Drinking alcohol

Alcoholic drinks contain varying amounts of alcohol and glucose which will have an impact on blood glucose during and after drinking.

The most important thing to remember is that alcohol can cause nocturnal hypoglycaemia while sleeping or delayed hypoglycaemia during the following day related to the total units of alcohol consumed.

As there is limited research in this area, it is important that any action taken for alcohol should be based on your own experience and the information provided is a guideline only.

• Alcohol is a toxin and impacts the liver to prevent the conversion of stored sugar (called glycogen) into glucose in the bloodstream. This is how alcohol increases the risk of nocturnal and delayed hypoglycaemia.

• If after drinking alcohol you become unconscious with a hypo and require the use of the Glucagen Hypo Kit it is important for the family to know that it may not work and that 999 should be called immediately (Glucagen injection kit normally works through the release of liver glycogen stores).

• The approximate rate to process alcohol is 1 unit/hr + 1hr, for example, if you were to drink a large glass of red wine (250ml, 3 units) then that would take a total of 4 hours to process. You need to be aware of the total number of units consumed in order to calculate the duration of the temp basal rate to help prevent hypoglycaemia after drinking alcohol. For the units present in different drinks see drinkaware.

• Drinks which contain carbohydrates will cause an initial rise in blood glucose but alcohol can still increase the risk of nocturnal or delayed hypoglycaemia.

Safety guidelines when drinking alcohol

• Do not drink alcohol on an empty stomach as increases the risk of hypoglycaemia.

• You should always take your meter out with you if drinking. If you have a spare meter, place it at the side of the bed with a high-sugar drink. If you only have one meter then make sure you place it beside your bed when you come home.

• Plan to eat something before you go to sleep (either takeaway food or food you’ve made yourself when you get home).

• If you use the Freestyle Libre 2, ensure that the low glucose alarm is switched on and set to alarm at a glucose of 4.5mmol/L.

• Do not correct high blood glucose before bed due to increased risk of nocturnal or delayed hypoglycaemia.

• Set up temp basal rate reduction and time period based on total units from when begin drinking.

• Be aware that when a large volume of alcohol is consumed that this could increase the risk of delayed hypo the following day and you may have to reduce basal insulin using temp basal rate in the morning.

Low blood glucose levels are commonly experienced during the night and up to lunchtime on the following day.