Diabetes and Alcohol Abuse

DIABETES

Diabetes is so wide spread in the world that there are hardly any person who does not know what diabetes is. But to recap, there are predominantly two types of diabetes; Type 1 and Type2. Some general information on these types of diabetes is given below.

In Type 1 diabetes the pancreas in the body is not able to produce insulin (the only hormone that reduces the content of sugar in the blood stream) and is common in children but not restricted to them. This type of diabetes is insulin dependent.

Type 2 diabetes is more common and it is estimated that some 95% of all diabetic patients belong to this type. In this case, the body does produce insulin, but either in insufficient quantities or the insulin produced is inefficient. This condition is also known as "Diabetes Mellitus". This type of diabetes is non-insulin dependent.

Another variety of Type 2 diabetes is "Diabetes Insipidus" where there is excessive excretion of highly diluted urine. Reduction in the amount of fluid intake does not have any effect on this condition. There are also different varieties of Diabetes Insipidus, the most common being "Neurogenic Diabetes Insipidus" and the other is "Nephrogenic Diabetes Insipidus".

There is another type of diabetes that occurs in pregnant women and is known as "Gestational Diabetes" and occurs in women with no history of diabetes but develop such symptoms during pregnancy.

SYMPTOMS OF DIABETES

The symptoms of diabetes varies from person to person and depends on the following factors:

i. Type of diabetes,
ii. The stage of advancement of the disease,
iii. The age of the patient,
iv. The progress of the disease - slow or gradual
v. The history of diabetes in the family of the patient,
vi. The dietary and lifestyle of the patient, and
vii. The presence of other complications.

Based on the above factors the symptoms vary though there is some similarity. Some of the more obvious symptoms are described below:

i. The foremost symptom would be excessive urination, in excess of the quantity of fluid intake; the urine being thin and pale in color.
ii. Excessive thirst.
iii. Significant increase in appetite but no significant weight gain.
iv. General body weakness.
v. Skin problems such as itching, more predominantly in the genital areas.
vi. Slow healing of wounds, a serious condition.
vii. Pain in many parts of the body, especially in the lower back and the limbs.
viii. A sort of side effect would be loss of vision with patients becoming myopic.
ix. Impotence in men.
x. Both the blood and the urine show a marked content of sugar.

Diabetes currently has no known cure and can only be controlled through medication, diet control and regular exercise preferably walking for a minimum of twenty minutes a day; the distance covered does not matter it is the duration of the walking that counts.

COMPLICATIONS

Know that we know, more or less, the details of diabetes and its symptoms we shall move on to the complications of the disease. The most common complications include the following:

i. Kidney function complications. The earliest to occur. More so if the diet contains too much of fat. Narrowness of the arteries leading to the kidney occur and the toxins in the system are not flushed out completely leading to a complication known as "Uremia".

ii. Cardio-Vascular problems leading to hypertension and heart disease.
iii. Damage to the retina of the eye and resultant blindness.
iv. Nervous damage causing loss or destruction of the senses of the patient. In severe cases may cause paralysis.
v. The most appalling complication is undoubtedly gangrene especially in the toes leading to its amputation.

As such it essential that a specialist in Diabetology is consulted if there is a suspicion that a person is diabetic and find out exactly what type of diabetes he/she is suffering from and follow scrupulously the physician's advice in the control of the disease.

DIABETES AND ALCOHOL

The adverse effects of the abuse of alcohol is too well known and really does not really require elaboration.

A drink of alcohol in normally associated with 12 oz. (350 ml.) of beer, 5 oz. (145 ml.) of wine or 1.50oz. (45 ml.) of hard liquor. Each of these is equal to some 15 gms. of alcohol. What is the quantity of alcohol that is considered "light or moderate" and what is considered as excessive? Drinking 15 to 30 gms. of alcohol a day is considered as light or moderate and any excess of this quantity is "excessive" drinking. There are some people who should not drink at all. They include:

i. Pregnant women and those who are trying to become pregnant,
ii. Alcoholics who are recovering,
iii. Individuals who are planning to drive or engage in other activities that need skill or concentration,
iv. Individuals taking certain medicines such as antihistamines, antidepressants and anticonvulsants and
v. Individuals with certain medical conditions such a advanced neuropathy alcohol abuse, pancreatitis and hyper-triglyceridemia.

In respect of individuals with diabetes who have not been drinking it is better not to start.

WHEN IS DRINKING HARMFUL?

Drinking is considered to be harmful for diabetics if they have the following conditions:

i. Damage of the nerves in the arms or legs,
ii. Diabetic related eye disease,
iii. High levels of triglycerides and
iv. High blood pressure.

Alcohol normally damages nerve cells, even light drinking. For those diabetic patients with nerve damage there will be an increase in pain, numbness and burning or tingling sensations.

For those with symptoms of eye disease, drinking can worsen the condition, leading to blindness.

Levels of triglycerides and blood pressure increase with the consumption of drinks, in whatever quantities. Diabetic patients with a high level of triglycerides should not drink at all.

Does this mean that a diagnosis of diabetes is the end to drinking? Well, yes and no. Traditional medical practice advocates the complete cessation of the intake of alcohol. Modern thought differs. Taking a drink is not advised but allowed, but there are some considerations.

- Alcohol can metabolize to produce energy and has dietary consequences.
- Alcohol supports the intake of blood glucose into the liver.
- Many alcoholic drinks contain sugar, especially mixed ones.
- The symptoms of hypoglycemia (drop in blood sugar) and drunkenness are similar and as such alcohol is liable to mask the symptoms of hypoglycemia.
- Excess consumption of alcohol increases the level of triglycerides.
- Diabetics with drinking habits must remain sober enough to take care of themselves.

What is acceptable in moderation are:

- Red wines,
- Dry sherries,
- Spirits with "diet" mixers,
- Dry light beers (light ales with low residual sugars and lagers) and
- Dry or medium dry white wines.

What can be used with extreme caution because of their high content of sugar include:

- Sherries or sweet wines,
- Ports,
- Wine coolers,
- Liqueurs,
- Cocktails,
- Spirits with normal mixers and
- Stout, Porters etc. that have a high residual sugar content.

What can be used with extreme caution because of their high concentration of alcohol are neat, undiluted spirits

The above are not meant as a substitute for proper advice from a physician. As the complications of consumption of alcohol by diabetic patients are more and severe than the detrimental effects of drinkers without diabetes, proper competent advice is advised.