Alcohol and Type 1 Diabetes: How to Manage A Night Out and the Morning After

Drinking alcohol is a tricky balancing act for anyone, even without adding type 1 diabetes into the mix. In the United States, it is recommended that men drink no more than two alcoholic drinks per day, and women no more than one alcoholic drink per day, with one to two alcohol-free days each week. In the short term, drinking more might cause excess weight gain given its high calorie content, and in the long term, it may increase the risk of high blood pressure and heart disease, as well as a number of different cancers.

Clearly, everyone should be conscious of their alcohol intake, but when you have type 1 diabetes, you have to be especially mindful at every stage of drinking–from night out to morning after.

The Night Out

Whether it causes a hangover or not, drinking alcohol in excess does increase the risk of hypoglycemia. When you drink, your liver puts everything else on pause to break down and remove the alcohol. This means that it can’t do all of the other jobs it normally would, like releasing stored glucose when your blood glucose levels fall. This doesn’t mean that individuals with type 1 diabetes can’t drink, it just means there are some extra things to keep in mind while drinking with type 1 diabetes. Here are a few pointers:

It’s best to avoid drinking large amounts of alcohol in one session. This doesn’t mean you can’t have fun, but try to pace yourself and keep track of how many drinks you’ve had.
Make sure you always have some carbohydrates to eat before you drink. This might mean dinner or appetizers out with friends, or making something for yourself before heading out. A small snack, like an apple or piece of toast with peanut butter is good idea.
It’s recommended that you don’t include the carbohydrate content of alcohol in your carb-counting calculations. You should aim to eat some carbohydrates every few hours as you continue to drink.
Test your blood glucose levels before you go to bed─if your level is normal to low, eat a snack before you head to sleep
If you’ve had problems with low blood glucose levels overnight, you may want to reduce your evening dose of insulin slightly, especially if you are planning to an active night out (like dancing), or if you’ve had an active day. Check in with your diabetes team before making a final call on adjustments like this.
It’s possible that your blood glucose levels will rise too high after drinking an alcoholic beverage that contains carbohydrates, especially if you have mixed drinks with soda, sweetened liqueurs, or large amounts of beer. When you can, choose a diet soda as a mixer and beware of sweetened liqueurs and too much beer.

The Dreaded Hangover

Hangovers aren’t particularly fun for anyone─but when you have type 1 diabetes a hangover can be dangerous. Delaying or missing your morning insulin can result in your blood glucose levels rising too high. Here are some important steps to take before and during a hangover:

If you know you’ll be drinking, make sure to set your alarm clock to wake you within an hour or so of your usual waking time. You don’t want to sleep through a meal or insulin dosing.
If you feel up to it when your alarm goes off, eat! If not, you can take your normal (or a slightly reduced) dose of your intermediate or long-acting insulin.
Before going back to bed, set another alarm to wake you again in two hours, so that you can check that your blood glucose level is not too low.
In an ideal world, one alarm will be enough─but if you’re feeling particularly groggy after the second one, be sure to set another.

Enjoying Your Night Out

A night out doesn’t have to be a nightmare. But, you do need to plan ahead a bit. You can talk to your care team about how your routine might be modified for drinking You can also talk to your friends about how they can best support you on a night out. If you take the time to prepare, you can enjoy your entire drinking experience, rather than suffering through parts of it.