Student Advice Column: Alcohol, Weed & T1D

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CDN Student Advice Columnists

Question: How does alcohol/weed affect blood sugar? I've heard hard liquor makes you go high and then drops you low in the morning, and wine keeps you high? So does that mean I should only bolus for wines and not liquor? 

Answers:

Zach: Hi! Great question! I can only offer you my thoughts on alcohol and my blood sugar, and I want you to know that everyone’s bodies react differently to alcohol, so you’ll have to experiment with your own limits. Personally, I don’t see a huge difference between hard liquor and wine/beer but remember, there are so many factors that contribute to how your body processes alcohol, such as sleep, how much food is in your system, how hydrated you are, etc., so each and every time you drink your body might experience something different. Alcohol does contain carbohydrates, and of course if you add in mixers like juice or regular soda that will certainly affect your blood sugars initially.

The thing to be mindful of with diabetes is that there can be a delayed effect on your blood sugars regardless of the type of booze. What many people (including myself) usually do is avoid giving a lot of insulin (either a bolus or a correction) because low blood sugars can be a result of alcohol, and severe low symptoms can often feel or look similar to intoxication.

Some peer to peer advice would be:

1. make sure you always have a buddy who will remind you to check your blood sugar and look out for you while you're out having fun.

2. Having a CGM is extremely beneficial to keep tabs on what your blood sugar is doing to avoid a dangerous situation.

3. Have a snack with you at all times, and have one before you go to bed. Even you end up a little high from the carbs after you've been drinking, it can prevent a natural drop in blood sugars from the alcohol that can often happen overnight.

4. If you wear an insulin pump, take advantage of playing around with settings like a temp basal-it can be another tool to help prevent significant high or lows, especially overnight.

Maddy:

Hi there! Glad you asked. As Zach mentioned, sort of like T1D and exercise, everyone’s body is different and my experiences might be different than another. First off, I would absolutely recommend wearing your CGM if you have one if you are planning on drinking. Having the ability to be woken up when low with an alarm can be lifesaving. What I have found as the most T1D friendly drink is clear liquor (like vodka) with a diet mixer (tonic water, diet soda or diet juice). I find this to be easier to deal with than drinking a sugary drink like a margarita. When I get home after having a few drinks, I usually eat about 20g of carbs without bolusing, and I don’t go low in the night. Sometimes I wake up a bit high in the morning, but I would rather play it safe and end up high than too low. If you do end up drinking a high-sugar drink, you will likely spike, but I would strongly recommend not correcting in the moment because your blood sugar can drop on its own later. Carry snacks and have a buddy with you who knows about your T1D in case of emergency. Also, tell a roommate you will be drinking so they can check on you in the morning just in case. Stay smart, be alert and you should be just fine!

Editor’s note: For more information on alcohol and T1D, check out http://www.drinkingwithdiabetes.com/.

Although marijuana generally doesn't have the same direct effects as alcohol, the indirect effects can raise your blood sugar – especially from the feelings of hunger that often accompany using weed. Use the same precautions like having a buddy, using a CGM if you have one, and keep both high and low blood sugar supplies handy. For more information on weed and T1D, check out this article by our friends at Beyond Type 1.

Keep an eye out for our upcoming blog series on marijuana & T1D!