Building Competency in Diabetes Education THE ESSENTIALS

TREATMENT MODALITIES: LIFESTYLE| 5-23

carbohydrate content of alcoholic beverages. Hypoglycemia can occur at even low blood alcohol levels (not more than mild intoxication); increased physical activity and/or decreased food intake in the presence of alcohol can further increase the risk of hypoglycemia. For people with type 1 diabetes, moderate consumption of alcohol two to three hours after the evening meal may result in delayed hypoglycemia the next morning after breakfast and as late as 24 hours following alcohol consumption (91,92), and may impede cognitive performance during mild hypoglycemia (93). Alcohol intake leading to hypoglycemia is also a concern for people with type 2 diabetes, particularly the fasted elderly who are using insulin and/or insulin secretagogues (94). Alcohol ingestion can also mask the symptoms of hypoglycemia, impair an individual’s judgement, increase the potential for weight gain and increase ketones (95). Guidelines on the use of alcohol should be included as part of self-management education (SME) for all patients who choose to drink.