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Alcohol

Alcohol is everywhere - when the family gathers, at cookouts, after = the=20 softball game, at parties. "What will you have?" someone asks. If you = have=20 diabetes, what do you say?

It all depends. Start by asking yourself three basic questions:

Is my diabetes under control?=20
Does my health care provider agree that I am free from health = problems=20 that alcohol can make worse-for example, diabetic nerve damage or high = blood=20 pressure?=20
Do I know how alcohol can affect me and my diabetes?

If you said "yes" to all three, it's OK to have an occasional drink. = But what=20 does occasional mean? The American Diabetes Association suggests that = you have=20 no more than two drinks a day if you are a man and no more than one = drink a day=20 if you are a woman. This recommendation is the same for people without=20 diabetes.

Your Body and Alcohol

Alcohol moves very quickly into the blood without being broken down=20 (metabolized) in your stomach. Within five minutes of having a drink, = there's=20 enough alcohol in your blood to measure. Thirty to 90 minutes after = having a=20 drink, the alcohol in your bloodstream is at its highest level.

Your liver does most of the job of breaking down the alcohol once = it's in=20 your body. But it needs time. If you weigh 150 pounds, it will take = about 2=20 hours to metabolize a beer or mixed drink.

If you drink alcohol faster than your liver can break it down, the = excess=20 alcohol moves through your bloodstream to other parts of your body. = Brain cells=20 are easy targets. When someone talks about getting a buzz from alcohol, = this is=20 what they are feeling.

Risk of Low Blood Sugar

If you have diabetes and take insulin shots or oral diabetes pills, = you risk=20 low blood sugar when you drink alcohol. To protect yourself, never drink = on an=20 empty stomach. Plan to have your drink with a meal or after eating a = snack.

How does alcohol add to your chances of having low blood sugar? It = has to do=20 with your liver.

Normally, when your blood sugar level starts to drop, your liver = steps in. It=20 goes to work changing stored carbohydrate into glucose. Then it sends = the=20 glucose out into the blood, which helps you avoid or slow down a low = blood sugar=20 reaction.

However, when alcohol enters your system, this changes. Alcohol is a = toxin.=20 Your body reacts to alcohol like a poison. The liver wants to clear it = from the=20 blood quickly. In fact, the liver won't put out glucose again until it = has taken=20 care of the alcohol. If your blood glucose level is falling, you can = quickly=20 wind up with very low blood sugar.

This is why drinking as little as 2 ounces of alcohol (about 2 = drinks) on an=20 empty stomach can lead to very low blood sugar.

When you mix alcohol and exercise, you increase the risk of going = low. This=20 can happen because exercise helps lower your blood sugar levels. Let's = say you=20 just played a couple of hard sets of tennis. You have a beer after the = match.=20 But in the hours after the game, your body is still working. It is = replacing the=20 energy your muscles used up. To do this, it clears glucose from the = blood and=20 adds it to the muscles' store. This is why exercise can cause your blood = sugar=20 level to go down.

If you take insulin or diabetes pills, they too are working to clear = glucose=20 from your blood. Unless you eat or your liver adds glucose to your = blood, you=20 could be heading for a low blood sugar level. If you drink a beer, the = alcohol=20 will stop your liver from sending out any glucose. Your chances of going = low are=20 even greater.

Check with your health care provider to see if it's OK to combine = alcohol=20 with your diabetes medications.

Low blood sugar when drinking is less of a risk for those with type 2 = diabetes who control their diabetes with meal planning and exercise = alone.

Don't Go Low

Follow these guidelines to avoid low blood sugar levels when you = drink:

Never drink alcohol on an empty stomach.=20
Limit yourself to 1 drink if you're a woman or 2 drinks if you are = a man.=20

Alcohol affects your body's ability to get over a low blood sugar = level. If=20 you have low blood sugar, you may need to treat it more than once as = time goes=20 by. If you've been drinking, check your blood sugar before you go to = sleep. Eat=20 a snack before you retire to avoid a low blood sugar reaction while you = sleep.=20

A warning: glucagon shots don't help severe low blood glucose caused = by=20 drinking. Glucagon shots treat very severe low blood glucose reactions = caused by=20 too much insulin. Glucagon works by getting your liver to release more = glucose=20 into your blood. But alcohol stops this process. You need to be able to = treat=20 your reaction with a carbohydrate, such as oral glucose tablets or gels. = So you=20 need to avoid letting a low blood glucose level become severe. If you = pass out,=20 you will need glucose injected into your bloodstream by a health care=20 professional.

Heavy drinking over time can hurt your liver. It won't be able to = make=20 glucose as well. When this happens, your diabetes is harder to = control.

Some of the signs of drinking too much, such as confusion or slurred = speech,=20 are similar to the effects of a low blood sugar reaction or ketoacidosis = (most=20 common in people with type 1 diabetes who have taken too little = insulin). You=20 may be asked to take a blood or a breath test for alcohol if you have = some of=20 these signs. Don't worry. Diabetes will not affect the results of a test = for=20 alcohol, even if you are having a reaction or have a fruity smell to = your breath=20 because of high ketone levels. If you are asked to take a test for = alcohol and=20 you have a choice, choose a blood test. That way, health care providers = can=20 check your levels of glucose and ketones, too.

Beer Belly Blues

Although an occasional drink may not hurt your blood sugar control, = it can=20 harm your eating plan if your goal is weight loss. Two light beers equal = about=20 200 extra calories. Alcohol is called empty calories because it does not = give=20 you any nutrients.

If you are on a low-calorie meal plan, think twice about adding = alcohol.

Wise Drink Choices

Some drinks are better choices for people with diabetes. Select = drinks that=20 are lower in alcohol and sugar. If you use mixers in your drinks, choose = ones=20 that are sugar free, such as diet soft drinks, diet tonic, club soda, = seltzer,=20 or water. This will help keep your blood sugar levels in your target = range.

Light beer and dry wines are good choices. They have less alcohol and = carbohydrates and fewer calories.

To make drinks last longer, try a "spritzer." Mix wine with sparkling = water,=20 club soda, or diet soda. Try a "virgin" Bloody Mary made without = alcohol.

When Alcohol Is a Poor Choice

Some people with diabetes should not drink alcohol. Alcohol can make = some=20 diabetic problems worse.

If you have nerve damage from diabetes in your arms or legs, drinking = can=20 make it worse. Alcohol is toxic to nerves. Drinking can increase the = pain,=20 burning, tingling, numbness, and other symptoms found with nerve damage. = Some=20 studies show that even regular light drinking (less than two drinks per = week)=20 can bring on nerve damage.

Heavy drinking (3 or more drinks per day) may make diabetic eye = disease=20 worse. If you have high blood pressure, you can lower it if you stop = drinking=20 alcohol.

Many people with diabetes have high levels of the fat called = triglyceride in=20 their blood. If you do, you should not drink alcohol. Alcohol affects = how the=20 liver clears fat from the blood. Alcohol also spurs the liver on to make = more=20 triglycerides. Even light drinking (two 4-ounce glasses of wine a week) = can=20 raise triglyceride levels.