Tobacco and Alcohol

Diabetes and Alcohol Use

Adults with diabetes can drink moderate amount of alcohol if they eat food at the same time. Alcohol counteracts the ability of the liver to produce new glucose by keeping the enzymes occupied with the breakdown of alcohol. The concentration of cortisol and growth hormone in the blood will decrease after alcohol intake. These biological factors come together, making the risk of suffering from low blood glucose (hypoglycaemia) much greater after drinking alcohol. Severe hypoglycaemia after drinking alcohol has caused death of young people with diabetes on rare occasions.
For persons with diabetes, the alcohol intake should be limited to one drink(defined as 350 mL beer, 150 mL glass of wine, or 45 mL glass of distilled spirits) for women and two drinks for men in one day. Make sure your friends know you have diabetes and wear some type of diabetes ID(necklace or MediAlert bracelet) when you are socializing. Always eat something at the same time as you are drinking alcohol. 
If you had too much to drink, eat extra food immediately before going to bed. You can eat potato crisps as they give slow increase in blood glucose over several hours. The blood glucose should not be less than 10 mmol/L when you go to bed. Decrease the dose of bedtime insulin by 2-4 units to avoid hypoglycaemia. Set your alarm and don’t sleep late.

Diabetes and Tobacco Use

Smoking is unhealthy as it results in increased risk of lung cancer, chronic bronchitis, and cardiovascular diseases. Having diabetes in itself increases the risk of cardiovascular diseases such as arteriosclerosis, heart attacks and stoke. In diabetes, the risks are cumulative and smoking increases the risk of pre-mature death for persons with diabetes by 1.5-2 times that of a person with diabetes who does not smoke. Research has shown that giving up smoking reduces this risk.
Nicotine from smoking affects the blood glucose level by contracting the blood vessels, resulting in a slower absorption of insulin from the injection site. Nicotine will also cause insulin resistance, which makes diabetes difficult to manage. The risk of developing Type 2 Diabetes is twice high for person who smokes. Scientific studies show that in a person with diabetes, smoking increases the risk of renal failure, visual impairment, foot ulcers, leg amputation and heart attack.
Passive smoking is a health hazard, more especially for children whose parents are smokers. Children absorb nicotine into their blood stream at twice the rate of adults through passive smoking.
Cessation of smoking improves the diabetes control. The use of nicotine chewing gums or patches maybe effective in giving up smoking.