Genevieve has diabetes type 1 and receives insulin for glycemic control. She tells the nurse that she likes to have a glass of wine with dinner. What will the best plan of the nurse for client education include?
A. The alcohol could cause pancreatic disease.
B. The alcohol could cause serious liver disease.
C. The alcohol could predispose you to hypoglycemia.
D. The alcohol could predispose you to hyperglycemia.
Correct Answer: C. The alcohol could predispose you to hypoglycemia.
Alcohol can potentiate hypoglycemic, not hyperglycemic, effects in the client. When the client drinks alcohol, the alcohol can inhibit the liver’s ability to release glucose into the blood. This can be particularly significant for people on stronger medication such as insulin because it can mean that the liver is not able to release enough glycogen to keep the blood glucose levels from going too low under the influence of insulin in the body.
Option A: Alcohol can cause pancreatic disease, but the client’s pancreas is not producing any insulin currently. Alcohol abuse is a well-recognized association of both acute and chronic pancreatitis, with repeated attacks of alcohol-induced acute pancreatic necroinflammation leading to chronic disease. The risk of developing pancreatitis increases with increased consumption of alcohol.
Option B: Alcohol can cause liver disease, but the more immediate concern is hypoglycemia. Moderate amounts of alcohol may cause blood sugar to rise, excess alcohol can actually decrease your blood sugar level – which can be dangerous for people with T1D.
Option D: People with T1D should only drink while eating food. Beer and sweet wine contain carbohydrates and may raise blood sugar. People may overeat when drinking alcohol which also can increase your BG.
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