Adjusting insulin for alcohol

Working out how to adjust  insulin when you are drinking is largely done by trial and error. Keeping a diary so that you can reflect on what you’ve done each time is useful.

Keeping your blood glucose stable is a matter of finding the correct balance between the type of drink, quantity, food (carbohydrate) intake, activity levels and insulin dose.

The table below gives an overview of the basic things that can cause your blood glucose to go up or down:

Alcohol Scenarios

Try to predict in advance what might happen to your blood glucose and plan ahead. Here are a few scenarios: 

• I’m having dinner at 5 pm and going out drinking at 8 pm, so I’ll take my normal insulin dose with my dinner – I don’t need to reduce it as I’m not drinking until a few hours later. 

• I’m drinking vodka and diet coke all night and will be walking in between bars and probably dancing, so I’m at risk of hypos as I’m drinking non-sugary drinks and will be active. I’ll have a few normal cokes with vodka to prevent hypos, as alternating between high and low carb drinks may be enough to keep my blood glucose levels stable. I’ll keep an eye on my blood glucose levels through regular monitoring. 

• I’m not sure how much I’ll drink or how active I’ll be. It depends on how the night goes, so I’ll test my blood glucose a few times during the evening to check. 

• I’m at risk of having a hypo through the night as I probably will drink quite a lot, so I’ll reduce my long-acting insulin a bit to help through the night and I’ll have 30–40g carbs just before I go to bed. 

• If I’ve had too much alcohol I’m at risk of hypos the next morning, so I’ll set my alarm, and will reduce my breakfast fast-acting insulin to prevent a morning hypo. 

To hear one person’s experience when they forgot to take their meter out, click here.