Written by Gavin December 2015:
“You’ll never hear me say, “sorry lads, I am not coming out-out tonight, I’ve got diabetes.” Not unless I’ve got a date lined up which I don’t want friends to know about, or my favourite movie is on the TV and I am seeking an excuse. While ‘playing the D-Card’ is something we can get away with from time to time – like when I flew to Vancouver in First-class despite holding an economy ticket, as I had a sudden ‘hypo’ on entering the aircraft when conveniently stood by spare First-class seats – the condition of type 1 diabetes itself is something that, with the right understanding and self care, should never stop us from being social and doing the things we enjoy most in life.
When it comes to a night out on the town, however, that ‘self care’ part should be emphasized. It is very difficult to keep on top of your health responsibilities when you are so battered you find yourself attempting to stage dive across a packed dance-floor, skiing down underground escalators like James Bond (but falling off) or swimming in public fountains on the way home.
Although I’ve calmed and matured a bit in my mid twenties now, I certainly am no stranger to the wild side, and those past experiences as a teen in particular have been real learning curves, both in general and with diabetes.
In Britain we have a big social drinking culture, you are born and then there is beer.
For me when I was a teen it was difficult. At that time I was learning the diabetes ropes independently as an adult. I was also misinformed about my insulin management – being told to inject a certain amount of insulin for each meal time following a switch from mixed insulin to basal and bolus, not carbohydrate counting for the meal itself.
So very much had to learn the hard way in managing my diabetes, from sports to socialising and all else in between.
The initial attitude I had, which many young adults may relate to, was to just get on with it – which is great – but the feeling was to just get on with it and almost ignore health duties. I realised the importance of insulin (even if without knowing at the time I was taking far too much insulin, with 14 units of bolus Novorapid for every dinner meal as a regime!!) but would seldom test my blood sugar levels regularly enough.
My A1C was well up in the 8s – maybe it should have been worse – but I had a lot of hypos due to the mass amounts of insulin I was told to take. So my long and short term health was at risk. Whilst this all sounds bad, in the bigger picture it was where I learnt more – you have to hit the ground sometimes in order to pick yourself up a stronger person.
In terms of night life, today I am better at knowing what I am drinking and that is key in keeping safe and healthier(ish). Back in those early outgoing years without that understanding of my blood sugars, I would either be flying hyper or crashing into hypos – or both – never well managed. This can create a real monster, out of character, we get angry when we are hypo and can also do so when too drunk – the two mixed together is a Frankenstein creation.
The added risk with that is if you are out-out and you are hypo, people don’t know your situation, that your blood sugars are low, they will just assume you are drunk.
The bottom-line is that you cannot hide from your diabetes, you have it and if you don’t respect that, you only harm yourself. Confidence is a big deal in life in general, a thing like diabetes can affect it too, but in gaining that understanding that you are still you and can live life to the full – if you just take on that responsibility to keep a check of your blood sugars, take the appropriate amounts of insulin your body needs, to look after your diabetes, your diabetes will (in parts) look after you too.
In living proudly with my British culture, I am aware of the potential affects on my blood sugars. In fact too aware, when I do go out-out in the present day I go to the level of waking up with selfies on my phone of returning home of myself holding my blood sugar meter with a good reading and smile on my face.
The smile is the main part – I am happy living which includes with diabetes, and that is where ‘control’ stems from. The blood sugar level alone is not so much the main part before bed, as Francesca Annan said at an event recently: it is not just about the level it is about what that level is doing. You don’t want a hypo in your sleep!
On nights out I confess to having switched drinks. I do not recommend mixing drinks at all, it messes you up man! One thing I used to do when paying attention, at the least, to my levels when noticing the drinks (usually continued beers) had caused my levels to go too hyper, was that I switched to a vodka and diet coke to drop the levels down. Did it work? In some ways yes… levels did fall, with the combination of that and the ‘dancing’ in the club. However, this usually meant a snack was required before sleeping, otherwise a likelihood of a hypo occurring – and no doubt the likelihood of a headache the next morning. While there was ‘plus points’ for being able to realise when levels were too high on the nights out, the movement to lower levels via more alcohol would only take me further away from common sense and responsibility – the best part, the responsible part, and perhaps the hardest part for a young adult on a night out, would have been to have stopped drinking any alcohol at that point, continued to have danced a bit and known when to call it a night.
Here is a rough Alcobetic guideline from experience. Always check with a Healthcare Professional, and remember, the drunker you are the more your liver has been directly impacted destroying stored glucose, which makes things more unpredictable.
Spirits, especially vodka: gets you drunk faster and therefore tends to lower levels quicker! There isn’t any carbs.
Ales and Beers: they are carby! Especially Ales and IPAs. They tend to rise levels gradually upwards like eating a meal, however, if you’ve had a few too many, a slow U-turn might take place – usually slower but heavier depending on how much you’ve had. You’re more likely to find the crash, if at all, the next day.
Lagers: can be similar as to the above, but usually a little less carby. May contain more sugars / sweeteners, depending on the drink, and could rise levels a bit faster than the above. I hate lager, but it might be the best bet if sticking to it and not mixing drinks.
Ciders: going to boost levels fast! Apples, pears, natural sugars and carbs! May not crash until the next day. Could get you unexpectedly drunk a lot faster though, and so a possible massive high followed by a crash come the early hours or next morning if you’ve had too many. Or you just stay high!
Stouts like Guinness: will also rise levels, not quite like cider, a slower process, but more carbs in stouts than in lagers, similar to Ales again.
Wines: whites sweeter than reds. Faster high, faster crash. Gets you a drunker faster means turns the liver upside down faster too, removing stored glucose. I heard red wine regulates blood cells, the truth in that… I don’t know? But maybe red is your best bet, not as sweetened as white to spike you, and apparently does good stuff to your blood cells… kebab on the way home?
Alcopops: just avoid altogether, they are awful drinks and are filled with added sugars , syrups and whatever else!
Cocktails and Jagerbombs: can have a quick rise and hard crash impact, more so with shots like jagerbombs – a lot of added sugar in red bull but also the spirits will decrease levels. Cocktails depends on the drink and level of alcohol included, as you can get many which include added sugar drinks, juices and syrup, which will make you fly. Also there is much more content in a Cocktail usually than a shot or jager, so you have the Alcopop issues as above, but at least it tastes better. Worse is that you are not going out and drinking Jagerbombs all night, so likely you’ll be mixing with other drinks making it more unpredictable – likely high spike and harder crash, possibly during the night out, and so snack before bed even more necessary.
Verdict: know what you are putting in to your body! You can make slight adjustments with insulin or plan what you will drink through the night. Type 1 diabetes cannot stop you enjoying yourself, just remember enjoying yourself is best done when feeling good. Know when enough is enough, that’s taking responsibility – and your night out doesn’t depend on alcohol.