Hey Everyone! My boyfriend is a Type I. I know some about diabetes because of what I've read about it and because I have severe hypoglycemia- so I have some of the same problems he does.. I just have a few questions about it...

My boyfriend, Rocky, is 21 years old and was diagnosed a little over 2 years ago.. diabetes runs in his family. He is usually very careful about what he eats/drinks, etc..

But sometimes he doubles his insulin dose so he can eat more. For instance, eating at Pizza Hut or somewhere of the like... that way instead of being able to eat 2 pieces, he can eat like 5 maybe 6.

Also, he drinks. Sometimes just one or two beers... but sometimes, he'll drink a lot more, 11 or 12.. sometimes more. He drank 4 margaritas at a friends house the other night and he told me he could feel that immediately- but after that he started drinking beer. When he knows he will be drinking a lot, he doubles his insulin dose before he starts drinking. Then after a couple of hours, he'll take a regular dose of insulin. Then before he goes to bed, he will take another double dose sometimes a little bit more depending on how much he drank.

Finally, he chews Copenhagen. When we first met, he had 6-8 dips a day. Now he's cut back to 2-4. Within the last few days, he has almost completely stopped chewing because he got food poisoning which turned into a stomach virus.

Anyways, I guess I was just wondering how these things are going to affect him... the doubling his insulin, drinking, chewing, etc... Any answers and help is greatly appreciated!

The thing that would concern me here is him injecting more insulin when he has drank alcohol. Alcohol actually lowers our blood sugars, so injecting more insulin is dangerous, as if he was to go into a hypo, you may automatically assume his symptoms were caused by him being maybe slightly drunk!

As for him injecting more to eat more pizza etc, that is fine, as diabetics now, we can adjust our insulin accordingly to how much or little we wish to eat, that is fine.

The amount of alcohol he is consuming is a bit worrying though.

Hope I have helped a little.

Well that is a little more reassuring... as for the amount of alcohol he can consume.. it is a lot more than most people. But it is because of his past most importantly when he was little..

He told me that when he was diagnosed he asked his boss (also a Type I) what he did when he wanted to drink.. and that's what his boss told him.. but I still worry about it. But I guess I always will.

Thanks for the answers though! I greatly appreciate it!

It seems he is drinking in excess from what you are saying!! as a diabetic type 1, we should not drink to much, alcohol in excess is dangerous for the healthiest of people, but as a diabetic even more so, he needs to slow down his drinking!

As I said before alcohol lowers blood sugars, get him to check his sugars before and after.

If he doubling his insulin after consuming alcohol that is dangerous!

He may well have had a bad past, but he will have a bad future also if he carrys on drinking as he is.

Good that he has you to care about him.

Take care:)

As far as I know he does check his blood sugar before and after.. but I can't be for sure as I am not always there. He doesn't drink that frequently especially now that he is out of school. Just a few beers here and there, and occasionally more when he is out with a bunch of friends.

what can his drinking do to him diabetic wise? Whether it is a one or two, 9 or 10. Long term and short term.

Hi again, I will try and answer as best to my knowledge.

I have had diabetes type 1 for 22 years, we are at a much higher risk of developing other problems, ie strokes, heart disease, nerve damage, early death through being either to low or to high in sugar levels, the list goes on and on!

Obviously a healthy person who drinks heavily is putting their health at risk, but as a diabetic he is adding further to his already high risk factor by drinking to much.

I am not saying don't ever drink, I have a drink or two sometimes, but what is worrying you said in your original post he drinks quite a bit, and doubles his insulin dose when he does!

As a diabetic we have to respect our bodies a hell of a lot, I for one am not the best diabetic on the planet, but you just have to know what is acceptable, and what is not.

It is good that he checks his sugars, but like you say you can't be watching over him all the time.

Good luck and hope I have helped a bit:)

That's a problem. As mentioned by others, alcohol first DEPRESSES blood Glucose levels. If he MUST drink a pile of mixed drinks, there is a good way of handling this: drink only drinks full of sweet fruit, i.e., strawberry margaritas instead of the bitter lime ones. No straight shots!

Much later, during the period 6-12 hours later, alcohol INCREASES bG (because alcohol is slowly "digested" by the liver, as a poison to be dealt with... AFTER having already entered the blood stream. Normal Digestion (enzymes, small intestine, etc.) doesn't apply. At the beginning, your liver works hard to break the alcohol molecules. That's why bG goes down: the liver is sucking up all your Blood Glucose, it's the biggest organ in the body and it's working HARD. Later, after it has broken the C=O double bond, the rest of the work has a positive payback, and drives blood glucose back up (strongly).

This digestion process has about the same timing as fat. So, the "up" side of a Bout of heavy drinking is like a Bout of too much pizza... it hits him late, in the middle of the night, his early AM bGs will be awfully high unless he sets the alarm to get up again at 3 AM.... not fun.

But the big danger is early. I have a horrified vision of your guy, having drunk too much, on the road with crashing bG and drunk, either of which alone is a felony offense against other innocent drivers... and then, being OFF the road, in God knows what condition.

Don't let him drive. For the funny timing of pizza binges, he can use a pump. But the last thing a T1 needs is a bad liver (it's his last line of defense against a really deadly, sub-25 hypo). The only real solution for this is to STOP BINGE DRINKING. And unfortunately, you can't make him do that: he has to choose it himself. You can print off this post, let him see me pointing at the liver issues, he should study them himself.

You and he need friends with better taste in partying. If he insists that there's nothing as fun in life as drinking 11-12 beers, DTMFA!

He doesn't binge drink.. he can drink quite a bit because his dad was an alcoholic and used to put beer and liquor into his baby bottles and sippy cups. When he got older his dad would pressure him into drinking... now, he can consume more alcohol than most because he has been exposed to it his whole life.

He doesn't drink a lot, 5 or more, very often... maybe once a month. He knows his limits.. but thanks to rickst for explaining all that- because that actually makes sense! He also told me after the margarita incident that he is never drinking that stuff again...

I just worry about him because I am 2 hours away and his mom doesn't really help at all, much less even care at all. I have asked him about the doubling his insulin many times but he just says it's fine if he doesn't do it that often.

As for the part about drinking in driving.. he doesn't do that. He stays wherever he is because he knows, like you said, drinking and driving is horrible and if something were to happen with his bG.. he wouldn't want to be by himself or driving.

But thanks to you all for responding.. now I actually know more about what goes on! And trust me- I tell him all the time that it may be fun to drink a lot now but in 15 years he'll look back and wish he would have been more careful.. when his liver is failing, heart problems, etc etc...

Forget about his "limits before falling down", and the fact that his liver has responded to repeated poisoning (that's how the liver views alcohol) by making more of the particular enzymes used in that process. By making more of those enzymes, his Liver is made capable of working even faster and harder, damaging itself even more quickly. 5 drinks is definitely, absolutely POSITIVELY too much.

It's the scale of the attack on your liver which matters most: 7 days of two drinks per evening is GREAT, NO PROBLEM for an undamaged liver. In contrast, two days per week of 5 drinks is TERRIBLE, even though the total number of drinks is less.

BTW, when my neighbor (County Pathologist) or any other Pathologist does an autopsy on victim of liver failure, their heart and arteries are nearly perfect. Alcohol is actually good for your circulatory system: the problem is, IT WRECKS EVERYTHING ELSE. (Brain, Kidneys, and especially the Liver. Liver damage is how habitual drunks die, unless accidents claim them first.)

You are correct that his past makes him less responsive to alcohol, "able to handle it". That's true of anyone who's liver has adapted to these repeated attacks. But-- that's merely the explanation, don't use it as an excuse. (There's a word, "enabler", which sums up the difference.)

If he "likes" getting truly drunk, rather than merely "warm and happy" (two drinks, three at the most), then he needs to quit cold turkey. AA. Or, DTMFA, it'll only get worse.

I have asked him about the doubling his insulin many times but he just says it's fine if he doesn't do it that often.
Frequency of changing insulin doses doesn't matter much. What DOES matter is keeping bG stable and controlled.

Fairly often, I'll do one of the buffets and kinda pig out. In the case of a local Indian Restaurant, I'll take quite a bit of rice to soak up all that yummy Tika Masala sauce. This does need about twice the insulin of my normal lunch. Not a problem pumping, and with a CGMS.... but if I was doing that at night and sleeping afterwards, without a CGMS, I wouldn't be able to control it with adequate reliability.

Consistency is key. If he sticks to brands and types of pizza which he knows well, then he can know (from experience) just what they take. Although a single extra shot (fast analog, or regular, or NPH) probably doesn't do a good job of matching the timing. A pump could be used to match it better.

In my personal case, I have a lot of bG surprises (up and down), totally unrelated to food intake. And I truly mean TOTALLY, as in many hours since the last meal. When they happen, I have to handle them with significant changes in planned insulin doses. I probably "double up" a lot more than he does. Handling your bG is good, not handling it is bad... he should simply do whatever it takes to make a near-perfect match, between his food and insulin dosage choices.

Of course the separate issue of saturated fat in the pizza cheese, (or even worse, trans-fats in artificially processed "cheese food" products), applies even more to D. people than non-D. people-- because our circulatory systems already have greatly increased risks. Pizza is a terribly unhealthy "food", both the huge amount of refined-flour dough and the horrible cheese/"cheese" are major problems.

Rick if you look back at this ladies original post, you will see that she mentioned he also doubles up his insulin dose to counteract his drinking!

Obviously doubling up or increasing insulin in fine when eating more, but the serious issue here is that her boyfriend in doubling up his insulin when he drinks!

I am very concerned that as the sugar level drops after the consumption, and then he takes double insulin, which drops it much further, the consequences can be fatal.

Right, thanks for pointing that out. In post #8, skittles mentions "the margarita incident", which I take to be a crash caused by drinking the sour ones I complained about in post #7 (where I said, if you're gonna do it, drink SWEETENED drinks).

Beer is an extremely high-carb beverage, depending on how slowly he drinks them and what he eats while drinking he MIGHT be doing about the right thing (within the first few hours). But he's walking a tight rope, drunk and trying to balance a big pile of beers and food which would probably overwhelm even me. (And he's half my age and experience, and he's DRUNK while trying to handle this.) I suspect that he's having bad Highs, or bad Lows, or BOTH, almost every time.

But if he focuses on Beer, the most likely problem is High bG after the Insulin wears off: NPH is a little bit too slow, with too big a tail for for the late +bG stage of alcohol digestion; R is a little to fast; and the fast analogs are WAY to fast. It's impossible to handle with just two shots before you go to bed, and it's impossible to handle with just a square-wave pump Bolus: You would really need to specify an entirely new (and highly variable) basal rate for the next 8-9 hours.

He needs to discontinue this "tightrope" habit. It's like watching a train wreck in slow motion, I'm REALLY upset by this story.

Being Type1 for 36 years and having it through my teens and my 20's (the Drinking Years)

I can tell you that what he is doing should not be a problem assuming he is testing his blood and ajusting his insulin accordingly. Does he feel his lows easily? this could be more of a problem if he has trouble feeling his lows.

As for Alcohol Lowering Blood Sugar.....If it is a straight shot then it will Lower it. but if it is mixed with any Carb and more is consumed, the carb will negate any Lowering effect that it has.

No one is gonna know how certain foods/drinks affect his sugar more then he will and he will know how much insulin he needs to negate the effects of addition carbs. If what he is doing is keeping his levels good then there is nothing you should be too concerned with. But it is critical that he test his blood more ofton when he is drinking...he should be doing it during as well as before and after.