Curing Diabetes

Try to convince your patient with diabetes to limit her alcohol consumption. Alcohol is high in calories, tends to be ketogenic, and increases the risk of hypoglycemia. Women should have no more than one drink (1 ounce of alcohol) per day; men, two drinks per day. Patients who are trying to lose weight and those with hypertriglyceridemia should limit their intake to less than two drinks per week.When you advise your patient about alcohol consumption, take the caloric value of each drink into account. For example, 8 ounces of regular beer contains 100 calories, 31/2 ounces of table wine contains 85 calories. Because the caloric value of alcohol is similar to fat, alcohol may be substituted for fat in the diet. One drink is equivalent to two fat exchanges.

Any patient who’s using insulin or taking an oral antidiabetic drug should consume alcohol only with a meal. Alcohol and certain sulfonylureas may cause a disulfiram-like reaction, flushing, headache, nausea, and breathlessness. Alcohol and metformin can increase the risk of lactic acidosis.

Because alcohol inhibits gluconeogenesis, a patient with diabetes must watch carefully for hypoglycemia when she consumes alcohol. When she’s fasting, or when glycogen stores are depleted, her body can’t make glucose from noncarbohydrate sources, such as fat and protein. So, when blood glucose levels begin to drop, the normal compensatory mechanism of converting stored energy into glucose is blocked by the alcohol. The result is hypoglycemia.

Filed under: Diabetes Treatment