Diabetes is defined as an imbalance of glucose metabolism, leading to high blood sugar levels and serious health consequences. Alcohol can both increase and decrease the levels of these blood sugars, exacerbating pre-existing diabetic symptoms.
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Alcohol has many adverse effects on an individual with diabetes. Even a small volume of alcohol can dramatically increase blood sugar levels, exacerbating associated conditions. This is especially true for sugary wines and beers which contain a large proportion of carbohydrates.
Type 2 diabetes has many risk factors, one of which is obesity. Alcohol contains many calories and excessive drinking can lead to significant weight gain. Consumption can therefore hinder the management of type 2 diabetes, encouraging poor dietary decisions and increasing hunger. Alcohol intake also increases triglyceride and blood pressure levels, which are other type 2 risk factors.
When coupled with insulin injections (and other medications), excessive alcohol intake can lead to dangerously low levels of blood glucose, causing hypoglycaemia. This effect is due to the alcohol’s adverse effect upon liver function, which typically works to regulate blood sugar levels.
Instead of releasing stored glucose as normal, the liver must break down the blood alcohol. This means that glucose is not released and the levels of blood glucose fall. This can result in a myriad of symptoms, including sweating, palpitations, blurred sight, trembling, and headaches.
In type 1 diabetics, a very small volume of alcohol is required to trigger hypoglycemia, especially on an empty stomach, which usually occurs 24 hours later. The symptoms of hypoglycaemia can easily be mistaken for a hangover, meaning that it is often unrecognised by medical professionals and is incorrectly treated.
Complications of diabetes
Alcohol can also exacerbate the complications of diabetes. For example, neuropathy, which affects both sensory and motor functions, and is one of the most serious complications associated with diabetes.
Consistently high glucose levels lead to blood vessel damage, interrupting blood supply to the nervous system, resulting in nerve damage. Alcohol exacerbates this condition, leading to hyperalgesia, which heightens an individual’s response to pain. Additionally, alcohol stimulates a constant release of pain-controlling hormones, further increasing pain responses as the signalling pathway is intensified.
Other conditions which can be exacerbated by alcohol intake are eye related problems. Alcohol intake reduces cognitive function, resulting in slow pupil movement and, gradually, weaker eye muscles. Over time, this can have a permanent effect on vision, resulting in blurry and poor eye sight. Eyes may also become bloodshot and develop rapid movements.
Guidelines for diabetics when drinking alcohol
To reduce the risk of developing these conditions, the following guidelines are in place:
- Only drink with food
- Stick to daily guidelines: Women should have no more than one glass a day and men should have no more than two glasses a day
- Do not drink wines, cheap beers and sweet cocktails
However, alcohol is not the only substance which can lead to worsening diabetic symptoms. Smoking leads to a dramatic increase in heart, kidney, vision and lung complications, whereas many drugs also lead to a plethora of conditions, such as cocaine which can lead to a dramatic increase in stroke and heart attack risk. Therefore, any substance should be considered with care, especially for an individual with diabetes.
Also, wearing a medical ID piece of jewellery can aid medical professionals in identifying those who are experiencing hypoglycaemia, allowing doctors to provide appropriate care.
Reviewed by Kate Anderton, BSc