Alcohol
For people with diabetes who keep their condition well controlled, there is no evidence that an occasional drink with a meal is harmful. Moderate alcohol consumption has little effect on blood glucose levels–as long as you drink with meals, and not instead of meals, or on an empty stomach.
What exactly is “moderate” alcohol consumption? Experts generally agree that it’s no more than two drinks a day. (One drink is equivalent to
However, for petite women, the safe daily limit is closer to one drink. Alcohol effects relate to weight–the less you weigh, the less it takes to become intoxicated. In addition, a given amount of alcohol gets women tipsier than men because men carry more of their weight in muscle tissue, which draws alcohol out of the blood. In women, more alcohol remains in the bloodstream, where it causes intoxication.
In the past few years, scientists have found that moderate drinking offers some protection against heart and blood vessel (cardiovascular) disease. Because cardiovascular disease is by far the leading killer of diabetics, you might think that doctors who specialize in the condition would encourage people with diabetes to drink. No so. While modest alcohol consumption can, indeed, help prevent cardiovascular disease, even moderate drinking can cause significant problems for diabetics. Meanwhile, there are plenty of nonalcoholic ways people with diabetes can minimize their risk of cardiovascular disease: maintain tight control of blood glucose, not smoke, eat a low-fat diet, get regular exercise, reduce high blood pressure and cholesterol, and manage stress.
Before you pour yourself a drink, talk it over with your doctor and dietitian and consider the following:
- Even one alcoholic beverage on an empty stomach can send your blood glucose level plummeting, raising risk of sudden hypoglycemia, possibly even loss of consciousness.
- Hypoglycemia and inebriation appear deceptively similar. If you’re having a hypoglycemic episode, people might think you’re just drunk and not take action quickly enough.
- Alcohol contains almost as many calories per gram as fat. So if your diet is a vital part of your diabetes treatment plan, you should think twice about the extra calories.
- Some diabetes medications stipulate limits on alcohol consumption. Discuss your medication(s) with your physician or pharmacist.
- Most importantly, alcohol can affect your motivation to maintain tight control.
- People with type 1 diabetes should be especially careful about drinking, and should check their blood glucose levels before and after drinking.
- Alcohol can cause low blood glucose levels for hours after you stop drinking. If you eat too little while drinking, you may develop hypoglycemia during the night or the next morning. If you drink late in the evening, you may need to eat a large bedtime snack.
Type 1 diabetics with the following conditions should probably avoid alcohol altogether:
- Neuropathy. Alcohol is toxic to nerves. If you have nerve damage in your arms or legs, heavy or regular drinking can increase your pain, numbness, and other symptoms.
- Intestinal problems. Alcohol can increase the discomfort of chronic bowel problems such as diabetic diarrhea or constipation.
- High blood pressure. Alcohol makes the blood vessels constrict, which raises blood pressure. Cutting down on drinking may reduce your blood pressure, which in turn, helps reduce risk of heart disease and stroke.
- Retinopathy. Consumption of three or more drinks a day has been linked with the development and progression of diabetic eye disease.
- Other complications. People with liver disease, high triglyceride levels, pancreatitis, heart or kidney diseases, and pregnancy problems probably should not drink.
Tobacco
Smoking is a major health hazard-for anyone, the nation’s leading cause of preventable death. But smoking is especially dangerous for people with diabetes because it narrows the blood vessels. Blood vessel constriction increases risk of high blood pressure, heart disease, stroke, diabetic sex problems, and limb amputation. Smokers account for an estimated 95 percent of all diabetic limb amputations.
What else does smoking do to your body? Here’s what scientists have learned over the years:
- Heart. Nicotine in tobacco smoke increases heart rate. In fact, compared with nonsmokers, smokers’ hearts beat on average 10 to 25 extra times per minute, or 36,000 extra beats per day. As a result, smoking contributes to chronic heart fatigue, medically known as congestive heart failure. Nicotine and other chemicals in tobacco smoke also cause the heart to beat irregularly, which can cause heart attacks and other potentially fatal heart problems. Because of diabetics’ high risk of cardiovascular disease, smoking is particularly hazardous to those with the disease.
- Blood Vessels. Compared with nonsmokers, smokers’ risk of blood vessel diseases is twice as high. Diabetics are already at serious risk of developing such blood-vessel-related complications as eye disease (retinopathy), kidney disease (nephropathy), heart disease (cardiovascular disease), and nerve disease (neuropathy). Diabetics who smoke are even more likely to develop these complications.
- Lungs. Tobacco smoke begins to chip away at your lungs’ natural defenses from the first puff. Over time it can completely paralyze the lungs’ natural cleansing process. This makes you more susceptible to colds, flu, bronchitis and other respiratory infections.
- Blood. Carbon monoxide, the colorless, odorless, deadly gas present in automobile exhaust, is present in cigarette smoke at more than 600 times the concentration considered safe in industrial plants. Research suggests that carbon monoxide may play a role in triggering heart attacks.
The carbon monoxide in cigarette smoke also makes it harder to exercise, something diabetics should do regularly. Smokers become short of breath more easily than non-smokers because so much of the oxygen in the blood has been crowded out by carbon monoxide that the body becomes starved for oxygen.
Other Drugs
- Appetite Suppressants. Your doctor may prescribe these medication to help you lose weight. If you eat less, your blood glucose level may fall, increasing risk of hypoglycemia. These drugs may also cause jitteriness, heart palpitations, and insomnia.
- Caffeine. The stimulant ingredient in coffee, tea, chocolate, and many soft drinks and over-the-counter drugs might cause a slight rise in your blood glucose level. Side effects include sleeplessness, shaking, and increased blood pressure and heart rate.
- Cocaine. Cocaine raises your blood glucose and changes eating habits. Heavy use leads to cardiovascular disease. Cocaine also raises blood pressure and causes sudden heart irregularities in heart rhythm, which increase risk of heart attack.
- Marijuana. Marijuana increases appetite. If you eat more than planned, your blood glucose rises.
- Sleeping Pills and Tranquilizers. These drugs slow breathing and may mask symptoms of hypoglycemia.