The fruit of the vine – questions about alcohol and diabetes

Today I was asked to see a young man (age 28) to have his insulin regimen adjusted before he left the hospital. He has Type 1 diabetes that was diagnosed about 9 years ago. Among many questions I asked him before getting a final regimen figured out, was the big one about alcohol – how much do you drink?{{more}}

Which brings me to our talk today since some of you asked me that same question during our trip in April. What about diabetes and alcohol?

There are a few issues to consider here. In general, there are no health related adverse effects of having alcohol UNDER the recommended amounts set out by the Nutrition and Cardiology associations (which by the way are no more than 1 drink for women and 2 drinks for men per day). The exception to consider would be interactions with medications of course, so please also discuss that with your doctor. There are many medications that interact badly with alcohol. Aside from that concern, there is no specific reason why an otherwise healthy diabetic cannot have an alcoholic drink.

BUT you must also consider the following:

1) Some diabetics have variations in their blood sugars after drinking alcohol. For most people, there is a rise in blood sugars after drinking alcohol because it acts as a carbohydrate/starch. For some, there is no difference or even a slight lowering in blood sugars. As always, the only way to know is to check your blood sugars to see the effects.

2) Alcohol does not have nutritional value. EMPTY calories! This is especially important for those of you who are already overweight or outright obese. Alcohol is a source of calories, so if you are trying to lose weight, this is probably one of the FIRST areas to cut back on (or cut out completely!)

What about the improvements from alcohol? You might ask. True, there are some benefits from alcohol including some cardiology data showing reduced heart attack risk as well as documented improvements in levels of good cholesterol. BUT these issues have to be weighed in comparison to those I discussed above. For instance the extra weight you may gain from drinking 2 alcoholic drinks per day may well outweigh the benefits of raising your good cholesterol by 3 points.

My best advice is to limit alcohol intake as much as you can, and definitely keep it under the recommended maximum amounts. Talk to your doctor if you have questions about medication interactions. By the way, the young man I discussed above: he drinks 4 alcoholic drinks per day. I asked that he really try to drop it down to no more than 2 drinks per day, and ideally less.

Until next week, stay safe and healthy Vincies!

Anita Ramsetty, MD endodocs@endocrinehelp.com
Medical Director Endocrine Care Group
www.endocrinehelp.com
Tel: 843-798-4227