Alcohol & Diabetes – a Fatal Combination

Tom was nine years old when he was diagnosed with diabetes, 10 when he began drinking alcohol, and 34 when he died from diabetes complications aggravated by daily alcohol use.

Alcoholism and diabetes are both chronic illnesses. When not managed, either one can be fatal. When both develop in the same person, risks of complications and early death increase.

In a person with diabetes, the pancreas doesn’t produce enough insulin or the body doesn’t use insulin that is produced. Insulin is a hormone that regulates levels of glucose in the blood. Glucose, a form of sugar, supplies the body with energy.

Alcoholism – the compulsive use of alcohol despite negative consequences – creates obstacles to diabetes management.

"Tom couldn’t hold a job because of his drinking, and he’d spend the money for his medical needs (insulin injections) on booze," said Tom’s sister. "He tried to regulate his insulin with how much alcohol he was going to drink."

This strategy ignores human metabolism. Normally the liver helps to raise blood-sugar levels by releasing glucose. This does not happen when alcohol is in the system, because the liver’s first priority is to get rid of alcohol. So, alcohol lowers blood-sugar levels. This puts people with diabetes at risk for hypoglycemia (low blood sugar) if they have not eaten for a while.

"We recommend that people with diabetes use alcohol only when their blood glucose is under good control," says Nancy Cooper, a diabetes nutrition specialist. "We also recommend that they limit their quantity of alcohol and regularly test their blood-glucose levels."

Limiting alcohol means following the guidelines for moderate drinking: no more than two servings of alcohol per day for men and one serving per day for women. One serving is: 12 ounces of beer, or 5 ounces of wine, or a single shot of liquor (one-and-a-half ounces).

Anyone, even the person without diabetes, who depends on alcohol as a major source of calories will see a decline in their health, said Cooper. This is especially true for the person with diabetes, who relies heavily on proper diet to control blood-sugar levels. Alcohol has virtually no nutritious value and is considered a fat in the food-exchange diet of people with diabetes.

Tom was treated for alcoholism several times. He was also hospitalized often for his poorly managed diabetes. His sister believes he denied his diabetes and used alcohol to help him forget about it.

Denial can be a problem for both alcoholics and people with diabetes. And that’s just one similarity between the two diseases. In a recent review of the medical literature, Thomas McLellan of the Treatment Research Institute in Philadelphia and his colleagues listed others. One is that both illnesses require lifelong care. For alcoholics, this means getting treatment and abstaining from alcohol. For people with diabetes, it means changes in diet, exercise, and other behaviors.

Also, both diseases are marked by relapse. About 40 to 60 percent of recovering alcoholics are still abstinent one year after treatment. Similarly, 30 to 50 percent of adults with Type 1 diabetes require additional medical care each year to reduce their symptoms.

Living well with either alcoholism or diabetes means following an individually designed treatment plan. If you have diabetes, talk to your doctor or a diabetes specialist about how to safely consume alcohol. Remember that some people with diabetes should not drink any alcohol. This includes people who take Glucophage (metformin), a diabetes medication that can cause liver complications when combined with alcohol.

Also remember a further parallel between diabetes and alcoholism: You can gain strength and hope by meeting other people with the same illness.

Alcoholics can join Alcoholics Anonymous (AA). For more information, look in your local phone book or access the AA Web site at www.alcoholics-anonymous.org.

People with diabetes can locate support groups through the American Diabetes Association (ADA). Web site at www.diabetes.org . The International Diabetes Center offers publications about diabetes management. Web access www.idcdiabetes.org.

Alive & Free By Hazelden is a health column that offers information needed to help prevent substance abuse problems and address such problems.

From; Join Together Online

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