In Australia, it’s recommended that men and women drink no more than 10 standard drinks in a week, and no more than 4 standard drinks in a day.
Of course, we’re all human and on occasion you might want to ignore these guidelines! If you’re planning on having more than a couple of drinks, there are some things to prepare and look out for to ensure you can have a great night and morning after.
One of these considerations is avoiding hypoglycaemia. Alcohol increases our risk of the dreaded 4am hangover hypo, but why does it do this? What’s the science behind this phenomenon, and how can you avoid it?
Alcohol and your liver
For people with T1D, excess alcohol increases your risk of hypoglycaemia.
When you drink alcohol (which your body considers a toxin), the liver prioritises breaking down the alcohol and removing it. While your liver does this, it can’t do all the other jobs it normally would – like releasing stored glucose if your blood glucose level starts to fall. In fact, your liver does 90% of the work processing the alcohol you consume, with the remaining 10% left to exit your body in your sweat, urine or breath.
Alcohol-induced hypoglycaemia
Throughout the day, your liver usually slowly releases stored glucose into your bloodstream. Your slow-acting (basal) insulin helps control how quickly this glucose is released.
But when you drink alcohol, your liver is too busy, and is no longer able to release enough glucose to prevent your blood glucose from going too low – especially if you have insulin on board. It takes about 1 hour for your liver to process a standard alcoholic drink; 6 drinks means 6 hours, which is why you’re at risk of alcohol-induced hypoglycaemia overnight.
Alcohol-induced hypoglycaemia can be dangerous if you go to sleep without first taking steps to mitigate the 4am hangover hypo.
Avoiding hypoglycaemia
- To avoid hypoglycaemia after drinking, it’s best to avoid drinking large amounts of alcohol in a session.
- Make sure you always eat some carbs before and while you drink.
- It’s also recommended you don’t include the carb content of alcoholic beverages in your carb counting calculations.
- Where possible, choose diet soft drink as a mixer and keep an eye on your food intake.
- CGMs can be very helpful overnight in these situations. Make sure you use the alert function. You can also use temporary targets or activity modes on automated pumps. Ask your diabetes team about this.
- You may sometimes find that your glucose level rises too high after a drink that contains carbohydrate – like spirits mixed with regular soft drink, or large amounts of beer. You might also find that you eat more when you drink alcohol.
- Test your blood glucose level before you go to bed, and if it’s normal to low, have a snack with carbs before you go to sleep.
