question to be discussed with your doctor. There may be reasons, unrelated to your diabetes, why you should avoid alcohol completely. Your doctor knows your complete medical history and can advise you best. Certain conditions such as pancreatitis, stomach ulcers, liver damage or high triglyceride levels may be made worse by the use of alcohol. Some medications such as tranquilizers and barbiturates may have bad effects if combined with alcohol. In some individuals, diabetic pills such as chlorpropamide may interact with alcohol to produce flushing, nausea, heart palpitations - very uncomfortable feelings. All women would be well advised not to drink during pregnancy since the chance exists that even moderate drinking may be harmful to the unborn child. So, there may be very good reasons why you choose to avoid alcohol completely.
Understand how alcohol affects you
In order to use alcohol wisely and safely, it is impotant to understand how your body handles it. The alcohol in a glass of wine or beer or liquor is absorbed very rapidly and needs no digestion. It is carried in the bloodstream to the liver, your detoxification centre. The liver removes the alcohol from your blood as fast as it can. However, the process is slow and it can only remove 10 to 15 g pure alcohol per hour. This would be the amount in one beer, one glass of wine, or one shot of liquor. Drinking more than this results in a buildup of alcohol in the bloodstream, and intoxication. Sipping a drink slowly over a period of time, diluting it with a mix, or taking a drink with food that contains carbohydrate and fat are all ways to slow down the rapid absorption of alcohol.
Does alcohol raise blood sugar?
Under normal conditions, blood glucose is not affected by the moderate use of alcohol. Alcohol cannot be changed into glucose or blood sugar, and does not need insulin for metabolism. However, if an alcoholic drink contains sugar or is taken with sugar-containing mix, the blood sugar level will be affected.
Alcohol Calories are Fattening
Alcohol provides energy that your body will use up or store as excess fat if the energy is surplus. If you have Type II diabetes (maturity-onset) and are overweight, the major goal of treatment is to lose excess body fat. Bringing your weight down to a more desirable level may not only bring your diabetes under better control but may also lower high blood pressure and blood fats and reduce the risk of a heart atack. Alcohol is almost as fattening as oil or fat. One gram of fat yields 9 Calories (37kj) of energy, and 5 ml (1 tsp) provides 45 Calories (190kj). Every gram of of alcohol provides 7 Calories (29 kj) of energy. One average drink will add 100-150 Calories (420-630 kj) to your diet. When weight loss is all important, it would make good sense to strictly limit alcohol or avoid it completely until you reach your weight goal.
