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 the websites at end for up to date info on alcohol.

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.

Seeking help

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)

More information

Check out these links for more info:

Diabetes Australia Fact Sheet

Alcohol and Drug Foundation

The National Drug and Alcohol Research Centre

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