Tuesday, 15 June 2010

It's all about units......of the alcohol and the insulin kind

Saturday night was set aside for a good catch up with my oldest and bestest friend, Kathryn, round at her house.  This usually includes some yummy food and copious amounts of wine....this Saturday was no exception.  The only difference this time was that I was actually paying attention to what I was eating, the carbs involved and the affect that alcohol can have on blood sugar levels.

In the past, mainly in my teenage years, I would have a few drinks and not feel any effects diabetes-wise as my sugars usually ran so high anyway that any alcohol I drank did not lower my sugar levels enough to make me hypoglycemic. 

I don't want you to get the wrong impression of me at this point so let me make it clear that I don't drink alcohol very often at all, in fact the last time I had a few drinks before this Saturday was in March and the time before that was January.

What effect can alcohol have on you if you are diabetic?
Alcohol can significantly increase the risk of hypoglycemia (low blood sugar levels). It can block your livers ability to release glucose.  It also blocks hormones that raise blood glucose and increases the glucose-lowering effect of insulin.
You should avoid drinking on an empty stomach, as this will quickly increase the amount of alcohol in your bloodstream.  You should never substitute alcohol for your meals as this can increase the risk of a hypo.
When drinking larger amounts of alcohol, serious hypoglycemia can occur. Some sources (including Diabetes UK) advise strict carbohydrate management, perhaps even eating chips or pizza, if a large amount of alcohol has been consumed.
The symptoms of drunkenness, i.e. slurring words, confusion, can be very similar to the symptom of a hypo. Furthermore, if you have been drinking heavily, there may be a risk of hypos for up to 16 hours (or even longer) after you have stopped drinking.  Obviously, monitoring blood glucose levels closely is an essential part of managing your diabetes in this situation.

So, back to Saturday....working out the carbs in the pizza was the first job.  4 slices at 50g carbs per slice = 200g carbs!!! This seemed an awful lot but we triple checked the maths (you would hope Kathryn got it right as she's a teacher after all) then worked out I'd need 60 units of Apidra as I'm currently using the ratio of 3 units for every 10 grams of carbs

I admit I felt a bit wary of doing so much insulin in one go as, before carb counting (which I only started at the end of April this year), I would never have injected so many units for one meal and 60 units sounded like a crazy amount, so I didn't inject for the 4 garlic dough balls or for the Doritos that I also ate.  I guessed that this would be ok as if I was drinking quite a lot of wine that would also bring my sugars down if I hadn't done enough insulin to account for the Doritos and doughballs......WRONG!!!

Woke up the next morning feeling rubbish but surprisingly not due to a hangover but because of the horrendously high blood sugar level of 23.1.  Not sure exactly what had gone so wrong here.......maybe I should have injected for the Doritos and doughballs after all??!!!

My sugars came back down to a reasonable level by lunchtime and we did have a great night catching up, giggling and singing - much to the neighbours dismay I'm sure - to old Take That songs, so I'm not going to worry about it too much.....until the next time, when I will try, once again, to get it right!!!

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