Has anyone found a reliable strategy with beer?

[RobertJ]

This evening, I thought it would be nice to go to my lovely, civilised, cosy local pub and have two pints of Charles Wells Dry Hopped Lager while reading a book. Obviously, for someone without diabetes this would be a very straightforward affair. You just go to the pub, have your two beers, then walk home and everything's fine.

For me, however, it was a bit of a disaster. It had gone a bit high from my evening meal but it was 12.3 when I ordered my first drink and I gave two units of Novorapid, thinking one unit per pint would be fine and the insulin I gave from my evening meal would still be working anyway, so it was best not give too much.

Once I sat down I noticed my Freestyle Libre saying 10.7 with the arrow pointing 45 degrees down so I thought, phew, it will be in the target range soon enough.

I started reading my book and tried to enjoy myself and not think about diabetes. When I got up to order the second pint my high glucose alarm was going off and I thought, wait, what?

It had then gone back up to about 15.1 so I gave another two units, now throwing the original plan out of the window. I thought, all that matters now is getting it down.

As I type this, it's 12.2 with the arrow pointing directly down, so I guess it will end up fine but even so... All this just for trying to have to lagers in a pub with a book like a normal person. I've had Type 1 diabetes for 19 years and still haven't settled on a reliable method. Just to be clear, there have been times where I've had far more than two pints and it's been a diabetes masterclass, between 5 and 9 all evening without even going low at the end of the night. This year, I was at a beer festival of all things and it was 8.4 at the start and about 6.8 four hours later, and that included food as well. So it can be done. But when that happens it feels more like dumb luck than actually having a plan and the plan working.

And for anyone thinking of saying "Just don't drink alcohol, you've got diabetes" or "Just drink something else", that's not an answer to my question. I am asking, does anyone drink beer as their alcoholic drink of choice and have you found a reliable method of avoiding spikes or hypos?

 

[Juicyj]

Hello @RobertJ

Ah as we all know nothing is straight forward with t1 !! Do the same thing tomorrow and expect different results !

Drinking alcohol and dancing is also a completely different experience, although you can keep yourself happily in range from exercising and drinking, I love a challenge so I would treat this as an experiment and go for it again, don't let the one episode affect doing it again, personally in your shoes I would of got up and tried to of moved about, sitting down gives my insulin the opportunity to become redundant so when running high I try to move more to get it working more efficiently.

 

[Ushthetaff]

from my personal experience with alcohol and diabetes my rule is when drinking don’t take insulin , it works for me as if I drink initially my sugars rocket upwarlds but later they come down just as quick as they go up, so I deal with them once they’ve settled . Not saying it works for eveyone but definitely works for me

 

[In Response]

My experience is to carb count and dose for the first 2 pints but, if I drink any more (which is rare because I am small and it makes me drunk), I need no more.
I also have a policy to avoid carbs of any kind if my levels are above 10 as I become insulin resistant.

Recently, I have started drinking non alcoholic beer. This has improved greatly in recently years and actually tastes of something other than water. At first I dosed assuming a similar carb content to alcoholic beer. Turns out low/no alcohol beer is also low carb and pretty tasty.

 

[RoughcutAU]

Good Question! I’m all ears for the answer too.

In my limited experience I too have found it easier managing a bigger drinking session then a couple of pints at the local. Whether by luck or not is another story.

Similar to In Response I usually bolus for the first 2 pints and not after. Though i would have them with a meal of some sorts that has carbs so do it all in one.

Alcohol has such a different effect on different people and even the same person at different times. I do find though that usually my BGs only go high hours later … probably when my body is done dealing with the alcohol it decides it wants to deal with the carbs and pump out glucose.

 

[RobertJ]

Good Question! I’m all ears for the answer too.

In my limited experience I too have found it easier managing a bigger drinking session then a couple of pints at the local. Whether by luck or not is another story.

Similar to In Response I usually bolus for the first 2 pints and not after. Though i would have them with a meal of some sorts that has carbs so do it all in one.

Alcohol has such a different effect on different people and even the same person at different times. I do find though that usually my BGs only go high hours later … probably when my body is done dealing with the alcohol it decides it wants to deal with the carbs and pump out glucose.

Accounting for the first two but not the next is a really interesting idea. I think I've kind of done that in the past without really realising it. I've given a dose at the beginning, noticed it's gone up then down. Then if I'm on the third pint and it's 4 or 5 I just go "Oh, I'll leave it now". So maybe this is the solution.

It should be possible, though, to have two quiet pints in the pub without the BG reaching 15 and 16. It's moments like this that I really feel like a disabled person with a terrible medical condition and that maybe I just shouldn't be attempting the things normal people do. It's very disheartening.

 

[In Response]

It should be possible, though, to have two quiet pints in the pub without the BG reaching 15 and 16. It's moments like this that I really feel like a disabled person with a terrible medical condition and that maybe I just shouldn't be attempting the things normal people do. It's very disheartening.

I am confused by this comment.
It is possible to have two quiet pints withoit BG going sky high.
The carbs in beer are like the carbs in food: if you dose your insulin for it, your BG can be kept in check.

I accept it can be frustrating having to inject but, over the years, I have got used to it and it is just normal to me now.

The other option is to drink something with less carbs like wine or spirits. There are many reasons for not drinking beer for “normal people”, such as taste, volume and weight management.

We have to adapt but that does not need to mean we have to miss out.

 

[Zhnyaka]

as far as I know, alcohol blocks the production of glucose by the liver, so I do not inject insulin for strong alcohol at all, and if I drink beer, I inject less than if I consumed the same amount of carbohydrates without alcohol, moreover, I mainly inject only snacks, literally 1-2 units for beer (I like sweet beer), and even then I try to eat something before drinking beer, and I have to inject quite a lot for sweet alcoholic cocktails. Do you drink beer without snacks?

"Just don't drink alcohol, you've got diabetes" or "Just drink something else"

just don't drink alcohol, just don't eat sweets, just don't go to a barbecue with friends, just don't live... haha, **** the people who say that

maybe this will help you

 

[Grant_Vicat]

This evening, I thought it would be nice to go to my lovely, civilised, cosy local pub and have two pints of Charles Wells Dry Hopped Lager while reading a book. Obviously, for someone without diabetes this would be a very straightforward affair. You just go to the pub, have your two beers, then walk home and everything's fine.

For me, however, it was a bit of a disaster. It had gone a bit high from my evening meal but it was 12.3 when I ordered my first drink and I gave two units of Novorapid, thinking one unit per pint would be fine and the insulin I gave from my evening meal would still be working anyway, so it was best not give too much.

Once I sat down I noticed my Freestyle Libre saying 10.7 with the arrow pointing 45 degrees down so I thought, phew, it will be in the target range soon enough.

I started reading my book and tried to enjoy myself and not think about diabetes. When I got up to order the second pint my high glucose alarm was going off and I thought, wait, what?

It had then gone back up to about 15.1 so I gave another two units, now throwing the original plan out of the window. I thought, all that matters now is getting it down.

As I type this, it's 12.2 with the arrow pointing directly down, so I guess it will end up fine but even so... All this just for trying to have to lagers in a pub with a book like a normal person. I've had Type 1 diabetes for 19 years and still haven't settled on a reliable method. Just to be clear, there have been times where I've had far more than two pints and it's been a diabetes masterclass, between 5 and 9 all evening without even going low at the end of the night. This year, I was at a beer festival of all things and it was 8.4 at the start and about 6.8 four hours later, and that included food as well. So it can be done. But when that happens it feels more like dumb luck than actually having a plan and the plan working.

And for anyone thinking of saying "Just don't drink alcohol, you've got diabetes" or "Just drink something else", that's not an answer to my question. I am asking, does anyone drink beer as their alcoholic drink of choice and have you found a reliable method of avoiding spikes or hypos?

Nearly 44 years ago a dietitian put 1 pint of Guinness on my lunch menu, but advised me not to include it as countable carbs. Being a student at the time, I regurlarly strayed, but didn't count it as carbs, mainly because alcohol delays metabolism. I kept with the system until 2013. Yes, i had ups and downs, but when I look through my records, there were many even patches with good results. However, I can't advise you!

 

[RobertJ]

I am confused by this comment.
It is possible to have two quiet pints withoit BG going sky high.
The carbs in beer are like the carbs in food: if you dose your insulin for it, your BG can be kept in check.

I accept it can be frustrating having to inject but, over the years, I have got used to it and it is just normal to me now.

The other option is to drink something with less carbs like wine or spirits. There are many reasons for not drinking beer for “normal people”, such as taste, volume and weight management.

We have to adapt but that does not need to mean we have to miss out.

Oh, I know it is possible for beer not to cause it to reach 15 or 16, but I'm saying this is what happened last time. I did dose insulin for it, but for various reasons this is what happened to my readings.

Maybe if I'd injected a little bit more in advance of the beer it would have worked.

I've tried things like white wine or gin and tonic and they definitely make it easier with diabetes but I just don't really enjoy the taste as much, hence me making this thread about beer.

 

[RoughcutAU]

Always worth repeating an experiment at least once … i mean its for “science” right. There are a few factors you can tweak ie bolus timing, type of food eaten with etc.

My biggest problem with beer is how varied the carb content can be and I like to try alot of different “craft” beers. At least with alot of the large companies a quick google can get the nutritional information - craft beers is just an educated guess.

 

[RobertJ]

Hello @RobertJ

Ah as we all know nothing is straight forward with t1 !! Do the same thing tomorrow and expect different results !

Drinking alcohol and dancing is also a completely different experience, although you can keep yourself happily in range from exercising and drinking, I love a challenge so I would treat this as an experiment and go for it again, don't let the one episode affect doing it again, personally in your shoes I would of got up and tried to of moved about, sitting down gives my insulin the opportunity to become redundant so when running high I try to move more to get it working more efficiently.

Although I am well aware that low-intensity activity lowers BG levels, I have never been told about how sitting down stops insulin working very well. However, that very much fits with my experience and so I'm sure it does apply to me too.

 

[RobertJ]

Always worth repeating an experiment at least once … i mean its for “science” right. There are a few factors you can tweak ie bolus timing, type of food eaten with etc.

My biggest problem with beer is how varied the carb content can be and I like to try alot of different “craft” beers. At least with alot of the large companies a quick google can get the nutritional information - craft beers is just an educated guess.

I think you're right that craft beers are more sugary than regular lager, such as Carlsberg. However, in the past even with regular lager I've gone very high if I haven't injected enough or injected too close to having it.

 

[LWA]

Hi Robert - good thread
when I was first diagnosed in 1988 beer (& other drinks) just didn’t affect my levels - beit beer, IPA, cider or Guinness as well as wines or vodka etc …….unfortunately any ‘pint’ is now a killer for me - I’m not a big drinker but on the odd occasion have 2-3 beers & always have to Bolus (2 units of novo rapid per pint) just to keep below 10.
I also experience insulin not working as efficiently when sat down /not active (happens with foods as well) but annoyingly never used too ‍
I’m 50 this year and just accept that certain changes are needed as I get older to counter act such challenges and despite never easy continue to strive for the best control.
best of luck - and enjoy your next pint

 

[jaywak]

Quite a lot of lagers / bears that you buy from the supermarket will tell you how many carbs they contain so when you go to the pub you can work out how many carbs they contain which can be quite high , I roughly estimate about 20-25 carbs for a pint of lager so inject as if I was eating the same as food , the alcohol content of lagers is not usually that high so doesn't effect me but if you drink the hard stuff it has no carbs but can lower your bg so be Careful !

 

[Toffer]

I get the same "problem" as you (though note I've put it in inverted commas). I love real ale - and sometimes the well-hopped artisan lagers. I know they're high in carbs and will spike my blood sugars. Also I know that if I try to dose my insulin for my blood sugars I'll end up with a hypo as the carbs act quicker than the alcohol. I tend to give myself more basal before bed which helps. All I can say is enjoy the evening. Adjust in the morning. A relatively high bg level overnight is not a huge problem.

 

[RobertJ]

I get the same "problem" as you (though note I've put it in inverted commas). I love real ale - and sometimes the well-hopped artisan lagers. I know they're high in carbs and will spike my blood sugars. Also I know that if I try to dose my insulin for my blood sugars I'll end up with a hypo as the carbs act quicker than the alcohol. I tend to give myself more basal before bed which helps. All I can say is enjoy the evening. Adjust in the morning. A relatively high bg level overnight is not a huge problem.

I really try and avoid it being high over night so that's non-negotiable for me. If I've had a bad day, I always try very hard to ensure at least overnight things are correct.

I think for now I'll try this method of treating the first two pints the same as food if the food was the equivalent amount of carbs. I reckon some craft beer or ale can be as much as 15 or 20 grams per pint, so at a 1:1 ratio that could be four units. It's worth a shot and if I go low I'll just try something else next time.

 

[RobertJ]

as far as I know, alcohol blocks the production of glucose by the liver, so I do not inject insulin for strong alcohol at all, and if I drink beer, I inject less than if I consumed the same amount of carbohydrates without alcohol, moreover, I mainly inject only snacks, literally 1-2 units for beer (I like sweet beer), and even then I try to eat something before drinking beer, and I have to inject quite a lot for sweet alcoholic cocktails. Do you drink beer without snacks?

just don't drink alcohol, just don't eat sweets, just don't go to a barbecue with friends, just don't live... haha, **** the people who say that

maybe this will help you

Hello @Zhnyaka, for some reason I didn't watch this video until now. It was pretty good, so thanks for finding it. These guys basically said beer should be treated like any other drink with that same amount of carbohydrate in it. This is what I do if I am having a small amount of beer, I guess, such as two pints.

I think the difficulty comes with timing. If I know I am going to be having three or four pints spread over a long period, I can't just give all the insulin at the beginning because I'll go low.

Also, if food happens, do I inject for the food and any beer I'll be having later on or not?

A common occurrence is to go for a meal in a pub where you have one pint before the food comes and another one with the food. I can't ignore the first pint because otherwise by the time the food comes it will be creeping up and will continue rising before it has any chance of coming down.

 

[Antje77]

I think the difficulty comes with timing. If I know I am going to be having three or four pints spread over a long period, I can't just give all the insulin at the beginning because I'll go low.

Also, if food happens, do I inject for the food and any beer I'll be having later on or not?

A common occurrence is to go for a meal in a pub where you have one pint before the food comes and another one with the food. I can't ignore the first pint because otherwise by the time the food comes it will be creeping up and will continue rising before it has any chance of coming down.

Why not inject more often?
Inject for the first beer, and then again for the food and more beer?

 

[Zhnyaka]

I think the difficulty comes with timing. If I know I am going to be having three or four pints spread over a long period, I can't just give all the insulin at the beginning because I'll go low.

Antje is right, just give a few injections.

Also, if food happens, do I inject for the food and any beer I'll be having later on or not?

Of course you need insulin for food. Snacks are more difficult than beer itself, because it usually contains a lot of both carbohydrates and fats, that is, it is a food that usually requires more than one injection. The strategy is about the same as with pizza . But you can drink beer with meat and vegetables for example