This leaflet is provided by Diabetes UK, the leading charity that cares for, connects with and campaigns on behalf of every person affected by, or at risk of diabetes.
Diabetes: is Alcohol a Problem?
Do you like a beer or two after a hard day? Or a sherry to relax with on a Sunday? Or some bubbly to celebrate good news?
Alcohol is a part of many of our cultures, and depending on your relationship with it, can be one of life's pleasures ... or one of its pains. This leaflet explains how alcohol affects diabetes, how to tell if you're drinking too much, and how to get support if you want to cut down.
Many people with diabetes enjoy alcohol and there is no need to give up completely unless you wish to. Whether you have diabetes or not, healthy guidelines in the UK generally recommend a limit of 14 units a week for both men and women (government guidelines have recently been revised for men). Drinking alcohol when you have diabetes can make hypoglycaemia (a hypo) more likely, so the following tips can help reduce the chance of you having a hypo:
- Don't drink on an empty stomach - eat something carbohydrate-based beforehand.
- You may need to eat some starchy food during the evening to keep your blood glucose levels up.
- Tell the people you are with that you have diabetes and carry a medical ID.
- Take a hypo treatment with you
- Alternate alcoholic drinks with sparkling water, sugar-free lime and soda or diet drinks.
- Pace yourself - enjoy your drink slowly and keep track of how much you are drinking.
- Stick to your recommended daily units of alcohol.
- Check your blood glucose levels and adjust your insulin as you've been advised.
- Eat a starchy snack before going to bed and drink plenty of water.
So what shifts the enjoyment of drinking alcohol into alcohol dependence? Alcohol dependence is characterised by at least three of the following signs over a period of a year:
- A need for increased amounts of alcohol to achieve desired effect; or diminished effect with continued use of the same amount of alcohol.
- Drinking in larger amounts or over a longer period than intended.
- Persistent desire or one or more unsuccessful efforts to cut down or control drinking.
- Important social, occupational, or recreational activities given up or reduced because of drinking.
- Drinking to relieve withdrawal symptoms.
- A great deal of time spent in activities necessary to get, to use, or to recover from the effects of drinking.
- Carrying on drinking despite knowledge of having a recurrent physical or psychological problem that is likely to be caused by drinking.
Alcohol dependence is common. The World Health Organization estimates that there are 140 million people with alcoholism worldwide. The biological causes are not fully understood but psychological and social factors such as mental health difficulties, environment, family history, stress, age, gender and ethnic group can all affect the risk of developing alcohol dependence. Some people with an alcohol difficulty don't realise they have a problem, and their problem can affect those around them as much as (and sometimes even more than) the individuals themselves.
Alcohol dependence normally requires treatment, and the withdrawal symptoms can make it hard to stop by yourself. It is important to seek medical advice when you are considering cutting down, as depending on how much you are drinking, some withdrawal symptoms can be life-threatening. This is one of the reasons why inpatient rehab treatment is often an option.
One of the most well-known treatments for overcoming an alcohol problem is the 12-step programme started by Alcoholics Anonymous. This group support approach has helped many people recover from an addiction to alcohol. It is a free to use programme, led and organised by people who have themselves overcome their difficulty with alcohol.
Psychological therapies can be helpful in recovering from alcohol difficulties. One of the most commonly used for people with alcohol problems is Cognitive Behavioural Therapy (CBT). CBT can be accessed individually or in a group. It can help you manage the stresses that led you to start drinking too much in the first place, by replacing unhelpful thoughts such as
- 'I can't cope, I'm a failure, I need a drink' with kinder thinking styles such as:
- 'I can ask for support', 'It's OK to find this difficult'.
Therapies also encourage the person to be curious about when and why alcohol difficulties started, and what triggers drinking, in order to understand it more fully.
As well as CBT, there are a number of other therapies to support those with alcohol difficulties. Many people find they need to experiment with more than one treatment approach, often alongside a group support programme such as Alcoholics Anonymous, in order to find one that best suits their personality.
The most important thing to know is that difficulties with alcohol can be overcome, and many people manage to successfully reduce or give up alcohol, if that's their choice.
Further advice and information
- Alcoholics Anonymous (National Helpline: 0800 9177 650)
- Alcohol Concern
- Hello Sunday Morning
- Nash, J (2016) ‘When Alcohol Stops Working’
- Carr, A. (2002) Allen Carr's Easy Way to Control Alcohol. Penguin Books, London UK
Content used with permission from Diabetes UK - Alcohol. Copyright for this leaflet is with Diabetes UK.