ALCOHOL& TYPE 1 DIABETES

The National Diabetes Services Scheme is an initiative of the Australian Government administered with the assistance of Diabetes Australia.

1300 136 588 ndss.com.au

Introduction 3

Whatisastandarddrink? 5

Howmuchistoomuch? 7

Howdoesalcoholaffectapersonwithoutdiabetes? 8

Howdoesalcoholaffectapersonwithtype1diabetes? 9

Alcoholandhypos 10

WhattypesofalcoholcanIdrink? 11

Peerpressure 12

WhentosayNO 12

Thinkwhenyoudrink:planninganeveningout 13

Beforeyougotobed 14

Resources 15

The following information on alcohol should be used as a guide. Alcohol affects people differently and some of this information may not apply to all people with type 1 diabetes.

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Alcohol is the most commonly used recreational drug in Australia, available legally to anyone over the age of 18.Itisactuallyclassifiedasa‘depressant’drugwhichsimplymeansthatitslowsdownyourbody’sresponserates,whichcanleadtopoordecisionmakingandslowerreflexes.Drinkingalcoholcancauseimmediateproblemswithspeakingandmovementwhichcanleadtoharmfulaccidentsorinjuries,orunwantedphysicalorsexualviolence.

Introduction 3

Whatisastandarddrink? 5

Howmuchistoomuch? 7

Howdoesalcoholaffectapersonwithoutdiabetes? 8

Howdoesalcoholaffectapersonwithtype1diabetes? 9

Alcoholandhypos 10

WhattypesofalcoholcanIdrink? 11

Peerpressure 12

WhentosayNO 12

Thinkwhenyoudrink:planninganeveningout 13

Beforeyougotobed 14

Resources 15

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Whenyoubecomeateenageryourbodygoesthroughalotofchanges.Justasyourbodykeepsdevelopingandmaturing,sodoesyourbrain.Therearealotofreasonsnottodrinkalcoholwhenyouareyoungbutoneofthemostimportantonesisthatitcanaffectyourbrainbecauseitcanactuallystopyourbrainfromdevelopingnormally.Alcoholaffectsthebrainsofyoungpeopledifferentlyfromthewayitaffectsadults,andcancausehealthproblems,memoryproblems,addictionordepression.

Ifyouhavediabetesyouarestillabletodrinkalcohol,butthereisahigherriskofyourdiabetesbecomingunstablewhenalcoholisaddedtothemix.Itisimportantforyoutoknowabouttheseriskssoyoucanpreventthemandavoiddangeroussituations.

What is a standard drink?

A standard drink is one that contains 10 grams of alcohol.

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285ml regular beer

30ml spirits

425ml low alcohol beer (less than 3% alcohol)

100ml wine Pre-mixed drink

60ml fortified wine (port, sherry)

One standard drink is equal to

Itisimportanttobefamiliarwithhowmuchisinastandarddrinkofeachtypeofalcoholasitiseasytomisjudgetheamountconsumed.ByAustralianlaw,thelabeloneveryalcoholicdrinkhastoshowhowmanystandarddrinksitcontains.

It’simportanttorememberthatsomedrinksservedatrestaurants,bars,clubs,andparticularlyatparties,canhavemorealcoholthanastandarddrink.Asanexample,anaverageservingofwineatarestaurantis150mlmakingit1.5standarddrinks.Inaddition,cocktailscancontainmanyshotsofdifferentspirits,soeventhoughtheymaylooklikeonestandarddrink,theycanactuallycontainawholelotmore.

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HOW MUCH IS TOO MUCH?Researchshowsthatpeoplewithdiabetescandrinkalcohollikeeveryoneelse,butitisadvisablethattheysticktotherecommended2standarddrinkslimitperdaywhichrelatestoallAustralians.Mostpeoplewithdiabetescansafelydrinkalcoholinmoderation,butitisalwaysbesttocheckwithyourdoctorifyouhaveanyquestions.

Foryoungpeopleunder18yearsofage,notdrinkingalcoholisthesafestoption.1

Excessivedrinkingor‘bingedrinking’canbedangerousforyourhealth.Shorttermeffectscanincludehangovers,headaches,nausea,vomiting,memorylossandinjuries.Thereisalsotheriskofalcoholpoisoningwhichcancausedeath.Othereffectsincludechangedbehavioursuchasaggressionordepression.Longtermaffectscanincludealcoholdependencewhichcanleadtoliverorbraindamageovertime.

Youcanloweryourhealthrisksandavoiddangeroussituationsbyfollowingtheseguidelines:/Adultmenandwomenshoulddrinknomorethan

2standarddrinksaday./Drinknomorethan4standarddrinksonasingleoccasion./Haveatleast2–3alcoholfreedayseachweek.

1 NationalHealthandMedicalResearchCouncil:2009Australianguidelinestoreducehealthrisksfromdrinkingalcohol:nhmrc.gov.au/_files_nhmrc/publications/attachments/ds10-alcoholqa.pdf

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HOW DOES ALCOHOL AFFECT A PERSON WITHOUT DIABETES?Becauseeveryoneisdifferent,alcoholcanhavedifferenteffectsonpeopledependingonanumberofthingsincluding:/gender/weight/amountofbodyfat/whattheyhaveeatenbeforehand/physicalactivity/howtheyarefeelingatthetime.

More information on the effects of alcohol can be found in the Australian Government’s National Health and Medical Research Council’s (NHMRC) guidelines here: www.nhmrc.gov.au/health-topics/alcohol-guidelines/alcohol-faq

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Peoplewithtype1diabetesfacemoreriskswhendrinkingalcoholthanpeoplewithoutdiabetes.Alcoholcanaffectyourbloodglucoselevels(BGLs),whichmaycausehypoglycaemia(a‘hypo’).

Whenyoudrinkalcohol,yourliverthinksitisatoxinthatneedstobeprocessed.Untilthealcoholiscompletelyprocessed,yourliverwillnotreleaseasufficientamountofglucoseintoyourbloodwhichmeansyourBGLsarelower,andmayleadtoahypo.SometimesyourBGLsarefirstraisedbythesugarcontentinsomealcoholicdrinks(whicharemixedwithsoftdrink)andthenloweredonceyourliverstartsprocessingthealcohol.Theriskofahypooccurringispossiblebothduringthetimeyouaredrinking,aswellasformanyhoursafterdrinking.

Symptomsofahypocanincludeshaking,sweating,dizziness,headaches,crying,grumpiness,hungerandnumbnessaroundthelipsandfingers.Soitisveryimportanttotreatahypoifyoufeelanyorallofthesesymptoms.Youshouldcheckyourbloodglucoselevel.Ifitisbelow4mmol/Lyoushouldhave:/Glucosetabletsequivalentto15gramscarbohydrateOR/6–7jellybeansOR/1/2canofregularsoftdrink(not‘diet’)OR/3teaspoonssugarorhoneyOR/1/2glassoffruitjuice.

For more information on how to treat a hypo, see the Diabetes Australia fact sheet: ndss.com.au/Documents/NDSS/Resources/Diabetes_Information_Sheets/HYPOGLYCAEMIA-2009.pdf

HOW DOES ALCOHOL AFFECT A PERSON WITH TYPE 1 DIABETES?

ALCOHOL AND HYPOSIfyoudrinkalcohol,youandyourfriendsmaynotrecognisethesymptomsofahypobecauseitmaybeassumedthatyouaredrunk.Thisisdangerousbecauseyoumaynotgettherighthelpfastenough.

Youngpeoplewithtype1diabetesneedtoplanaheadiftheyaredrinking.Tipstoreduceyourriskofalcohol-relatedhypos:

/Neverdrinkonanemptystomach.Alwaysensureyouhavesomecarbohydrateinamealorsnackpriortocommencingdrinking.

/Checkyourbloodglucosejustbeforegoingtobedtominimisethechancesofhypoglycaemiawhilesleeping.

/Eatasnackbeforegoingtobed.Rememberthatthebodycontinuestoprocessalcoholevenafterdrinkingstops.

/Neverdrinkalone.Identifyafriend,whoknowsyouhavediabetes,towatchoutforyouifyoudecidetodrink.Makesuretheyknowhowtorecognisewhenyouarehavingahypoandthattheyknowhowtohelpyoutotreatit.

If you drink alcohol, you and your friends may not

recognise the symptoms of a hypo because it may be

assumed that you are drunk.

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WHAT TYPES OF ALCOHOL CAN I DRINK?Differenttypesofalcoholmayhavedifferenteffectsonyourbody.WhilealcoholcanloweryourBGLsitisimportanttorememberthatmanytypesofbeveragesalsocontaincarbohydrateswhichcanraiseyourBGLs.

Thereisnohardandfastruleastohowmuchinsulintotakeforeachdrinkyouconsume.It’sbesttopaceyourselfandlearnhowyourbodyrespondstodifferenttypesofalcohol.

/Learnthecarbohydratecontentofwhatyouaredrinking.WebsitesandappssuchasCalorieKing(www.calorieking.com.au)cantellyouwhatisinyourdrink.Themoreinformationyouhave,theeasieritwillbetomanageyourBGLs.

/Pre-mixeddrinksoftenhavehighersugarcontentandcaninitiallyraiseBGLs,followedbyafalloncethealcoholeffectontheliverhaskickedin.

/CheckyourBGLsoftentoseehowdifferenttypesofalcoholicdrinksaffectyourbody.

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PEER PRESSUREWantingtofitinandmakefriendscanmakeyouactincertainways.Sometimesyourfriendsmightpressureyoutodosomethingyoudon’treallywanttodo,makingyoufeeluncomfortableorleftoutunlessyoujoinin.

Ifyouareofferedalcoholthatyoudon’twishtodrink,standyourground.Youhavetherighttosayno.Resistingpressurecanbehardattimesbutyoucandoit.Youshouldonlydosomethingifyouwantto,knowhowtodoitsafelyandfeelcomfortableindoingso.

Ifyou’refindingithardtoworkupthecouragetosaynotosomething,youshouldknowthatstickingupforwhatyoubelieveinfeelsreallygood.Peopledon’thavetoagreeoneverything,andifyoucanexplaintopeopleinacalmwaywhysomethingisnotforyou,moreoftenthannot,you’llgaintheirrespect.

WHEN TO SAY NOItmaybewisetodrinklessoravoidalcoholalltogetherifyou:/areoverweight/havepoorbloodglucosecontrol/havehighbloodpressure/havehightriglycerides(fat)levels/haveeyediseasecausedbydiabetes/havenervedamageinthearmsorlegs.

Drinkingalcoholcanmakealloftheseconditionsalotworse.

/Makesuretoeatacarbohydratecontainingmealbeforeheadingout.Avoiddrinkingonanemptystomach.

/Carryextracarbohydratesnacksincaseyouhaveahypo.Thismayincludelongactingcarbohydrates(amueslibaror2–3piecesofdriedfruit)aswellasquickactingcarbohydrates(6–7jellybeansor 1/2canofsoftdrink).

/Weardiabetesidentificationsuchasamedicalalertbracelet./MonitoryourBGLs.Takealongyourbloodglucosemeasurement

kitandchecklevelsfrequentlywhileyouareout./Paceyourself.Consideralternatingonealcoholicdrinkwitha

glassofwater.Bingedrinkingisneveragoodideaasyourliverwillnotbeabletokeepupwiththelargequantitiesofalcoholbeingconsumed.Thiscouldresultinvomitingandcloudingofyourjudgementsoyouwon’tbeabletomanageyourdiabetesproperly.

/Neverstoptakingyourinsulin.DoingsocouldresultinveryhighBGLswhichcanleadtodiabeticketoacidosis(DKA)whichmaybelife-threatening.

THINK WHEN YOU DRINK: PLANNING AN EVENING OUT

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BEFORE YOU GO TO BED/Checkyourbloodglucoselevelsanddrinkwatertoavoidwakingup

dehydratedthefollowingday./Setyouralarmtowakeyouupafewhourslatertocheckyour

levels.And/oraskaroommate,familymemberorpartnertocheckuponyouwhileyou’resleeping.

/Havehypotreatmentwithinreachduringthenight.

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Further ResourcesDiabetesAustralia:AlcoholFactSheetwww.ndss.com.au/alcohol-information-sheet

NationalHealthandMedicalResearchCouncil’s2009AustralianGuidelinestoReduceHealthRisksfromDrinkingAlcoholwww.nhmrc.gov.au/health-topics/alcohol-guidelines/alcohol-faq

AustralianDrugInformationNetworkwww.adin.com.au/content.asp?Document_ID=71#information

Type1DiabetesNetwork:Alcoholwww.t1dn.org.au/our-stuff/all-about-type-1-resources/starter-kit

Headspace:NationalYouthMentalHealthFoundationwww.headspace.org.au

DiabetesUK:Alcoholwww.diabetes.org.uk/Guide-to-diabetes/Teens/Me-and-my-diabetes/Living-my-life/Going-out/Alcohol/

The National Diabetes Services Scheme is an initiative of the Australian Government administered with the assistance of Diabetes Australia.

1300 136 588 ndss.com.au