Has anyone found a reliable strategy with beer?

[RobertJ]

I am on a pump now and have thought of a cunning plan. If I know I'm going to have, say, three pints over a period of a few hours could I just put in a temporary basal rate higher than usual and deal with it that way? I wonder if that would be a more stable way of countering the carbohydrate in beer than doing little doses for each one. Has anyone on a pump ever tried this?

 

[Zinadane]

Would be good to get a carb count list for most of the mainstream beers, lagers and ciders.
I remember holstein pils being recognised as low carb, but not actually sure of its true content anymore, not that it's seen much nowadays.

 

[jaywak]

Holsten Pils is in the supermarkets still and I think it's about 15 carbs a can which is about the same as the rest of the popular lagers , a lot of them now actually print on the can how many carbs they contain which is helpful .

 

[Zinadane]

Perhaps the ad was misleading then.
'All the sugar turns to alcohol'
Or has this lager changed over the years?

 

[RobertJ]

Would be good to get a carb count list for most of the mainstream beers, lagers and ciders.
I remember holstein pils being recognised as low carb, but not actually sure of its true content anymore, not that it's seen much nowadays.

I've found it for Molson Coors, which includes a fair few well-known beers.

They're all pretty similar though. Almost all lager is between 15g and 20g of carbohydrate per pint.

Knowing that information has not been enough for me to achieve good control. I can hear the voices saying "Just stop drinking beer then" but it's a nice thing to do. That's why I used the word "strategy" in this thread. I'd like to know if anyone has unlocked a strategy that works every time.

Tomorrow I am going to an Indian restaurant and will probably have two Cobras. Since moving onto a pump, my management is worse than before and I am fully expecting a disaster.

 

[Zinadane]

Good luck.
In my experience, pre-bolus to keep on top things whilst having pre-drinks.

 

[jaywak]

Perhaps the ad was misleading then.
'All the sugar turns to alcohol'
Or has this lager changed over the years?

I think the recipe perhaps may have changed but I think the ad was correct at the time , all the sugar turns to alcohol but you still have carbs left with the rest of the ingredients , I can remember when it used to have a little label on the bottle saying recommend by the BDA .

 

[RobertJ]

Good luck.
In my experience, pre-bolus to keep on top things whilst having pre-drinks.

Thanks. Earlier this year, towards the end of my time on pens, I got pretty good. I used to view a spike up to 11 or 12 as a failure.

Since going on the pump, however, all the problems are exaggerated. Now, the moment I have a high carb and/or high fat meal I see numbers like 16 and 17 and stay above target four hours. It's awful.

 

[CheeseSeaker]

Beer is very fast carbs and hits quickly to BG - I tend to bolus about 12g per pint, then when the insulin kicks in you can often get a low afterwards.

Just re-read read and you're MDI on Novorapid.

So - strategy here is time and insulin. BG above 14 I found Novorapid to be less effective - you might need to increase the amount of insulin to get your BG to respond (increase of say 25% to 50% - you need to test this by going for more beer in a controlled manner ;-) )

You will always get a high as the insulin time to work is quite high (1-2 hours) unless you pre-bolus (but thats not real life).

Consider a faster acting insulin (Fiasp or Lyumjev) as that will help with speed of action in more than just a night out.

For me I found Lyumjev and DIY Looping (with an insulin pump) can solve these highs and handle the lows off the back of them - but its a complex path

 

[RobertJ]

Beer is very fast carbs and hits quickly to BG - I tend to bolus about 12g per pint, then when the insulin kicks in you can often get a low afterwards.

Just re-read read and you're MDI on Novorapid.

So - strategy here is time and insulin. BG above 14 I found Novorapid to be less effective - you might need to increase the amount of insulin to get your BG to respond (increase of say 25% to 50% - you need to test this by going for more beer in a controlled manner ;-) )

You will always get a high as the insulin time to work is quite high (1-2 hours) unless you pre-bolus (but thats not real life).

Consider a faster acting insulin (Fiasp or Lyumjev) as that will help with speed of action in more than just a night out.

For me I found Lyumjev and DIY Looping (with an insulin pump) can solve these highs and handle the lows off the back of them - but its a complex path

This is actually a good reminder to update my profile, which I've done. I don't know what MDI means but I'm on a pump now.

My only insulin is Novorapid so I can't change to something else.

What do you mean by DIY Looping?

 

[Zinadane]

MDI - multiple daily injections.
Fiasp is an improved version of novo rapid. Much more active within the first hour. I suggest you speak to your consultant GP.
DIY looping, I'll let someone more qualified than me explain this one.

 

[CheeseSeaker]

This is actually a good reminder to update my profile, which I've done. I don't know what MDI means but I'm on a pump now.

My only insulin is Novorapid so I can't change to something else.

What do you mean by DIY Looping?

Ok - MDI means 'multiple daily injections' - if you're pumping it opens up different strategies.

You can pre-bolus for your meal to reduce the 'post prandial high' (high after eating) which means you'd start from a better place (remember Novorapid doesn't start working till at least 1 hour after it goes in, generally not peaking till 2 hrs - so if you can get it in early it can cope with the food hitting your system at the same time).

For beer its more fun as the carbs hit very fast (I love real ale - so have experience on this but its never a straight forward ride) so get the insulin in early, and enjoy your pint - expect a high, and then watch for a low following as the insulin takes the fast arbs out (worth having a dextrosol tab or something with you just in case).

DIY looping - where you use the readings from your Libre (or whatever) to talk to a program on your phone that works like an artificial pancreas. So you tell it what you've eaten, and it monitors your BG and puts more insulin in as and when you need it by controlling your pump. If you drop low, it slows/stops insulin delivery.

On mine I set a temp-target (before eating) to drop my BG before the food hits, but keep to a safe level, and it adjusts my Basal to do that an hour or so before food.

Was on Novorapid for 20+ years, the benefits of 'Ultrafast' insulins is much quicker insulin action (15-20 minutes, peak at 40-60) so the post prandial high is much, much less.

Fiasp (for example) is Novorapid with 'stuff in it' to make it work faster (added nicotinamide/B3).

You can always ask to change, or discuss it with your Diabetes Nurse to understand further - makes mealtimes and pumping much easier as you're not 2 hours behind your food.

 

[SamJB]

Generally, each pint is 15-20g carbs. Mega high GI, almost as good as Lucozade for pushing my BGs up!

 

[stephenlowefinland]

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?

Yes. Had Diabetes 11 for about 30 years since I had a Double ByPass. Also I have High Blood Pressure. I am on Tragenda, Metformin, and other medications also for Gout.
One pint og Gold Lager with up to 5,5 ABV with a meal is ok. Two glasses of Re Wine up to 11 ABV with meals do no harm.
Since of past 4 months, I have drunk one litre of Green Tea (4 sachets) + one inch of sliced Ginger + a teaspoon of Turmeric to maintain my Fasting BG level at 5,6 - 7,4.

 

[TMG123]

I am on a pump now and have thought of a cunning plan. If I know I'm going to have, say, three pints over a period of a few hours could I just put in a temporary basal rate higher than usual and deal with it that way? I wonder if that would be a more stable way of countering the carbohydrate in beer than doing little doses for each one. Has anyone on a pump ever tried this?

Hi Robert, it's tricky but in my experience, a temp basel is the best way to deal with beer. I find that if my BG reading is high (i.e. above 10) when I start then it's way more difficult to keep levels normal so I'd make sure you don't start drinking until BG readings are lower; 5 - 7ish?? Again, in my experience with Novorapid the insulin lasts much longer than the sugar in the beer so if I do bolus for drinking I tend to drop too low later which isn't much fun. I've recently swapped insulin to Lyumjev which works more quickly and has a shorter 'half life'. This has helped. Finally, is there any way you can start using a closed-loop system? If you can I'd highly recommend it, it takes some/alot of the stress away.

 

[moby1234]

I normally drink wine. I do not inject
when drinking alcohol. I am type 1 for more than 40 years.

 

[Dcooperxyz]

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?

This is a subject i jave a great deal of experience with. The first problem is that all beer/ larger are very different, and its not easy always to find out how many carbs are in your favourite tipple. I can say that the lowest carb draft beer ive found is Carling at 6 g per pint roughly and interestingly a similar larger like fosters is double and real Ale even more. Anyway,my way of dealing with beer is pre bolus at least half an hour before as all beer spikes me really really quickly. Plan ahead but if you are gonna have a lot of beer/ alcohol eat something before u go to bed as the alcohol will lower your bg during the night because the liver is dealing with the alcohol and doesn’t kick out glucose as it normally would.

 

[Stewart McConnell]

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

interesting you tube vid ta.

 

[Steve 007]

I like beer around and above 5% - carb count in carbs and calories app is 17g-18g and that’s what I work to, does it work?, can honestly say it varies - some nights all in the green, other nights higher, never really low though. If eating, I factor in 2pints into food intake and jab once. RobertJ I think the best thing to do is contact your GP or diabetic team, and, in the name of research, get an open repeat prescription for beer - I’m happy to assist and support you in your trials, purely for science monitoring purposes

 

[rsvines]

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?

The most reliable method I've found over the years is to stick to pilsners wherever possible, but it's still hit & miss a lot of the time and hugely dependent on what I've eaten & how active I've been. I've found the 'drink something else' argument even more traitorous when I'm out. Clear spirits & a diet mixer are great, until you're accidentally given one or two with regular coke, then your on a correction/overcorrection rollercoaster for 3 to 4 hours.

Not a solution, I know, just my experience. If & when I drink, I just take it as an isolated experience. Test far more regularly & manage accordingly.