Alcohol disrupts the liver's normal production of sugar. While your liver is busy metabolizing the alcohol you've consumed, it doesn't release its stored sugar when your blood sugar level starts to drop. Your blood sugar can then drop too low. If you take insulin or oral diabetes medications, even as little as 2 ounces of alcohol — the equivalent of two drinks — can cause low blood sugar. Sometimes, though not often, alcohol can cause the opposite reaction, driving up your blood sugar because of the added calorie consumption.
That doesn't necessarily mean you have to abstain altogether. Instead, follow a few guidelines:
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Drink only moderately. If your diabetes is well controlled, you might be able to have a moderate amount of alcohol. A moderate amount is generally defined as no more than two drinks a day for men and one for women. One drink equals one 12-ounce beer, one 5-ounce glass of wine, or one 1.5-ounce shot of spirits. And remember to include this in your calorie count.
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Fill up first. Don't drink alcohol on an empty stomach. Food helps moderate the effects of alcohol.
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Test your blood sugar. Check your blood sugar before drinking alcohol. If it's already low, don't have that drink, because the alcohol can push blood sugar even lower. Monitor your blood sugar before and after drinking to see how your body responds to alcohol.
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Don't drink and work out. Both alcohol and exercise can lower blood sugar. Although it may be tempting to down a couple of beers after a hard game of baseball with the guys, you risk a more severe drop in blood sugar, especially if you take insulin or oral diabetes medications. And remember, injections of the fast-acting hormone glucagon aren't useful in treating severe low blood sugar caused by alcohol. Instead, you'll need a carbohydrate, such as oral glucose tablets or gels. If you pass out, you'll need a glucose injection into your bloodstream.
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Watch what you drink. If you do drink, select drinks that are lower in sugar. If you have mixed drinks, use mixers that are sugar-free, such as diet soda, tonic water, club soda or seltzer. And choose alcohol with fewer carbohydrates, such as light beer. Read the labels carefully.
If you have diabetes-related complications, such as nerve damage or retinopathy, don't drink at all. Alcohol can worsen the damage. If you're not sure, ask your doctor if it's safe for you to drink any alcohol.
Diabetes and menstruation
Your ovaries produce the hormones estrogen and progesterone, which regulate your menstrual, or reproductive, cycle. As the hormone levels fluctuate during the cycle, so can your blood sugar. Most women who have menstruation-related changes in blood sugar notice differences in the seven to 14 days before bleeding begins. Blood sugar generally stabilizes a day or two after the period starts. Menopause can also affect your blood sugar levels.
You can avoid problems by:
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Keeping a log. Keep track of all your blood sugar readings and look for patterns related to menstruation that can help you predict fluctuations.
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Consulting your doctor. Your doctor may recommend changes in your medication dose or schedule, or your eating and exercise regimens, to make up for swings in your blood sugar.
Diabetes and other medications
Insulin and oral diabetes medications can, of course, lower your blood sugar. But the amount of blood sugar reduction you get from taking insulin or oral diabetes medication depends on the timing and size of the dose. Any medications you take for conditions other than diabetes may affect your blood sugar as well, sometimes only minimally but sometimes significantly.
What to do:
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Review your dosing. If your diabetes medications cause your blood sugar to drop too low, talk to your doctor about adjusting your treatment.
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Store insulin properly. If it's spoiled — or was improperly stored — it may not be effective. Check the expiration date and talk with your pharmacist if you're uncertain.
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Get informed about new medications. When you get a prescription to treat another condition or if you want to take an over-the-counter medication, be sure to tell the doctor or pharmacist you have diabetes and ask if the medication can affect blood sugar. If the drug may make blood sugar control more difficult, consult your diabetes doctor.
Diabetes and stress
Stress can affect your blood sugar in two ways.For one, when you're under heavy stress, it's easy to abandon your usual routine. You might cut back your exercise, eat fewer healthy foods and test your blood sugar less often. In that sense, stress indirectly causes your blood sugar to rise.Stress can also have a direct effect on your blood sugar level. As with the stress of a physical illness, prolonged or excessive emotional stress can cause your body to produce hormones that prevent insulin from working properly. That, in turn, increases your blood sugar levels. This is more common in people with type 2 diabetes.
