If you have diabetes, you likely have a lot of concerns regarding food and drink. If you have just been diagnosed, you probably have even more questions. Diabetes does not mean that you can never have your favorite foods or enjoy a little social hour with your friends. Like all things, moderation is the key. 

A big concern for those with diabetes, is blood sugar. Keeping your blood sugar under control is the main thing you can do to keep your body functioning the way it should be. People with diabetes should be especially careful with alcohol. Alcohol causes blood sugar to rise, and it can interfere with the effectiveness of certain medications. 

Again moderation is key. According to the American Diabetes Association, if your doctor says it's OK for you to have a drink once in a while, you should follow the same guidelines as people who do not have diabetes:

• Women - one drink or less/day
• Men - two drinks or less/day
• One drink = 12 oz beer, 5 oz wine, or 1-1/2 oz distilled spirits

Facts About Alcohol and Diabetes

• Alcohol can cause blood sugar to rise or fall.  When taken with medications that lower blood sugar, your body can go into a very life threatening condition known as "insulin shock." Insulin shock is when you go unconscious because of low blood sugar. When showing symptoms of low blood sugar, be sure to have a snack to help bring it back up.
• Alcohol inhibits the liver from doing it's job. This is especially bad if you had a drink when your blood sugar was already low because your liver is working to get out the alcohol instead of working to equalize your blood sugar. Always test your blood sugar before having a drink. You should ideally be checking your blood sugar while drinking, after, and before bed just to be on the safe side.
• Don't drink alcohol on an empty stomach. Food slows down the absorption of alcohol. Alcohol also stimulates your appetite, so be careful not to overeat which can also affect your blood sugar. 
• While alcohol counts as a carbohydrate for those on a portion meal plan, do not replace real food with alcohol to get your carbohydrate option in. 

Precautions

As mentioned above, there are many facts to think about when drinking while you have diabetes. Because there are many ways in which alcohol can affect your blood sugar, mainly causing it to go too low, you should come prepared. Having diabetes doesn't mean you have to give up all your fun, but it does mean you have to be a little more careful and come prepared. 

Always bring your glucose monitor with you, especially if you are going to be drinking. Since alcohol can cause your blood to drop quickly, test yourself before during and after drinking. You can be discreet about it by stepping into the restroom if you are more comfortable with that. If you see that you are getting low, eat something. Good emergency choices are juice, regular (not diet) soda, raisins, jelly beans, peanut butter, or a sandwich. If you are already low, the goal here is to get your glucose levels up quickly. Once they are up, eat regular food to help stabilize them so they don't quickly drop again from another sugar crash!

If you are going out with friends, be sure that they know the symptoms of low blood sugar and what they can do to help. Sometimes, your blood sugar can drop so quickly that you won't be able to notice it yourself, so you need to have help from those around you. 

Wear an I.D. bracelet or necklace that identifies that you have diabetes. This will let other people or emergency personnel know in case there is a situation where you are unable to tell them. 

Low Blood Sugar

Even when you are very cautious, sometimes your body doesn't react the way you expect. Here are some symptoms of low blood sugar, although you can have low blood sugar and not show these symptoms. You will notice a lot of these symptoms are similar to the symptoms of drunkenness. It's important for people to know that you have diabetes, so they can get you the treatment you need.

• blurry vision
• heart rate racing
• feeling cranky
• headache
• hunger or nausea
• shaky feeling
• sweating
• tingling fingers, lips, or tongue
• unclear thinking

If you have low blood sugar, and eating a snack is not helping it to normalize, you may need to seek medical treatment. Having an extremely low glucose level is a medical emergency that can cause unconsciousness, seizures and brain damage. 

Go to the emergency room. Do not try to drive yourself. Have someone take you or call 911. 

If you are with someone that you know is diabetic, get medical help if you notice them becoming less alert or become unconscious. 

Sometimes it helps to discuss a lifestyle with diabetes with others. We invite you to attend a free support group at Johnson Memorial Hospital. 

Our internal medicine specialists are also available to answer questions and help you with diabetic care.