Despite its prevalence in this country—one in 10 Americans have the condition—diabetes remains poorly understood. Even less awareness surrounds the relationship between diabetes and alcohol. This article will take a closer look at how alcohol impacts diabetes and provide an overview of what those affected need to know.
Understanding Diabetes: Symptoms, Causes, and Treatments
Diabetes is a metabolic disorder involving insulin and the abnormal absorption of glucose by cells. People with Type II diabetes do not have enough insulin to allow glucose to enter cells. This causes glucose to accumulate in the bloodstream. Glucose levels exceeding 180 mg/dL indicate a diabetic condition.
Insulin resistance (prediabetes) is also a metabolic disorder associated with being overweight, poor diet, and having a waist measurement over 40 inches. Prediabetes may be controlled without medication by losing weight, eating healthier foods, and exercising regularly.
Symptoms for all types of diabetes (I, II, and gestational) are similar and include frequent urination, constant hunger, thirst, and slower healing of wounds. Untreated diabetes may eventually cause life-threatening symptoms such as diabetic coma, diabetic ketoacidosis, stroke, or cellulitis.
Doctors prescribe insulin, alpha-glucosidase inhibitors, or biguanides (Metformin) to help reduce blood glucose levels. To work as well as possible, these medications should be taken as prescribed and in combination with eating the right foods, exercising, and not smoking.
Since Type II diabetes affects many more people than Type I diabetes, this article will talk exclusively about alcohol and Type II diabetes. Type I diabetes is a less understood blood sugar disorder that involves the immune system attacking the body and preventing the pancreas from making insulin. People with Type I diabetes must take insulin every day to avoid dangerous health problems.
How Does Alcohol Interact with a Diabetic Condition?
The liver, which is primarily responsible for metabolizing alcohol, can efficiently metabolize one or two alcoholic drinks occasionally. Drinking more than that can take a toll, however, especially if you’re regularly consuming more than the recommended limit. What follows are some of the effects that can occur.
Low Blood Sugar and Other Complications
Diabetes and alcoholism interfere with the ability of the liver to release enough glucose to prevent hypoglycemia (too little glucose). While the liver is trying to metabolize large amounts of alcohol, it can’t perform other functions necessary to stabilize blood sugar levels. Low blood sugar problems can ensue.
Signs of low blood sugar include rapid heartbeat, shakiness, anxiety, sweating, and confusion. However, someone with diabetes who is intoxicated most of the time may not be aware of these symptoms. They may pass out or have seizures unless they are immediately treated for hypoglycemia.
Ketoacidosis and Other Health Issues
Individuals with prediabetes or full-blown diabetes who abuse alcohol can also develop pancreatitis, peripheral neuropathy, high cholesterol, or worsening glaucoma.
Diabetic heavy drinkers are also at risk for diabetic ketoacidosis, a potentially life-threatening condition involving a complete absence of insulin in the blood. Without insulin, the energy required by the body for physiological processes must be extracted by quickly burning fat stores. The consequence of diabetic ketoacidosis is dangerous levels of ketone bodies in the bloodstream.
Once fat stores have been depleted, the body must rely on these ketone bodies to continue functioning. Unless reversed, diabetic ketoacidosis will lead to uncontrollable vomiting, dehydration, difficulty breathing, disorientation, and, eventually, coma.
How Alcohol May Interfere with Diabetic Medication
Mixing alcohol with Metformin may increase your risk of a rare but toxic condition called lactic acidosis. Arrhythmia, shortness of breath, drowsiness, shivering, and weakness are signs of lactic acidosis. Emergency medical help is necessary to avoid shock and coma.
Combining alcohol with insulin can significantly increase or decrease glucose enough to cause hyperglycemia or hypoglycemia. Insulin is meant to lower and stabilize glucose but alcohol interferes with insulin’s purpose.
Diabetics taking chlorpropamide to lower their blood sugar may suffer an adverse reaction to this drug if they drink alcohol. Symptoms of this reaction include nausea, severe headache, flushing, and dizziness.
Whether you are taking diabetic medication or medication for another health issue, it is never safe to combine medications with alcohol.
Is It OK for Diabetics to Drink Alcohol?
If your A1C test result is higher than 6.5 percent, or your fasting blood sugar test is above 126 mg/dL, you have clinical diabetes and should only have a glass of wine or one beer occasionally (once a month, at the most) during a meal. Although one drink won’t affect blood sugar much, you should never drink an alcoholic beverage on an empty stomach.
In addition, diabetics who occasionally drink alcohol should always test their glucose before and after having one drink. Do not drink alcohol before, during, and after rigorous physical activity. If you are drinking a mixed drink, choose diet soda, club soda, or another calorie-free mixer.
Diabetics who are habitual drinkers (three or more drinks every day) will experience significant increases in their blood sugar regardless of whether they drink on a full stomach. Diabetic heavy or binge drinkers are also at high risk for:
- Cardiovascular disorders
- Impaired immune system
- Early onset dementia
- Mental illnesses (especially organic dementia or psychosis due to strokes or circulatory disease)
- Alcohol poisoning
- Cirrhosis of the liver
- Kidney failure
Diabetes is the leading cause of kidney disease in the U.S. Long-term damage to blood vessels inhibits kidney functioning, which can cause waste products to accumulate in the bloodstream. People with diabetes and high blood pressure are at triple the risk for kidney disease. Fortunately, early kidney damage due to diabetes can be reversed with medication, exercise, and eating diabetic foods.
Drinking alcohol on top of having diabetes puts more stress on the kidneys to filter toxins and waste products out of the body. Excess glucose sticks to the inner walls of vessels much like cholesterol sticks to artery walls. As blood vessels narrow from the accumulation of glucose, the kidney’s pumping mechanism has to work harder to circulate blood throughout the kidney. Alcoholism and diabetes not only increase the risk of kidney disease, but also of developing blood clots, having strokes, and experiencing irreversible peripheral nerve damage.
Can Quitting Alcohol Reverse Type II Diabetes?
Reversing Type II diabetes may be accomplished by maintaining an active, healthy lifestyle that does not include smoking or drinking excessively. Quitting heavy drinking can help keep your weight close to what it should be for your age. Being overweight is a major contributor to prediabetes and diabetes.
Going into diabetic “remission” does not mean glucose levels won’t start rising again if you stop living a healthier life, however. Moreover, if you were once diabetic and improved blood test levels no longer indicate you are diabetic, drinking again—even occasionally—could destabilize blood sugar and cause the diabetes to reappear.
What To Do If You Are Diabetic and Have an Alcohol Problem
If you have diabetes and are having trouble controlling your drinking, that may be exacting a serious toll on your physical and mental health, your family relationships, and your ability to succeed in a chosen career. At FHE Health, our experts have decades of experience providing integrated care that treats the whole person, not just the alcohol problem but any co-occurring health issues as well, including diabetes. For more information, call us today.