In a person with insulin-dependent diabetes, alcohol has two potentially problematic effects:

1. It impairs the liver's ability to produce glucose in the event of a severe hypo
2. Early signs of hypos can be indistinguishable from drunkenness (for you and people around you) or ignored

When you have a hypo, under normal circumstances, the hormone glucagon is secreted from the alpha cells in your pancreas. Glucagon travels to your liver and stimulates it to release glucose from its stores of glycogen. This occurs well after you have had early signs of the hypo and hopefully been able to treat it. However, if you do not treat a hypo your liver will eventually kick in with the glucose. Yet if you've been drinking a lot of alcohol this life-saving mechanism can be impaired and blood sugar levels will continue to fall indefinitely.

Something else to be aware of when drinking is that it can become very easy to ignore or misinterpret hypo warning symptoms. They can be similar to feeling tipsy, or you can just ignore them altogether as there are so many other things going on!

Some people with diabetes have found the following ideas helpful:

	Before a big night out, eat a decent meal
	If you're planning on being very active you may like to reduce your insulin by 10-20
	Try to nibble on something with carbos and protein while you drink (chips, nuts, etc)
	Wear or carry some form of identification; in the case that a hypo is mistaken for drunkenness this can be a lifesaver
	When you get home after a big night try to do a blood test and eat or drink something like multigrain toast, glass of milk, banana (low GI).
	Make sure someone you are drinking with knows you have diabetes
	If you get stuck in shouts/rounds and are drinking faster than you would like, on your shout buy yourself a soft drink
	Carry some hypo food on you

Other stuff:

• Alcohol is high in kilojoules/calories, so can contribute to weight gain.
• Some types of alcohol are high in carbohydrates and can raise blood glucose levels, however they vary greatly, eg. Carlton Cold has 9 g carbohydrate per 375mL, VB has 10.1g, Toohey's Blue 17.0g, Hahn Longbrew 5.0g.
• "Diet" beers contain less carbohydrate but the same amount of alcohol as regular beer
• Mixing spirits with regular sugary soft drinks, milk or juice is one way to consume carbohydrates while you drink if nothing else is available.