# alcohol and type 1 diabetes - proseco, pink cava & rose wine



## Marianne Simpson (Jan 3, 2016)

Has anyone got any advice about alcohol please?  As a diabetic type 1 is it best to avoid alcohol?  I do enjoy proseco and pink cava, also rose  wine.  I always end up with high glucose levels if I enjoy a few glasses then  there's the risk of hypos. I know what the recommend allowance is but sometimes it is nice to let your hair down and have a good time especially at a wedding,  party, night out etc how do others manage it?


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## Robin (Jan 4, 2016)

I think the most important thing is, never have so much to drink that you can't take care of yourself. It's just not worth the risk. There are too many horror stories around, about diabetics having hypos who are assumed to be just drunk.
if you do have a few drinks, I find white wine and fizz raises my blood glucose initially (and red wine lowers it) so you may need insulin at the time if drinking white, or sweeter wines. It's also sensible to eat with the alcohol and to alternate a glass of wine with a glass of water.
It's afterwards you need to be careful. My DSN told me that for every unit of alcohol consumed, your liver doesn't pump out any of its usual background glucose, as it is so busy dealing with it, so eat a carby snack before bed, and run your blood sugars a bit higher.
I'm lucky, I have an inbuilt gene, or something, that makes me lose my appetite for it after a couple of glasses, so I just stop, and I'm spared the hangover!


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## DeusXM (Jan 4, 2016)

The best advice I can give is test, test, test.

Although alcohol does inhibit your liver's ability to put out glucose, often the drink you have will be quite carby. I actually have quite the opposite problem to most people with T1 when it comes to alcohol - often, drinking raises my blood sugar a lot so to have a successful night out, I usually have to bolus at least 3-4 times in an evening to stay level. Then for me, the next day can be completely unpredictable. Some days, I'll be fighting off hypos the whole day. Other days, I will find that my liver just loses it and decides to chuck out as much glucose as possible.

It IS sensible to eat but do try and retain some judgement about what to eat. As my alcohol reaction can be a real mixed bag, sometimes, eating something carby is actually the worst thing I can do as it's just adding petrol to the fire. Other days, it's essential. I might post up my Freestyle Libre log from New Years' Eve later as an example of how erratic things can get - you can clearly see the moment I start drinking (it starts to spike), then the moment I bolus (the spike stops), the moment the bolus runs out (it starts to spike), and then even with no insulin on board, how it starts to plummet. You can then clearly see at 2am when I at a carby snack, which then fired my BG up to 15, and how even a quite large bolus did absolutely nothing to stop it, and how I then spend the next 12 hours bolusing every 2 hours to absolutely no effect until 8pm on 1st Jan.

So to reiterate, test, test, test. Alcohol adds a significant level of unpredictability and the only way to keep on top of it is to test as much as possible and make sure you never forget the basic diabetes rules.


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## khskel (Jan 7, 2016)

Had a few glasses of Cava over the Christmas hols with meals with no unexpected highs or lows.


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## JamesAM (Jan 10, 2016)

Hi Marianne

New to the boards (diabetes not new, unfortunately!).

Diabetes is of course very individual, though as Deus mentions above, your liver will stop synthesising any glucose from fat whilst it flushes out the alcohol from your body, causing your blood glucose to drop through prolonged drinking. Personally, I am very sensitive and find that even a glass of wine will mean I need at least some sugar soon after to stop a hypo.

Specifically on the wines you mention:

Cava is made in exactly the same way as Champagne and will contain anywhere between 0-12g sugar per litre (if it says Brut on the label, this is set under European law). Most likely, around 6g.

Prosecco is made a little different and to appeal to a wider audience, is a little sweeter, likely to be around 12-17g sugar per litre.

Not a huge difference there and both are likely to cause your blood sugar to drop if not consumed alongside food.

Lastly is the rose - bit of a mine field as they range from bone dry (still taste sweet due to the fruitiness of the wine) to actually containing a LOT of sugar.

As a rule of thumb, the big brand Rose's found in supermarkets, in particular Californian rose like Echofalls, will contain a huge amount of sugar. 20g per litre, most likely even more - I have seen 35g in some! Coupled with a lower alcohol content often found (10% vs the 11/11.5 in Cava or Prosecco) these wines will play havoc with your blood sugar levels and definitely best to steer clear if having a few glasses.

In general, rose from Europe is bone dry - off dry. Rose from Provence in France (EXCEPT Rose d'Anjou) can be more expensive, but more often than not, there is virtually no sugar (around 2g/litre), they are quite delicate and lots of fresh red fruit flavour. Really refreshing! Think rose cava, without the bubbles! Spain also do some really good value rose still wines which will be very dry too and Pinot Grigio Rose or 'blush' is becoming ever more popular. Worth trying to see which style you prefer! The two latter will most likely be cheaper than Provence.

Most pubs/bars these days will have both a dry and sweet rose by the glass/bottle and sticking to the 'rules' above should eliminate most doubt.

Hope this helps PM if you have any questions.

James


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## Northerner (Jan 10, 2016)

Very informative @JamesAM , thank you


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## JamesAM (Jan 10, 2016)

Northerner said:


> Very informative @JamesAM , thank you



Thank you Northerner, I hope it helps Marianne and any others wondering the same. My biggest bug bear is that alcoholic drinks in large part contain no nutritional information!

Extremely unhelpful and potentially dangerous to people like ourselves


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## JamesAM (Jan 10, 2016)

DeusXM said:


> The best advice I can give is test, test, test.
> 
> Although alcohol does inhibit your liver's ability to put out glucose, often the drink you have will be quite carby. I actually have quite the opposite problem to most people with T1 when it comes to alcohol - often, drinking raises my blood sugar a lot so to have a successful night out, I usually have to bolus at least 3-4 times in an evening to stay level. Then for me, the next day can be completely unpredictable. Some days, I'll be fighting off hypos the whole day. Other days, I will find that my liver just loses it and decides to chuck out as much glucose as possible.
> 
> ...



Deus, just out of interest, what is your usual choice of poison?


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## Amigo (Jan 10, 2016)

Although not really qualifying for this discussion as a type 2, my biggest bug bear is the lamentable lack of low/no sugar mixers and soft drinks in pubs and clubs save for Diet Coke (which becomes very sickly after a while). 

Very informative detail James. It certainly makes me realise what a delicate balancing act alcohol can be for type 1's! Your description is very useful in aiding that understanding Deus.


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## JamesAM (Jan 10, 2016)

Well we all have a similar problem, Amigo!

Couldn't agree more on the mixers. I tend to now drink gin and slim line tonic when out with friends. I have been known to resort to gin and soda due to the above scenario...not a great combination.

Trying to get a bartender to understand the importance of pouring slimline, only to watch them instantly open a full sugar tonic is frustrating to say the least!


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## DeusXM (Jan 10, 2016)

JamesAM said:


> Deus, just out of interest, what is your usual choice of poison?



Umm...most of them, to be honest!

Lager is probably my 'least preferred' starter drink as primarily cider is my first drink - although I'm quite particular about cider and only drink cloudy dry farmhouse style, which tends to not be available in most pubs, so invariably I go for a decent lager rather than drink a crud cider. All of those drink types contain quite a lot of carbs so I have to bolus for them.

Once it gets later in the evening I tend to get fed up with walking the tightrope required for managing pints (plus I get full) so I usually change gears to gin and tonic. In my experience, most bar staff are actually pretty good at giving the slimline tonic but I don't get too hung up on it as regular tonic is usually still only about 5g per 100ml and my gin to tonic ratio means that there isn't that much tonic in there to start with anyway!


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## JamesAM (Jan 10, 2016)

Yeah lager does it to me too. Never been much of a fan to be honest. If I have a couple of Guinness or real ale, I tend to find an hour later I will crash.

If I have two lagers, an hour later I would be about 14! 

I used to drink mainly cider, but since diagnosis, I haven't touched a drop. Might try a dry version some time. Think I was warned off it so much by the nurses it just put me off completely


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## Amigo (Jan 10, 2016)

The obvious problem with being an 'unmedicated' type 2 is I can't take or do anything to counteract the effects of full sugar mixers that I know some unscrupulous bar staff will try to fob me off with. As a result I won't have mixers from the soda tap because one night I went sky high with no explanation except dodgy drinks.

I have however managed to persuade my local pub to stock diet lemonade. When I was abroad, Diet Coke was usually the only option because I can't stand tonic. 

I understand the issue around sweeteners but I've no idea why anyone would choose to drink full sugar sodas and even less clue why they'd feed their kids them!


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## JamesAM (Jan 10, 2016)

Diet drinks do get a lot of bad press, but in reality, the science backs up the fact they are not harmful.

Aspartame is public enemy number one at times, but as two amino acids artificially joined, when broken down, they turn back in to the very same amino acids which are found in all sorts of foods.

Is it one of the most tested substances in the human diet and no ill effects have ever been found.

That said, some studies suggest that those who regularly drink diet sodas tend to be the heaviest, but those stiudies do not account for factors such as those who drink lots of diet soda may eat more calories, because they believe they have 'saved' them elsewhere.

i guess it all comes back to 'everything in moderation'!


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## Bloden (Jan 16, 2016)

After a few glasses of wine of an evening, I found it was hypo-central from about 3am onwards and throughout the next day...to the point that I realised I was putting myself at risk. So I quit drinking...


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## Austin Mini (Jan 16, 2016)

Since becoming a type 1 in 1987 I just cant even get tipsy anymore.


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## Marianne Simpson (Jan 23, 2016)

Thank you james for the very useful information about the different amount of sugar contents in the different wines, it's interesting to hear others experiences too. Love this forum shouldve joined ages ago Great for support and advice ☺


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## JamesAM (Jan 24, 2016)

No problem. It is a mine field! Rather confusingly, sparkling wines labelled extra dry are actually sweeter than brut. You should be fine with most cava, just something to watch out for maybe, especially on the prosecco.


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