The SA Journal Diabetes & Vascular Disease Volume 17 No 1 (July 2020)

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RESEARCH ARTICLE SA JOURNAL OF DIABETES & VASCULAR DISEASE
22 VOLUME 17 NUMBER 1 • JULY 2020
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How to drink responsibly if you are diabetic
A ccording to the World Health
Organisation (WHO), the average
South African consumes 11 litres of
alcohol in a year, which is almost twice as
much as the global average. Out of 195
countries surveyed, South Africa closes in
the top 30. In addition, the International
Diabetes Federation (IDF) counts 3.5
million diabetics in South Africa and
about two million further cases are
undiagnosed.
With these statistics in mind and the
country now being in Advanced Level
3 for Covid-19, which entails a further
easing of restrictions on alcohol and ludic
activities, the need is great for education
on alcohol consumption for people living
with diabetes or those who are at risk.
‘When you eat a meal, your blood
sugar level usually spikes within two hours
and drops after four hours. At this point
the liver releases stored glucose into the
bloodstream to keep your sugar level up
within the normal range. When you drink,
ethanol, which is a substance found in
alcohol, it is toxic to the body. It therefore
takes priority to be metabolised by the
liver. During this process, the liver is unable
to release glucose into the bloodstream,
which causes hypoglycaemia, or low blood
sugar level,’ says Omy Naidoo, Dietician at
Newtricion Wellness Dieticians.
However, the real danger resides in
the fact that the symptoms displayed by
a hypoglycaemic are very similar to that of
a person who is intoxicated. ‘You may slur
your speech, wobble around, feel dizzy or
weak. So if you are having a night out with
people, and have a low blood sugar level,
your mates may think you have just had
too much to drink rather than thinking you
are having a medical emergency,’ added
Naidoo.
When this goes untreated, low blood
sugar level can cause seizures, loss of
consciousness, and, in worst cases,
death. There is a popular maxim among
diabetics: a high sugar level may be fatal
over the year, but a low blood sugar level
will kill you in a matter of hours.
As a diabetic, being mindful of the
following may assist in minimising the
risks associated with alcohol:
• Drink according to what diabetes
experts recommend, which is two
alcoholic drinks per day for men
and one drink per day for women.
A single drink is the same as a tot of
spirits, or 330 ml of beer or a medium
glass of wine.
• If taking medication in the evening,
such as insulin or tablets, try to
have a sober person around to assist
you. A common scenario is that the
intoxicated patient dials up more
insulin than usually taken.
• Exercise lowers your blood sugar
levels, and in the event of heavy
drinking as well as late-night dancing,
this could increase your risk of having
hypoglycaemia.
• Work with a dietician to formulate a
plan as to how you incorporate alcohol
into your diet without compromising
your health goals.
• Always wear a medic alert bracelet
that states you are diabetic, so that
people around you may pick up
that you could be having a medical
emergency rather than being
intoxicated.