Sugar Mama's Podcast: Type 1 Diabetes

#60 TEEN SERIES Part 8: Drinking and Diabetes with Rachel Halverson, RN, CDCES

March 03, 2022 Katie Roseborough Season 1 Episode 60
Sugar Mama's Podcast: Type 1 Diabetes
#60 TEEN SERIES Part 8: Drinking and Diabetes with Rachel Halverson, RN, CDCES
Show Notes Transcript

Today, Rachel Halverson (RN, CDCES), and I are talking about drinking, diabetes and the effect that alcohol has on blood sugar. Why is this HERE as part of the teen series, you may be wondering?? I think it's very important to have a calm discussion with your older teen about how alcohol effects the liver and what that can do to blood sugar levels in the body of a T1D. My hope is that they will use that information to make smart decisions that will keep them safe while out with friends. Quite honestly, I think we are kidding ourselves if we think our teen is never going to drink before they are legally allowed to do so. This episode is full of great and, in my opinion, fascinating, information.

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Katie:

This is episode 60 of the sugar mamas podcast and the eighth in the series for parents of teens living with type one, Rachel Halverson, my favorite certified diabetes care and education specialist. She's back today to talk to us about drinking alcohol and the effect it has on blood sugars. If you're wondering why I chose to put this in the teen series, then you'll just have to keep listening to find out. You're listening to the sugar mamas podcast, a show designed for moms and caregivers of type one diabetics here. You'll find a community of like-minded people who are striving daily to keep their kids safe, happy, and healthy in the ever-changing world of type one. I'm your host and fellow T one D mom, Katie Roseboro. Before we get started. I need you to know that nothing you hear on the sugar mamas podcast should be considered medical advice. Please be safe, be smart, and always consult your physician before making changes to the way you manage type one diabetes. Thanks. All right. We are back with Rachel Halverson and today. Rachel and I are talking about drinking with diabetes and alcohol and just the effects that it has on the body. yeah, I just, I have to say, cause this thing it's so funny, but Rachel brought it up too. I named this episode drinking with Rachel and if it wasn't 10 30 in the morning right now, Rachel and I decided that it would have been very appropriate to show. With a beverage

Rachel:

For science.

Katie:

for science for the sake of science, maybe next time. yes. Well, hello, Rachel, how are you?

Rachel:

I'm doing well. I'm excited to be back.

Katie:

I'm always excited to have you on, it's getting bad though. Cause now I know I can show up to Rachel's talks with Rachel with like, like right now my hair is soaking wet because I didn't have time to dry it. So like I've already told her, I looked like a wet rat that climbed out of the swimming pool. So who knows what was going to be next time, Rachel? I mean, I might just be laying in my bed, recording an episode.

Rachel:

I'm like in a blink 180 2 shirt from the nineties and I even, yeah. It's, it's not you, you look great comparatively.

Katie:

thanks. Well, just for anyone listening, if you ever want to come on the show, there's no dress code. You can just show up in your pajamas, whatever it is you're wearing All right. Well, this is a, this is kind of a touchy subject, especially for a podcast that is for parents and caregivers of T1 DS. And this is going to be part of our teen series. but I think it's something that's really important to talk about, because I don't know about you, but it's confession time, but I did drink alcohol before I did. 21. So, and I feel like really, you'd be hard pressed to find a teen that hasn't right before they get to college most likely, or definitely when they get to college, if not before

Rachel:

yes. Definitely fair to say. I was a bit of a weirdo and like waited until 21%, but that was weird. and I can attest like most of my friends had already, like, it wasn't even fun by the time I was 21, cause everybody was burned out, uh, drinking. So cause they, they did it before me. So, yeah, I mean, it's definitely, it's a thing to discuss because it happened so much earlier than we, we think it will.

Katie:

well, Rachel I'm majorly impressed.

Rachel:

I don't know what I was like busy studying or something. It was so bizarre, but yeah,

Katie:

do you think this is something that's even worth bringing up too? I hope so. Cause we're about to record an episode on it, but do you think it's something worth bringing up to parents who have T1 D teens?

Rachel:

absolutely. because, you know, even if it's something that we, we hope that our. Teens. We'll wait until they're a little bit older and a little bit more able to make some more mature decisions to do those mature activities. the reality of it is that just what happens, statistically speaking, and just from our society and cultural standpoint, we tend to, we just, We often drink a lot earlier than 21.

Katie:

Yeah.,

Rachel:

so I, I think it's, it is important because of what happens when you have type one diabetes to have that discussion with your, with your team or your, if they're going off to college to reiterate that with them. and, and we'll have that discussion with them.

Katie:

And I mean, I think the U S has like one of the latest drinking ages.

Rachel:

Yeah.

Katie:

the world. So if people are listening from other countries, which I know a lot of people do, then, then yeah, they, their kid might be able to drink at 18 or maybe even younger than that. You know, a lot of times younger than that, it was so funny when my sister turned 18, my dad was like, okay, well, what do you wanna do you wanna vote like out to a bar and get a drink? And my sister was. Um, dad, I'm only 18. he was like, wait a minute. What's the drinking age? And she was like 21. And he's like, when did they change that?

Rachel:

Yeah, I was good. Yeah. It was 18. Not too long ago. It was like a couple what, 20 years ago or something. So

Katie:

to be more than that. Cause my sister's 40, but I mean, yeah, maybe not, not too long, relatively speaking, maybe 30 or so years ago. So yeah. I used to be used to be a teen years. Okay. So let's just start with basic question of how does alcohol affect blood sugars?

Rachel:

It is wildly unpredictable, which is why it is important to talk about it because it is very, it, it relies on like a lot of different factors. so it can drop you. That's usually what we're concerned about is the, the hypoglycemia accompanied with. Alcohol drinking. and we'll talk more about the processes with that, but, typically drops you low and for a lot of people also, it can be. Treating above target blood sugars, difficult as well because it to hide alcohol dehydrates, you and, just makes, makes it difficult to get the insulin moving at that point. so it can do lots of, lots of different stuff to your blood sugar. But the main thing we are concerned about usually is those that blood sugar drop, that happens. Usually overnight, unfortunately, happens hours after you've been, you've been drinking.

Katie:

And I'm guessing not all alcohols are created equal. Can we maybe like break it down and talk about different ones? like what about beer?

Rachel:

they all have the same. Effect on the blood sugar. the issue mainly is like, you know, wine and beer are going to have carbs because of what they're made of. Um, and then, you know, those sugary mixers also are gonna have carbs. So that, that does make it more unpredictable when you add some carbs in, and then you're like, well, do I bolus for this? How much more do I bolus for it? if I'm kind of worried about going low. They, but they do, you know, depending on the type, necessarily change the effect that alcohol is going to have on you. but rather it's just that the addition of carbohydrates that may be, might add a little bit of uncertainty when you're kinda kind of doing stuff.

Katie:

Yeah. So we'll, we'll get back to that in a second with the carb heavy alcoholic beverages, but like, let's just say hypothetically you're in like a lab setting and somebody with type one diabetes is going to take like a shot of vodka that has no carbs in it. Right. So is that by itself, like the effect of the alcohol is that it's going to lower your blood sugar.

Rachel:

Yes. So, when you are drinking alcohol, Your liver has decided that alcohol is the main thing to process and nothing else. So it's not even really going to be processing a food anymore. And it's also not going to what the liver does on a day-to-day basis in people, without diabetes and people that are living with diabetes. It, uh, affected by glucagon, which is a hormone that we still produce with diabetes, but a little bit weirder and more unpredictably, but we still produce it and glucagon causes the liver to produce, really sugar stored up glycogen, which, which acts as glucose in the bloodstream. And when you are drinking, that's not going to be happening anymore because your liver is busy processing the alcohol, because that is a, it's like the first threat that it sees. And that's, that's what it wants to work on. So you're not going to be getting that glucose that's stored up in the liver. And that's why we tend to see people dropping because we have basil rates. And things like that that are typically we are using for, that the glycogen release. So when your liver is, is busy, that's, that's why we see those, those drops is because that's not going to be happening anymore.

Katie:

Interesting. Okay. So the liver is very, it's like, it can only do one thing at a time, so,

Rachel:

Yeah,

Katie:

okay.

Rachel:

can't multitask.

Katie:

so if the liver was a human let's personify the liver, it would not be a mom.

Rachel:

No, Nope. It is very one track. One minded it's yeah. It's not very helpful in this situation.

Katie:

Okay. I, there was a disconnect in my brain about why, cause I kept reading that like alcohol is going to drop your blood sugar and I'm like, well, why nobody's explaining why it's going to drop your blood sugar.

Rachel:

Yeah.

Katie:

sense. Okay. Cause your liver can only do one thing at a time. And when there's alcohol in the system, it's going to focus on that and filtering that through.

Rachel:

Yup.

Katie:

Okay. So, and then it's not going to be till how long does it usually take the liver? I mean, I guess it depends on how much he drank, but like, like what is it like a tip, like one drink? How long does it take the liver to process, know, a beer or a glass of wine or something like that?

Rachel:

That would vary per person, I think is it, it's like two to three hours. whenever you're not, when you're, when you're supposed to, however long you're supposed to wait before you go drive, after you have those, I would never like even probably have one drink and drive, but. so I, I'm not

Katie:

hours, Rachel 24 hours.

Rachel:

I always thought that was weird advice, like have one glass of wine and go drink. I would just feel very wrong doing that. But I think it's like two to three hours is kind of, if you had one, you know, wine, drink a wine or a shot, a serving of, alcohol, which is like a glass of wine, one beer, six ounces of hard liquor or something like that. But, you know, typically when we are, if you are a younger person drinking, you're probably gonna have a little bit more than that. And then, you know, that's just going to take longer to process. and yeah, when that's the case, then the liver is really not going to be paying attention to your blood sugars.

Katie:

You said six ounces of liquor. And I'm like, that sounds like a lot of liquor. Cause isn't an ounce

Rachel:

one.

Katie:

ounce of liquor. I mean a it's a shot, isn't it. Or one. and a half ounces. Maybe it's One and a half. I just Googled it. Here. I'll read it. What is a standard drink? So 12 fluid ounces of regular beer, eight to nine fluid ounces of malt liquor, five, five. They've changed that five fluid ounces of table wine. I'm like, I think he used to be eight. Dang.

Rachel:

That's that's what it says.

Katie:

And then 1.5 fluid ounces of spirits, like liquor and rom and all that stuff. Okay. We got off, we got off track, but just FYI for anybody that wanted to know what a standard serving size was.

Rachel:

Right. Well, you're supposed to have like one drink. If you're a lady get one drink a day and then two drinks for men today. like I'm like, I can't imagine drinking every day. I would just be,

Katie:

Oh, I can't either. I know.

Rachel:

but yes, that's the typical serving size recommendations every day for.

Katie:

Well, and the older I get, I can't like I can't even sleep anymore. If I have even a glass of wine. I'm like, well, this is fun. This is so

Rachel:

No, I totally agree. Not worth it.

Katie:

Right. Well, let's talk about, the carbs. Let's go back to the carbs. So, you know, rarely are people just doing shots right? In the absence, especially in the absence of food or at least I hope they're not. Cause that would be very dangerous. But so either there's carbs in the beer or the wine or in the sugary mixers that you're dealing with. And then you're also usually like eating on top of that because most people at least start drinking when there's a meal involved. So. W, how do you handle that? Like how, how do you know, do you even bolus for the carbs in a beer or a glass of wine, or do you cut back on your Bazell rate? Like, I'm sure everybody's different, but what have you, what do you typically do and what are your thoughts on that?

Rachel:

I think if anything, you're going to cut back on, it would be like your basal rate. And you know it now we have, thank goodness we have continuous glucose monitors available. Cause that's really what made it so difficult and dangerous previously. I mean, I personally still don't want to go above target, so I. for, if you can opt for those sugar-free, you know, like a diet, rum and Coke or a skinny, any skinny version of something is going to be the low sugar version. Um, just cause we don't want to add that kind of thing to the mix. Um, as much as possible if though you choose to have. And I think for the most part, like beer and wine are They're not as sugary as those, those mixers. So that's still kind of a safe thing to, to bolus for. And unfortunately, the other thing that's crazy is that there's no nutrition facts or labels on your alcoholic beverages because it is not regulated by the FDA. So that's always a pain in the butt. So you're going to have to Google. What the, carb count is on those. and if you're a little tipsy, that can be a struggle as well. so I, I do, I try really hard myself to I'm I'm like a vodka soda person. Like it's very no carbs kind of experience because I just don't want to, if I'm going to be bolusing for something, I want it to be my food basically. and you want to always be eating with your alcohol because. If you're drinking on an empty stomach, it's gonna move very, very quickly and really inhibit your liver and, and everything else. So I'm always having a meal and thankfully bar food is very, it's what we would recommend it's high,

Katie:

Cracker.

Rachel:

high protein, a little bit of carbs. Just to help hold you overnight and everything like that. I think. I think it's totally reasonable to consider that attempt. Bazell like you would use for exercises is reasonable to put on during this time. If you are MDI the same thing you would do as if you're about to go exercise. So maybe just a little bit less, insulin than you would take for a snack or something along those lines, just because we want to air on the, on the side of caution. If you have the opportunity to drink something that's lower in sugar, you know, aim for that, just cause I really, it can be very triggering to see your blood sugar spike from those sugary drinks and you want to bolus for them and raged bolus and that kind of thing. So if you can kind of prevent that from happening as much as possible then, that would be. A good recommendation, but you do. Yeah. It's a, it's a balancing act sort of thing as you sort of figure out how you react to alcohol and, and that sort of thing, then you'll, you'll kind of understand what, what a good percentage of the bolus is for you to take. And it's kind of observing.

Katie:

I feel like you could get into a sticky situation if you had something really sugary, like a margarita or something like that, and it spiked you. And then, like you said, you're kind of tempted to bolus for that, but then you're not thinking about, you know, later on down the road, it's that alcohol is going to bring you down anyway. Because of what what's going on in the liver.

Rachel:

Right, right.

Katie:

Okay. Okay. Well, so, but if you were to go out and like have a drink and you are doing like a L no sugar, no carb beverage, but you're also eating a meal. You would still bolus for the meal. Like you would know, like you normally would, or maybe do a tiny bit less or.

Rachel:

if, if you're wearing an insulin pump, I think the decrease in temp Bazell is. Good. And we'll set you up for being as safe as well. And of course, if you're wearing these control IQ or the new Omni pod or something like that, Shuts off Bazell or adjusts it for your, for what's going on. that is also an added layer of protection for you, yes, it is still advised that you correct and bolus at the same rate. maybe a little bit less if, especially if you're, if you're dancing or being active or running around like a crazy person, but. Yeah. If you're just having a normal, normal people night at the bar or something. Yeah. Kind of just, just as you normally would, bolus would be fine,

Katie:

Yeah. And you bring up a good point because people aren't usually just sitting on their couch, especially in college, you know, or the teen years sitting on their couch and drinking by themselves. they're usually like out walking around, the bar scene or the club scene or they're out dancing. So there's the activity to factor into. So like I like that advice, like until, you know how your body's going to react. Just be cautious, just be

Rachel:

Right, right.

Katie:

Yeah. I think my main concern with a teen would be, and not that I'm going to be, I'm definitely going to talk to Sarah about this because I think she needs to be aware and I don't want to like scare her or anything, but like, Hey, you're, you know, this is what alcohol does, in a body that has diabetes and this is why you need to be mindful of it. And, just so she knows, and can be, it could be thinking about it. I don't know, I thoughts on this and opinions on this is probably very different, but I don't, I don't feel like having a, level headed conversation with your teen about something like that is gonna, encourage them to just go out and go hog wild. I don't think it necessarily means you're giving them permission to go do those things. You're just being realistic and it's like, you know, chances. This is probably going to happen. Not that you actually have to say that to your team, but you know, in your mind that chances are, this is probably going to happen. So I at least want you to be aware of what could, could happen.

Rachel:

I mean, it definitely helps to have them make better decisions. I, had, they did have that conversation with me, I obviously was not paying enough attention, but I. Even as somebody that did follow the quote-unquote rules and went out when I was 21, I was still being very reckless because I did not understand what it did to my diabetes. And this was pre CGMs, all that good stuff. So I was like falling asleep, like didn't care, um, because it just wasn't a conversation that anybody had with me. I think it's, it's good to say, Hey, I, I'm not going to lecture you about this, but I want you to know that there are serious implications and dangerous for somebody with diabetes when they're drinking. Would it be okay if we talked about it and if they're not okay, talking about it with you, then asking your healthcare provider to discuss it with them or giving them a little, uh there's. Uh, the college diabetes network has some really good information about drinking. Um, and we can link it, but. Giving giving them that resource and, and always just bringing it up every, every couple of years before we, we send them off is really important, just so that they are again, reminded of the fact that they, they need to be a little bit more careful than the average person. So I think that's totally reasonable.

Katie:

Yeah. I agree. all right. My next question is about the liver, but we kind of already talked about that. oh, I do have a question. Okay. So let's review real quick. The liver has a one track, mind cannot multitask. So when there's alcohol in the system, it's focusing on processing the alcohol and it's not releasing the normal glucose that it normally releases. okay. And then. Y. So I have heard and read that glucagon, like, let's say somebody was out drinking and they did have a pretty severe low, or even just a low or whatever. And they, or maybe a friend was trying to give them glucagon. I have heard that glucagon is not effective when you're drinking alcohol. Is that true? And if so, why? Hey guys, it's Katie interrupting for just a second to tell you about the product feature of the week diet detector, test strips. Have you ever ordered a diet drink for your type one kiddo at a restaurant, and then watch as their blood sugar launches off into outer space because the beverage they were served, wasn't actually a diet. Yeah, it's really not very fun. But with the diet detector test strips, you can be confident that the drinks you order are T one D friendly. You literally just dip the test, strip into the drink and within seconds, you know, if it's really what you asked for, I will leave an Amazon affiliate link in the show notes. So you can grab some for your diabetes. Last I want to give a huge shout out to Heather thumb, who recently supported the show through buy me a coffee. Thank you so much for your generous donation. I can assure you that every single penny given goes straight into the software virtual space and equipment needed each week to make this show come to life. So again, from the bottom of my heart and the bottom of my daughter's insulin cartridge. Thank you. Would you like to check it out? Head on over to buy me a coffee.com forward slash sugar. Mama. I'll leave a link in the show notes. I have heard that glucagon is not effective when you're drinking alcohol. Is that true? And if so, why?

Rachel:

It is. Yeah. And that's again, part of what makes it so stank and dangerous is fact that the lows are not only does it make you low, but it also makes the lows really hard to treat. Yeah, so the glucagon. It's the same glucagon that your alpha cells release and poke at the liver and say, Hey, we need you to release some glycogen and then turn that into glucose.

Katie:

Hm.

Rachel:

When you're injecting that glucagon, same thing. It's going to say I'm busy. I'm not going to do it. So, the, the glucagon injection is not going to be effective and it's not going to work. and so if that person who has been drinking and has diabetes is passed out, our only option now is to take them to the emergency room, to get, Ivy dextrose, which is glucose and. that they can push and super, I actually, I think even the EMT is, can do it. So somebody will come in and push that, very quickly. And, and I say that, and I know that sounds really drastic and crazy, because we usually kind of associate the hospital with like a really, we should know. Same with glucagon. We often think glucagon is this last resort. And then I get worried that people are afraid to use it because it's got like this stigma attached to it and same with the hospital. But, you know, by all means, please call someone if that is the case. because yeah, it's, the glucagon is not going, going to work because your, your liver is busy. Unfortunately.

Katie:

Yeah, I think, and I forget get it too, but I think a lot of people think that glucagon, like the, like we have the nasal spray and then I know a lot of people use like the G Voke hypo pen. And there's like the old school glucagon, but I think a lot of people That glucagon is glucose. Like you are putting glucose into the system, but it's not, it's, it's a substance that's going to trigger the liver. And then the liver will dump out glycogen or like their normal sugar supplies. so, and then of course, like we already discussed, if the liver's already processing alcohol, it's not going to pay attention to that glucagon. So what about like, would shoving frosting in someone's cheek work in that situation or like, cause it's, that's getting absorbed through the, saliva or membranes or whatever it's getting absorbed through the thing.

Rachel:

yeah, that's definitely a possibility as well. I do worry just because, depending on. Yeah, I D I get nervous, I guess suggesting those things just cause, Are, you know? Yeah. And you know, like other processes in the body are a little bit inhibited as well, if you are that out of it. but yeah, so, so putting some sugar, so I always, whenever I'm. Your, you know, when you're walking around and you're drinking, hopefully you're walking around and the, the glucose, glucose, tablets, and glucose gels and things that you can put in your mouth and dissolve that way are going to be the best way to treat a low when you are drinking. Because also, unfortunately we tend to eat a bunch of junk. Sometimes if we weren't paying, you know, pizza party or something like that, We also have, now our digestive system is a little bit slower than it should be. So Google's tabs in gel are going to be your best friend or some frosting, like stick that on your cheek. but yes, it's somebody unconscious. I prefer that we just, you know, call,

Katie:

right.

Rachel:

Emergency services just cause yeah, there, there could be, a fear that somebody could choke on something or throw up and then we just have more issues.

Katie:

I feel like I've been doing a lot of laughing, which is really not inappropriate. That's that this is not like an inappropriate, this is part of my coping mechanism. Everybody, if you're wondering why I'm laughing, it's just a terrifying and a little uncomfortable to talk about. So that's why you probably hear me laughing. But when you, when we were talking about frosting and you. You said, like walking around if you're walking around and you've been out drinking, like using frosting, have you ever been at a kid's birthday party and like the frosting on the cake or the cupcake is blue and it's like their entire mouth and their teeth. So I'm just picturing like this college age kid, like out dancing and they're got blue teeth.

Rachel:

I mean, is like this, maybe this will comfort someone a little bit, but like, we I've been out like, this is probably just an insane scene, but like I work or I, I volunteer with a diabetes camp and the. Also has type one diabetes and after the camps are over, we usually go out to a bar and two and have some drinks together. it's honestly like I, if the bartenders knew how volatile the situation was, I'm sure they would never, be like, this is ridiculous. but, it's funny because one time. I was texting a friend that was at that party and I was at a different place. And I, I was talking to him and he said, yeah, we were at so-and-so bar. And now we're at the ER.

Katie:

Oh, no.

Rachel:

this girl's blood sugar wouldn't come up. And my, I texted her, I said, where's the ER, I thought it was another bar,

Katie:

Oh, my gosh.

Rachel:

but, but it was a very matter of fact, like all these, you know, they're all nurses with diabetes. And they all knew, like we need to just go to the emergency room and

Katie:

Have

Rachel:

Some, this person wasn't passed out or anything like that, but they were just having difficulty getting her blood sugar up and they were like, we're just going to have to go

Katie:

the, or you're like, where's he, I've never heard of the, ER, sounds like a fun place.

Rachel:

some trendy, like club or something.

Katie:

Yeah.

Rachel:

So, we still, we still have fun despite the fact that it is, it tends to be a little bit more unpredictable, but I think that's important too, to make everybody aware that like going to the ER is not sometimes that is necessary. And it's a tool that we, as people with diabetes have to use sometimes. And that's okay. I obviously don't want you to have to go, but if push comes to shove and you can't treat the low and you know, that glucagon is not an option for you, then that's totally an okay. Step to take. And you can text me about it and I will know exactly where you are this time, so,

Katie:

yeah. well, and at some point in time, they started calling ER, the ed, in a lot of places. So, you know, I feel like that's an honest mistake. I know. when I started working at a hospital, this was back in 2012. I remember like looking up charts for patients that I was going to go see, and I'm like, what is the ed? Like? What does ed cause you know, there's like a million acronyms in there. I'm like the ed, I had to ask one of my coworkers, like, what does ed stand for? I've never seen that acronym. They're like, uh, emergency department. I'm like, oh, well when did we start calling it? The ed. But it was the ER.

Rachel:

I know they, they're just changing these names up on me and I feel, you

Katie:

I know, right,

Rachel:

know, we know.

Katie:

exactly. We won't mistake mistaken for a bar next time. Hilarious. All right. okay. So luckily that person that you were just talking about was with a group of who knew what to do. But, most of the time you're probably going to be out with people that don't have type one. I would imagine, so I just definitely want to like pause for a second and talk to parents about like, trying to encourage your kid to educate their friends about. Just type one in general, teach them how to use your glucagon if you ever needed

Rachel:

yeah,

Katie:

mean, obviously when maybe work in the case of the drinking situation, but like, you know, even if there's just at school or, you know, at a sporting event or whatever, try to encourage your teens to educate their friends and teach them how to use, use their stuff, should they, should they need to, give their friends your phone number. And I mean, I'll definitely. I would never be angry at somebody for calling me in an emergency, I would just be grateful that they called me. But what else? Like what, you know, it's, it's tricky because being. Drunk or tipsy can often look like you're

Rachel:

look like your book.

Katie:

So there a difference, but between the two, like, I mean, I'm just curious to know. I mean, if you're a teen and you're out drinking, you're probably not going to have any clue, but is there a difference between actually being low and being tipsy?

Rachel:

another layer to the, again, I'm so sorry. It's it's, it's like the Olympics Uh, diabetes, because it really adds all of these challenges. and that's one of them also, you really probably are not going to be able to tell the difference in yourself and someone else who is having a hypo episode. I watched like a couple of cops episodes where they would pull people over. Looked very drunk and were acting super drunk and they actually just had low blood sugars. So, um, it's really hard to tell, and the person that is experiencing it probably won't be able to, it really masks those symptoms as well. So you're really going to be relying on finger sticks or CGM checks. The alcohol should not affect your continuous glucose monitor readings, so those should still be accurate. So that's, that's a good thing to know. But, I always, like my designated driver is always also my designated diabetes buddy. Like I let them know that this is, this is what needs to happen. like I have a little index card and I write down, it's like, It's like caring for someone's someone's plant when they leave. but yeah, like this, this is what I need. If this happens, this is where my supplies are, if this happens. when in doubt, if something seems off to you, it is okay. I am not going to be upset if you call nine 11 and get me help, like that is okay. So, uh, and then honestly, like just letting everybody, so like, I always let, my, my mom would text me when I got to a new dorm or something was like, you have to tell your roommates that you have type one diabetes, but yes, always just letting people know kind of what you're I know at the time that it annoys me, but I did. And I'm sure it was, it was helpful,

Katie:

Yeah.

Rachel:

to have, have everybody around, you know, that, but especially when you're in a group of people that are drinking to. Have them aware of that so they can assist you when they hear that Dexcom alarm. Cause it's still going to be going off.

Katie:

Oh, my gosh, Rachel, I hadn't even thought about that until right now. if you go to college and you're in a dorm and you have a random roommate, sorry, I'm so sorry, but you're going to hear me beeping in the middle of the night. These are my alarms. You're not going to get any sleep for the next four years.

Rachel:

So it's so awkward, Thankfully the college I went to, we were in separate rooms, so that was really helpful. I actually only had an insulin pump, so I didn't have that same experience, but yeah, it's, it's definitely, it would be ideal if they could pair you up with a, another person with diabetes. I'm sure that's something you could ask about, but Yeah. It's. But it still works out though, because you know, when you, when you are in that situation where you're with a group of people or at a party, then everybody's aware of something that might be going on. And, people are, people are really nice thankfully, and we'll, we'll try to help you. And, so

Katie:

Okay. I'm going to put that out. of my mind and not think about that again until Tara is going off to college. Cause there's no point in worrying about that now.

Rachel:

I honestly had not considered that. Because again, it's like CGMs for me are pretty new and I, I never had a shared room with somebody. so I've never considered that, uh, what I would do in that situation, they're just going to have to not sleep. They're probably not sleeping because they're studying so hard anyway,

Katie:

Yeah.

Rachel:

fine. It's fine.

Katie:

I mean, honestly, Sarah alarms don't really go off that much at night anymore. Thank goodness. Cause we've dialed in her. Bazell pretty well, but so hopefully it wouldn't be like a crazy amount of alarms going off, but anyway,

Rachel:

young adults sleep so heavy, like I'm sure it, yeah. They'll probably just sleep through it. Yeah.

Katie:

Yeah. I know I've already told Sarah, I'm gonna have to like rig up some sort of mouse trap situation, like over her bed where a bucket of cold water will get dumped on her head if she doesn't wake.

Rachel:

Like people learn how to just sleep through them. So I'm sure that all that's probably. That'll be the saving, saving grace.

Katie:

Yeah. I don't think Sarah has ever woken up for one Dexcom alarm. Which again, again, not going to be thinking about that now Going to save that worry for where are we eight years from now.

Rachel:

Right? Exactly. We have time to figure that

Katie:

Right? Exactly. Maybe it'll figure itself out. before that time. Maybe her body will, I don't know. You know, as you get older, your body's a little bit more aware of things. Okay, I'm going to start praying for that. Now I'm going to like writing down a list of prayer requests. Start praying for a good roommate. Good spouse, best friend. It's her to wake up to her alarms. Goodness gracious. All Right. Let's see. We've already covered some of those things. eating you, you mentioned eating, making sure you're. If you're you are going to drink that you are also eating with it, having food in the system. And then having a buddy system of some sort, giving friends, your kids, friends, your phone number or your spouse's phone number or whatever it takes. anything else? What other tips to stay safe while drinking.

Rachel:

I think that that really is the, there is if you are not wearing a CGM maybe you don't wake up to those alarms, it would be like, if you did some CR or your plan on doing some pretty decent drinking, or you think that might be your situation than having alarms set on your phone. I used to do that. I would, I would have it every two hours. I would, it would say check your blood sugar. And of course you're responsible to me was like, but my friends would hear it. And they were like, Rachel, it's time to check your blood sugar. So that was helpful. but also then during the night it can kind of coax you awake so you can check to make sure that you haven't dropped her, that you don't need to treat. you were much more likely to wake up to alarms when you. I have been drinking since you're getting poor sleep. But just to have that added, added alarm there, if you're not wearing a CGM or if you tend to not wake up for, for that alarm, just before you go out set those alarms so that you can unfortunately wake up in the middle of the night just to check on things, but that would, that would be something I would, add, add into it, just to give yourself some extra, extra reminders and accountability.

Katie:

Okay. That's a good idea. Yeah. it just seems like. Such an unpredictable thing, which is the first, those are the first words that came out of your mouth. So trial and error, lots and lots of trial and error

Rachel:

Yeah.

Katie:

Okay. I think, I think that about covers it for my questions. Is there anything else that you think we missed or anything else you want to add?

Rachel:

I don't think so. if it comforts anybody, most people I know, and myself included have very good experiences

Katie:

Yeah.

Rachel:

drinking alcohol. These are more like, you know, uh, worst case scenario kind of experiences, but

Katie:

Yeah.

Rachel:

most of the time, you know, it, it might drop your blood sugar. but a lot of the time you, you tend to stay kind of within normal limits. You're pretty good about just monitoring it.

Katie:

Yeah. And I think the real danger comes when you're just drinking way too much, which I mean can happen, especially in college, but hopefully if you've had a chat with them beforehand, so there are aware there'll be a lot more. willing and, you know, capable of taking care of themselves and staying safe. So, anyway, goodness, I hope I didn't scare anybody. It probably did probably scared the pants off of most parents listening to this.

Rachel:

I think I that's what I think it would be really surprising to find out how supportive friends are and how, how responsible they are when they, when they have someone, um, that needs a little, little bit of extra monitoring and that kind of thing. So if there is ever a situation where somebody needs a little bit more help or is a little bit more out of it, then than everybody else in the group, they are, you know, I was, I was, I know I was always very impressed. My friends always took really good care of me as well.

Katie:

Yeah.

Rachel:

that's one perk, like when the sure friends are, tend to be bad influences, but they do, they do, they are very good at that. Just making sure everybody's safe.

Katie:

Yeah, that's good. All right. Well, thank you So, much. Thanks. Thank you for your time. And, oh, you know what, real quick, just take a minute. Cause I've been, I've been talking it up on, some of my other episodes, but tell people about your bolus busters course that you've created. It's amazing everybody.

Rachel:

I'm super excited about it. So I, I know there was a lot of, there's always a lot of, it's just like a struggle, trying to figure out like what. The right technique is for certain foods like pizza or takeout, breakfast, cereal, all of those sorts of things. So I put it all into one spot, to kind of help people get a deeper dive and understanding of how foods are digested and how that affects the blood sugar and how you can bolus for them. So when you, when you're making those decisions, or helping your, your kid make those decisions, you, you. You have a little bit better of a plan put in place to or baseline. cause again, something else that is very variable and unique is, is But, so it does take, take some trial and error, but in this way, at least you'll, you'll have like a very deep understanding of how it works in the body and, and, um, like a good baseline and. Liberal tools for tracking those things and, workbooks to go through and a little section, thanks to, thanks to Katie on alcohol. it has a, the diet, uh, let's see the designated diabetes buddy index card that I handed my friends in there. so, uh, yeah. And yeah, so that's the, and you can find it on. My website, which is www dot, give me some sugar.coach/bolus busters. it'll be, it'll be there.

Katie:

Yeah. Yeah, it's really great. I had the opportunity to go through it myself. You know, I it's, I Like how you've it's a lot of, I don't know, you just laid it out in such like an easy to follow, easy to understand practical way there's texts, there's videos, there's pictures. So it's kind of like, you know, it. hits all the senses and, I think it was Great. And I really liked that. It's not just like a course that people sign up for. Like they see, they can act, they actually have access to you where they can, you know, use the chat box to kind of ask you questions, troubleshoot things, get your opinion on things. So I think it's great. I'll link to it in the show notes for sure.

Rachel:

Great. Thanks

Katie:

You're welcome. All right, girl. Well, have a good rest of your day. It's we still got the whole day ahead of us really. I'm going to go blood dry my here All right. Have a good one. See you soon. Bye. That's it for our show today, I will link to the information that Rachel alluded to about drinking from the college diabetes network that will be in the show notes. And let's see, I will also link to where you can find Rachel and her new super amazing bolus busters course check. Seriously, if you're having trouble getting diabetes under control and you want a little bit more one-on-one time and attention from a certified diabetes care and education specialist on how you can bolus for those are really tricky foods and really just all foods in general. Then you should definitely take a look at the course. Not only do you have access to awesome. But you also have access to Rachel she's available to chat and help you troubleshoot and take all the information you learned from the course and apply it to your everyday life. Again, all the links are in the show notes and bonus. If you use code sugar, mama that's S U G a R M a M. At checkout, you can save $50 off the course. That's pretty sweet Emma. Right? All right. Talk with you next time, friends as always stay calm and bolus on bye.