Should I lower my basal insulin for a couple of beers?

[Quinapril]

Hello everyone.

I am planning on consuming 2 beers this evening and I was wondering whether I should lower my basal rate for that because I am scared of going low while I sleep.

Now I have done a bit of research and it seems that 2 beers will only stay in the system for up to 5 hours based on my weight. According to various calculators, after 5 hours my blood alcohol content should be back to 0 %. So I am assuming that after this time the liver will stop working on alcohol and will return to its normal function.

I won't go to sleep within the 5 hours after a couple of beers so I was wondering whether I should lower my basal or keep it the same and simply keep my eye on my blood sugars? (I have a CGM).

Any ideas and tips are highly appreciated!

 

[In Response]

Firstly some basals do not react fast enough, Tresiba takes 3 or 4 days for a change to take effect.
Secondly, beer is carby so likely to raise your blood sugars and, for most people, a couple of beers will not have enough alcohol to have a significant affect regrading lowering your blood sugars - do you feel drunk after 2 beers?

The advice I was given was to ensure I went to bed with a higher than usual blood sugar after drinking. The suggestion was to eat a slice of toast with no insulin.
You can also set an alarm in the night for you to check your blood sugars if you are concerned your CGM alerts would not wake you.

My advice would be NOT to reduce your basal.

 

[Jaylee]

Hello everyone.

I am planning on consuming 2 beers this evening and I was wondering whether I should lower my basal rate for that because I am scared of going low while I sleep.

Now I have done a bit of research and it seems that 2 beers will only stay in the system for up to 5 hours based on my weight. According to various calculators, after 5 hours my blood alcohol content should be back to 0 %. So I am assuming that after this time the liver will stop working on alcohol and will return to its normal function.

I won't go to sleep within the 5 hours after a couple of beers so I was wondering whether I should lower my basal or keep it the same and simply keep my eye on my blood sugars? (I have a CGM).

Any ideas and tips are highly appreciated!

Hi,

Short answer is don't mess with your recomended dose of basal.
If your not planning on sleeping on it. Fair play. Some beers can & have been like "liquid bread" for me in the past..?

Enjoy your evening.

 

[KK123]

Hello everyone.

I am planning on consuming 2 beers this evening and I was wondering whether I should lower my basal rate for that because I am scared of going low while I sleep.

Now I have done a bit of research and it seems that 2 beers will only stay in the system for up to 5 hours based on my weight. According to various calculators, after 5 hours my blood alcohol content should be back to 0 %. So I am assuming that after this time the liver will stop working on alcohol and will return to its normal function.

I won't go to sleep within the 5 hours after a couple of beers so I was wondering whether I should lower my basal or keep it the same and simply keep my eye on my blood sugars? (I have a CGM).

Any ideas and tips are highly appreciated!

I agree with all of the above, basal isn't meant to cope with immediate carbs as it were, it's background insulin, slow and steady (in theory). I would look at your beers as normal 'carbs' but with the capacity to lower your levels faster than normal so use less (if any) bolus. If I was having just two beers I don't think I'd do anything different just test more and see how you go. You can always have a carby snack before you go to sleep as well, like anything else it is trial and error. It's definitely not an exact science, your liver might decide to work on the alcohol for an hour, then take a nap, then wake up and get going again on hour 4...or 5...or 7!!!! x

 

[kvetiny]

2 beers would require bolus insulin. For me 2 units of Novarapid. It's similar to eating 2 slices of bread for me I would need 2 units of Novarapid for.

 

[StewM]

It should be noted that composition* of beers varies so massively from beer to beer that there’s no such thing as a one size fits all dosage requirement for all beer.

*alcohol content/carbs (amongst many other Blood Sugar influences)

 

[KK123]

It should be noted that composition* of beers varies so massively from beer to beer that there’s no such thing as a one size fits all dosage requirement for all beer.

*alcohol content/carbs (amongst many other Blood Sugar influences)

I absolutely agree. I actually don't require ANY bolus for a couple of lagers.

 

[SueJB]

I'd drink it, have a bag of crisps, check BG before bed but certainly would NOT do anything to basal or bolus

 

[bmtest]

Couple of beers is negligible just monitor b4 and after. I do not drink the volumes these days but I would test before going out the mid evening and b4 bed. The volumes I drank was 8 pints to 15 bottles spread over 5 hours. Never had any problems and slept like a baby but there is no room for error or mistakes and practised to get to this level.

These days the beers have roo much carbs.

 

[kvetiny]

Yes all beers are different in regards to carbs but it's true what they say about it being liquid bread. Beer sends my sugars up sky high.

 

[Ushthetaff]

Totally agree with all previous comments , don’t adjust Basel , just treat as per normal carb intake for 2 beers, just a test before bed and if worried a wee carb snack .

 

[KK123]

I hope @Quinapril comes back and tells us how it went! He probably had a few extra too as we all know what it's like, we go out full of good intentions and then.....wake up covered in kebab!

 

[Quinapril]

Hey again.

Thanks to everyone for the tips!

It went quite alright! I ended up having 3 beers instead of 2 and didn't mess with my basal insulin.

At first, the beer did make my sugar spike up to bout 11 mmol and I got panicky and took a second correction shot.
However, I didn't go low and the correction made my sugar come down to 5 mmol and it stayed like that for a while.
I took a bit of glucose before bed to raise my sugar up just a little bit and went to sleep with about 7 mmol. Woke up with about 6 mmol and Id say it was a success

I'm a little concerned about what @In Response said tho. Could you elaborate on this a little more? I personally take basaglar which is glargine insulin and according to all of the official sources, it stays in your system for 24 or sometimes up to 26-28 hours. How could it stay in your system longer? I mean if for some reason I need to lower my basal by 1 point, the effect won't be visible the next day? How can that be and why? If that's the case is there some type of basal which is more flexible?

 

[In Response]

I'm a little concerned about what @In Response said tho. Could you elaborate on this a little more? I personally take basaglar which is glargine insulin and according to all of the official sources, it stays in your system for 24 or sometimes up to 26-28 hours. How could it stay in your system longer? I mean if for some reason I need to lower my basal by 1 point, the effect won't be visible the next day? How can that be and why? If that's the case is there some type of basal which is more flexible?

I was referring to longer lasting basals such as Tresiba which take 3 or 4 days for a change to take full effect. It has a much flatter profile than Glargine but is less flexible.

 

[OscarC]

Found this thread very interesting. About to venture out to the pub myself this evening - first time trying a beer since my diagnosis about 3 months ago. I spike like crazy after just one slice of bread so...............

 

[Ushthetaff]

I hope @Quinapril comes back and tells us how it went! He probably had a few extra too as we all know what it's like, we go out full of good intentions and then.....wake up covered in kebab!

As long as it’s only kebab lol I know I’ve woken up with a lot more and worse than a kebab on me ,,,,, oerrr missus

 

[TypeZero.]

Hello everyone.

I am planning on consuming 2 beers this evening and I was wondering whether I should lower my basal rate for that because I am scared of going low while I sleep.

Now I have done a bit of research and it seems that 2 beers will only stay in the system for up to 5 hours based on my weight. According to various calculators, after 5 hours my blood alcohol content should be back to 0 %. So I am assuming that after this time the liver will stop working on alcohol and will return to its normal function.

I won't go to sleep within the 5 hours after a couple of beers so I was wondering whether I should lower my basal or keep it the same and simply keep my eye on my blood sugars? (I have a CGM).

Any ideas and tips are highly appreciated!

In my experience a few low ABV drinks won’t make a significant difference in blood glucose especially when beer and wine is already very carb-heavy.

I would keep my basal the same and adjust the bolus, alcohol affects us all differently but a 10-20% decrease in bolus dose seems reasonable.

The only thing I would be super concerned about are spirits, they’re usually very low carb and have much higher alcohol concentrations so they can cause dangerous lows

 

[Jaylee]

In my experience a few low ABV drinks won’t make a significant difference in blood glucose especially when beer and wine is already very carb-heavy.

I would keep my basal the same and adjust the bolus, alcohol affects us all differently but a 10-20% decrease in bolus dose seems reasonable.

The only thing I would be super concerned about are spirits, they’re usually very low carb and have much higher alcohol concentrations so they can cause dangerous lows

Hi TZ,

In my experience with the spirits. (Which I prefer regarding BG managment overnight. After a bit of R&R.)
The insulin causes the lows. The spirit's part in this keeps the liver too busy to kick in with a glycogen dump. So the lows may come on quite rapid should one occur..
So, some long acting carbs as a nominal snack can help curb this..

 

[scaryblueberry]

I was taught on a Dafne diabetes course to calculate the carbs in the beer and inject as normal for the first beer as it won’t yet have effected your livers ability to produce glucagon. The second beer plus will have put enough alcohol in you body to have affected your body’s ability to produce glucagon so half the insulin for them. This always worked more or less for me. The tricky thing is knowing how much carbs are in the beer to start with as the info is not always available. That said I think my general assumption for lager was that it had about 20g carbs per pint and that usually worked out about right.