Why alcohol and hypos go together

Some people may find it all too easy to let diabetes drift out of their mind when having alcohol and not worry too much about blood glucose levels. There are some obvious reasons why alcohol seems to lead to hypos; for example, having so much fun you forget to eat. But to make matters worse, alcohol can shut down the natural, protective mechanism your body has for raising your blood glucose.

Alcohol can affect blood glucose levels because it prevents the liver from regulating your glucose level. The liver plays an important part in blood glucose regulation by steadily releasing glucose into the blood throughout the day. Normally when you don't eat, your liver helps to keep your blood glucose levels steady by making glucose from glycogen. But when you drink, your liver is so busy dealing with the alcohol, it shuts down glucose production.

One consequence of this is that hypoglycaemia can be more likely to occur after drinking alcohol. It is well known that alcohol can affect our liver in the long term, however in the short term that can make hypoglycaemia more likely if you have diabetes.

Here are a few tips for safer drinking:

• Food and drink go together
  Protect yourself from hypos by never drinking on an empty stomach.
   
• Watch out for carbohydrates
  A number of alcoholic drinks (such as beers, cider and liquors) contain carbohydrate and so they may cause our blood glucose levels to rise initially.
   
• Party with a friend
  The symptoms of a hypo and the symptoms of being drunk are unfortunately very similar. So try to ensure you have a friend or partner with you who knows about your diabetes and what to do for a hypo. 
   
• Know what you're drinking
  You may already have a good idea of how much you can drink safely but it can be easy to get taken by surprise. So, keep an eye on what's being served. To be on the safe side, assume that any drink poured at home or at a party is likely to be at least twice as strong as a pub measure.
   
• Watch out for unexpected exercise
  It’s easy to exercise without realising it (e.g. dancing) when you are having fun. As a result always keep a small pack of biscuits or some glucose sweets handy just in case.
   
• Before you go to bed
  Back home and exhausted, it's tempting to simply fall into bed. Unfortunately it's just as easy to slip into a hypo during your sleep. So if you've been out for a few drinks, a starchy bedtime snack is essential.

When you drink alcohol:

• See how your body reacts
  There is quite a lot of variation in how people react to alcohol. Testing before and a couple of times after you have a drink can help you judge how at risk you are of having a hypo. Watch out! Often drinking makes your levels rise at first but they will go down later, so remember your bedtime snack.
   
• During the night
  Put your testing equipment and a starchy snack ready beside your bed, then if you feel unwell during the night it will be easier to test whether you are hypo or just suffering from a little too much to drink!
   
• The morning after
  The effects of alcohol can last well into the next day, so test more frequently and be extra careful throughout the following 24 hours.