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Best advice to a diabetic is to abstain from alcohol. Unfortunately for some diabetic it may not be possible to stop the drinks, we have come a long way from the times when 'GIN' was equated with 'SIN'. Today drinking has become an accepted social custom. Hence a diabetic must atleast understand the additional problems which he has to face, so that he will drink sparingly and sensibly.
a) Empty calories
Alcoholic drink provides calories but has no nutritive value. They do not contain vitamins, proteins, fats or minerals. Caloric content of common alcoholic drinks are as follows:
| |
Type of Drink |
Measure |
Calories |
| I. |
Whisky - Gin, Rum,
Vodka (80 proof) |
30 ml. |
80 calories |
| II. |
Beer (6-7% alcohol) |
650 ml. |
400 calories |
| III. |
Sweet wine
(18% alcohol) |
100 ml. |
130 calories |
| IV. |
Dry wines
(18% alcohol) |
100 ml. |
90 calories |
b) Extra calories
Mostly the drinks are taken with snacks which further add to the calories. Hence a
diabetic patient who takes alcohol may tend to become obese. This is true particularly with beer drinking.
c) Alcohol, neuritis and diabetes
Diabetics are prone to develop neuropathy and alcohol also produces neuropathy. Hence
in a long standing diabetic, with poor control and alcohol intake, peripheral neuritis tends to be severe and difficult to treat unless the alcohol is stopped and diabetes is well controlled, neuritis will not improve.
d) Antabuse type reaction
Diabetic patients who are on oral hypoglycemic agents particularly choropr op amide may
develop unpleasant facial flushing after taking alcohol. This is similar to antabuse like reaction such patients should avoid alcohol intake.
e) Alcohol may precipitate hypoglycemic reaction in diabetics
Chronic alcohol intake may be associated with glycogen depletion in liver due to poor food
intake. If diabetics are on oral hypoglycemic agents or insulin and if they happen to develop hypoglycemia then such patients may have prolonged hypoglycemia and it may take longer time to recover inspite of treatment. In chronic alcoholics-neoglucogenesis is inhibited hence there is prolonged hypoglycemia.
f) Alcohol and Lipid abnormalities
Alcoholic Lipaemia is typically characterised by increased VLDL levels with
hypertriglyceridaemia with or without chylomicronaemia (Type IV or V) 40% of diabetics have increased VLDL and increased triglycerides and in severe lipid disorders even chylomicrons are elevated. Both alcohol and diabetes mellitus produce same type of lipid disorder which are coronary risk factors.
g) Chronic alcoholics can develop acidosis, acute or chronic pancreatitis, alcoholic cardiomyopathy, myopathy and diarrhoea. All the above complications are also known to occur independently in a diabetic of long duration. Hence one can imagine when two risk factors like alcohol and diabetes are present in a patient the amount of damages occurring in different organs and tissues.
Alcoholic diabetics who are taking phenformin may get serious complication like Lactic acidosis.
In conclusion it can be said that there are many problems related with alcohol intake in a
diabetic. Ideally a diabetic patient should be asked to abstain from drinking alcohol.
REFERENCES
1. Alcohol and diabetes mellitus S.M. Sadilot, Jr. of Diabetic Association of India Vol.XX
VIII Page 69, Oct 1988.
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