Insulin: Alcohol's Impact on Diabetes and Injection Side Effects

Q: Insulin: Alcohol's Impact on Diabetes and Injection Side Effects

Hello, dear user： <br>Regarding your first question about the relationship between alcohol consumption and diabetes, the interaction between these two is quite complex, which I will simplify into several aspects： <br>1. <br>**Drinking on an empty stomach**： Rapidly increasing blo

Insulin Questions

Hello Dr.
Chen,
1.
Why do alcoholic beverages, which contain no sugar, harm diabetic patients?
2.
What are the potential side effects of insulin injections? Currently, I am using NovoMix 30.

Mr. Chen, 20~29 year old female. Ask Date: 2013/01/15

Dr. Chen Bozhang reply Family Medicine

Hello, dear user:
Regarding your first question about the relationship between alcohol consumption and diabetes, the interaction between these two is quite complex, which I will simplify into several aspects:
1.
Drinking on an empty stomach: Rapidly increasing blood alcohol concentration can inhibit the liver's release of glycogen into the bloodstream, leading to exacerbated hypoglycemic symptoms, and in severe cases, can result in coma.
Therefore, drinking on an empty stomach is absolutely not advisable.
2.
Drinking after meals: Alcohol can increase insulin resistance, making postprandial blood glucose levels more difficult to control.
In patients with poorly controlled diabetes, postprandial blood glucose levels may rise.
3.
High caloric content of alcohol: Each gram of alcohol contains 7 calories, which can be converted into fat and stored in the liver and other areas of the abdomen, leading to fatty liver and obesity, further exacerbating insulin resistance and worsening blood glucose control.
Therefore, the calories from alcohol must be included in the total daily caloric intake to maintain weight control.
4.
Sugars in alcoholic beverages: Many alcoholic drinks contain sugars, such as fruit wines and red wines, which often consist of high glycemic index monosaccharides and disaccharides.
Excessive consumption can adversely affect blood glucose control.
For any diabetic patient, we strongly advise against drinking on an empty stomach.
If drinking is unavoidable, please consult your physician regarding your blood glucose control status to determine if moderate drinking is permissible.
Even for those with stable and well-controlled blood glucose levels, alcohol intake should be limited to safe levels (less than 20 grams per day for men and less than 10 grams per day for women) to balance the cardiovascular benefits of alcohol with the need to manage diabetes effectively.
The second question pertains to the side effects of insulin injections.
The most significant side effect of insulin is hypoglycemia.
If the dosage, duration of action, and dietary glycemic effects are not closely coordinated, it is easy to experience low blood sugar after injecting insulin and before eating.
Long-term use of insulin, especially if the same injection site is used repeatedly, may lead to localized subcutaneous atrophy or hypertrophy in a minority of individuals.
Additionally, traditional animal-derived insulin can cause allergic reactions, hives, and edema; however, most patients now use human insulin analogs (such as NovoMix 30, which you are using), which have significantly reduced allergic symptoms and can be used with confidence.
I hope this information is helpful to you.

Reply Date: 2013/01/15

More Info

Hello! Thank you for your questions regarding the impact of alcohol on diabetes and the side effects of insulin injections. These are important topics for anyone managing diabetes, and I’m glad to provide some clarity.

Alcohol and Diabetes
1. Alcohol and Blood Sugar Levels: While it's true that many alcoholic beverages do not contain sugar, alcohol can still significantly affect blood sugar levels in several ways. When consumed, alcohol is metabolized by the liver, which prioritizes breaking down alcohol over producing glucose. This can lead to a decrease in blood sugar levels, especially if consumed on an empty stomach, which can result in hypoglycemia (low blood sugar). For individuals with diabetes, this is particularly dangerous because they may not recognize the symptoms of low blood sugar until it becomes severe.

2. Impact on Insulin Sensitivity: Alcohol can also affect insulin sensitivity. After a meal, alcohol consumption can increase insulin resistance, making it more difficult for the body to manage blood sugar levels effectively. This is particularly concerning for those with poorly controlled diabetes, as it can lead to elevated postprandial (after meal) blood sugar levels.

3. Caloric Content: Alcohol contains calories—approximately 7 calories per gram—which can contribute to weight gain if not accounted for in the overall dietary intake. Increased body weight can worsen insulin resistance, complicating diabetes management.

4. Mixed Drinks and Sugary Beverages: Many alcoholic drinks, such as cocktails and sweet wines, contain added sugars, which can spike blood sugar levels. Therefore, it’s crucial for individuals with diabetes to be mindful of what they are drinking.

5. Recommendations: For those with diabetes, it is generally advised to consume alcohol in moderation and to never drink on an empty stomach. The American Diabetes Association suggests that if you choose to drink, men should limit themselves to two drinks per day and women to one drink per day. Always consult with a healthcare provider for personalized advice.

Insulin Injection Side Effects
1. Hypoglycemia: The most significant side effect of insulin therapy, including the use of NovoMix 30, is hypoglycemia. This can occur if the insulin dose is too high relative to food intake or physical activity. Symptoms of hypoglycemia include shakiness, sweating, confusion, and in severe cases, loss of consciousness.

2. Injection Site Reactions: Repeated injections in the same area can lead to lipodystrophy, which is the abnormal distribution of fat. This can manifest as either lipoatrophy (loss of fat) or lipohypertrophy (accumulation of fat). These conditions can affect insulin absorption and efficacy.

3. Allergic Reactions: Although rare, some individuals may experience allergic reactions to insulin, which can include redness, swelling, or itching at the injection site.

4. Weight Gain: Insulin therapy can lead to weight gain, as insulin promotes the storage of glucose as fat. This is an important consideration for individuals managing diabetes, as excess weight can further complicate blood sugar control.

5. Long-term Effects: Long-term insulin use does not typically lead to severe complications, but it is essential to monitor blood sugar levels regularly and adjust dosages as needed in consultation with a healthcare provider.

Conclusion
In summary, while alcohol can be consumed by individuals with diabetes, it must be done with caution and awareness of its effects on blood sugar levels and overall health. Insulin therapy is a critical component of diabetes management, but it comes with potential side effects that require careful monitoring. Always consult with your healthcare provider for tailored advice and management strategies that suit your individual health needs.

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