Consequences of Alcohol Use in Diabetics PMC

Hypoglycemia can have serious, even life-threatening, consequences, because adequate blood sugar levels are needed to ensure brain functioning. C-peptide levels, and thus insulin production, were significantly lower in both groups of diabetics than in non-diabetics. No difference in C-peptide levels existed, however, between drinking and nondrinking diabetics, indicating that chronic alcohol consumption did not alter the diabetics’ insulin production. Consequently, the elevated glucose levels observed in the drinking diabetics likely were not caused by alcohol’s effects on insulin levels, but may have resulted from an alcohol-induced increase in insulin resistance in those diabetics. Accordingly, more studies are needed to determine whether the beneficial effects of daily moderate alcohol consumption outweigh the deleterious effects.

For the first h of fasting, hepatic glycogenolysis provides most of the glucose from glycogen stores. After that, lipolysis and protein breakdown provide fatty acid for energy, and glycerol and amino acids for gluconeogenesis. Therefore, assuming that a person is eating adequately at regular intervals, hypoglycemia can be avoided through various back-up mechanisms.

People with type 2 continue to produce insulin in early disease stages; however, their bodies do not respond adequately to the hormone (i.e., the patients are resistant to insulin’s effects). Thus, insulin does not lower blood sugar levels to the extent that it does in people without diabetes. For example, obesity, inactivity, and cigarette smoking may worsen genetically determined insulin resistance. Insulin primarily serves to lower blood sugar levels by promoting the uptake of sugar (i.e., glucose) in the muscles and fat (i.e., adipose) tissue as well as the conversion of glucose into its storage form, glycogen.

If it cannot fulfill its role in maintaining blood sugar levels at the time, a person may experience hypoglycemia. As demonstrated in this case series, it seems that socioeconomic factors may also play a large role in affecting the clinical presentations of patients because of their effect on basic science pathophysiology. Alcohol-induced hypoglycemia may be only one example of this phenomenon; further research should be done to elucidate how these factors can affect other basic pathophysiologic processes.

Whether the elevated blood sugar levels in diabetics were caused directly by alcohol’s impact on blood sugar regulation or by the patients’ alcohol-related failure to comply with their diabetes treatment is unknown. Chronic malnutrition also decreases the availability of triglyceride in adipose tissue, which results in deficient glycerol available to be converted to glucose and fewer fatty acids to support energy metabolism. The average weight of an adult man alcohol consumption in our ED is approximately 50 kg. These patients would then not only have gluconeogenesis limited by alcohol metabolism , but they also have an inability to back up glucose stores with appropriate glycogenolysis and lipolysis. In the United States, alcoholic patients who present with a depressed mental status are usually not in a hypoglycemic coma, but instead have other etiologies of coma such as sepsis, shock, hypothermia, trauma, or excessive intoxication.

However, Lin and colleagues reported that the LDL cholesterol in alcoholics exhibits altered biological functions and may more readily cause cardiovascular disease. The researchers found that the levels of vitamin E, an agent that in part is bound to LDL cholesterol and which may decrease the risk of cardiovascular disease, also are lower in alcoholics than in nonalcoholics. Those observations suggest that the reduced levels of vitamin E in alcoholics actually may have harmful long-term effects. Ketoacidosis typically occurs in patients with type 1 diabetes who completely lack insulin.

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Being tipsy has another downside, making it easy to mix up your medications or to forget to take them entirely. People with alcohol use disorder may experience chronic health issues because of repeated hypoglycemia. The glucose, insulin, and cortisol data from this study were presented in abstract form at the annual professional meeting of the British Diabetic Association (Brighton, U.K., 15–17 March 2000). While I rationally understand that there are millions of people living with type 1 diabetes, which m… Here’s a handy pocket guide that we created to help you manage drinking with diabetes.

Plasma glucose, insulin, triglyceride and ethanol concentrations during each test were compared. LDL cholesterol is strongly related to cardiovascular disease and stroke and has been called “bad” cholesterol. Reduction of LDL cholesterol decreases a person’s the signs and symptoms of alcohol abuse likelihood of suffering a heart attack or stroke. LDL cholesterol levels tend to be lower in alcoholics than in nondrinkers (Castelli et al. 1977), suggesting that chronic alcohol consumption may have a beneficial effect on cardiovascular risk.

In most patients, the disease develops before age 40, primarily during childhood or adolescence. In those patients, the immune system attacks certain cells of the pancreas, called beta cells. (For more information on the structure and function of the pancreas, see textbox, p. 213.) Beta cells produce insulin, one of the two major hormones involved in regulating the body’s blood sugar levels and other metabolic functions. Most importantly, insulin leads to the uptake of the sugar glucose into muscle and fat tissue and prevents glucose release from the liver, thereby lowering blood sugar levels (e.g., after a meal) . As a result of the immune system’s attack, the beta cells can no longer produce insulin. Consequently, the patient essentially experiences total insulin lack.

Effects of Alcohol Consumption in the Fasting State

Thus, ethanol consumption rapidly increases the blood lactate concentration, while decreasing the level of glucose. Ethanol also can redistribute pancreatic microcirculation to enhance late-phase insulin secretion. This can cause hypoglycemia directly and inhibit the release and activation of counter-regulatory corticotropin, cortisol, and growth hormone that normally counteract hypoglycemia, which increases the risk for reactive hypoglycemia . That effect has been observed in both type 1 and type 2 diabetics as well as in nondiabetics .

In one study of 275 originally potent diabetic men, heavy drinkers were significantly more likely to develop impotence during the 5-year study period than were moderate drinkers (McCulloch et al. 1984). Based on assumptions regarding the alcohol content of the beverages mentioned in the study, “heavy” drinkers were defined as those who ingested 29 grams of alcohol, or approximately two to three standard drinks, per day. The combination of alcohol-induced hypoglycemia, hypoglycemic unawareness, and delayed recovery from hypoglycemia can lead to deleterious health consequences. For example, Arky and colleagues studied five diabetics who experienced severe hypoglycemia after ingesting alcohol.

Acutely, moderate alcohol doses inhibit release of FFA from adipose tissue, probably through the action of acetate . Prolonged infusion leads to a progressive increase in FFA levels , potentially via increases in catecholamine levels. The suppression of FFA by ethanol may be responsible for the impaired recovery from hypoglycemia seen in type 1 diabetes, via increased glucose utilization . In our study, the acute increase in blood ethanol occurred as insulin was decreasing. This would have yielded competing influences on FFA levels, and we can only speculate about the net short-term effect.

Alcohol and Diabetes

Afterwards she reported feeling shaky/tremulous and nauseated; when her BG was then checked, it was found to be 59 mg/dL. Her symptoms resolved when she was given dextrose and her BG increased to 105 mg/dL. The patient was then correlation of the incidence evaluated by the Endocrine team, and a 72-hour fast was started. If you have type 1 or type 2 diabetes, you can drink wine, but you should be aware of the particulars of this alcohol and how it might affect your blo…

As we’ve described in this article, alcohol can lead to unexpected fluctuations in your blood sugar. Carry diabetes identification when you go out drinking and make sure you have friends who know about the risks of drinking with diabetes. Show them the hypoglycemia handout on this page before going out so that they know how to help you.

Alcoholic Hypoglycemia & Ketosis

Alcohol reduces blood levels of testosterone and may thereby further exacerbate the existing hormonal deficit. Clinical experience indicates, however, that a testosterone deficit rarely is the sole reason for impotence in diabetic men, because treatment with testosterone rarely restores potency in those men. Thus, both neuropathy and vascular disease likely play significant roles in impotence in diabetic men. Your liver will choose to metabolize the alcohol over maintaining your blood sugar, which can lead to hypoglycemia. The liver often makes this choice when you drink without eating food—so consider snacking while you sip. Take a look at the numbers and you’ll find that only moderate drinkers have less cardiovascular disease.

One of the ways to compensate for this is to adjust your basal rate while drinking. If you’ve consumed so much alcohol that you begin vomiting, this is your body’s way of try to manage the “overdose” of alcohol. As a person with diabetes—especially if you take insulin—it’s important to check your blood sugar very often in the hours after vomiting. If you are intoxicated, you may not hear your CGM alarms or feel the usual symptoms of low blood sugar.

The Ugandan diet is mostly carbohydrate starch from matoke and cassava, with a small amount of protein intake from beans and legumes. The impoverished low socioeconomic rural population that we serve in our hospital does not typically have access to a more varied diet. Patients commonly demonstrate kwashiorkor and marasmus syndromes. The first was the small number of participants and the lack of randomization of the order of each test. The second was the divided administration of the alcohol load and its volume containing 20 g; differences in the loading methods might have affected carbohydrate metabolism and alcohol‐induced hypoglycemia differently. In addition, other nutrient loads, such as a complex carbohydrate‐ or protein‐rich meal, could have induced different effects.

• The carbohydrate content was matched to the average evening meal carbohydrate level given in the prestudy food diary.
• On the basis of previous findings made not only in healthy individuals3, 15, but also in patients with type 1 or type 2 diabetes, several mechanisms for alcohol‐induced hypoglycemia have been proposed.
• In most patients, the disease develops before age 40, primarily during childhood or adolescence.

The effect is more potent after 2–3 days of fasting and potentially lethal in patients with chronic alcoholism who are treated with insulin . However, in circumstances in which gluconeogenesis is not critical to maintaining blood glucose, its suppression by ethanol seems less likely to cause hypoglycemia. On the basis of previous findings made not only in healthy individuals3, 15, but also in patients with type 1 or type 2 diabetes, several mechanisms for alcohol‐induced hypoglycemia have been proposed. Therefore, changes in insulin secretion or peripheral insulin resistance during the first 30 min do not represent a likely mechanism for the hypoglycemic events identified in the present study. Studies of diabetic patients have failed to show any short-term effect of moderate alcohol intake with a meal or alcohol administered intravenously after an overnight fast . However, some authors report an increased risk of hypoglycemia in the morning, 12–16 h after consumption of an alcoholic beverage in the evening .

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It is very common for blood sugar levels to spike shortly after drinking due to sugary mixers, and then dramatically drop low hours later when you are likely sleeping. 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. If you were consuming alcohol until going to sleep at 1 a.m., you could experience delayed low blood sugars throughout the rest of the night and in the morning. In fact, alcohol-induced hypoglycemia can happen up to 12 hours after drinking. Detoxification and rehabilitation are the best ways to reverse hypoglycemia related to alcohol abuse. The body needs to detox from too much sugar, alcohol, caffeine and other stimulants that can exacerbate hypoglycemia.

This organ stores and produces sugar according to hormonal signals from insulin and glucagon. A 55-year-old female presented to the ED after being found unresponsive in bed by friends in the morning. She was last seen by her neighbors the night before when they ate dinner together. Her neighbor stated that the patient does not regularly consume alcohol. Her past medical history was significant only for peptic ulcer disease, but she was not currently taking any medications. On the first day of admission, she had a regular meal consisting of pasta, fruit, and part of a sandwich.

Otherwise, please use the information below to connect with your appropriate health care provider. Don’t let alcohol or related hypoglycemia permanently damage your health. Partner with Reflections Recovery Center to address all aspects of your dependency.