Alcohol, Sex and Drugs

ALCOHOL

Everyone’s heard about the dangers of drinking and we know it’s illegal until you’re 18, but the more you know now, the better off you’ll be. If you’ve got diabetes and you drink – there’s important stuff you need to think about…

What’s safe?

Alcohol can affect your brain, liver and general health. If you do choose to drink, the safe limits for adults are:

  • Men – no more than 2 standard drinks each day
  • Women – no more than 1 standard drink each day
  • At least two alcohol free days a week

What’s a standard drink?

A standard drink is not what fits in your glass, bottles and cans. All drink come in different sizes!

One standard drink is:

  • 285ml regular beer (a middie or pot) or
  • 425ml low alcohol beer (a schooner) or
  • A nip / shot of spirits or
  • A small glass of wine
    It’s not as much as you think!!

Risky Business

Alcohol can make you do things you normally wouldn’t – and when you’ve got diabetes there are other risks you need to know about!

Alcohol can…

  • Increase the risk of hypos because it stops your liver from releasing glucose. Especially if you’re out late, dancing or drink heaps.
  • Make it more difficult for you to recognise the symptoms of a hypo – you may be mistaken for being drunk.
  • Cause vomiting and dehydration which may lead to DKA (ketoacidosis) and a possible trip to hospital
  • Make it easy for you to forget about looking after your diabetes

TIPS

Before you go…

  • Try and have dinner before you go out or head out for a meal before you start drinking
  • Don’t skip your insulin – talk to your doctor or diabetes educator about any changes that you might need to make to your dose if you’re staying out late or dancing all night
  • Test your blood glucose levels (BGLs) – if you’re low have some carbohydrates before you go out

While you’re out

  • Have fun, don’t get wasted – being out of it can be scary and dangerous if you’ve got diabetes
  • Pace yourself – try not to drink too much too quickly, try to have a non-alcoholic drink in between drinks
  • Don’t mix drinks
  • Steer clear of the alcohol and drug mix
  • Make sure that you eat some carbohydrates before you drink and while you’re drinking. If you’re going to a party take some chips with you, munch out on the crackers and dip or if you’re out, try the late night pizza or kebab. Regular soft drinks or juice as mixers can give you some extra carbohydrate if there’s no food available.
  • Have something with you to treat a hypo like jelly beans – especially important if there’s a long wait at the bar for juice or soft drink. Remember that being drunk can make it hard for you to tell when you’re having a hypo!
  • Make sure that one of the friends that you are out with (one who isn’t drinking) knows about your diabetes and knows what to do if you have a hypo – tell them not to try and make you eat if you’re unconscious and that they should call an ambulance.
  • Wear some ID so that if anything happens, the ambulance or hospital knows you have diabetes
  • Buy your own drinks and watch out for drink spiking – this can be really dangerous
  • Don’t drink drive, even if you feel OK you might still be over the limit

Getting home…

You might not feel like testing when you’re looking good on the dance floor, but a test before bed is really smart. If you’re low, treat the hypo and have some extra carbohydrates to keep your BGLs up. Even if you’re not low, some extra carbohydrate foods before bed can stop a bad overnight hypo. Plan ahead – ask someone to wake you up or check your BGL for you overnight. Don’t forget to take your long acting insulin before bed – if you’re really late home, you may need to take less. Talk to your diabetes educator or doctor about how to adjust your insulin when you have a big night out.

The next day…

OK, so you might not be feeling great, but it’s still important to drag yourself out of bed, take your insulin and have something to eat. You might find that you’re more prone to hypos after a big night out – so make sure that you eat enough the next day (even if it’s dry toast & vegemite). If you forgot your evening insulin or you’ve been vomiting – remember to check for ketones. If your BGL is high and you have ketones – treat it like you would a sick day. Don’t forget, ask for help if you need it!

Big night out DISASTERS…

Here’s some important stuff NOT to do…

  • Forget to take your insulin
  • Drink too much, too quickly
  • Leave your hypo foods at home
  • Miss meals or not eat enough carbohydrates
  • Forget to wear your ID
  • Skip your BGL test and supper
  • Ignore a hypo or not treat it properly
  • Forget to test for ketones if you’re sick or have high BGLs (over 15mmol/L)
  • Lie about drinking
  • Keep on drinking alcohol the next day
  • Keep your diabetes a secret from your friends
  • Drink alcohol if you’re pregnant

Want more info?
Check out these web sites for up to date info on alcohol…

SEX

When things get serious in relationships, and you find yourself thinking about having sex, the most important thing is to make sure it’s the right thing for you – remember it’s your call. You need to think things through and stay safe…

STDs (sexually transmitted diseases) 

STDs are one of the biggest risks of unplanned / unprotected sex. The scary thing is that your partner could have an STD without even knowing it! STDs can be dangerous, they can affect fertility and some may even be life threatening (eg. HIV)

Unwanted pregnancy

It you or your partner want to get pregnant – great! But if it’s unplanned it can stuff up your future plans and affect relationships. Think carefully and play it safe!

Getting wasted 

Drugs and alcohol can make you do stuff you wouldn’t normally do. You might feel like nothing can go wrong, but it might – unplanned sex (and unplanned pregnancy) are a real possibility. Getting wasted can be ugly and hangovers are not fun – neither is wondering what you did last night?

There’s no going back but… 

You can always say “no”, it’s never too late! Make sure it’s right for you and don’t regret it in the morning. Talk to your friends about it, but remember everyone’s different and deals with things in their own way.

Where does diabetes fit in?

When things are “hotting up”, the last thing on your mind is usually diabetes! There’s some other stuff you should think about like –

Telling your partner about diabetes… 

You might not want to tell them that you’ve got diabetes – what if they think they can catch it or they won’t like you any more? If they think like that, don’t feel bad – they just don’t understand. You’ll probably find that once you explain it they’ll be fine with it. You may wonder “why should I bother telling them anyway??” It’s about staying safe.

Contraception Choices

  • Condoms
    Condoms are the only way to protect yourself from STDs. No matter how well you know the other person or what other method of contraception you’re using, always use a condom.

  • The Pill
    The oral contraceptive pill can be used by most females with type 1 diabetes unless there is a history of high blood pressure or blood clots. Talk to your diabetes doctor or educator about the best choice for you.

  • Other choices

    Intrauterine devices (IUDs) should not be used by females with type 1 diabetes because of the risk of infection.Contraceptive implants may affect insulin sensitivity – talk to your diabetes doctor or educator.

Pregnancy

Pregnancy in females with diabetes should be planned. It’s important that blood glucose levels are well managed both before and during pregnancy. The pregnancy should be closely monitored by your diabetes team along with an obstetrician (baby doctor).

Hypos

Sex is a form of physical activity and when you’ve got diabetes, this means you can be at risk of having a hypo. Have some hypo treatment handy.

Erectile Dysfunction

Lots of guys worry about not being able to get an erection. This may occur in adults who have had diabetes for a long time but may happen for other reasons, often psychological. Good diabetes management is the way to go to reduce the risk.

Want more info? Check out: FPA Health
http://www.fpahealth.org.au/

DRUGS

Drugs can be harmful to the health of everyone and they’re just not cool, especially if you’ve got diabetes. When you’ve got diabetes, drugs can also cause problems like:

  • Changes in awareness, consciousness and understanding which means that you may not recognise your hypo symptoms and forget to look after your diabetes
  • Affect your ability to make good judgements
  • Make you forget about routines, injections, meal times and the stuff you need to do to look after your diabetes
  • Poor appetite and lack of interest in food, increasing the risk of hypos
  • Increased appetite (marijuana) leading to high BGLs
  • Nausea and vomiting, which means you might be at risk of high or low BGLs
  • Changes to the way you feel, like faster heart beat or sweating that may be mistaken for a hypo
  • ‘Hangover’ effects after the drugs have worn off like depression or sleep problems which can make you lose interest in looking after your diabetes

Many drugs can have long term effects on your health, such as damage to the body’s major organs – liver, heart and brain. Combined with diabetes the damage can be even worse. There’s also the risk of over dose and bad reactions to drugs that can make you extremely unwell and in some cases cause death. Mixing drugs or combining drugs and alcohol can further increase these risks.

If you think you have a drug problem you need to tell someone and get some help. Contact your local drug and alcohol counselling service for advice on where to get help or you can call one of the following help lines:
Lifeline: 131 114 (cost of a local call)
Kids Help Line: 1800 55 1800 (free call, for people under 18)

Check out these links for more info:
www.adf.org.au
www.reachout.com.au

Diabetes Australia Fact Sheet