When it comes to drinking alcohol with diabetes, there are lots of things you need to think about when these two worlds collide. Safety is paramount. The challenges you could face from being diabetic may involve your blood sugar going too high for a long period, such as the whole night, or you consuming too much alcohol and it being driven down.
You could also over correct for high blood sugar, which could result in your blood sugar falling too low which could then result in you having a hypo and passing out. Mix that with drink and you’ve got bad, bad news. If you make it through the night you’ve then got to contend with the morning after and the low BG you will more than likely experience. Confused? Don’t worry, I was too!
Now this is a real piece on type one diabetes and drinking, written by a real diabetic man, so I am not going to start suggesting you ‘only drink 2 alcoholic drinks a day’ or ‘never exceed more than 4 units in one evening’ because I know you may like a drink and you don’t want to deprive yourself of that just because you’ve gone and got fucking diabetes. I really do get that. Instead let’s get into some real talk about type 1 diabetes and drinking alcohol.
For me, drinking alcohol with diabetes has never been too bad. I make sure I take all the usual precautions I normally would. I have a tester, my insulin and glucose tablets with me at all times and I treat my illness with the respect it demands. I think the best way to take a look at drinking with diabetes is to approach the different drinks you will often enjoy on a night out and discuss how each one of them affects me.
Of course, with all the content like this I write, I would love to hear your guy’s thoughts and experiences on how it affects you too. I’m aware that diabetes is different for everybody and therefore different drinks will affect different people in different ways.
Drinking Different Alcohol With Diabetes
Diabetes and Drinking Beer
So let’s start with what is arguably the favourite tipple of the British masses on a night out, that’s beer. When I drink beer I experience a small effect on my blood sugar. Nothing too substantial. If I was to have just a couple of beers on an evening, I wouldn’t expect much of a blood sugar increase at all. If I was to go out drinking most of the evening, which I have to admit I don’t really do any more (yes, because I’m too old) I would expect to see a moderate increase in my blood sugar. We’re talking topping out at 12 – 14 mmol if I don’t keep an eye on it.
Beer does have a carbohydrate level and this is what will impact your blood sugar. Personally, I haven’t seen much of a difference between different types of beer either. Whether I’m drinking piss water (Carling) or my preferred choice, a nice ale or a stout, the results always seem to be the same. So, enjoy a cold pint or 10 safe in the knowledge that your blood sugar increase is likely to be slow, steady and easy to manage with regular testing and corrections.
Diabetes and Drinking Cider
Now let’s think about cider. Cider is obviously a slightly more sugary drink. With it being made from fermented apples, or pears, and quite often having a sweeter taste to it. As you would expect, I do see a slightly higher increase in my blood sugar when drinking cider. One pitfall you really should avoid when diabetic, or just make sure you’re aware of so you correct appropriately, is flavoured ciders or fruit ciders. Stuff like Koppaberg, or Brothers Toffee Apple.
As anybody who has drunk them will know, they are quite often sweeter than the normal ciders and that’s because they have sugar in them. So you could drink a few pints of Aspall’s for example, that being one of my favourite ciders (I’m not being paid by them by the way) and not experience too much of a rollercoaster. When you drink a lot of the fruit ciders you are likely to notice a far more significant increase in your blood sugar, I believe. I know it sucks to deprive yourself of things you enjoy, but if you can, it’s worth avoiding them when you go out for a few drinks.
Diabetes and Drinking Wine
So let’s talk about wine. Maybe I’m lucky but wine does not seem to do much to me at all. I’m not sure exactly why that is. I’ve got no doubt wine is lower in carbohydrate than beer and cider, but it may also have something to do with the volume that you drink in comparison to those other beverages. I don’t drink rose very often, so can’t comment directly on that. However, I can tell you that when drinking either red or white wine I experience very little in the form of BG increases.
One exception to this, that is currently on my mind as I am writing this coming up to the festive season, is Mulled Wine. There’s nothing quite like a cup or two of mulled wine when you’re exploring a Christmas market but you have to remember that this will often be loaded with sugar alongside the spices, that’s what gives it it’s delicious taste. This is the same for pre-bottled mulled wine you buy in the shop. If you’re planning on drinking it at home you can make your own, sugar free mulled wine that tastes (almost) as good. Of course, you can always stick a bit of sweetner in there too! Here’s a recipe I’ve found for you if you’re interested.
Diabetes and Drinking Spirits
Then we come on to spirits. Happily, spirits on their own have little to no affect on my blood sugar. In fact, I can quite comfortably say that they don’t have an impact at all. Whether we’re talking about whiskey, brandy, vodka or rum. When drinking all of these straight it’s a safe bet.
Challenges can be experienced when mixing spirits with a mixer of some sort. The quick, easy and simple answer of course is to mix them with a diet mixer. For me this is generally a safe bet. There are a few things to be conscious of here though. One being that diet mixers can sometimes still impact your blood sugar. I haven’t experienced this myself but there is research out there that suggests this is something that you want to check as a diabetic.
The other is that you need to consider human error. Try as you might to ask for diet mixers you will not always be given them. In a quiet pub of an evening it’s fairly easy to figure out. In a busy club at 2 o’clock in the morning it’s nigh on impossible to be sure. You don’t know if the server hears what you say. You don’t know if the server then remembers. And of course, it’s very difficult for you to see exactly what they’re doing. A glass of full fat coke contains a ludicrous amount of sugar and has the capacity to spike your blood sugar immediately and significantly.
Your best bet is to drink spirits straight if you can stomach that. If not, do your best to ask clearly and observe the server while they make your drink. Another sage piece of advice would be to not feel like it’s rude or impolite to ask for a new drink if you believe it’s been made with a full fat mixer.
One note on this is that the strength of spirits can mean that over consumption can in fact have the opposite effect on your blood sugar by plummeting it downwards. Always be very careful when enjoying a few shots.
Diabetes and Drinking Cocktails
As we are talking about mixers there is one group of drinks that you should really avoid like the plague. Yep, unfortunately, that’s cocktails. Cocktails are bloody delicious and it only takes a couple to get you feeling nice and merry. But for the most part they are absolutely loaded with sugar. Part of the reason cocktails taste so good is the fact that they are made with bitters, syrups, hi sugar juices etc. These strong, sweet flavours help mask the alcohol and make them very easy to drink.
However, this means they are very much a minefield for a diabetic. Depending on where you are drinking you can always ask the server about low sugar/sugar free cocktails, because there are such things. However, this is the same scenario that we just spoke about with spirits and mixers. Judge your environment and understand whether you can trust the outcome.
At a high-end cocktail bar, during a brunch when you have the opportunity to talk to the server, I would say you are fine. 2-for-1 cocktails in Revs on Saturday at 11 pm? Oh you’re playing a dangerous game.
There is one relatively safe bet when it comes to cocktails, which is a go-to of mine if I’m ever out with people who are drinking cocktails (and always has been in fact, even before I was diabetic) That is the legendary/infamous Long Island Ice Tea. This is because the majority of this cocktail is actually spirits and there is one mixer, Pepsi or Cola. Of course, you can easily swap this out for its sugar free alternative. It is bloody strong though so be careful.
So, those are what I would class as the different drink ‘groups’ (not to be mistaken for your 5-a-day), how they affect me and my thoughts on what you need to consider.
Diabetes And Drinking Alcohol Side Effects
We’ve talked about the specific drinks, and their specific effects, but it’s worth having a general recap of the effects drinking can have when you are a type one diabetic:
- Alcohol can make you go high or low
- Different alcohol will do different things to different people
- Alcohol makes your liver work harder, impacting how it can help control your blood sugar
- Alcohol can interact with some oral diabetes medicine (I only use insulin so can’t comment much on this, here’s some more info)
Pretty gnarly right? Thankfully, if you’re conscientious and clever about it, you can really minimise these effects.
There’s more to diabetes and drinking than just the drinks though. I think it would be beneficial for me to run through some diabetic drinking dos and donts, some diabetic drink hacks if you will, all learnt the hard way by myself. This is with the aim of making sure you can stay safe and have as enjoyable a night as possible.
Type One Diabetes And Drinking Tips
1. Make Sure You Carry Everything You Need With You (And Let Your Friends Know Where It Is And How To Use It)
Depending on the sort of state you get into when drinking (no judgement here) having your friends know how to test your blood sugar and administer you a correction can be the difference between you waking up in bed with a stinking hangover or waking up in A&E connected to a drip.
If, like my friends, yours care about you and are decent people, they will be happy and even interested to learn about how to help you. This isn’t always an easy one, as you can’t always choose who you hang around with, but hopefully you’ll have at least one or two people that you can trust with this.
2. Test Often
This is one of the simplest and most effective tips I can offer you and also the one I am most guilty of forgetting or avoiding. Regular testing is the only way you will find out where you are on the BG rollercoaster and whether you need to bring it down a notch or bring it up a touch. However, when you’re out with people, especially people you may not know that well, testing can be a bit of a weird prospect. You don’t know whether you’ll pull out a tester and get met with weird looks, hundreds of questions, an awkward silence or, of course, nothing at all. I get that mind-set because I have been there very often and do sometimes end up there even now.
You are doing yourself a disservice though if you second guess whether you should be testing or not. After 3 years of being diabetic I can safely say that I can count on one hand the number of times testing in public has led to anything at all, and all of those times it was a simple question and conversation. Nothing more weird, or painful, than that. So please, get your tester out and enjoy yourself safe in the knowledge you’ve got your BG in control.
3. Talk To Security Staff
As I’m sure you know bouncers can be quite high strung and jumpy and can sometimes be looking for any excuse to cause a problem. Head that off by making them aware of what you’re carrying on you and why are you carrying it as you’re entering a club. This way you can avoid any misunderstandings, possible confrontation, and a general bad experience.
4. Avoid Rounds Wherever Possible
This isn’t always easy, and you don’t want to come across as tight, but staying out of rounds means you won’t have to consume drinks that don’t sit well with your diabetes. I myself have fallen victim, quite a few times, to gentle peer pressuring into drinking beverages that aren’t going to help me. Think Jaeger bombs. On this, if people are doing shots or Jaegers, make sure you order a spirit that works for you.
5. Get Food At The End Of The Night (And The Morning After)
This isn’t a very hard one for me to stay on top of, because I love a filthy drunken kebab. All joking aside though, eating a meal with a good amount of carbs is really important after a night of drinking. This is because drinking can spike your blood sugar in the short term, and drop your blood sugar in the medium to long term (more on the science behind that here).
So you may leave a club with a high BG, deliver a correctional dose, and go home and fall asleep. If at some point in the process you haven’t taken on any carbohydrates you run the risk of falling into a dangerous low during the night and, in the worst case scenario, not waking up again in the morning. Eating a meal with a good amount of carbs in, after you finish drinking, ensures your body has a source of carbohydrates to level out the inevitable dip it will experience post alcohol ensuring you will still wake up in the morning. It won’t do much about the hangover though unfortunately.
While we’re on the morning, the next day is the real witching hour for an alcohol related hypo so, no matter how ropey you feel, make sure you eat a nice, low GI carb breakfast in the morning. Then crawl back into bed if you have to.
6. Know When To Stop
This rule is applicable to everybody, not just diabetics. But I feel it is more pertinent when you are dealing with a challenge such as type one diabetes. What I mean by knowing when to stop is knowing when you’ve had enough to drink. Knowing when you’ve had enough while also fulfilling your desire to have a good time can be the difference between still making it home in one piece. In fact, as we’ve already seen, really overdoing it can actually lead to a drop in your blood glucose levels on the night which could be catastrophic.
In practice this really means making sure you don’t drink so much you end up blackout drunk or passed out somewhere on a bench, in an alley, or in your back garden. Combining the dangers of drunken blackouts with the challenges of type one diabetes is a very, very risky game to play and has no doubt killed diabetics in the past. Check out Max’s experience below, good thing he was with his mates!
So there you have it, all the sage advice I have to personally offer on this subject. Just because these are the only questions, thoughts and experiences I can think to write about now doesn’t mean they are all the ones I have had or are all the ones that are relevant to you. Please drop me a comment or get involved in the discussion on social media if you’ve got another question you want answered.