Somewhere between Thanksgiving and New Year’s Day, you might have one too many drinks. Or that one sugary margarita at the holiday office party may turn into three, or you party into the wee hours with old friends. If you have type 1 diabetes, there’s no reason you can’t drink, if you want to. So, we sat down with Erin Kelly RN, BSN, Certified Diabetes Educator (CDE) in the Adult Clinic at Joslin Diabetes Center for recommendations on how people with type 1 diabetes can safely enjoy a drink on any occasion.
“For people with type 1 diabetes, alcohol can be tricky in terms of diabetes management,” says Kelly. “While we don’t recommend avoiding alcohol altogether, the message we always give is to be cautious. The most common concern with drinking alcohol is hypoglycemia.”
Here, Kelly shares a few suggestions on how to keep your blood sugar levels out of the danger zone
Learn How Different Drinks Affect You
Alcohol can affect people differently. A glass of wine during a big meal might work for one person, but a couple of beers after work might send someone else’s blood sugar soaring.
If you don’t have a handle on your pattern, it’s a good idea to do a test run at home. So have a drink or two with dinner one night then check your blood sugar more frequently over the next 24 hours,” says Kelly. Pay attention to what happens in that controlled situation.
Whether you take a bolus insulin to cover the extra carbohydrates in drinks really depends on the amount of alcohol you will consume, over what time period, how much you weigh, and what you will be eating. Remember, all alcohol, whether it contains carbohydrates or not, can actually lower blood sugar several hours after it’s consumed, especially for people with type 1 diabetes.
“Some people see that lowering effect after one drink, and other personal factors, so you should use caution with insulin due to the potential for alcohol to lower your blood glucose later,” says Kelly. “If you are going to have more than two drinks, you may not need to take any insulin for the carbs in the drink.”
For women, the rule of thumb, explains Kelly, is that if you are going to have more than two drinks you should not take insulin, or take less than you normally would because more than that will, in general, decrease your blood sugar level. For men, it’s three or four drinks.
Think About What You Drink
Some alcoholic drinks have carbohydrates (such as beer and sweetened mixed drinks) and some don’t. If the drink has carbohydrates, like anything else, it will cause your blood sugar to rise.
“What always surprises people is that wine doesn’t have a lot of carbohydrates, it only has three or four grams of total carbohydrates per glass, certainly that can be a way of having a drink without worrying about spiking your blood sugar,” says Kelly.
Another way to enjoy a drink without concern that the carbohydrates will spike your blood sugar is to stick with spirits — vodka, whisky or rum — because they contain zero carbohydrates. For example, rum mixed with diet coke or vodka and sugar-free cranberry juice.
Wine or hard alcohol in moderation will not dramatically influence your blood sugar, she says. However, if you do overindulge, those alcoholic choices might not be the way to go because you won’t get a bump in your blood sugar, but you will get the lowering effect from the excess alcohol well into the next day.
What you eat before, during and after you drink could make it easier to keep your blood sugar in check. If you are going to a cocktail hour serving only hor d’oeuvres you might not get the right balance from healthy fat and protein, which helps stabilize blood sugar, so the alcohol may have a stronger effect on your blood sugar than if you had two or three glasses of wine with a big meal. Try drinking slowly and alternating a glass of water with every drink to lessen the alcohol’s impact.
Check Your Blood Sugar Frequently
If you’re going to a party, remember to test blood glucose before, during and after you drink. Most events tend to occur in the evening so if alcohol is going to lower your blood sugar, it’s probably going to happen when you are sleeping.
At night, always check blood sugar before going to sleep. You might need to have a snack, take less of your long-acting insulin, or turn down the basal rate in your pump, all things that will help protect you from hypoglycemia in that overnight period, says Kelly.