Alcohol and Type 1 Diabetes: What You Need to Know

Drinking alcohol often seems to go hand in hand with Christmas, New Year’s Eve and dinner parties with friends.

While having a drink is entirely allowed when you live with type 1 diabetes (T1D), there are some aspects you need to consider to avoid unpleasant surprises. Drinking alcohol is one of the many factors that impact blood sugar management.

Understanding what the liver does

The liver is an organ that stores sugar as glycogen. When blood sugar levels drop, it changes glycogen back into glucose and pushes it in the bloodstream.

When you drink alcohol, the liver prioritizes another one of its roles, which is to detoxify the body in reaction to what it perceives as poison. During this time, the liver is unavailable to help regulate blood sugar levels.

Even when your liver is unable to fulfill this role, the action of the insulin you administer to treat your T1D is not interrupted. That’s why drinking alcohol increases the risk of hypoglycemia for up to 24 hours. The risk varies depending on how much alcohol you had, how fast you drank it, whether you ate a meal at the same time, and how fast your body metabolizes alcohol, which varies from one person to another.

If you have a drink that contains carbs, your blood sugar will initially rise, then drop.

Better safe than sorry!

It can be difficult to see or feel the signs of hypoglycemia when you have been drinking alcohol, since they can be similar to the signs of intoxication. Also, it’s important to know that if you have severe hypoglycemia (i.e., if you need someone’s help to treat it) and need to be given an emergency medication such as glucagon, it will not be as effective due to the alcohol in your blood. The person helping you will still need to administer it, and then call emergency services.

A few tips to enjoy your drink while staying safe

Keep your friends informed. Make sure that people around you know that the symptoms of hypoglycemia might look like signs of intoxication and know what to do in case of an emergency. It might not get to that point, but you’re better safe than sorry!
Try to drink mostly while eating. If you eat while you’re drinking alcohol, it will be absorbed more slowly. Opt for food that contains carbs, especially if your drink doesn’t have any. This will ensure there are carbs in your bloodstream and decrease the risk of hypoglycemia.
Keep an eye on your blood sugar. Make sure to monitor your blood sugar closely while you’re drinking and in the hours that follow to adapt your decisions based on the situation.
- If you have a hyperglycemic episode after consuming alcohol, it may be best to monitor your blood sugar level for some time before taking a correction bolus, as the hyperglycemia may be only temporary. Keep in mind that carbs contained in alcoholic beverages are quick acting; their effect won’t last very long. If you wish to take a correction bolus, you should be careful and take a smaller one to avoid hypoglycemia in the following hours (and possibly at night).
- However, if you are worried about falling into hypoglycemia while you sleep, don’t hesitate to have a snack (containing carbs and protein) before going to bed and/or take less long-acting (or basal) insulin after drinking alcohol.

These are only tips that can help you avoid risky situations. But as you may know, we learn best by trial and error. The important thing is staying safe!