Hi jimbaen,
I?m concerned that your blood glucose is rising, even with the tablets
you are taking. Have you had a glucose or a Hemoglobin A1C (Also
called HbA1c or glycosylated hemoglobin) drawn to evaluate your blood
glucose? The HbA1c blood test can give a better picture of your
glucose levels by assessing glycemic control over the preceding
several weeks. Perhaps its time to revisit your doctor for evaluation.
HbA1c from eMedicine:
http://www.emedicinehealth.com/articles/17044-5.asp?pd=12/21/2003%209:55:25%20PM
I too, am a teetotaler, and would not be able to take a drink or two
a day, even for medicinal purposes, but I am not opposed to
responsible social drinking! I found some evidence that supports 1-2
drinks a day for diabetics, as well as a study that would prefer no
alcohol be taken by folks with diabetes. However, while you may take a
drink or two a day, diabetes can not be managed with alcohol. I will
discuss my findings further down in the answer.
== You said ? I'm looking for definitive info (with numbers!)
regarding optimum safe levels of alcohol to drink per day.?
Some studies by the ADA (American Diabetic Association) have found
that 1-2 drinks per day is acceptable for people under 65, 1 drink a
day for those over 65. However, since blood alcohol can impair the
liver?s ability to metabolize fat, folks with serum triglyceride
levels over 200mg should abstain from alcohol completely. (I hope this
does not sound like I am preaching about the evils of alcohol!)
In order to begin a moderate alcohol regimen, you should have your
blood glucose (BG) fairly well regulated.(It sounds like yours is not
stable, if glucose levels are rising!) When you drink alcohol, your
liver temporarily stops producing glucose, instead working on clearing
your system of alcohol. This can cause hypoglycemia (Low blood
glucose) in diabetics, especially if you have been drinking on an
empty stomach, or if you?ve taken your oral glucose tablets just
before drinking. The ADA also recommends that a friend or family
member be with you when you drink, and that they are versed in what to
do should you suffer a hypoglycemic attack.(Hypoglycemia can make you
appear to be intoxicated.) They should know to seek prompt medical
attention if you lose consciousness or start vomiting.The symptoms of
hypoglycemia, as you probably already know, are the ?shakes?,
paleness, dizziness and confusion. Keep glucose tablets with you when
you have an alcoholic drink. If you do drink in the evening, have a
high protein snack before going to sleep, to help prevent sudden dips
in blood glucose levels. The ADA says not to drink alcohol until
several hours after exercise. Exercising keeps your metabolism high
for several hours, lowering your glucose levels ? you don?t want to
further do so with alcohol.
According to the ADA, one alcoholic drink equals 2 fat exchanges;
regular beer is an additional 1 starch exchange.
http://www.diabetes.org/health/nutrition/alcohol/alcohol.jsp
http://www.diabetes.org/health/nutrition/foodpyramid/alcohol.jsp
Here are more recommendations from the ADA:
If you have chronic hypertension, limit or eliminate your alcohol
intake. People with diabetes are already at risk for high blood
pressure, and alcohol has been shown to raise blood pressure levels
even further. Chronic high blood pressure can contribute to a host of
diabetic complications, including kidney failure, heart disease, and
retinopathy.
A number of diabetes medications and other prescription and
over-the-counter drugs should not be taken with alcohol. Check the
label, and ask your pharmacist and/or physician if you are unsure.
If you are practicing tight control, you may do better to forgo the
drinks altogether. Tight control and the impaired judgment that comes
with intoxication is a recipe for disaster. In addition, since tight
control means you are fairly close to normal glucose levels,
hypoglycemia may occur more quickly.
http://diabetes.about.com/cs/alcoholdiabetes/a/alcohol_basics.htm
From the Wine Skinny site:
?Alcohol consumption can lower blood sugar levels to the point of
hypoglycemia (low blood sugar) that causes symptoms. A person with
diabetes should keep careful track of his/her blood sugar levels when
drinking alcohol, because certain diabetes medications, including
insulin, also lower blood glucose levels. If levels are too low, or if
the stomach is empty, alcohol consumption should be avoided.?
Alcohol can at times cause blood glucose to RISE, from the
carbohydrates in certain drinks. Drinking just before eating, or
eating while drinking can cause blood glucose to become elvated.
http://www.wineskinny.com/past_issues/health/health001011.htm
It seems that moderate consumption of alcohol can raise the ?good?
form of cholesterol, known as HDL (High density lipoprotein), and may
prevent blood clots. ?Still other research shows that alcohol lowers
fasting insulin levels, another potential predictor of heart disease
in people with diabetes. Does all this positive spin on alcohol
automatically suggest that all people with diabetes should begin to
drink alcohol? Not necessarily.? The ?Not? refers to consuming MORE
than the recommended 1-2 drinks per day. Drinking more actually
increases risk of disease.
?What the additional information from these recent studies tells us is
that a moderate intake of alcohol may offer people with diabetes some
protection from heart disease. However, each person's drinking
patterns and behaviors should be considered and recommendations made
on an individual basis. People with diabetes should check with their
physician to see if and how alcohol intake fits into their daily
routine.? Quoted in part, from Health and Age web site, report from
Tufts University, Sept., 2000
http://www.healthandage.com/Home/gm=0!gc=12!l=2!gid2=870
The Bournemouth Diabetes & Endocrine Center, Dorset, UK ran a
controlled study of Type I diabetic and moderate alcohol consumption.
You can see the entire presentation here:
http://www.b-dec.com/presentations/benturner_bda/Benturner_bda_files/frame.htm
The conclusion can be seen on the last slide, #15. The study concluded
that small to moderate alcohol intake in the evening increased the
chances of a Type I diabetic having a hypoglycemic reaction the next
day, after breakfast.
From this LookSmart article, outlining the above study : ?Ethanol has
been found to significantly lower overnight secretion of growth
hormone in nondiabetic subjects (14,15), and reduced response of
growth hormone to hypoglycemia in the presence of ethanol has also
been reported. The effect of ethanol on nocturnal growth hormone
levels in diabetes is unknown and may be relevant to delayed
hypoglycemia.?
?We chose the quantity of alcohol in our study to represent an average
evening's drinking in young adults and an amount that would generate a
peak blood level just above the legal limit for driving in the U.K.
(17.4 mmol/l). We used wine to keep the total volume of beverage to a
reasonable level and separated drinking from eating to ensure
consistent gastric absorption of ethanol. Although the subjects did
not experience a "hangover" as such, they had increased scores on
several associated symptoms. Several possible mechanisms, perhaps
acting in concert, might account for our findings. Smaller ethanol
doses, as recommended by the British and American Diabetes
Associations, would be expected to have less effect on secretion of
growth hormone and gluconeogenesis and be less toxic to the
gastrointestinal tract. However, it is unknown whether there is a risk
of delayed hypoglycemia at these doses.?
http://www.findarticles.com/cf_0/m0CUH/11_24/80381008/p2/article.jhtml?term=
Should people with diabetes completely avoid wine?
Here is what the Joslin Diabetes Center says:
?The use of alcohol should be discussed with your physician and health
care team As a general guideline, for persons using insulin, two
alcoholic beverages may be used in addition to their regular meal
plan. No food should be omitted in exchange for an alcoholic drink.
For persons who are not on insulin and are watching their weight,
alcohol is best substituted for fat choices and in some cases extra
bread/starch choices.
Some alcoholic beverages contain higher amounts of sugar and
carbohydrate -- these include sweet wines, sweet vermouth and wine
coolers. Use these sparingly as they may increase your blood sugar
levels too much?
Discuss the use of alcohol with your doctor and dietitian.?
Wine Skinny
http://www.wineskinny.com/past_issues/health/health001011.htm
And
Methodist Health
http://www.methodisthealth.com/diabetes/alcohol.htm
According to eMedicine, diabetics can use alcohol in moderation or
eliminate it altogether. They recommend no more than 7 drinks a week,
and never more than 2-3 in one night. Too much alcohol is a risk
factor for diabetics.
http://www.emedicinehealth.com/articles/17044-6.asp?pd=12/21/2003%209:55:49%20PM
To summarize, jimbaen, it appears it is safe for you to have 1-2
drinks per day. (1 per day if you are over 65 years of age) This is
providing your blood glucose is stable, your blood pressure is normal,
your blood triglyceride levels are under 200mg, you are not taking nay
other medications that contraindicate alcohol use, and someone knows
you are drinking and are a diabetic. On the other hand, if you don?t
care to drink, there is no need to start! The two Look Smart articles,
whose links I have placed at the end of this paragraph concur: There
is evidence that light-moderate drinking MAY help prevent heart
disease in diabetics, but taking alcohol is never concretely
recommended as a therapy. You can help prevent future heart disease by
stabilizing your glucose, eating well, and exercising. Keep your
doctor or endocrinologist apprised of your decision to have a daily
drink or not.
http://www.findarticles.com/cf_dls/m0CUH/7_25/89379212/p1/article.jhtml
http://www.findarticles.com/cf_dls/m0887/8_18/55587248/p1/article.jhtml
I hope this has helped you! If any part of my answer is unclear, or if
I have duplicated information you already had, please request an
Answer Clarification. Using the Answer Clarification process before
rating will allow me to assist you further, if possible. I wish you
the best of health!
Regards, crabcakes-ga |
