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43 Responses

  1. Penny
    Penny November 24, 2012 at 6:12 am | | Reply

    THANK YOU for writing this, Wil. My T1 gal is only 10, but I was just reading about teenagers and drinking, and going to ask Gary Scheiner about it. I want my daughter to know all this, and to stay alive. Dear God, stay alive. I would rather be totally honest with her and have her live to see another day than to hide my head in the sand and pretend that she will never drink.
    Thank you.

  2. Mike Ratrie
    Mike Ratrie November 24, 2012 at 6:46 am | | Reply

    Bravo!

  3. Mike
    Mike November 24, 2012 at 6:46 am | | Reply

    Great column and excellent advice for partying w/ D!

  4. Amanda
    Amanda November 24, 2012 at 8:02 am | | Reply

    Good article. Aaaah, so much to remember, my T1 is only 8, but I worry about teenage drinking. I know I did it, got plastered as a teen, did all kinds of dumb stuff. Of course, I don’t want my kids to do these things, but I’m not naive enough to think they won’t. I am worried about her especially when she is a teenage T1 trying to be sneaky and drink behind our backs. Sigh…..

  5. Susan f
    Susan f November 24, 2012 at 9:49 am | | Reply

    I am concerned about the glucagon message in this post. Because the low often comes HOURS later, you are not drunk when it happens. Does glucagon work then?

    Also I am a big fan of two things:
    A) run high on purpose; crashing in and out of the 20′s sweating and shaking is no fun. Surely going to bed at 250 or higher for the rare binge is better. Stop trying to stay under 200; as soon as that third drink goes in your system, your new target should be closer to 300. That is, don’t correct your highs aggressively OR stack boluses.
    B). Temp basals are your friend – much like after a day of intense exercise, try running a lower basal after a night of drinking; if you are 300 @ bedtime, it is probably not neede, but if you are under 200 it is!

  6. Casabby
    Casabby November 24, 2012 at 10:48 am | | Reply

    I think it’s fine to reduce a basal injection or use temporary basals on the pump. However, I disagree strongly with the idea of eliminating a basal injection and even more strongly about the idea of removing the insulin pump. DKA comes to visit pumpers very quickly when basal insulin is stopped because there is no Lantus or Levemir to cover that background insulin. If a young person (or old person) is totally sh*t-faced, they’re probably not going to remember to re-attach the pump. Add dehydration and puking to the menu and you’ve opened the door to a catastrophe.

  7. Sharon Carlyle
    Sharon Carlyle November 24, 2012 at 3:32 pm | | Reply

    Thank you sooooo much for writing this. My daughter has had the D for thirteen years. She is now 17. Also my sons best mate is Type 1. Will be showing both of them this article. Taught me a thing or two. Can’t thank you for your wisdom. X

  8. Gail Shaw
    Gail Shaw November 24, 2012 at 3:50 pm | | Reply

    Thank you for the information. As the parent of a 15 year old T1d I appreciate the frankness of your article and will be sure to share it with him.

  9. Karen H
    Karen H November 24, 2012 at 4:15 pm | | Reply

    Thank you for this candid and realistic post. I will definitely share with my T1D kids.

  10. Kim
    Kim November 24, 2012 at 6:41 pm | | Reply

    Thanks for being honest. One additional item to remember:
    Related to the liver comments, a Type 1 diabetic will usually get wasted quicker than a non-diabetic. Yup, lots of diabetic friends and all of them are light weights. Don’t binge or try to keep pace, your friend will just throw up in the bathroom, you will come to in the hospital… if you are lucky.

  11. Lisa
    Lisa November 24, 2012 at 6:49 pm | | Reply

    Thank you!! As a 26 year old diagnosed less than 1 year ago, I appreciate this. I still drink like a college student once in a while and I’ve been looking for some practical advice like this.

  12. Tim
    Tim November 25, 2012 at 5:33 am | | Reply

    I think it should also be said that nobody NEEDS alcohol. I’ve devoted myself to a life of wine, women and song—but I haven’t got to the women or wine yet.

    I’ve been around people who don’t drink, people who drink moderately and those who shouldn’t be drinking and not one of these groups has more fun because of the amount of alcohol ingested, though it causes a lot of ruined lives for the latter group. This is just to say that there ARE people out there who don’t feel the need to drink and THAT’s alright, too.

    I was surprised to find that my brother-in-law felt the same way I did: Never liked the taste, didn’t see the point, so I don’t. For those kids out there who feel that way, stick to your guns! Choosing not to drink and sticking to it is a completely valid way to go–especially if you have a family history of alcoholism or other addictions. You truly are not missing out on anything.

  13. Marianne
    Marianne November 25, 2012 at 8:06 pm | | Reply

    Very interesting – but my burning question – how bad is it for a T2 to drink? Is the reaction similar? I’ve hardly had a drink since I’ve been dx’d but I’d like to know – just in case I ever decide to have one or two … too many, that is …

  14. Bennet
    Bennet November 26, 2012 at 6:12 am | | Reply

    I knew there was a reason I hung out with you at the bar…

  15. Natalie
    Natalie November 26, 2012 at 8:42 am | | Reply

    I do not ever recommend taking a pump off… you still need basal, even if it is reduced. DKA can start in 3-5 hours…. so then you have a vomiting, drinking teen on your hands…or a blood sugar of 500+ the next morning……yuck

    I suggest decrease basal before you even leave the house or have your first drink and food with alcohol if its available… and Skittles in both pockets/purse.

    For Lantus/Levemir take less that evening… a lot less…

  16. MommaKat
    MommaKat November 26, 2012 at 11:46 am | | Reply

    The things us moms won’t tell you Uncles straight to your face? We both need and adore you. Even if we could say this straight to our T1D kid’s face, they’re simply not going to hear it the same from us. From Uncle Will, though? Yes, and with a much more open mind – cuz Uncle’s cool and a whole let less, umm, judgey. So, yes – thank you for this. It’s been printed, laminated, and left under the pillow for the teens to find on their own time. (Us moms have to keep up images, too.)

  17. Stephanie
    Stephanie November 26, 2012 at 7:45 pm | | Reply

    Wow so I found this on Pinterest the day after visiting the E.R. bc of a night of drinking gone bad.
    Whenever I’d drank before I always ended up going to bed not caring about my BS but this time my husband took care of me & gave me insulin. I woke up fine the next morning with a sugar of 131 & ate a bagel. Later on I drank some water & after that I couldn’t keep anything down & eventually went low & couldn’t come up. I’ve only been a T1D for a year now so I wasn’t sure what to do. Now after meds, iv & sugar I’m much better.
    Lesson learned though.
    Alcohol & diabetes isn’t the best combination.

  18. Denise
    Denise November 27, 2012 at 8:27 am | | Reply

    The real problem with drinking is that nobody will know if you are in trouble or how to help! They won’t know if you are low or loaded, if you are passed out drunk or just passed out. You will go low while you’re sleeping it off and your friends will think you are just sleeping it off and you won’t wake up and no one will know and you’ll die. Or you’ll be suffering a low and sluring your speech and falling down and your friends will think yoy’re drunk but you’re too low to ask for help.

    My advice to D folk who drink is the same as for anybody who drinks: Have friends you can trust to take care of you. Someone who won’t let you go home with someone creepy. Someone who will make sure you make it home. Have a best friend who will hold your hair back while you puke and who knows YOU ARE DIABETIC! Someone not afriad to call an ambulance if they think something is wrong. Someone who knows when you are loaded and makes sure that you don’t drown at the pool party. This is when young ppl really need to look after each other. and when parents have to make it clear that they can call you anytime no matter what. Thanks so much for the info.

  19. Julia
    Julia November 27, 2012 at 8:57 am | | Reply

    We have a 15 year old as well. And you taught me quite a few things I didn’t know about Type 1 and drinking such as the fact that the effect of drinking is like taking more basal. Is there a carb amount per drink to ingest (I had heard a suggestion of 20) but I’m sure they were figuring on one or two drinks. So far we have been lucky but what young adult has never gotten drunk at least once? Thanks Uncle Will. PS. Will a slice of pizza at 25 grams a slice be enough to hold them? If drunk, will they remember to reduce basals? Maybe just get into the habit of not dosing for alcohol and eating 20 grams free every few drinks? Very scarey styff,

  20. Tracey
    Tracey November 27, 2012 at 12:16 pm | | Reply

    Good information.
    I’ve been a T1 diabetic since the age of 9. I went to college, joined a sorority, moved tothe UK, etc. and at the ripe age of 27, am a teetotaller, having never drank.
    When I was a teenager, an endo straight up told me, “You can never drink.” And that was basically it.

    But it was cool, because I was already neck deep in the Straight Edge hardcore movement, and it was a moot point. http://en.wikipedia.org/wiki/Straight_edge . I just wish I would have had this info a little earlier so I could sidestep some of the more awkward conversations of my younger years.

    Now I can use it in awkward conversations with my business clients, because “Hey I’m involved in a punk rock subculture blah blah blah covered in tattoos blah blah blah…” is perhaps not the best approach!

  21. susan f
    susan f November 28, 2012 at 7:47 am | | Reply

    @Julia – terrifying for my friends, but way back in the day in college, I would actually remember to do ‘all of those things’ to stay safe, including eating or dropping basals. Somehow, after 20 years of being diabetic, it’s engrained in me. Now granted I would get drunk, but not to the level of passing out.

    Denise’s comment is spot-on; if you want a ‘back-up system’, you have a very good friend who won’t let you go to sleep without testing and/or eating. Even better if they have the phone number of a diabetic to call for advice if they test your blood and things aren’t so hot. If you can be that awesome mom who is willing to help in that situation, even better, but yeah, an ‘uncle’ works too.

    If you are not diabetic, drinking buddies are essential if you are a young college women, and a common occurence. Now you are just asking that buddy to take it one step further.

    While I appreciate those that refrained from drinking in college, and admire your point of view, reality dictates that not all diabetic children will grow up to be such upstanding citizens. Therefore – this dialog is pretty crucial. No, no one HAS to drink. But in college many do, so let’s make sure our kids are aware of the consequences before sending them off to college!

    I never bolus for alcohol. I’d rather coast up a little and give a small correction. If I bolused 20g for a beer, I’d be on the floor in an hour.

    But I also don’t drink sugary alcohol drinks; I find managing a temporary high from a sugary drink, and a possible super low later from the combo of insulin & alcohol is not worth it. I’d rather not be bolusing a lot, and sticking to beer/wine is a great way to do that.

  22. Michelle
    Michelle November 28, 2012 at 9:36 am | | Reply

    glucagon doesn’t work when you’re drunk?! I feel like this should be advertised more, because I had absolutely no idea.

  23. MyBustedPancreas
    MyBustedPancreas November 28, 2012 at 10:08 am | | Reply

    Freaking awesome. Thank you for posting. A few things to add. First, you can use glucagon once the most drunken stage has passed. I know because I’ve gotten sick before AFTER bolusing (while still fairly wasted) and had to take glucagon to counteract the insulin in my system. Worked, except I threw up even more. I’m not the only person who’s done this apparently – Jacquie over at TypicalType1 wrote a post last year about an eerily similar incident. For us, glucagon did the trick.

    Second, avoid sugary mixed drinks. I always stick to beer, wine, and gin. They will still mess with your BG, but you won’t have as much of a mess to deal with.

    Third, eat, eat, eat!! Food helps things considerably.

    Fourth, practice. That’s right, practice getting drunk with someone around you trust. Understand how alcohol affects YOU. We’re all different and all have different thresholds for what our bodies can tolerate. Find what combination of food, drink, and fun works for you.

    Fifth, I cannot emphasize enough how important it is to let people around you know that you’re a type 1 diabetic. If the EMT’s show up, they will think you’re just another wasted idiot. Hypos and drunkenness look very similar.

    Sixth, never sleep alone when you’ve been drinking. Only drink heavily if you know you’ve got someone next to you for the rest of the night. T1s have died this way.

    If you’re old enough to go out and party, you’re old enough to take responsibility for yourself and your actions. Have fun, but be an adult about it. No one looks cool wasted off their ass, and neither will you. You’ll look even less cool if you die. Personally, I’ve always had just as much fun watching everyone else get wasted while I nurse a beer or glass of wine.

  24. MikeH
    MikeH November 29, 2012 at 12:38 am | | Reply

    This is a great conversation. I’m one of those who did drink during college… quite a bit. This wasn’t a specific conversation with my parents beforehand, but they weren’t afraid to have it – we just didn’t get into it too deeply aside from the general “be safe and know what alcohol will do to you.” My endo(s) refused to acknowledge this reality and opined that I not drink at all. So, I really learned through trial and error… but it didn’t matter much, since I typically ran High anyhow in those years (not just while drinking) and so when I did see a BG drop, it didn’t make me crash. I did avoid the sugary drinks with mixers and usually went with lighter beer or something with diet soda, and did make sure that I had eaten enough to get me through the post-drinking excursions. Anyhow, thanks for writing this, Uncle Wil! Wish I’d had it when I was younger!

  25. ria
    ria November 29, 2012 at 5:34 am | | Reply

    thanks, uncle wil !
    wish i had heard this 30 + years ago (in my party years) when I almost died on a bathroom floor from too much rum and too little information about alcohol and diabetes

  26. Scott S
    Scott S November 30, 2012 at 8:02 am | | Reply

    For the most part, I think you’ve covered the bases pretty darn well Mr. Wil Printcrafter Dubois!! However, I would just add that alcohol, like pretty much anything when it comes to diabetes, is something that one learns from experience. The best advice I ever got was when I was an exchange student in Finland where they not only have lots of type 1s, but they also like to drink their Salmiakki kossu, vodka, which is basically grain alcohol with salty licorice infused, as well as other hard liquors. My fellow T1 Finns advised that I should drink and eat, just as you did, but they also advised not to worry about correcting high BGs until I’m well into hangover mode. Of course, that exaggerates how lousy you’ll feel the next day, but it also meant I didn’t pass out from hypos and the only bed-spins I was having was from the booze. You can always correct highs later, but its tough to correct a low with a room full of drunks including yourself. There’s risk in everything we do; drinking is one of them, but learning how booze affects us is an important learning process that all type 1 people should learn about from experience.

  27. Denise
    Denise November 30, 2012 at 8:28 am | | Reply

    I have two kids with T1D. My older daughter was 15 and got drunk and passed out at a party. Nobody knew she was actually drunk and severely hypoglycemic at the time. Her sister happened to find her unconscious on a couch and got her to the ER where they promptly cut off her clothes and had to resuscitate her to save her life. It really sucked. Now we talk all the time about drinking. I really think your approach is best. Thank you Uncle Wil

  28. Ellen
    Ellen November 30, 2012 at 9:57 am | | Reply

    Bless you for saying the things that no one else has the guts to say!! The world (in all fields) needs more people who can face reality & deal with it. Denial gets no one anywhere useful.

  29. KT
    KT November 30, 2012 at 5:25 pm | | Reply

    Thanks for the “Keeping it Real” column. I’ve always read about how alochol is suppose to react to my Type-1 body, but I find the opposite to be true for me. Whenever I go drinking (beer mostly), I find that I must bolus. I also find that either I don’t bolus enough or alcohol doesn’t allow my insulin to be absorbed as efficiently. Either way, I always end up being super high (even overnight). Didn’t mean to add to the confusion, but it just seems to me that alcohol hinders the effectiveness of insulin, more than gives me lows later or anything of that sort. Maybe you can comment on this with your thoughts?

  30. Ollie
    Ollie December 2, 2012 at 5:57 am | | Reply

    Amazing and much needed post, really wise. Thank you for writing this.

  31. Ollie
    Ollie December 2, 2012 at 6:04 am | | Reply

    I’ve found it very hard to get straight answers from healthcare professionals about issues where there’s a social judgement attached to a lifestyle choice. Even with less charged topics like eating fast food or sleeping in late I have had struggles to get conversations past “just don’t do it” and get any meaningful information. I’m really grateful that you’ve written this.

  32. CGH12O6
    CGH12O6 December 10, 2012 at 2:33 am | | Reply

    I know WilD has been kicking around the DOC for quite some time now. While I see he offers good advice, I have always been unclear as to what regulated health profession he is a member of and how it is he has patients.

    I remember at one point reading that he informally counseled underprivileged / uninsured type 2 patients. Now I see in this article is treating / counseling pediatric type 1 patients. I am just concerned about the ethics / logistics behind how that works.

    Honestly, as I recall this gentleman has not even had diabetes for very long.

    1. MommaKat
      MommaKat December 10, 2012 at 10:03 am | | Reply

      A quick search for Wil Dubois tells you everything you need to know. Author of several D books (national award winning books), Diabetes Coordinator at Pecos Valley Medical Center, author of multiple D columns, and a veteran T1D. Wanting to ensure the advice you read comes from someone knowledgeable makes perfect sense; casting aspersions on one’s ‘right’ or qualifications to author advice columns carries a different feel. Complete profiles are available here, on tudiabetes, blogger, and LinkedIn.

  33. C6H12O6
    C6H12O6 December 10, 2012 at 10:51 pm | | Reply

    Advice columns are great; and this one includes a disclaimer. It is treating pediatric type 1 patients when you are not a member of a regulated health profession that concerns me.

  34. New Years Eve with Diabetes
    New Years Eve with Diabetes December 20, 2012 at 12:59 pm |

    [...] I'm not a Type 1 and I've never been on insulin, so I don't know how accurate this article is, but I found it interesting reading: D-Teens and Alcohol: No Bull from Uncle Wil : DiabetesMine: the all things diabetes blog [...]

  35. amireally
    amireally March 20, 2013 at 8:41 am | | Reply

    Thank you thank you for writing this! I too wish I had gotten this when I was younger (the internet existed when I started drinking but was still in dial-up mode and there certainly wasn’t this information readily available… in fact there still is NOT enough about this stuff on the internet).

    One thing – I really disagree about taking off the pump. I’ve learned my lesson the hard way, and I think people should NEVER take off or suspend the pump. I think that’s dangerous when you’re sober (I’ve woken up with large ketones this way) and much more so when drinking. You GOTTA DO A TEMPORARY BASAL because you do not want to forget to turn it back on, especially if you’re out of it and gonna sleep for a long time. I also think the risk would be increased for DKA because that involves your body bein too acidic and so does alcohol poisoning.

    My endos (or anyone else) didn’t talk to be about alcohol. At one of my first college parties, I had a lot of questions in my head. And then the perfect opportunity! I saw a guy testing his blood sugar on top of the keg. I was so excited and said hey I’m diabetic and I want to learn about drinking and stuff and his friend slapped him on the back and said “Well THIS is your guy! He knows all about it!” and then the fire alarm went off and I never saw him again. I figured some things out, and like many others here I often ran too high in general so that helped avoid some crashes. And I didn’t drink as heavily as many of my peers.

    Also, my riskiest diabetes issue from drinking came from taking off my pump. It was annoying me while I was dancing (making my skirt sag), and I figured I didn’t need much insulin between the alcohol and dancing so, I took it off and set it down. Because I was drunk and distracted with a potential makeout, I left the party without it. Didn’t realize it til a few hours later, and was too tired/lazy/poor judgmenty too go look for it. Luckily I took some injections and didn’t sleep too long so was fine, and my friends helped me find it (in the grass behind the house party) the next day. But it coulda been much worse.

  36. Adrian
    Adrian May 9, 2013 at 11:11 am | | Reply

    These are the exact reasons I struggle to educate my T1 son about having a healthy relationship with alcohol.

    The biggest challenge to his safety is, tragically, my well-meaning family. They think that abstinence is the best approach. But, as you point out, drinking happens. This leads to arguments at family gatherings but, for my son’s safety, I’m sticking to my guns.

    Being prepared is way safer than pretending something will never happen.

  37. Amy
    Amy July 10, 2013 at 8:51 pm | | Reply

    I just linked this in a post on my (tiny little) blog — I will never be able to express how much your words meant to me about 5 months ago when my type 1 son came home completely obliterated. I almost called 911 – but between this and calling the on-call doctor kept him home and out of the ER.

    This type 1 teen thing is no joke – it is straight talking like yours that gets people through. THANK YOU!!!!!!!

    Love (and tears)
    Amy

  38. Lily Parkes
    Lily Parkes July 11, 2013 at 7:50 am | | Reply

    Thanks a lot Wil! I’m sure your message will reach thousands of teens with diabetes and it will discourage them from taking alcohol. Your site will help so many young people. :-)

    1. Adrian
      Adrian July 11, 2013 at 11:12 am | | Reply

      I don’t think that anything will prevent teens from drinking alcohol.

      I also don’t think it’s in their best interest to get them to not drink.

      I think it’s important to dispel the North American delusion that drinking is a right of adulthood and that drinking to impairment is a ‘Macho’ or ‘Cool’ thing to do.

      Other places in the world that accept drinking with dinner as a casual thing that people of all ages can partake in at a reasonable level tend strongly towards much more reasonable consumption.

      Instilling that approach into my kids is my goal.

      Also; a healthy respect for firearms and how to use them safely.

  39. Caitlin
    Caitlin October 24, 2013 at 7:40 pm | | Reply

    Best Article Ever!! I’m an 18 year old T1D! This article is absolutely fantastic! It’s exactly what i needed to read! Advice from someone who doent just want you to NOT drink at all because im a T1D! Thanks

  40. Roberta
    Roberta July 13, 2014 at 3:33 pm | | Reply

    As a scotch drinker I can agree with all the points in your article, thanks for posting

  41. Ann Byrne
    Ann Byrne September 10, 2014 at 11:29 am | | Reply

    What a fantastic piece I have just sat down with my 16 year old and we read it together We have both learned so much Thank you Uncle Wil :)

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