Diabetes and Alcohol - Think Twice Before Drinking! 🍺⚠️

Asanga (age 38), a marketing executive, came to my clinic last Friday evening. He was very worried.

"Dr. Priya, I drank two cans of beer with my friends last Friday. About 20 minutes after drinking, I felt incredibly dizzy and my whole body started shaking. Along with that, I broke out in a cold sweat. I thought it was the strong taste of regular alcohol. But I couldn't even walk on the street and started fainting. When I checked with a glucometer that a friend had, my blood sugar level had dropped to 55 mg/dL! I am a diabetic. Why did this happen to me, doctor?" Asanga asked.

I explained to Asanga: "Asanga, you are facing hypoglycemia , a dangerously low blood sugar level. Normally, when our body's sugar level drops, the liver converts the stored sugar, or glycogen, back into glucose and releases it into the blood. But when you drink alcohol, the liver has to prioritize the task of burning and releasing alcohol, which is a poison to the body. At that time, the liver temporarily stops producing sugar. Therefore, if a person taking diabetes pills drinks alcohol on an empty stomach or without enough food, their sugar level will drop rapidly."

🚨 Red Flags that require immediate medical attention

Many people mistake the symptoms of low blood sugar (hypoglycemia) after drinking alcohol for the symptoms of normal intoxication (e.g., feeling dizzy). However, if the following symptoms occur, it is a medical emergency and should be treated immediately:

• Uncontrollable severe shaking of the body and cold sweat.
• Slurred speech (slurring of words) and severe disorientation.
• Inability to walk, blurred vision, and fainting.
• Symptoms such as loss of consciousness or seizures.

How alcohol affects diabetics

Alcohol consumption directly affects blood sugar levels and health in the following ways:

1. Adverse drug interactions: Diabetes medications such as sulfonylureas and meglitinides stimulate the pancreas to produce more insulin. Drinking alcohol while taking these medications can cause blood sugar levels to drop rapidly.
2. Delayed hypoglycemia: There is a risk of low blood sugar levels within a few minutes to 12-24 hours after drinking alcohol. Especially if you drink alcohol at night and go to bed, your blood sugar levels can drop while you sleep.
3. Increased complications: Frequent alcohol use increases the risk of cardiovascular disease and neuropathy, the main complications of diabetes.The situation is rapidly deteriorating.

Steps to be taken in case of danger (Rule of 15)

If your blood sugar level drops below 70 mg/dL after drinking alcohol, take the following steps immediately:

1. Immediately provide 15 grams of sugar to the body: 3-4 glucose tablets, half a cup of fruit juice, or a tablespoon of sugar dissolved in water and drink.
2. Wait 15 minutes: Wait 15 minutes without eating anything and then measure your blood sugar again.
3. If the sugar level is still below 70 mg/dL: Give 15 grams of sugar again and measure the sugar level in another 15 minutes.
4. ⚠️ Important: If the patient is unconscious or has difficulty swallowing, do not give anything by mouth and take them to the hospital immediately. Glucagon injections, which are given to raise blood sugar levels after drinking alcohol, will not work (because the liver is busy clearing the alcohol).

Do's & Don'ts

Scientific sources (References)

• 📚 Low blood sugar (hypoglycaemia) - NHS
• 📚 Consequences of Alcohol Use in Diabetics - PMC