Coming out with diabetes

With the summer and party season heading our way, there are some things people with diabetes need to think about before heading out and/or drinking alcohol. The better prepared you are for a night out, the more you can focus on having a good time.

Going to parties, bars, or events can be a lot of fun, but be aware that alcohol affects diabetes control. There’s a high probability that you might need to do things differently to manage your blood glucose on a night out.

We’ve compiled some info to check out, but we also recommend you discuss how your particular body might handle alcohol with your GP or Diabetes Specialist Nurse.

BE PREPARED

It is important that you check your blood glucose before, during, and after drinking alcohol. This will help you learn how different drinks might affect you.

• Our judgment can be affected when we drink, and it is easy to not realise this when experiencing a hypo.

• Always carry hypo treatment with you as you never know when you might need it.

• It’s important to wear your diabetes ID and tell those you are out with that you have diabetes. This can be a lifesaver because others might mistake a hypo for being too drunk.

SIGNS OF HYPOGLYCEMIA AND INTOXICATION ARE VERY SIMILAR

The signs of hypoglycemia can look a lot like being drunk – drowsiness, unsteady movements, slurred speech, feeling weak or tired, etc.

A severe hypo can lead to mental confusion, unconsciousness, or seizures, which can all be extremely dangerous to your physical wellbeing and ability to treat the low yourself.

This is why it’s especially important for your friends and family to know the risks of drinking alcohol with diabetes and the signs of low blood sugar.

Teach your friends – if you are ever vomiting or showing the signs of hypoglycemia, they should encourage you to check your blood sugar with your BGM or your blood glucose levels with your CGM. And they should call 111 if they are concerned.

HYPOS WITH ALCOHOL

If you go hypo due to alcohol, your body’s ability to help itself is severely reduced.

• Alcohol can lower your blood glucose hours after it is drunk – even through to the following morning! If you go low when you drink, your insulin may need to be withdrawn.

• If drinking spirits, use diet sodas as mixes, not ‘ready to drink’ premixes. RTDs are very high in both alcohol and sugar. Discuss with your diabetes team how you might manage this.

• Don’t inject insulin when drinking alcohol (even with sugary drinks) unless you have spoken with your diabetes specialist or local healthcare team.

EATING AND DRINKING

If you are going to eat before you go out and drink alcohol, you may need to change your insulin dose. Discuss all of these scenarios with your diabetes team.

• You don’t have to drink alcoholic drinks all night. Alternate between non-alcoholic and alcoholic drinks.

• Make sure you eat some foods containing longer-acting carbohydrates before and after drinking, such as wholegrain bread, or curry and rice.

UNDER 18?

Te Whatu Ora provides the following advice:

• For people under 18, the safest option is not drinking at all

• For people aged 15-17, the safest option is to delay drinking for as long as possible. Delaying or avoiding drinking can go a long way to preventing a range of risks for young people. This is important because:

• Alcohol has impacts on brain development for people under 20.

• Young people have a lower tolerance for alcohol than adults. They are at higher risk of hurting themselves when intoxicated.

• Someone who starts drinking at a younger age is at higher risk for drinking harmfully later in life.

ALCOHOL INTAKE GUIDELINES FOR ADULTS

Remember, you don’t have to drink alcohol to have fun.

If you are drinking alcohol, follow the Te Whatu Ora guidelines:

• Two standard drinks* a day for women and no more than 10 a week

• Three standard drinks* a day for men and no more than 15 a week

• Have at least two alcohol-free days every week.

And if you want to reduce your risk of injury on a single occasion, drink no more than:

• four standard drinks for women on any single occasion

• five standard drinks for men on any single occasion. Finally, for those who are pregnant, or who are planning to be:

• Health professionals strongly recommend no alcohol use at any stage of pregnancy.

* One standard drink is 100 ml wine, 30 ml spirits or 300 ml beer. This is less than most glasses will hold. For guidelines on standard drinks, see www. alcohol.org.nz/help-andsupport/advice/standarddrinks-and-legal-limits/

For information about alcohol in general, visit www.alcohol.org.nz

For information about Type 1 and drinking, visit https://beyondtype1.org/ alcohol-and-diabetes-guide/