Day After the Night Before
Influence of evening alcohol on risk of hypoglycemia in patients with type 1 diabetes
- Tristan Richardson, BSC, MRCP1,
- Melanie Weiss, RGN1,
- Peter Thomas, PHD2 and
- David Kerr, MD, FRCP1
- 1Bournemouth Diabetes & Endocrine Centre, Royal Bournemouth Hospital, Bournemouth, U.K
- 2Dorset Research and Development Support Unit, Poole Hospital & Bournemouth University, Bournemouth, U.K
- Address correspondence and reprint requests to Dr. Tristan Richardson, BDEC, Royal Bournemouth Hospital, Castle Lane East, Bournemouth, BH7 7DW. E-mail: tristan.richardson{at}rbch.nhs.uk
There is no evidence to suggest that individuals with type 1 diabetes adopt a different approach to their use of alcohol than the rest of the population. Nevertheless, in patients treated with insulin, alcohol has been implicated in up to one-fifth of hospital attendances with hypoglycemia (1). Recently, in a laboratory-based study, Turner et al. (2) reported that ingestion of alcohol with an evening meal increased the risk of hypoglycemia the next morning in patients with type 1 diabetes. However, this study was small, patients were admitted to a research unit, their “usual” insulin doses were reduced at meal times, and the overnight insulin was administered intravenously in a controlled environment. To date there has been no study examining the effect of alcohol in free-living patients with type 1 diabetes over a 24-h period.
RESEARCH DESIGN AND METHODS
We studied 16 free-living patients with type 1 diabetes aged 39 ± 7 years, with a duration of diabetes of 15 ± 11 years, who consumed alcohol on a regular basis (<28 units/week). All gave written informed consent for the study after approval from the local research ethics committee. All had normal awareness of hypoglycemia and stable glycemic control (HbA1c 8.1 ± 1.0%). The patients wore the continuous glucose monitoring system (CGMS) (Medtronic Minimed, Minneapolis) for 36 h …
