Does alcohol cause insulin resistance?

[mark_in_toronto]

For myself, I've pretty much identified that having some drinks requires at least 50% more insulin overnight. Yes, this is contrary to the usual argument, which states that alcohol causes hypos because your liver stops releasing sugar to process the alcohol in your bloodstream.

I have tried this alcohol test drinking rum/diet coke, zero carbs (yes, I've verified this). No food, yet my sugars rise overnight (note - my sugars don't move for the first few hours). My usual insulin dose has little effect, I have to increase by about 50%.

Looking for others' experiences with this, as it seems to be difficult to find related info. Thanks.:)

[xMenace]

I experienced a persistent unexplained rise last night after downing four beers. Typically I drop. Back in the 70's and 80's I was told that people reacted differently. Some would drop and some would rise. I'd be concerned about treating expected highs then going low as all the documentation suggests.

[EasyType2]

Contrary to the common theme on this site, my endo tells me that alcohol raises blood sugar, and preaches constantly that diabetics should not consume more than tiny amounts.

[BlueSky]

I drink Whiskey on the rocks, and it doesn't affect my blood sugar at all. It's just ethanol, water and some flavouring. Nothing there that will increase blood sugar. It's the snacks that do all the damage .... :o

There is no reason why alcohol should cause insulin resistance. But if it, for whatever reason, it caused an adrenalin response this would cause the liver to spit out glucose. And that would increase the insulin requirement. Maybe you are allergic to alcohol ;) ...

[Mich]

As I understand it, and in simple terms without getting into cell receptors, liver function and the rest--your body treats alcohol the same way it would teat some drugs or even a mild poison.

It processes alcohol first. Your body wants to cleanse your system of things it considers potentially harmful. Alcohol is processed even before most simple or complex sugars that come from food. If you drink a lot, your body is busy with it for a longer time. Whatever you eat along with the alcohol gets put on hold and is not processed until after most of the alcohol is finished.

If you had pizza with your beer, the fats will slow down the utilization of the sugars even more. So much for "bar food."

That's why diabetics can even go low while having a drink, and some experts advise having a tiny snack before drinking, to keep you level while the alcohol is being processed.

This has come up before on this forum. I search should bring up some of the excellent and knowledgeable opinions shared.

My opinion, of course. Mich

[Jill-O]

I actually read recently that alcohol may improve insulin sensitivity! Not sure if it's true. I do drink but not excessively.

[Geoff]

Hi all,

What are we talking about here when we say that "contrary to what most people say, my bs rises when I drink alcohol, and does not drop" What are you all drinking, moonshine perhaps? Because beer contains carbohydrate, wine contains carbohydrate, cider also. Only pure alcoholic drinks like vodka do not. So it is little wounder that most of you are seeing a rise in bs levels when you drink.

[mark_in_toronto]

Hi all,

What are we talking about here when we say that "contrary to what most people say, my bs rises when I drink alcohol, and does not drop" What are you all drinking, moonshine perhaps? Because beer contains carbohydrate, wine contains carbohydrate, cider also. Only pure alcoholic drinks like vodka do not. So it is little wounder that most of you are seeing a rise in bs levels when you drink.
Geoff, I think I speak for all that we're not THAT retarded to drink poor choices of alcohol, something like a vodka cooker with sugar then stupidly wonder why our sugar went up!!!

Most diabetics who ingest ANY alcohol knows what it does to them. I posted that I drink rum (0g carb) and diet coke.

I was just hoping to hear new info from people who drink 0g carb alcohol like, whisky was mentioned, or rum like I do and have their sugar go up later.

[Mich]

Geoff,

From what I can find, a glass of red wine contains about 100 calories and 5 grams of carb. For people on a weight loss diet, the calories must be counted. The carbs? I personally do not count 5 grams of carb in wine because it is absorbed so much more slowly, almost like consuming fat. 5 grams of carb for me is .45 units of Novolog if I weren't counting the delay. When drinking wine, I do my dinner or snack bolus like I was eating thin crust pizza--a combo with half up front and 1-3 hours for the rest.

Mark,
I also drink rum and diet Coke, and gin and diet tonic. I drink tequila and fresca, my famous "Fresca-rita." I don't drink any of these all by themselves, usually before or with dinner or a snack. My blood sugar rise occurs later because of all of them, especially if I have two.

Most of my friends are social drinkers and I have always joined them, in moderation. I never drink alcohol during the daytime because I am a wimp and I immediately need a nap.

Mich

[soso]

This is an interesting thread and very topical for me....

I feel much better if I just lay off booze, but I'm English so hey, what can I say....
We tend to drink every day then periodically go on the wagon for varying amounts of time ranging from a few days to 2 years once...more often a couple of months at a time... Since diagnosis I have systematically gone off all my favourite tipples, until I am down to Cuban rum or champagne recently.... I was having a decent sized shot before dinner every night for the last few months, I would say 1.5 to 2 ozs and just before the latest wagonride would often have a second drink later in the evening as well...
My bgs were pretty good throughout that time...I did bear it in mind when I was giving my insulin and once in a while I would have to top up my carbs a tiny bit latish on...


Now here's the odd thing, since I stopped drinking my fastings both in the morning and before meals have been quite a bit higher... usual was 4.2 to 4.8 and now it is 5.3 to 6 and even 6.2 a couple of times.

In a conversation with my endo (not really talking about D and alcohol per se) he made the comment " the body sees alcohol as a fat" not sure what he meant by that, but I think we were discussing heart disease risk at the time.

Only thing that occurs to me is that maybe it is my liver that is a big proponent in my D , although I do have diminished insulin production I am still only using a bolus insulin..
Any thoughts?

[Cyborg]

I posted that I drink rum (0g carb) and diet coke.

What type of rum do you drink? Have you tried some other type of alcohol to see if you experience the same effect?

[TenderVittleS]

Beer is the only drink that raises my BS even Lite beer and that's because of the carbs. I think 4 beers is about 35 - 45carbs, about the same as regular soda. Hard alcohol usually doesn't cause a rise in BS.

[blue_eyed_devil]

i need extra insulin when i drink too... in fact my bsl's skyrocket... everyone is different, just do what suits you!

and isn't rum made of sugar cane (molassis) anyway? so it is high in sugar, just carb free (i think that's possible...) i personally find that all alcohol makes my bsl rise, no matter what...

[BlueSky]

.... and isn't rum made of sugar cane (molassis) anyway? so it is high in sugar, just carb free (i think that's possible...) ....
All that sugar is turned into alcohol and CO2 during fermentation. And sugar left is removed during distillation. The stuff you drink is essentailly flavoured spirit (ethanol and H2O). There is no sugar in it at all.

[REDLAN]

I asked my consultant about this particular effect, because I was mystified as to why my BG would tend to rise after drinking alcohol, despite drinking 0 carb alcohols - I can get monster rises from red wine (and there are virtually 0 carbs in red wine).

The response I got was that either it was insufficient fast-acting with my evening meal, or a rebound from a low in the night - otherwise he did not know.

The effect of alcohol lowering blood glucose overnight is well known, simply because of the number of people with type 1 who come to the attention of the emergency services because they have gone into a hypoglycemic coma.

I have done some research...

first off there is nothing terribly remarkable about ethanol metabolism. It gets converted into acetate and enters the citric acid cycle - ultimately it is metabolised like a fat. one of the intermediaries (acetaldehyde) is toxic and requires energy to convert it into acetate. This might explain why it tends to displace gluconeogeneis/glucose synthesis in the liver.

I have found 2 studies, 1 in humans

Glucose-lactate interrelationships: effect of ethanol (http://www.pubmedcentral.nih.gov/articlerender.fcgi?&pubmedid=5101294)

and 1 in rats

Blackwell Synergy - Addiction Biology, Volume 1 Issue 1 Page 71-83, January 1996 (Article Abstract) (http://www.blackwell-synergy.com/doi/abs/10.1080/1355621961000124706)

the human study showed that lactate blood levels rose - lactate conversion into glucose dropped to 1/3 the normal rate - experimentally they have demonstrated the classic suppression in glucose production which causes alcohol induced hypos, however they also found...

that glucose conversion to lactate had also decreased - meaning that peripheral utilisation of glucose had dropped also.

in the rats that they used a euglycemic clamp - it's an experimental technique for working out how much insulin is needded to maintain normal BG - the more insulin needed the more insulin resistant your subject has become.

they then gave the rats alcohol (I assume a lot of alcohol) - they found that hepatic production of glucose dropped, but also crucially it was also accompanied by a marked decrease in uptake of glucose and glycogen synthesis in skeletal muscle - the rats became markedly insulin resistant.

so the answer to the question, does alcohol make you insulin resistant? Is Yes, BUT...

it also suppresses the production of glucose by the liver.

which possibly explains why the next day after drinking (particularly when I was younger and used to drink alot), that I would wake up high, take my insulin, and then have the mother of all hypos later on.

The insulin fixes the insulin resistance - my muscles start taking up glucose, however my liver is still knackered by the alcohol, and what does insulin do? Yeah that's right it suppresses the conversion of glycogen to glucose.

[Jill-O]

What are you all drinking, moonshine perhaps?

Vokda in diet Sierra Mist, usualy :)

[mark_in_toronto]

Thx for the info. Seeing the endo tomorrow, and hopefully he can enlighten me further about this...and of course he will tell me NOT to drink, lol. I have my reply planned: "Put in a day at my job and see if you don't need a beer when you get home!" Lol.

[JediSurfer]

I have discussed this with a few of my consultants over the years. And from my understanding alcohol blocks the uptake of carbohydrates into the blood. And i think the initial peak i tend to get when drinking is caused by glucogen from the liver.

but don't quote me on that;)

[mark_in_toronto]

found a study by the Canadian Diabetes Association...lengthy and technical, but the gist of it is in the attached:

The mechanism involved in the causal relationship between excess alcohol consumption and diabetes may, in part, be related to insulin resistance.Two novel metabolites of alcohol, 2,3-butanediol and 1,2-propanediol, in serum concentrations found in people who consume alcohol to excess have been shown to inhibit insulin action on adipocytes in vitro (14).This suggests that excessive alcohol intake reduces insulin sensitivity, thereby increasing insulin resistance. In addition, the beta cells of the pancreas may diminish because of episodes of pancreatitis due to alcoholism. Alcohol in moderation, however, may reduce the incidence of diabetes by augmenting insulin sensitivity.

[Cyborg]

Perhaps you are drinking too much? :hmmmm:

[mark_in_toronto]

Do I drink more frequently than I should? Probably, with personal stress, other ****. But in the last two weeks I cut it off completely during the week.

found this info regarding a drinking/diabetes study on the 'net:

Effect of alcohol on diabetes control

The first study to demonstrate the effect of chronic consumption of alcohol on metabolic control in patients with diabetes was conducted in Italy 10 years ago. In this study, people with diabetes who consumed approximately 3 to 4 drinks per day had higher fasting and postprandial PG levels than did those with diabetes who were non-drinkers.

C-peptide levels, however, were not significantly different between the 2 groups, suggesting that the differences in PG levels were due to greater insulin resistance in those who consumed alcohol. After 4 days in the hospital, the glycemic levels of those people with diabetes who consumed alcohol were similar to those who did not consume alcohol, suggesting that the excessive insulin resistance associated with alcohol intake was reversible.

The mechanism involved in the causal relationship between excess alcohol consumption and diabetes may, in part, be related to insulin resistance.Two novel metabolites of alcohol, 2,3-butanediol and 1,2-propanediol, in serum concentrations found in people who consume alcohol to excess have been shown to inhibit insulin action on adipocytes in vitro. This suggests that excessive alcohol intake reduces insulin sensitivity, thereby increasing insulin resistance.

The study does indeed target the T2 diabetic and not the T1, but makes mention of insulin resistance in healthy volunteers contributing to T2 diabetes.

Re: "Insulin resistance being reversible" : I was finding my insulin doses to increase more and more lately (with frequent intake of alcohol), without any real reason for it seemingly (zero carb drinks). After reading this information about resistance being reversible, I stopped all alcohol intake completely. Lo and behold, after a week of abstinence, my insulin doses returned to normal if I had a couple of rum/diet cokes.

So, as far as I'm concerned, the insulin-resistance finding pertaining to Type 2 diabetics ALSO applies to Type 1's.