|PURIM DRINKING:Diabetes/Alcohol: A Dangerous Combination|
How your Body metabolizes Alcohol
Alcohol is absorbed in to the bloodstream very quickly, without being broken down (metabolized) in your stomach. Your liver does most of the job of breaking down the alcohol once it’s in your body. But it needs time. If you weigh 150 pounds, it will take about two hours to metabolize a drink.
If you drink alcohol faster than your liver can break it down, the excess alcohol moves through your bloodstream to other parts of your body. Brain cells are easy targets. This is the cause for acting drunk and losing control.
Risk of Low Blood Sugar
If you take insulin or oral diabetes pills, you risk low blood sugar when you drink alcohol. How does alcohol add to your chances of having a low blood sugar? It has to do with your liver
Normally; when your blood sugar level starts to drop, your liver steps in. It goes to work changing stored carbohydrate into glucose. Then it sends the glucose out into the blood, which helps you avoid or slow down a low blood sugar reaction.
However; when alcohol enters your system, this changes. Alcohol is a toxin. Your body treats alcohol as if it were a poison, so the liver wants to clear it from the blood quickly. In fact, the liver won’t put out glucose again until it has taken care of the alcohol. If your blood glucose level is falling, you can quickly wind up with very low blood sugar. This is why drinking as little as 2 ounces of alcohol (about 2 drinks) on an empty stomach can lead to very low blood sugar.
When you combine alcohol and exercise, [which is usually the case on Purim, when you are carrying all your Mishloach Manos, and going around collecting money for charity (JDA?)] you increase the risk of going low. This can happen because exercise helps lower your blood sugar levels. Hours after you do exercise, your body is still busy replacing the energy your muscles used up. To do this, it clears glucose from the blood and adds it to the muscles’ storage. This is why exercise can cause your blood sugar level to go down.
Now, if you take insulin or oral medication for stabilizing BG, they too are working to clear glucose from your blood. Unless you eat, or your liver adds glucose to your blood, you could be heading for a low blood sugar level. If you add some alcohol on top of this, it will stop your liver from sending out any glucose. Your chances of going low are even greater.
One of the reasons that we need Basal or Long Acting Insulin is primarily because of the constant glucose output from the liver that is needed for bodily functions. If the liver will be busy cleaning out the alcohol and it will not put out the glucose, there will be unused or extra insulin circulating in the blood, which will cause a low blood sugar. Let's use some common sense: Our Rabbis have been telling us that we are allowed to check blood sugars on Shabbos, even though there are some Rabbinical prohibitions involved. Why? Because of the danger of having a low BG. If this is considered enough of a life-threatening situation to violate Shabbos, how can we put ourselves into such a dangerous risk by getting drunk?
Alcohol affects your body’s ability to "bounce back" from a low blood sugar. If you have a low blood sugar, you may need to treat it more than once as time goes by
Warning: Glucagon shots don’t help severe low blood glucose caused by drinking. Glucagon works by getting your liver to release more glucose into your blood, but alcohol stops this process. You need to be able to treat your reaction with a carbohydrate, such as oral glucose tablets (Winkies) or gels. So you need to avoid severely low glucose levels. If you pass out, you will need glucose injected into your bloodstream by a health care professional.
Heavy drinking over time can hurt your liver. It won’t be able to make glucose as well. When this happens, your diabetes becomes harder to control.
Some of the signs of a low blood sugar reaction such as confusion or slurred speech, are similar to the effects of drinking too much, so if CH"V someone with diabetes will pass out, and people will smell the alcohol in his breath, they will assume that he is intoxicated and not even check and/or treat his low blood sugar, which is very dangerous!
For those with type 2 diabetes who control their diabetes with meal planning and exercise alone there is far less risk of low blood sugars.
Guidelines to avoid low blood sugars levels as a result of excessive drinking
ü Never drink on an empty stomach.
ü Plan to have your drink with a meal or after eating a snack
ü The next morning, get up at the usual time, test your blood sugar, take insulin, eat breakfast, and then go back to bed if you feel ill. "Sleeping-in" can result in a bad reaction
ü Check your blood sugar before you go to sleep, and eat a bedtime snack (solid protein and some carbohydrate) in the evening after drinking. Do this even if the bedtime blood sugar level is high, to avoid a low blood sugar while you sleep
ü NEVER drink and drive. Ask a friend who has not been drinking to drive, or call someone to pick you up
When Alcohol Is a Poor Choice
Some people with diabetes should not drink alcohol. If you have nerve damage in your arms or legs, drinking can make it worse. Alcohol is toxic to nerves. Drinking can increase the pain, burning, tingling, numbness, and other symptoms associated with nerve damage. Some studies show that even regular light drinking (less than two drinks per week) can cause nerve damage. Heavy drinking may also make eye disease worse. If you have high blood pressure, you can lower it if you stop drinking alcohol
Many people with type 2 diabetes have high levels of the fat called triglycerides in their blood. If you do, you should not drink alcohol. Alcohol affects the livers ability to clear fat from the blood, and also spurs the liver to make more triglycerides.
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