Alcohol may increase delayed low blood sugar risk
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Drinking a modest amount of alcohol with an evening meal may increase the risk of low blood sugar the following day in patients with Type 1 Diabetes, the results of a study published in Diabetes Care suggest.
“There is no evidence to suggest that individuals with adopt a different approach to their use of alcohol than the rest of the population,” Dr. Tristan Richardson and colleagues from Royal Bournemouth Hospital, UK, write. However, in patients treated with insulin, alcohol has been implicated in up to one fifth of hospital visits for episodes of low blood sugar, also known as Hypoglycemia.
To investigate the effect of evening alcohol use on the risk of Hypoglycemia in type 1 diabetic patients over a 24-hr period, the researchers studied 16 patients. The subjects were an average of 39 years old, had diabetes for an average of 15 years and drank alcohol on a regular basis. All of the subjects “had normal awareness of hypoglycemia” and stable blood sugar levels.
Hypoglycemia occurs when your body’s blood sugar, or glucose, is abnormally low. The term insulin shock is used to describe severe hypoglycemia that results in unconsciousness.
The participants were evaluated with a continuous glucose monitoring system (CGMS) on two occasions separated by 2 weeks. On one occasion or the other they were given either orange juice or vodka and orange juice with a standardized meal.
The subjects received the same dose of insulin with the meal and before bed. On day 2, the patients abstained from alcohol and the team recorded meals, insulin doses, exercise, sleep and hypoglycemic events.
Type 1 diabetes mellitus, more commonly known as type 1 diabetes, is a disease in which the pancreas produces too little insulin to meet the body’s needs. Insulin is a hormone that helps control the level of glucose in the blood. Glucose is the main form of sugar in the body.
The subjects experienced an average of 1.3 hypoglycemic episodes per day during the 24 hours after the alcoholic drink compared with 0.6 after the placebo, statistically significant difference. No episodes of severe Hypoglycemia were reported.
The average blood sugar levels after alcohol were lower than after orange juice alone, Richardson and colleagues report. “This translated into an increased risk of (Hypoglycemia) throughout the 24-h period, with a persistent risk of hypoglycemia continuing into the next day,” the team concludes.
- Fatigue
- General discomfort, uneasiness, or ill feeling (malaise)
- Nervousness
- Irritability, or even aggression
- Trembling
- Headache
- Hunger
- Cold sweats
- Rapid heart rate
- Blurry or double vision
- Confusion
- Convulsions
- Coma
Additional symptoms that may be associated with this disease:
- Excessive sweating
- Sleeping difficulty
- Paleness
- Muscle pain
- Memory loss
- Palpitations, or feeling your heartbeat (heartbeat sensations)
- Hallucination
- Fainting
- Different size pupils
- Dizziness
- Decreased consciousness
They suggest that this information may enable people with diabetes “to be proactive and adjust insulin appropriately, with the aim to reduce the overall risk of Hypoglycemia associated with alcohol.”
SOURCE: Diabetes Care, July 2005.
Revision date: July 3, 2011
Last revised: by Janet A. Staessen, MD, PhD
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