Alcohol and drugs
Alcohol
Alcohol can play a big part in university life and for many students there are no problems. In Type 1 diabetes there are some guidelines which will help keep you safe. The general principle is that alcohol often lowers your blood sugar level, sometimes many hours later.
- Have a slow acting / low glycaemic index carbohydrate snack after drinking even if your blood glucose appears high (e.g. kebab or chips on the way home)
- The sugar in some alcoholic drinks may cause your blood glucose to go up at first but don’t give extra insulin to compensate for this
- Never drink on an empty stomach
- Excess alcohol may cause you to forget to take your basal insulin
- Alcohol in excessive levels may distort your ability to sense when your blood glucose levels are too high or too low
- Be aware that low alcohol or alcohol free drinks usually have a much higher sugar content
- But… drinks with low sugar content (e.g. Pils lager) have higher alcohol content
- Drinks with a high alcohol content are more likely to cause hypos
- If you have been drinking in the day you may need to reduce the short acting insulin you give in the evening
- Never drink and drive – be aware that alcohol could lower your blood sugar and affect your ability to drive safely the following day
- Ensure your friends know what to do if you have a hypo
- If excess alcohol causes you to be sick your blood sugar can get out of control very quickly. You need to test your blood sugar levels and try to drink sugar-free fluids. If the vomiting continues for over 4 hours you should go to hospital as there is a risk of Diabetic Ketoacidosis
Drugs
Illegal recreational drugs carry health risks for any individual but those with Type 1 diabetes should be aware of the specific issues which can cause serious problems.
Any drug use may distort your ability to sense when your blood glucose levels are too high or too low. You may not realise that you are having a hypo.
Speed, Ecstasy, and cocaine all suppress the appetite, which combined with dancing can cause a severe hypo.
Cannabis stimulates the appetite, and excessive food intake could raise your blood sugar level.
Cannabis can make people feel out of it, which could cause you to forget to take insulin / medication.
It is OK to say no to drink and drugs - not everyone drinks to excess or takes drugs.
For the science behind it all see an article by P. Lee, J. R. Greenfield, L. V. Campbell - Managing young people with Type 1 diabetes in a 'rave' new world: metabolic complications of substance abuse in Type 1 diabetes Published in Diabetic Medicine April 2009 Volume 26 (4) p 328-333