Almost 300,000 Canadians have Type 1 diabetes, a condition in which the pancreas produces less or no insulin. Insulin is a hormone that favors the transfer of glucose from the blood into the cells, where it is used as energy. In Type 1 diabetes, the body cannot use glucose optimally, and so it builds up in the bloodstream. Although it is a manageable condition, if not managed properly, it can cause health complications such as stroke, blindness, heart disease, and nerve damage.

Various factors can increase the risk of diabetes-related complications, and alcohol is one of them. While this does not mean that one cannot have alcohol at all, it should be consumed in moderation, as it increases the risk of hypoglycemia, requiring frequent monitoring of blood sugar levels.

Excessive Alcohol and Type 1 Diabetes

Individuals with Type 1 diabetes have to be extremely careful while consuming alcohol. According to the guidelines set by Diabetes Canada, one cannot have more than three standard drinks and more than 15 drinks in a week (for men) and no more than two standard drinks in a day and more than ten drinks a week (for women). “A standard drink is 341 mL (12 fl oz) of beer, 142 mL (5 fl oz) of wine, or 43 mL (1.5 fl oz) liquor.”

However, if a person with Type 1 diabetes already has nerve damage, hypertension, or eye complications, alcohol consumption is not recommended. Alcoholic drinks have carbohydrates, which are broken into sugar, and consuming excess alcohol could cause a sudden spike in blood sugar levels.

Some other complications include:

Slows Down the Liver

Alcohol prevents the liver from releasing glucose, which may result in low blood sugar levels. The liver takes almost two hours to break down one alcoholic drink. While drinking, as the liver is breaking down alcohol, it cannot release stored glucose.  Alcohol interferes with the liver’s function of releasing glucose, slowing down the body’s reaction time. All this may cause individuals with Type 1 diabetes to develop hypoglycemia. With Type 1 diabetes, even a small amount of alcohol may increase the risk of hypoglycemia for up to 24 hours later.

Furthermore, the symptoms of alcohol intoxication and low blood sugar level are similar and may prevent the person with Type 1 diabetes from receiving appropriate care. The delay can further increase the risk of complications.

Worsens Eye Conditions

An occasional drink may result in temporary blurry or double vision. However, alcohol abuse can worsen any existing eye disorder in any individual with Type 1 diabetes. Alcohol makes the mind sluggish, which alters the pupil’s reaction and its ability to constrict or widen openly.  Gradually, excess alcohol intake could weakens eye muscles, resulting in a permanent double or blurred vision.

Alcohol may cause swelling of blood vessels in the eyes, giving it a bloodshot appearance. Rapid eye movement, involuntary movements of eyes, may develop in individuals consuming excess alcohol. They may also face gradual deterioration of vision.

Triggers Nerve Damage

Uncontrolled Type 1 diabetes may cause nerve damage, and alcohol abuse can worsen the symptoms. Alcohol also results in hyperalgesia, a condition where damaged nerves become more sensitive to pain. Excess alcohol releases hormones responsible for further damage and controlling pain, and a sustained increase in nervous system activity further intensifies pain signals. 

Reduces Effectiveness of Insulin

Insulin injection offers a specific amount of insulin to individuals with Type 1 diabetes. Excessive alcohol consumption fluctuates blood glucose levels and makes it difficult to determine the exact insulin dose. In addition, an intoxicated individual is prone to making poor food choices. The combination of overeating and incorrect insulin dose may increase or decrease blood glucose levels.

Type 1 Diabetes and Alcohol Risk Factors

Chronic excess drinking can damage kidneys, liver, heart, and pancreas. Kidney and liver damage are especially dangerous for people with Type 1 diabetes. Alcohol abuse can damage the liver, preventing it from functioning normally. Some other risk factors include:

• Low LDL cholesterol
• High triglyceride levels
• High HDL cholesterol
• Diabetic ketoacidosis
• Cardiovascular disease
• Impotence

Type 1 Diabetes and Alcohol Blackouts

Binge drinking or having more than five drinks at one go may increase the risk of overdose. Some symptoms of overdose are:

• Blackouts
• Sleepiness
• Nausea and vomiting
• Confusion
• Loss of consciousness
• Muscle weakness
• Dizziness

To-Do List for Drinking with Type 1 Diabetes

As alcohol can alter the action of insulin and fluctuate sugar levels, the following precautions should be taken to prevent any complications:

• Monitoring glucose levels before drinking
• Drinking alcohol slowly
• Choosing drinks with less alcohol, such as wine or beer
• Using sugar-free mixers with alcohol, such as diet tonic, water, or club soda
• Having a snack before going to bed to prevent hypoglycemia during sleep
• Wearing diabetes identification, such as a MedicAlert® bracelet
• Avoiding alcohol after exercise

Final Thoughts

Type 1 diabetes is a manageable condition, but excess alcohol consumption increases the risk of diabetes-related complications. Although one can have a moderate amount of alcohol with Type 1 diabetes, those with complications should refrain from having it. If you plan to drink, follow a to-do list to prevent hypoglycemia and other complications, it is a good idea to consult your doctor in case of doubts.

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