Tuesday, May 15, 2012

#DBlogWeek: One Great Thing.

Today's prompt: Living with diabetes (or caring for someone who lives with it) sure does take a lot of work, and it’s easy to be hard on ourselves if we aren’t “perfect”. But today it’s time to give ourselves some much deserved credit. Tell us about just one diabetes thing you (or your loved one) does spectacularly! Fasting blood sugar checks, oral meds sorted and ready, something always on hand to treat a low, or anything that you do for diabetes. Nothing is too big or too small to celebrate doing well!

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I'm not sure what this says about me, really, but I seem to have developed a reputation for bolusing for alcohol with some finesse - to the point that a fellow PWD recently texted me well into the night hours, asking for advice on a stubborn high after a couple of glasses of wine. They wanted to bolus, but didn't want to tank later while they slept (alone, and in an unfamiliar hotel room).

Again, should I be proud of this? Because, kids, it takes a lot of trial and error to get here. I emphasize errors. (It also takes finally admitting to yourself that mixed drinks are just a horrible idea all around, unless you can use a Diet mixer.) I don't know the answer to that question, but I do know that a few years back, I would have LOVED to read how someone else did this, because I was clueless and needed to hear someone else's trials and tribulations.

I can only say what works for me, and it is said along with the typical disclaimers: I'm not giving anything even remotely resembling medical advice; don't try this at home; YDMV (your diabetes may vary); I'm not condoning drinking in general, OR drinking with diabetes; consult your doctor first, etc. etc.

Okay, now that THAT's out of the way...

If I drink, it tends to be white wine. Sometimes I'll try a red, and sometimes I'll have a cider beer or a "diet" mixed drink. If you can figure out the full-sugar drinks, more power to you; I just can't walk that tightrope very skillfully. After several years of stubbornness trying, I've pretty well given up. So what's the pattern, you may ask? What's the central piece of knowledge I've gleaned?

Wine will make me go a little higher for the first few hours, and then once I hit hour five, I start tanking.

Here's the deal with me and wine: if I start drinking before the meal (say, half an hour before) and the meal has some degree of fat in it (think Italian food), the two pretty much cancel each other out in terms of delayed spikes and drops, so I do a regular one-time bolus and let it ride.

If I didn't start drinking until after I've eaten some food, I bolus a little bit extra up front. Every time I hit that five hour mark, though, I start dropping. Hardcore. I need food in my stomach at that point, even with no IOB - really.

Am I recommending that you drink? Nope. But if you do, I hope you'll do it safely. I watch my Dexcom receiver like a hawk, and I check my blood sugar as often as I can remember. I can drop very, very quickly once those drinks have had a few hours to do their thing, and past experience has taught me to watch out.

It's also a great idea to let someone that you're out with know about your situation, as it were - and wear a medical ID, wuddya? You do not want things to go badly and have people not know how to help you (or, worse yet, just think you're extremely drunk and let you "sleep it off").

And if anyone can figure out and share how to bolus and stay under 200 (without dropping like it's hot) for sugary drinks - well, I'll buy you one.

 (If you want to know more about how diabetes and alcohol mix - go here.)


  1. i drink normal coke and vodka dont bolus and stay between 4 - 6 so 72 - 108. i drink a diet coke and vodka for the first drink then for the rest a normal coke works because for me the vodka counteracts the sugar (my liver normally does a pretty good job of spitting glucose out so my basal covers the coke) . i just eat a sandwich before going to bed :)

  2. You should put these tips in a book...and someone should give it to Type 1 teens before they head to college, lol. Just don't let us parents see it so we don't have a cardiac event.
    Look, it's the real world, if you've figured it out, be proud of it. And be happy to be done with the "trial and error" portion of our show :)

  3. I don't typically tank after drinking, but if I have more than two of anything, I need less insulin to cover the carbs. When I got my last three month supply of insulin, it came with a prescription sticker that said, "Do not drink alcoholic beverages when taking this medication." That made me really angry, because you CAN have alcohol if you're on insulin, but you have to drink responsibly... And so should everyone else. Sorry, I'll put the soapbox away.

    It really is important stuff to know and great advice.

  4. Let me take this opportunity to extol the virtues of light beer. Yes, I love super-rich crafty beers, but they are a bitch on blood sugars -- at least for me. Miller Lite, though? Drink it with food and you're pretty much home free.

    Now I really want a beer.

  5. LOL! I love that "someone" would text you to ask a question like that...

    Oh wait...

    What can I say, I am a sucker for an open bar at a wedding ;)

  6. I drink mostly white wine and find I don't tank, my blood sugar (annoyingly) spikes about 4-5 hours after I drink if I've had more than one drink. After waking up many times at 3:00am at 250+, I have found I have to temp basal 125%, and that seems to help me.

  7. I drink mostly craft beer. I found out right away not to bolus up front for me.....to let it rise and correct as needed. For some reason, even with the carbs in the beer, it does tank me if I bolus for it. Mixed drinks, I stay with diet soda as a mixer.

  8. Love this example of how we are all unique! I'm a little scared thinking about all of Kim's errors in figuring things out to this level of detail... ;-)

  9. It never ceases to amaze me the level of thought people with T1 have to go through multiple times each and every day. The idea of thinking that much when I'm drinking is beyond me. You rock! (and I agree with Dvnmama that this information should be given to college age T1s. The trial and error is scary stuff!!)

  10. i also used the word 'finesse' in my post today huzzah! i will bookmark this post to show to my kid in about 6 years, thanks for the info! ;)

  11. This post is spot-on. I also find that eating "fattier" foods (think Thai (pad thai, anyone?) or Italian-ish, tends to help when I'm enjoying a glass (or 3) of vino. Back in my pump-wearing days, I would actually cut my night-time basal in half (set the pump on a timer with a 50-60% reduction for 4-5 hours depending on how many drinks I had) in order to deal with this. Now that I'm taking a break from the pump because my insurance company decided to take a break from me, this is a lot trickier to deal with. Once you inject that Lantus for the evening, you're pretty much stuck with it. If I drink wine now, I'm likely to have a midnight snack, er...meal? (Sometimes a grilled cheese)...but that bites you in the butt because sometimes you wake up in the 300s after doing that, and negotiating an extra bolus is tricky. Drinking while bolusing is way harder to do without a pump, I am noticing. I tend to stay away from beer because that makes me drop like CRAZEEE and I can't make it stop. Beer is a pseudo-insulin for me, and not in a good way. Harder liquors I partake of occasionally, but not very often. It makes the whole bolusing thing even trickier. Sigh.

  12. and p.s. just to rant, a personal pet-peeve of mine is when people see me with a glass of wine in my hand and say LOUDLY, and annoyingly..."But you're DIABETIC, ARE YOU ALLOWED TO DRINK?" ...........

    It's just as bad as "ARE YOU ALLOWED TO EAT THAT?"

  13. One of the happiest days of my d-life was meeting with the nutritionist when I was diagnosed. Finding out bourbon has no carbs - priceless!

  14. I'm a t2 and for some reason have been scared to have even one tiny sip since the diagnosis. I've never drunk beer or wine, only mixed drinks. I can't tell you how many times I've wanted a daquiri or margarita. :-)


  15. As a light beer drinker, I usually do a dual bolus over time and don't have much issue. But whenever I go with liquor or wine, that's different and I tend to tank later on (assuming I've stayed within range while actually drinking). Great post, Kim. Lots of practical tips and so honestly put out there. Now, I really want a beer...

  16. I feel a sudden urge to turn that episode of "True Life: I have diabetes" into a drinking game.


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