Alcohol

Here we are: alcohol. A pleasure for many, a sore point for the vast majority of diabetics. Its dangers and drawbacks are well-known: goes without saying that I strongly discourage any binge drinking-related behaviour. We always have to keep in mind that the disruptive effects of alcohol excess are exponentially more harmful on us diabetics. However, if you are looking for a safe and simple way to handle your BG throughout a moderate and responsible alcohol consumption, you're in the right place!

First and foremost, from a biochemical point of view, why and how does alcohol impact on our glycaemic levels? Well, since ethanol, its main component, is promptly converted to glucose, its consumption will most likely determine an early rise in our BG levels (if you consume beer, the effect wil be implemented because of its starchy components). Furthermore, due to the fact that the liquid calories ingested with alcohol are a "false" source of energy, they will be consumed through a lipogenetic and catabolic metabolism, which will, as a final effect, inhibit gluconeogenesys (the liver's ability to generate glucose), generating a late glycaemic drop some hours after drinking.

So, going step by step, let's talk about the early rise first. This effect, directly proportional to the alcoholic percentage and the amount of the ingested drink (obviously, added sugar will enhanche its pace and duration), will be exponentially more observable if you consume alcohol on an empty stomach: your GI tract will only have to deal with the drink you have just had, and will digest it a lot faster (this is also the reason why less alcohol is required to get inebriation far from meals). Viceversa, one or two glasses of wine during a rich meal will most likely produce way smaller or maybe even insignificant early spikes. For these reasons, the way to go in terms of diabetes management for this particular effecr of alcohol is the one to have an accurate insulin injection for the carbs content of the drink itself if you consume it on an empty stomach (never forget to prebolus!), otherwise, if we talk about moderate quantities of alcohol consumed during a meal, they can be almost neglected in the bolus calculation, or, if at all, you could add one or two units of insulin depending on the amount you're going to ingest.

On the other way, we have to pay even more attention to the secondary effect of alcohol: the late drop. As perceivable, even in this case this effect will be way more evident if you drink alcohol on an empty stomach: even one or two drinks can determine deep and steep drops two to three hours after their ingestion. In this case, for what concerns my experience, the solution is not the one to let your BG skyrocket just after you drink in order to let it fall later: this might not even happen at all. The only strategy I've found efficient is the one to prevent the fall through the consumption of a snack mainly composed by complex carbs (bread, crackers...) as soon as you notice the slightest drop: waiting to be in a hypo and trying to only use sugars as a correction will most likely take longer and be less effective. On the contrary, a moderate alcohol consumption throughout consistent meals will usualy not determine a late drop at all, since the lack of hepatic glucose generation will be compensated by the ingested food.

To conclude, goes without saying that the glycaemic effects of binge drinking are hardly manageable, if not unmanageable at all without big risks, even due to the drunkenness which alcohol brings: this is the reason why this behaviour has to be discouraged expecially in diabetic people. On the other hand, if your goal is to enjoy the pleasures of alcohol through a responsible and moderate consumption, I hope to have provided a complete and useful guide, whose aim is always the one to help T1Ds like me not to give up anything. Stay safe out there, and don't forget to keep reading my website! ;)