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Ask Ange about alcohol & diabetes

 by angela blair rn cde on 29 May 2017 |
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Paul sent in an email wanting to know a little more about alcohol especially in relation to high and low blood glucose levels. Whilst he understands the management of diabetes, he always thought that alcohol had its own sugar content. How does it work?

Answer: Unless advised not to by your healthcare team, you can enjoy alcohol in moderation, just like everyone else. When you have diabetes, there are some extra considerations you need to keep in mind, if you choose to have a drink. Alcohol can have a number of different effects on your body, including weight gain, or cause both high and low blood glucose levels.

Hypos or low blood glucose levels can occur while drinking alcohol or even many hours afterward. If you are taking insulin or certain diabetes tablets that increase insulin production, you are at risk of alcohol-related hypoglycaemia (hypos). A hypo is when blood glucose levels drop below 4mmol/L. Normally, the liver releases stored glucose if your blood glucose level falls too low. However, when you drink alcohol, the liver always processes the alcohol first, instead of releasing stored glucose. This can increase the risk of a hypo. Alcohol can also reduce your ability to recognise the symptoms of a hypo and make it more difficult to treat. Avoid drinking on an empty stomach, as this will quickly increase the amount of alcohol in your bloodstream. Also, avoid binge-drinking or sustained drinking, and never substitute alcohol for your meals. All of this can increase the risk of a hypo.  Remember if you have been drinking to test your blood glucose before bed and have a carbohydrate snack to avoid a hypo, carry a hypo treatment with you and make sure you eat a meal containing long-acting carbohydrates.

Moderate amounts of alcohol may cause a rise in your blood glucose level. Beer and sweet wine contain carbohydrates and may raise glucose levels. Also, alcohol stimulates your appetite, which can cause you to overeat and may affect your blood glucose level.
As a general rule drink slowly, avoid "sugary" mixed drinks, sweet wines, or cordials or mix spirits with water, club soda, or diet soft drinks.

For more information on alcohol click here or call and speak to a diabetes educator or dietitian on 1300 136 588.

Ask your doctor or diabetes health professional whether you might be at increased risk of alcohol-related hypos.

Warren asked about starting Byetta his GP prescribed after his last visit.  He had his script filled and wasn’t sure what to do next. He was also worried about remembering to inject twice a day and what other products he would need.

Answer: BYETTA is not insulin, however, is injected in the same way as insulin. BYETTA is used in treating type 2 diabetes as it helps your body release its own insulin. When used with diet and exercise, BYETTA works to help improve blood sugar levels in the following ways:
  • Helps the pancreas release insulin
  • Stops the liver from making glucose that is not needed
  • Makes sure insulin is released as your glucose levels rises after eating
  • Delays the digestion of food, so the glucose level rises slowly
  • Decreases hunger
Byetta comes in a pre-filled pen that needs to be kept in the refrigerator at a temperature between 2°C to 8°C. After you start using a pen, it can be kept at room temperature (no higher than 25°C. If your pen freezes you must throw it away.

The disposable Byetta pen measures each dose for you and is injected twice a day within 60 minutes before you eat your breakfast and evening meal. DO NOT inject after a meal. If you miss a dose just wait until the next dose.

Some of the side-effects are The most common side effects with BYETTA include nausea, vomiting, diarrhoea, feeling jittery, dizziness, headache, acid stomach, constipation or weakness. These symptoms usually improve with time. Hypoglycaemia may occur if BYETTA is taken in conjunction with insulin or a medication that increases insulin production such as a sulphonylurea.

Pen needles are not included so you will need to have a “NDSS
change of medication” form completed by your doctor or credentialed diabetes educator to obtain pen needles through the NDSS for free. You can take this form to your pharmacy and they will update your NDSS registration.

You will also need a sharps container for your used pen needles. There are many different sizes, visit for the complete range. I would recommend a screw top version especially if you have children around your home.

Remembering to take Byetta twice a day can be a challenge. I suggest setting a reminder in your phone or keeping your kit where you eat can help you avoid missing an injection.

To help you with injecting if you can’t see a diabetes educator, please view the tutorial found here.
Once you have your pen needles, Byetta disposable pens and a sharps container you are ready to go.

For more information, please call 1300 136 588 to speak to a diabetes educator.

Maisy rang the other day to ask about eye drops for glaucoma. She had just started on them but lives alone and was having trouble using the eye dropper.

Answer: I steered Maisy to our diabetes shop that carries a wide range of diabetes-related products.
Luckily we carry a really useful product, the 
Flents Ezy-Drop Guide & Eye Wash Cup that helps you get your eye drops where you need them every time. It can be used just as an eye wash cup but also helps place drops directly onto the eye. It costs $11:45 or receives a 10% discount if you are a member of Diabetes NSW & ACT.



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