First things first, a little about me and my relationship with alcohol
I was diagnosed with type 1 diabetes when I was 16 and I had tried alcohol just before then. I'd never been "drunk" as such, but I did know what a cocktail tasted like. I could have easily made the decision not to drink at all or not learn how to master the art of drinking with type 1 diabetes, but, I knew I wanted to enjoy a glass of wine or champagne or a pina colada on a beach whilst travelling...so...I made sure I knew how to find the balance.
This isn't a guide on "binge-drinking" with diabetes....rather, I don't think being extremely drunk with type 1 diabetes is a good idea at all, especially since the symptoms of a bad hypo are similar to those being drunk, rather this is a guide to knowing what to do to safely enjoy drinking with type 1 diabetes whilst travelling.
Carbohydrate counting alcohol
When I'm travelling, there is always the opportunity to enjoy a drink, or enjoy new types of alcohol. However, a simple carb count usually isn't the way to deal with alcohol.Different types of alcohol have different carbohydrate counts in them which make counting your carbs a little more difficult. Regardless of the carbs...alcohol will drag your blood sugar down. So, even if it rises it initially, there will be a delayed pull of your blood which can risk you going into hypo for a full 24 hours after you have stopped drinking.
Lets have a look at some of the different carbohydrates in alcohol and some of my advice on how to handle them.
Whether it's a wine on a Friday evening after a long week of work or a celebratory glass of fizz, these drinks do contain carbohydrates.
As a general rule, the bigger bodied the wine, the higher the carb count. The lighter bodied the wine, the lower the carb count. You can get very low carb wines- which may be useful, but in general, it's typically around 4-5 g of carbs per serving. Prosecco and champagne are pretty low in carb, so these are a better choice.
If you are drinking one glass of wine or fizz- then chances are it won't have much effect on your blood sugars. So just test as normal and keep an eye, but you should be fine.
If you drink around 2-3 glasses of wine (250ml glass), then this is essentially a bottle, and you will usually find that it begins to raise your blood sugar. My advice is to avoid bolusing for the wine and if you rise, you will come back down. If you are eating with your wine, then still bolus for your food.
Spirits come in the form of vodka, gin, rum, whiskey, etc. These drinks contain little to NO carbs.
My "easy" drink of choice is always vodka with diet Pepsi as it doesn't require any insulin from me. There is no sugar in this drink at all, so it's never going to make my blood sugar rise, but it will make it drop. I find it easier knowing it's going to go one way, rather than go high then maybe go low etc.
When I am drinking vodka and diet mixer, I make sure my blood sugar is on perhaps an 8 or 9 and typically I'll drop to around a 4-5, by which I will make sure I eat something.
If you are dancing in a club, then switch your diet mixers to full-fat mixers and it will help counteract the drop that the spirit will bring and help to keep you level. Remember dancing is exercise, so you will need to be extra cautious.
It's taken a lot of practice to know how to drink this type of alcohol without going into hypo- and sometimes I get it wrong! But, alcohol will affect everyone differently and you will typically find something that suits your blood sugars better.
These all contain carbohydrates, and often are quite high. Especially if you are drinking fruit ciders. Whilst they are delicious, they are filled with sugar and will typically send your sugars quite high. I enjoy a cider on a hot summers day, but these drinks do not make me go low, so I take the full carbohydrate amount and cover it with insulin.
Guinness- 10 grams
Budweiser- 12 grams
Use apps like "My Fitness Pal" to get carbohydrate counts on drinks you don't know.
Because of the high carbohydrate count in these drinks, I don't recommend completely avoiding insulin, because you will just end up feeling sluggish, tired, thirsty (and everything else a high blood sugar makes you feel). I would suggest giving "half" the amount of the required insulin for the carbs to begin with and record how that affects your blood sugar.
It's always important to record how each drink has affected your blood sugars. This way you can develop a pattern and you can learn what to do, what not to do, and how much your "body" can "handle" without falling into a hypo OR going super high.
Here are some other tips for drinking with type 1 diabetes
- Don't start drinking "spirits" with a blood sugar that's lower than 6. You could fall into hypo quite quickly.
- Remember no more than 14 units is recommended for anyone a week!
- Never drink on an empty stomach (you absorb the alcohol quicker)
- Wear a CGM or Freestyle Libre if you can- It will help you catch things quicker and work out patterns
- Set an alarm to check your blood sugar in the middle of the night so around 3 am (or 5 am if you just got back at 3!) Allow yourself to run a little higher whilst drinking to avoid major lows. Especially if you are "clubbing". Aim for 140-200mg/dl (7.8-11.5)
- Lower your temp basal overnight or reduce your basal Lantus/Levemir dose by 20% or so
- Test frequently
- Bolus for alcohol when it's got carbs but only HALF the amount
- Carry a glucagon pen if you are out and about whilst drinking. It will still work, the effectiveness will just be limited, but it's still worth using in an emergency. Make sure someone you are with knows how to use this pen.
- Wear diabetic ID if you're out with your friends drinking or out alone
- Make the people you are with aware you are type 1 diabetic, and that the symptoms of being low are similar to that of being drunk
- If your blood sugar is below 180 mg/dl (10.0) then have a carb snack!
- Have an emergency contact number with you
- Keep some glucose on you, such as a small packet of sweets or dextrose, and if you've got some friends with you, ask them to carry some too.
I'm now almost 25 and I did Uni for 4 years, so I know the drinking culture and I've had my practice within it. I've never had any serious issues with my diabetes whilst drinking (thank god) and as long as I monitor and be sensible, I hope I never will.
When traveling, there are lots of opportunities to party, but Bradley and I party a lot less as we've got older (Uni takes it out of you! :P ), whereas we are more inclined to enjoy a bottle of wine at home than in a bar doing shots. That's not to say we don't party sometimes. (I won't say no to full moon parties), but I am certainly more refined in what I drink and how I drink nowadays.
Finding the balance with alcohol is literally a game of practice. There is no simple method. But, if you want to lessen the calculations, then spirits and sugar-free mixers or low carb alcohols such as Prosecco are a great place to start!
Never feel peer pressured into drinking if you don't want to. Drinking isn't something you have to do, rather it's something you should be given the choice to do and diabetes shouldn't take that choice away from you.
So be sensible, drink safely and follow these tips! Alcohol tends to be cheaper in Asia, South America etc (almost anywhere that isn't the UK), but make sure you're drinking real alcohol and not pure poison (ethanol). Only drink branded drinks and don't accept drinks from people you don't know.
Comment below if you've got any other tips for drinking with type 1 diabetes.
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