April is Alcohol Awareness Month, so what better time to share resources from the Diabetes Online Community (DOC) aimed at raising awareness about diabetes and drinking?
Some of the most common questions we get -- from folks newly diagnosed with type 1 or type 2 to the longtime diabetes veterans -- are about alcohol consumption. Variations range from whether specific drinks are "blood sugar friendly" to carb counting queries and the alcohol-effect on blood glucose levels hours later.
Fortunately, there are now good resources for the college-aged crowd through the College Diabetes Network, for one thing.
We've also covered this topic for "grown ups" here at the 'Mine quite a bit, so here's a "flight" of resources we've compiled that remain share-worthy today.
Drinking with Diabetes
Back in 2013, fellow D-advocate Bennet Dunlap (who has two kids with T1D and lives with T2D himself) created an online resource, appropriately named Drinking with Diabetes. While it hasn't been updated in a bit, there's a goldmine of handy info and personal stories from around the D-Community about their experiences with alcohol.
The online guide isn't exactly a "how to" on drinking safely with diabetes, but it offers real stories from PWDs (people with diabetes) who've dealt with that experience and serves as a way to start conversations with parents and young type 1s about responsible drinking behavior. Whether it's choosing not to drink, limiting consumption, or learning in advance about what others say they "should have done," the DOC voices are open and honest.
The site includes guest posts from our own team members Mike and Wil, who've shared their personal stories about drinking with D. Of course, you may remember that "Uncle Wil" put it all on the line here at the 'Mine with some "no-bull" advice on drinking with diabetes in a now-classic column a while back.
Tips and Tricks from a T1D Endo
Our friend Jeremy Pettus, who's not only a longtime type 1 himself but also a practicing endocrinologist at UC San Diego, knows his stuff when it comes to diabetes and drinking. He regularly speaks on that topic at conferences around the country. In fact, we just saw him speaking at the TCOYD health fair event in Southeast Michigan in regard to drinking and diabetes.
His message: Yes, you can drink alcohol when keeping moderation in mind.
Jeremy points to experts who say women should have no more than one drink per day, and men no more than two drinks per day. To be clear, one drink is: 12 oz beer, a 5 oz glass of wine or 1 ½ oz distilled spirits.
It’s important to know what you’re consuming as well. So how many carbs and calories are found in beer? Some examples:
- Amstel Lite contains 95 calories and 5 grams carb
- Dark beer, like Guinness has 126 calories + 10 carbs
- Budweiser has 145 calories + 10.6 carbs
- A really “good beer” from a popular microbrewery, probably contains about 219 calories + 20 carbs
The general rule of thumb is, per Jeremy: the darker the beer, the more calories and carbs it contains.
Wine is on average 120 calories + 5g carbs. White wine is thought to be a little higher-carb than red, especially the sweeter-tasting varieties.
Here are some tips that Jeremy offers to PWDs, in helping to stop the BG roller coaster:
- Always eat something before drinking
- Avoid sugary mixed drinks
- Bolus for alcohol, but HALF what you normally would for the carbs
- TEST A LOT (before drinking, while drinking, before bed)
- If not on a pump, ALWAYS take your basal insulin (maybe even before you go out)
- Lower temp basal overnight or reduce your basal Lantus/Levemir dose by 20% or so
- Take smaller boluses the next day
- Set an alarm in the middle of the night (3 AM) to check BG
- Don’t bolus right before bed
- If you don’t have one already, GET A CGM
- Allow yourself to run a little high while drinking to avoid lows: target range 160-200 mg/dL
In case you’re wondering (and in case of emergency), glucagon can still work while drinking, although the effect may be reduced.
The bottom line is: avoid binge drinking!
Beer and Diabetes
OK, beer lovers, this one's for you.
A few years ago, our own Mike Hoskins conducted a very non-scientific study on his own craft beer consumption and the blood sugar effect, which he dubbed the Great Beer Experiment of 2015. He trial-tested a handful of local Michigan craft brews, and found that each boosted his BGs on average 75 to 115 points per glass, without any insulin.
What he learned was that (aha!) advance planning is key to being able to go out and enjoy a few brews. As a PWD, you have to think hard about the type of drink you'll be imbibing, and the food and physical activity that will likely accompany it.
In our weekly Ask D'Mine column, Wil Dubois has also tackled this question of craft beer consumption. He shares this:
"There’s no doubt at all in my mind that PWDs who are winos and whiskey hounds have the advantage over the beer lovers. That's because a good craft beer has the dual challenges of alcohol and carbs. Oh, and the better the beer (and the more of it), the greater the challenge.
"Put another way, if you are thinking about drinking a lot of pints, you’re better off drinking the ones with lower alcohol contents.
The best way to offset the alcohol-infused blood sugar drop is to eat a high-fat, lowish-carb snack right before you crash for the night. The idea is to have some carbs slowly infusing into your blood to stand in for the liver until it recovers from its hangover the next morning. This is one of those times when those vexing slowly-digesting fats can actually be deployed to your advantage."
So yes, we have some tips to help you enjoy those brewskies -- whether the craft variety or not.
Low-Carb Alcoholic Drinks
Yes, these do exist!
We recently spotted a post over at A Sweet Life about low-carb beers, by our friend Kerri Sparling. Here's a rundown of what she found as to lower-carb brews:
- The lowest-carb beer I found was Marston’s Resolution, coming in at 85 calories and 1.65 grams of carb per bottle. It’s not a beer we’d find here in the States, but it’s more easily found in the United Kingdom. Surveys say it tastes refreshing and the double fermentation process makes its carb load almost undetectable.
- Michelob Ultra, weighing in at 95 calories and with 2.6 grams of carb per bottle, is a more common beer, and found regularly at bars. It doesn’t boast a lot of flavor, much like its counterpart, Natural Light (95 calories, 3.2 grams of carb). But if you’re looking for options without the high carb load, it’ll do.
- A bottle of Amstel Light has 95 calories, 5 grams of carb.
- Heineken Premium Light has 99 calories, 7 grams of carbs. These are really popular beers and very common in American bars.
- Want to go light? How about a Corona Light (109 calories, 5 grams of carb), or a Bud Light (110 calories, 6.6 grams of carbs), or a Sam Adams Light (119 calories, 9.7 grams of carbs)? All three are readily available in most markets and are mellower on your blood sugars than your average high-carb beer.
- And if you’re living with diabetes and celiac disease, there are a few gluten-free beers on the market that might work for you -- Omission Lager comes in at 140 calories and 11 grams of carbs, is touted as a beer that “pleases all palates, including those of average beer drinkers and craft connoisseurs.” A pint of Magners tasty gluten-free, Irish cider is another option, with 125 calories and 9 grams of carb.
So there you go, low-carb enthusiasts!
That is what we have to share for this April, or really any time when drinking and diabetes may be on the mind. Have any other resources or stories to share?