Diabetes in the Raw
Diabetes in the Raw
Ep. 18 - Let's Talk Alcohol - Safety Considerations & Handy Tips
Use Left/Right to seek, Home/End to jump to start or end. Hold shift to jump forward or backward.
This is a quick one where Jaimee talks about the impacts of alcohol for those of us living with diabetes. Planning and knowledge is key to keeping safe if consuming alcohol when you have Type 1 or Type 2 diabetes. This has some tips for everyone, from the young ones to those of the more mature years 😊 I touch on some of the better choices of alcohol, how to reduce risks of the very dangerous hypo’s (low blood glucose levels) when drinking, the short-term and long-term considerations, planning & why glucagon injections may not work in the case of severe hypo. Why correction doses may be dangerous for those on insulin. Tips on how often you should check your glucose levels after drinking, and for how long after? Jaimee shares a bit about her personal (and silly) moments with alcohol when she was younger with T1D. This episode is basically a summary of the NDSS fact sheet on alcohol and diabetes (link below). THIS IS NOT INDIVIDUALISED ADVICE! Please check with your healthcare team before making any decisions or management changes to your diabetes.
References for this episode:
Please get in touch if you have any kind of diabetes and would like to share. We would love to have parents or family members on too.
Women with Gestational Diabetes - sharing your experience will certainly help others on their journey, so please do reach out if you are willing :-)
Don't forget to rate us on your favourite podcast app so we can help more people living diabetes feel less alone!
Follow Diabetes in the Raw Podcast on Instagram or Facebook
Jaimee and Hayley (@diabetesintheraw)
Diabetes in the raw podcast | Facebook
Email us: diabetesintheraw@gmail.com
Find more about Jaimee as Credentialled Diabetes Educator at
Real-I-Deal Health - Find your happy, healthy balance
Instagram (@realidealhealth_diabetescare) & (@t1drealidealhealth)
Email: admin@real-i-dealhealth.com
Welcome to Diabetes in the Raw podcast. I'm Jamie. I'm Hayley. And together we are Diabetes in the Raw. We both live with diabetes, but in different ways. Jamie has type 1 diabetes and has lived with it for over 25 years and is also a credentialed diabetes educator. Hayley has two boys who both have type 1 diabetes. Listen in as we share our lived experiences and our guest share theirs. Please get in touch via our socials or email if you would be interested in coming on as a guest. Our contact details will be in the show notes. Nothing in this podcast is intended as individual medical advice. Always talk to your healthcare team before making changes to your diabetes management. Please help us reach more people to help them feel less alone by rating us on your favorite podcast app. Hope you enjoy listening Hi everyone. Welcome back to another episode of Diabetes in the Raw. You've got Jamie today, solo. I'm just going to talk, briefly today about alcohol and the importance of understanding what alcohol can do to those of us living with diabetes. So most of this will be focused on type 1 diabetes, but it will also be relevant for people living with type 2 diabetes who are on insulin or oral medication that can result in low blood glucose levels or hypos, if you like. So I guess as a starting point, we'll just start with that alcohol is something that is often in our lives and something that people like to have to enjoy socializing and things like that. So it's just important that, you know, we understand the risks of drinking One important thing is to consider how calorie dense or kilojoule dense alcohol is, so it can lead to weight gain, it can lead to increased triglycerides in the blood and increased blood pressure. That's especially important if you have been diagnosed with type 1 or type 2 diabetes and already have Some of those risk factors or it's always important to watch our weight because it does increase our risk of heart disease and stroke and things like that even more by increasing cholesterol, blood pressure, things like that. I won't go into too much detail about that today. I guess the main focus was around alcohol and safety. Now some examples of some standard drinks would be 425 ml of low alcohol beer, 285 of regular beer, 250 ml of a pre mixed alcohol such as a vodka cruiser, 100 ml of wine or 30 ml of spirits. This is directly from the NDSS National Diabetes Services Scheme fact sheet. So I will post a link to that in the show notes. So, weight gain, as I mentioned, is one risk. There is a risk of hyperglycemia, or high blood glucose levels as well, because alcohol does contain carbohydrate, and depending on the type of carbohydrate, it could actually cause a spike in glucose levels. Now, This may sound confusing, but it's also something that can cause low blood glucose levels, or hypoglycemia, where you drop below 4. 0 when drinking. And the risk there is that you can actually drop low hours after drinking, which is often going to be overnight. So, it's really important that family and friends understand the risks around this as well as the person with diabetes because it's something that we need to, I guess, plan for and have, have some guardrails in place to make sure that you're safe after you've been drinking. Now, obviously we're talking not just about excess alcohol and partying, but also Just having those social drinks and being mindful of what you can do to reduce the risk of having a hypo during those sleeping hours. So let's just pretend we haven't gone out partying and got inebriated. We will just talk about... how much alcohol is actually safe. So the guidelines in Australia do say that women should limit alcohol to no more than 10 standard drinks per week and no more than four standard drinks on any one day. And the recommendation is the same for people with or without diabetes. But you might be advised to drink less if you are above the healthy weight range for your height. If you're having difficulty managing your glucose levels. And as I mentioned earlier, if you've got high blood pressure or end or triglycerides and any complications that go with diabetes, because it will increase your risks even further. So there could be other. Factors as well that can be impacted by drinking alcohol. And this is liver disease, pancreatitis obviously pregnant and breastfeeding. The guidelines suggest that we'd be best to avoid alcohol. And if you are under 18 I'm going to say... You shouldn't be drinking as a health care professional and as a mother, that would be the absolute dream. But I do understand that people do drink before they're 18. I was young once as well. So it is illegal for anyone under 18 to be drinking, but I'm not living in a bubble and I understand. So this podcast will also be to help create some safety. I think that's the most important thing when we're talking to our adolescents is if they are going to drink, hopefully they're able to tell their parents, their friends, and put some safety yeah, some safety plans in place. So let's talk about which alcohol drinks might be better than others. Generally, it's best to try and avoid very sweet drinks, such as the soft drink mixes the sweet liqueurs and the pre mixed alcohol beverages. But they're also the ones that the adolescents will often go with. So we'll talk about how we can reduce risk of hypo shortly. Wine, low alcohol beers and spirits with diet mixes or plain mineral water or soda can be good. And I'll be honest, that's what I used to do when I did drink. I, I don't drink anymore and part of that reason is because of the impact on diabetes. I found the flow on effect for 24 hours. later was just not worth it. But I have been young, I have drank, I have had some episodes where my friends yes, potentially saved my life just by knowing the difference between someone being drunk and knowing to monitor blood glucose levels. And there wasn't continuous glucose monitors out there at that time. So my dear friends and my siblings have tested my glucose level via fingerprint when I had had too much to drink and wasn't able to do that myself. And I do look back now and think how ridiculous that was. But as I said we all are young ones and we all do try different things. So if you are young and you are drinking, I just want to make sure that you know how you can try and keep yourself safe. So if you can talk to your diabetes team often. As adolescents, you'll have the opportunity to talk to your doctor and diabetes educator, dietician alone. And if you can't, then it would be a good time to say, mum, dad, I want to have a chat without you, or you can also. Even go to clinic on your own if that's possibly an option. Sometimes the doctors and diabetes educators will ask mum and dad or carers to wait in the waiting room as well just to talk about all things adolescence. So reducing, sorry, so avoiding large amounts of alcohol would be the ideal. But again not something everyone is always going to do in those younger years. That's, that's when we tend to. Go to parties and consume lots of alcohol. One of the big things you can do to make sure you're safe is have carbohydrate. So a big carb meals, rice, pasta, bread before drinking and have snacks with carb in it while you're drinking as well. Particularly if you are What, doing what we just mentioned and avoiding the super sweet mixer drinks and things like that. So if you're going for the diet alcohol drinks or the plain mineral water or soda, you definitely want to have some carbohydrate before and while you're drinking. If there's no carbs available, you might just want to have the non diet alcohol drinks or even have some fruit juice if you are having mixed drinks. But you just want to be mindful that that's. possibly and probably going to cause a spike in the glucose levels too. So then when we talk about spikes in glucose levels with diabetes and you're on insulin, we may want to go and do a big correction. And that can be really, really dangerous if you were to go and give your usual correction. for a high. The safest thing to do would probably be to wait and see what your glucose levels do in hours to come. Being mindful that if you are super high, it's probably a good time to try not to drink anymore, have some water. Make sure someone knows what you've had and what your levels are doing. And talk to your team because this podcast is just very generalized advice, very generalized information. There's no way I can give individualized advice on here. Every scenario, everyone is different. So yeah, just please talk to your team. And the first. Time or second time you drink, try not to overdo it and just check what your levels do. You might be able to find a happy place where you can have four drinks over five or six hours and everything sits pretty steady. And if you go above and beyond that, it might actually throw things outta whack. So I actually did come up with. I believe a plan where I was able to have sort of four drinks over four or five hours with some carbohydrate, go for the diet ones, and, and things glucose levels wise would sit pretty good for me. So, but yeah, it just depends on, on where you're at and what you're doing socially and that too. As always, make sure you've got some hypo treatment with you, such as some jelly beans or some quick acting carb. Make sure you have someone with you that does know and understand what they need to do and how to treat a hypo. That's absolutely essential. And I guess with CGM these days, hopefully someone could just check your phone, look at your glucose level, see which way they're going, and not have to... Get the strip out and prick your finger and things like that because that, that comes with lots of other challenges. If you can, it is smart to wear some identification saying that you have diabetes as well. If you are on glucose lowering medications of any kind, so that's the insulin or the oral meds. And if you're not sure, for those of you with type 2 diabetes who not, who are not sure, if you're at risk of a hypo with your medications, it's good to talk to your team to find out so that you know to be prepared. Hopefully you already have been advised about that or done your own research. Eat a snack with carbs before you go to bed. That's really, really important. The liver gets busy overnight metabolizing alcohol and It may not be able to release glucose if you went too low, so you can end up going unconscious with a hypo. And people often just think you've passed out from being drunk, so it's super important that you do have someone that knows about diabetes, how to treat a low, and that someone is checking in on you so that your glucose levels can be managed and you not be at risk of going too low and Yeah, getting into really dangerous territory. When you wake up in the morning, make sure that you test your glucose levels or check your sensor as you would. And make sure someone knows to check on you as well. Because the alcohol can have an effect for hours and hours after you've actually drunk. As I said, I felt the effects for a good 24 hours. And if I did exercise the next day, I would definitely be having loads and things. So it does say in this in on the NDSS. Website to avoid vigorous exercise and extended periods of strenuous activity such as dancing when you're drinking or after. And yeah, it's important to understand that after is a risk as well. It sounds a bit silly to say don't dance and drink because that's what the young people are probably going to be out doing or could be out doing. And if you're having the high sugary drinks that could actually counterbalance each other and work okay. So. It's important to look at what you might be doing. How to sort of help manage things would be to have some water while you're drinking alcohol, so you're not drinking alcohol to sort of cure the thirst. Sip the alcohol drink slowly. Well, that's a great tip if it's sort of, Sitting around at a dinner party, having a social drink, maybe not so relevant for the younger people out there partying. But it is a good tip. If you can dilute the alcohol in some way, that will reduce the alcohol content. And I think sometimes the drinking is social. And I actually used to get the Diet, Bundaberg, lemon, lime, and bitters drinks because it looked like alcohol. And when everyone else is drinking and partying, as long as you've got something in your hand that looks like alcohol, no one questions it because I know it can be hard when everyone's like, why aren't you drinking? Why aren't you drinking? So that was something I learned. Yeah, in my early twenties that actually made life easier for me just to take a full pack of the diet, lemon, lime and bitters, Bundaberg drinks and and have those. But I guess it's up to you whether you want to drink or you feel like you just need to fit in a bit and, and have the alcohol looking like it's alcohol or the drink looking like it's alcohol. Sorry. And hopefully the drinking isn't frequent. And you know, there is a whole booklet for, for the teenagers out there that maybe don't feel comfortable talking to their team or their parents, but I really would encourage you to do that because alcohol is dangerous and more dangerous for those of us living with type 1 diabetes. So do try and plan it. Do try and. Think and talk about which might be the safer options, making sure there's carbohydrate available. Alcohol will affect everyone different. It'll depend on gender. It'll depend on your body weight, how much body fat you have, what you've eaten beforehand, how much physical activity you've done before, and how you're feeling at the time as well. I think if you're. Depending on your mood, you may drink more or less alcohol as well. So, I hope this helps. Do remember that glucagon injection, if we have a severe hypo, it may not work if we've been drinking alcohol because of the effect on the liver, that alcohol has on the liver. Glucagon does work by stimulating the liver to kick out glucose. And if the liver is busy metabolizing alcohol and doing other things from drinking, it may not work. So that is a really important thing to think about. And I guess in... In contrary to what I just said, peer pressure is a real thing for the young people out there. Feel like you can say no. I did start to use diabetes as a reason to say, I'm not drinking, I have type 1 diabetes. And people did sort of stop asking. I know there are lots of people out there who do drink, and that's okay. I hope they, you know, know what to do in terms of keeping themselves safe. But it's okay to say no. And if your blood glucose levels are outside of target range, if you've had, you know, a rough day with hypos or hypos in the 24 hours leading up, if you've done lots of physical activity, played sport in Australia, alcohol's a massive part of celebrating sports wins and things like that, but that, that can be the most dangerous time. To drink as well. So as I said, don't feel like you need to do it. If it's not something you want to do, maybe talk to parents or your team about how you can come up with you know, some comments in that to help you feel more confident to say no around your peers make sure you're aware of where your drinks are. Unfortunately people do spike drinks out there. So we want to make sure that we keep our drinks with us if the lid is off or if it's in a glass or a cup so that. you know, you're reducing that chance of someone spiking your drink, whether that be with alcohol or party drugs. You still need to take your diabetes medications if you're drinking, so definitely you don't want to stop insulin completely. But you do potentially want to reduce the amount of insulin you take. So a really important conversation with your team. We don't want to end up in diabetic ketoacidosis, DKA, because we've stopped insulin altogether. We need to try and find a happy balance. And there are some guidelines around how to adjust your insulin. When drinking alcohol. So, before you go to bed, make sure you drink some water, check your glucose levels. Set your alarm to wake up a few hours later. Ask someone to check on you, a family member, a friend, while you're sleeping. Don't just put yourself down and expect to have a full 8, 10 or more hours sleep. It's really dangerous. And make sure you've got your insulin to have the next morning. So that you can give yourself some more insulin if needed, but do remember, you don't want to go give a huge correction without being mindful that you still are at risk of hypoglycemia or low alcohol or low glucose levels. I'm just going to sum up how you can help keep yourself safe if you are drinking. You want to eat some carbohydrate before drinking. You want to have some carbs while you are drinking throughout the day or evening, whenever that might be. You want to have some carbs before bed and you want to try and drink some water as well to reduce the chances of dehydration. And that will help make sure your senses working accurately if you are wearing a CGM as well. If you're on a closed loop system, we are relying on that. sensor to adjust the insulin and potentially help keep you safe. And that's something that I didn't have when I was younger. So I am very grateful that those the technology is out there now. Try and check your glucose levels more frequently. So before bed. during the night around 2, 3 a. m. and early the next morning at sort of 6 a. m. as well. Consider reducing your long acting insulin overnight. So whether you are on a pump, and you can obviously only do that if you're not in a closed loop system or reducing your levomere or optisaline if you're on a long acting injection at night time, don't use a full correction of short acting insulin, such as Novarapid or Humalog after drinking, wait and see what your glucose levels do. But you do need to eat some insulin on board. Remember a really important conversation with your team to plan this. If drinking regularly, you might need to adjust the timing of your insulin as well. If you are having injections, just so you don't forget it. So just think about that where you're going to be in the night and will you remember to give your long acting insulin. Never stop giving insulin. We've talked about this, especially the basal. You don't want to risk going into hospital or getting very, very unwell with DKA. Set an alarm and get someone to check on you the next morning. And if you need to, take your basal insulin if you do in the morning as well as at night. Or think about having your rapid acting insulin with some breakfast. Have a support person stay with you or wake you the next day. Okay, making sure that you are okay. Always carry your fast acting carbs to manage your hypo, avoid physical activity after alcohol. If you are, if you have gone out partying on a Friday night and you do have a sports game on the Saturday, let someone know, have extra carbohydrates as well. And you probably want to reduce your rapid acting insulin before your game or your sport. Again, I'm going to refer back to talking to your team and planning that. If there's no carbs available at your social event, you can use the full sugar drinks, soft drinks and fruit juices when mixing. It's better to have something than nothing at all. My advice would be to have something in your bag that you can sneak off and eat like a muesli bar. or something like that, you know, to follow up after your hypo that you might have with you. Just use that to and have some extra snacks with you. And if you can choose low alcohol drinks rather than the low carbohydrate drinks might help keep you safer as well. So very important to check your glucose levels. Think about your insulin doses. If you are on insulin and have type 2 diabetes, as well as all of us with type 1 out there, and being mindful that you can drink alcohol, but if you do, there just needs to be lots of safety parameters, like everything with diabetes. If we go on camps, if we go and do some sport. There's just always planning, always thinking ahead and always being prepared. I hope this was insightful and helpful. If you know of someone with type 1 diabetes who might benefit from a quick overview, please let them know to listen in. And as always, we'd love you to rate us and let us know what you think. If you would like to look at the resources I've been referring to, I will put the links in the show notes. There's a fact sheet from NDSS as well as a booklet called Alcohol and Type 1 Diabetes. So I'll pop them in the show notes. Thanks for listening everyone. Some days thriving, others just surviving. Diabetes in the raw. Thank you. We hope you enjoyed the episode. Thanks for listening. Please rate us on your favorite podcast app to help us reach more people and make them feel less alone. Remember, some days thriving, others just surviving. If you'd like to make contact with Jamie as a diabetes educator, look up the website, www.real-i-dealhealth.com. I can also be found on Instagram and Facebook under Jamie Panora Real Ideal Health.