This article was originally published on dLife.com - a website dedicated to helping people with diabetes live happier and healthier lives. This article is reposted here with permission from the original publication.
Do you like a beer or two after a long day at work? Or a glass of bubbly to celebrate some good news? Drinking alcohol is a part of many of our cultures, and depending on your relationship with it, can be one of life's pleasures…or one of its pains. This article looks at the effect of alcohol on diabetes, how to spot the signs if you're drinking too much, and how to get help.
Alcohol and Diabetes
Many people with diabetes enjoy drinking alcohol and there is no need to give up unless you want to. Whether you have diabetes or not, healthy (American) guidelines generally recommend a limit of 1 drink per day for women and 2 drinks per day for men. One effect of alcohol on diabetes is hypoglycemia (low blood glucose levels). Drinking alcohol makes these more likely to occur, so the following tips can help reduce the chance of you having a hypo and keep yourself safe whilst drinking:
- Have something to eat before / at the same time as you drink alcohol as drinking on an empty stomach means it will be absorbed too quickly into your bloodstream.
- If you drink more than a few drinks during an evening, you will have an increased risk of hypos all night and into the next day too, as your liver continues to get rid of alcohol. A tip that many find useful is to snack on a starchy food, such as cereal or toast, before going to bed to help minimize this risk.
- Avoid low-sugar (sometimes called ‘diabetic') beers and cider. Although they contain less sugar, their alcohol content is usually much higher.
- Low-alcohol wines are often higher in sugar than ordinary ones, so if you do choose these, just stick to a glass or two.
- Remember that those around you could confuse a hypo with being drunk as, unfortunately, many of the ‘symptoms' are the same! Do let people you are with know that you have diabetes and what help you might need if you have a hypo. Also, make sure you carry some ID to let others know you have diabetes, such as an ID card, medical necklace or bracelet.
- Alcohol Dependence
So what turns the pleasure and enjoyment of drinking alcohol into alcohol dependence? Alcohol dependence is characterized by at least three of the following signs over a 12-month period:
- A need for markedly increased amounts of alcohol to achieve intoxication or desired effect; or markedly diminished effect with continued use of the same amount of alcohol
- Drinking to relieve or avoid withdrawal symptoms
- Drinking in larger amounts or over a longer period than intended
- Persistent desire or one or more unsuccessful efforts to cut down or control drinking
- Important social, occupational, or recreational activities given up or reduced because of drinking
- A great deal of time spent in activities necessary to obtain, to use, or to recover from the effects of drinking
- Continued drinking despite knowledge of having a persistent or recurrent physical or psychological problem that is likely to be caused or exacerbated by drinking
Dependence on alcohol is extremely common. The World Health Organization estimates that there are 140 million people with alcoholism worldwide. The biological causes are not fully understood, but psychological and social factors such as family history, mental health difficulties, environment, stress, gender, age, and ethnic group can all affect the risk of developing dependence on alcohol.
We know that the physiological effects of alcohol help people to ‘disconnect' from stressful situations, and can be a way of coping with difficult emotions. Consequently, the effect of alcohol on diabetes is not the only thing to be concerned about. There is also the effect on others. Some people with an alcohol difficulty don't realize they have a problem, and that their problem can affect those around them as much — sometimes even more — than the individual themselves.
Alcohol dependence normally requires treatment to overcome, and the withdrawal symptoms can make it hard to stop on your own. It is important to seek medical advice when you are contemplating cutting down, as depending on how much you are drinking, some withdrawal symptoms can be life threatening. This is one of the reasons why inpatient rehab treatment is often a good option, although if you don't have access to private medical insurance it can be an expensive solution.
One of the most well-known treatments for overcoming alcohol difficulties is the 12-step program started by Alcoholics Anonymous. This group support approach has helped many people recover from an addiction to alcohol. The only requirement for membership is a desire to stop drinking and the fellowship values honesty and supporting one another to aid recovery.
The psychological therapy most commonly used with people with alcohol problems is Cognitive Behavioural Therapy, or CBT for short. It is a popular therapy approach which can be accessed on an individual basis or in a group format. It aims to help the individual with the stresses that made them start drinking to excess in the first place, by replacing unhelpful thoughts such as ‘I can't cope, I'm a failure, I need a drink' with kinder, more self-affirming thinking styles such as:
- ‘It's ok to find this difficult'
- ‘I can ask for support'
- ‘One small step in the right direction is great progress'
In addition to CBT, there are a number of other therapies to support those with alcohol difficulties toward recovery. Many people find they need to experiment with more than one treatment approach, often in conjunction with a group support program such as AA, in order to find one that best suits their personality and style.
The most important thing to know is that difficulties with alcohol can be overcome, and many people manage to successfully reduce or cut out alcohol from their lives. Reach out to one of the following organizations to find out more and take the first step toward your own journey of recovery:
Alcoholics Anonymous - http://www.aa.org
Rehab International - http://rehab-international.org/
Positive Diabetes (to find a psychologist) – www.PositiveDiabetes.com
Dr. Jen Nash is a clinical psychologist who has lived with diabetes for more than 20 years. She runs www.PositiveDiabetes.com, an education, therapy and coaching service that supports people with type 1 and 2 to manage the emotional and psychological impact of day to day life with diabetes. Read more of Dr. Nash's columns on dLife
: The information is not intended to be a replacement or substitute for consultation with a qualified medical professional or for professional medical advice related to diabetes or another medical condition. Please contact your physician or medical professional with any questions and concerns about your medical condition.