Alcohol, acceptable in moderation or not at all?

I can’t believe anyone with type 1 diabetes would drink alcohol, which is a poison, and which is always labelled as such in chemistry labs. We are burdened with an enormous health problem as a result of the disease, so we have to do everything possible to sustain or improve our health in other areas, so why on earth would anyone want voluntarily to ruin their health with drinking? For my part, I simply took it for granted when I was diagnosed at age 14 that I would never drink any alcohol, and now 52 years later, I still haven’t.

As a type 1 diabetic, your whole life is a desperate struggle to maintain consciousness against the constant threat of hypoglycemia, so why would you voluntarily diminish consciousness by drinking alcohol? It simply makes no sense, since with alcohol you only make one of the worst problems of the disease even more horrible.

Speak for yourself, this is not my experience of having type 1 diabetes. Lots of things are poison when done to excess. I see nothing wrong with enjoying a good drink and no reason why a type 1 should be denied that pleasure.

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You only live once, right!? I want to experience all life has to offer.

While taking care of myself as best I can of course :smile:

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Believe it…

Clearly our experiences are not even remotely similar. This does not characterize my life by any stretch of the imagination.

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The alcohol used in chemistry labs is indeed a poison, but it’s completely different from the alcohol that is found in a yummy glass of wine, an ice-cold beer, or a refreshing gin and tonic.

There was a recent thread on this forum about how to deal with people who are judgmental of others about how they manage and treat their diabetes. That might be a good thread for you to read through. I believe the subject was, “How to deal with people who think they know it all about diabetes.”

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I do believe alcohol is poison if it is drunk to excess. A glass of wine or beer or a cocktail is not enough to harm the body and is so enjoyable. Just as a diabetic you may need to be more careful with how much you drink.

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When we are diagnosed with type 1 diabetes, we are burdened with a massive challenge to our health and survival, so it seems clear to me that we have to do everything possible to sustain our health against this threat. For my part, at least, I can’t imagine why I would go out of my way to purchase an expensive neurotoxin like alcohol under those circumstances.

On the toxicity of alcohol for type 1 diabetics, see:

Nurs Stand. 2015 Aug 12;29(50):41-7. doi: 10.7748/ns.29.50.41.e9812.
Type 1 diabetes and alcohol consumption.
MacNaught N1, Holt P1.
Author information

Abstract
Type 1 diabetes is a challenging and complex disorder to manage, and this becomes more difficult when young people are beginning to experience the pleasures and effects of alcohol consumption. For a young person with type 1 diabetes, alcohol consumption can have harmful effects on their current and future wellbeing. The article focuses on the effects of alcohol in type 1 diabetes and the difficulties a young person faces in maintaining glycaemic control when drinking alcohol. The effects of living in an alcohol permissive culture and the knowledge and risks of alcohol consumption, as well as issues associated with depression and denial are discussed. In addition, we aim to raise awareness of best practice guidelines for healthcare professionals to reduce short and long-term complications associated with alcohol-induced hypoglycaemia.

The consensus in the literature is that moderate alcohol consumption can in fact have health benefits, even for people with diabetes (primarily, but not exclusively, type 2). Of course alcohol in excess has more risk factors than benefits. Based on gender, genetics, other health conditions, and various other factors, each individual will have their own “tipping point.”

What follows is not, of course, a mandate to go forth and get blotto. But for those who do choose to drink moderately and responsibly, it’s nice to know we are not necessarily digging our own grave.

For example, since heart health is a concern for people with diabetes, here are some recent findings (from https://www.hsph.harvard.edu/nutritionsource/alcohol-full-story/):

Cardiovascular Disease

More than 100 prospective studies show an inverse association between moderate drinking and risk of heart attack, ischemic (clot-caused) stroke, peripheral vascular disease, sudden cardiac death, and death from all cardiovascular causes. (4) The effect is fairly consistent, corresponding to a 25 percent to 40 percent reduction in risk.

The connection between moderate drinking and lower risk of cardiovascular disease has been observed in men and women. It applies to people who do not apparently have heart disease, and also to those at high risk for having a heart attack or stroke or dying of cardiovascular disease, including those with type 2 diabetes, (5, 6) high blood pressure, (7, 8) and existing cardiovascular disease. (7, 8) The benefits also extend to older individuals. (9)

The idea that moderate drinking protects against cardiovascular disease makes sense biologically and scientifically. Moderate amounts of alcohol raise levels of high-density lipoprotein (HDL, or “good” cholesterol), (10) and higher HDL levels are associated with greater protection against heart disease. Moderate alcohol consumption has also been linked with beneficial changes ranging from better sensitivity to insulin to improvements in factors that influence blood clotting, such as tissue type plasminogen activator, fibrinogen, clotting factor VII, and von Willebrand factor. (10) Such changes would tend to prevent the formation of small blood clots that can block arteries in the heart, neck, and brain, the ultimate cause of many heart attacks and the most common kind of stroke. […]

For a 60-year-old man, a drink a day may offer protection against heart disease that is likely to outweigh potential harm (assuming he isn’t prone to alcoholism).

  1. Goldberg IJ, Mosca L, Piano MR, Fisher EA. AHA Science Advisory: Wine and your heart: a science advisory for healthcare professionals from the Nutrition Committee, Council on Epidemiology and Prevention, and Council on Cardiovascular Nursing of the American Heart Association. Circulation. 2001; 103:472–5.

  2. Koppes LL, Dekker JM, Hendriks HF, Bouter LM, Heine RJ. Moderate alcohol consumption lowers the risk of type 2 diabetes: a meta–analysis of prospective observational studies. Diabetes Care. 2005; 28:719–25.

  3. Solomon CG, Hu FB, Stampfer MJ, et al. Moderate alcohol consumption and risk of coronary heart disease among women with type 2 diabetes mellitus. Circulation. 2000; 102:494–99.

  4. Mukamal KJ, Maclure M, Muller JE, Sherwood JB, Mittleman MA. Prior alcohol consumption and mortality following acute myocardial infarction. JAMA. 2001; 285:1965–70.

  5. Muntwyler J, Hennekens CH, Buring JE, Gaziano JM. Mortality and light to moderate alcohol consumption after myocardial infarction. Lancet. 1998; 352:1882–85.

  6. Mukamal KJ, Chung H, Jenny NS, et al. Alcohol consumption and risk of coronary heart disease in older adults: the Cardiovascular Health Study. J Am Geriatr Soc. 2006; 54:30–7.

  7. Booyse FM, Pan W, Grenett HE, et al. Mechanism by which alcohol and wine polyphenols affect coronary heart disease risk. Ann Epidemiol. 2007; 17:S24–31.

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Agreed.

On the subject of younger diabetic adults (including older teens - this is the reality) who may be just coming of age where alcohol becomes a choice (legal or illegal - again - reality), real, valid and medically sound information is critical. (IMHO)

Telling a young person not to drink and then not providing further information (again IMHO) can lead to potential disastrous consequences. Providing false information based on fear mongering is just as bad (once again IMHO).

In terms of young adults, my personal approach is to ensure that accurate and medically sound information is made available and reinforced appropriately. Further discussions around sensible behavior as relates to alcohol are entirely appropriate.

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Expensive? Obviously you weren’t around for $1 beer nights at McGill. Who knew a few loonies could buy so much happiness…

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Same 52 years of type 1 diagnosed at 14 like yourself but unlike yourself I never ever let diabetes rule my life then or now and therefore if I want a drink I have one, if I want an ice-cream I have one, if I want a cookie I have one, etc. But like with everything in life you should do it in moderation and yes as mentioned above by others it does effect your BG up first and down later but by now after decades of dealing with this disease you can compensate for it up or down. Yes it has been trial and error but now with a couple of glasses of wine or a light beer or two it is easily manageable like one orange has more carbs than another orange or apple etc.
I would recommend a glass of wine with a good meal as it will take the edge off that you might need.

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The dose makes the poison.

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Ethanol, the type of alcohol which is in alcoholic beverages humans drink, is a neurotoxin:

Neurotox Res. 2015 Oct;28(3):253-67. doi: 10.1007/s12640-015-9536-x. Epub 2015 Jun 24.
A Comprehensive View of the Neurotoxicity Mechanisms of Cocaine and Ethanol.
Pereira RB1, Andrade PB, Valentão P.
Author information

Abstract
Substance use disorder is an emerging problem concerning to human health, causing severe side effects, including neurotoxicity. The use of illegal drugs and the misuse of prescription or over-the-counter drugs are growing in this century, being one of the major public health problems. Ethanol and cocaine are one of the most frequently used drugs and, according to the National Institute on Drug Abuse, their concurrent consumption is one of the major causes for emergency hospital room visits. These molecules act in the brain through different mechanisms, altering the nervous system function. Researchers have focused the attention not just in the mechanism of action of these drugs, but also in the mechanism by which they damage the nervous tissue (neurotoxicity). Therefore, the goal of the present review is to provide a global perspective about the mechanisms of the neurotoxicity of cocaine and ethanol.

Since type 1 diabetes is a disease which tremendously increases the risk of neuropathy, it makes no sense to me to swallow a substance which will have additional toxic effects on the nervous system. Why struggle so hard, risking hypoglycemic attacks all the time, to keep the blood sugar levels as close as possible to normal in order to avoid diabetic neuropathy (among other threats), and then undo all that effort by swallowing a neurotoxin? If you want dietary interventions to promote cardiovascular health, there are plenty of non-toxic options to accomplish that.

Indeed, in college we once diluted %100 ethanol from a biology lab into reasonably dosed mixed drinks (we couldn’t bring it back for use in other studies once poured out for us, and it seemed a shame to waste…), which while is not recommended because of possible cross-contamination in labs with actually harmful things, hurt no one, just got people drunk. Ahh college…

There’s no inherent reason someone with reasonable hypoglycemic awareness and/or a CGM who takes precautions shouldn’t drink in moderation. I recommend for any people starting out with drinking to always err on the side of running higher while alcohol is in your system, especially overnight. Better to eat a decent sized snack before bed and wake up at 200 than to risk a severe low, but that’s another reason to make drinking a sometimes/occasional thing, especially while figuring out its effects.

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This is overly reductive, and again, doesn’t consider dose effects. You have a tendency to cherry-pick single, narrow studies to make your points, which is not how science works. This article is talking about substance use disorders (i.e., not moderate use) and mentions ER visits (assumes a very high level of intoxication)—no one here is arguing that those things aren’t bad ideas for anyone, diabetic or not. That has nothing to do with whether a few drinks here and there, or a glass of wine with dinner, is problematic for T1 diabetics or anyone else.

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Lol there’s no getting through to this person, every thread I’ve seen ends up like this with endless cherry-picked research articles to make a point no one agrees with. I’d say we should all have a drink and agree to disagree, but the poster doesn’t drink so don’t know what the solution is!

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I’ll buy him one

I don’t drink either (being a diabetic with a history of alcohol abuse), but I’d happily raise a glass of sparkling water and buy everyone else a round of their poison of choice. But only if it doesn’t cost any actual money, since I don’t really have the means to buy a round…

But seriously, I think it’s important to emphasize what @cardamom said as well: many of the studies are talking about alcohol abuse or addiction. It is a common error (that seems primarily to persist in American and some other highly religious cultures) that some people seem to make: any alcohol use is necessarily abuse or misuse. The majority of people, however, are perfectly capable of moderately using alcohol in an appropriate manner, and being a diabetic doesn’t somehow magically change that. We just need to be educated on the BG effects so we can make good choices about how to moderately use (or not) alcohol.

This isn’t any different than any other substance, whether that be a prescription drug or a legal or illegal intoxicant. Some people will use such substances, and sharing how to do that successfully (and non-judgmentally) is more useful than the alternative.

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Ad hominem attacks are inappropriate. Ethanol is a neurotoxin at any dose, although its clinical significance increases with increasing doses. For people already suffering from a disposition to diabetic polyneuropathy, it seems reckless in the extreme to burden that pre-existing risk by drinking a neurotoxin like ethanol. Although its effects, such as melting the protective myelin sheath around nerve cells, will be more evident in more sensitive subjects, such as the developing fetus, it is still a substance toxic to all living things, as is abundantly illustrated by its widespread use to kill bacteria.

A Low Ethanol Dose Affects all Types of Cells in Mixed Long-Term Embryonic Cultures of the Cerebellum

Chris Pickering1,2, Grzegorz Wicher 3, Sofi Rosendahl3, Helgi B. Schiçth1 and sa Fex-Svenningsen3,4 1Functional Pharmacology, Department of Neuroscience, Uppsala University, Uppsala, Sweden, 2Addiction Biology Unit, Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, University of Gothenburg, Gothenburg, Sweden, 3Division of Developmental Genetics, Department of Neuroscience, Uppsala University, Uppsala, Sweden, and 4Anatomy and Neurobiology, Institute of Medical Biology, University of Southern Denmark, Odense, Denmark (Received 21 August 2009; Accepted 18 October 2009)

Abstract: The beneficial effect of the ‘1-drink-a-day’ lifestyle is suggested by studies of cardiovascular health, and this recommendation is increasingly followed in many countries. The main objective of this study was to determine whether this pattern of ethanol use would be detrimental to a pregnant woman. We exposed a primary culture of rat cerebellum from embryonic day 17 (corresponding to second trimester in humans) to ethanol at a concentration of 17.6 mM which is roughly equivalent to one glass of wine. Acutely, there was no change in cell viability after 5 or 8 days of exposure relative to control. By 11 days, a reduction in the numberof viable cells was observedwithout an accompanying change in caspase-3 activity (markerof apoptotic cell death), suggesting changes in cell proliferation. As the proportion of nestin-positive cells was higher in the ethanoltreated cultures after 5 days, we hypothesized that an increase in differentiation to neurons would compensate for the ongoing neuronal death. However, there were limits to this compensatory ability as the relative proportion of nestin-positive cells was decreased after 11 days. To further illustrate the negative long-term effects of this ethanol dose, cultures were exposed for 30 days. After this period, virtually no neurons or myelinating oligodendrocytes were present in the ethanol-treated cultures. In conclusion, chronic exposure to ethanol, even at small doses, dramatically and persistently affects normal development.

I agree, but you just don’t know when to stop. I get it, you think alcohol is poison and have the research to back it up. What is your point? If you don’t want to drink it, please don’t. Not all of us struggle with hypoglycemia the way you say you do. You shouldn’t judge other people for having a drink and no one is going to stop because of some research articles you post. The original poster asked if a type 1 diabetic can drink and all of us, except for you, agree that the answer is yes and have discussed healthy. responsible approaches to drinking with diabetes.

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