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How does alcohol lead to a hypo? - Anonymous Question

Alcohol is a toxin and when we drink it it has to be removed from our systems and our livers do this job at roughly the rate of one unit of alcohol per hour. So ten units of alcohol will take roughly ten hours to be detoxed by the liver.

Once our livers get filled with alcohol it stops its other more important job of regulating glucose in our blood whilst it deals with the alcohol.

This can cause a drop in bg levels which can lead to a hypo, best advice seems to be to eat some long acting carbs either whilst drinking if a long session or afterwards before sleeping this should help to keep bg levels above hypo territory.
 
Insulin acts to help glucose into cells but it's presence also acts to stop too much glucose being released from the liver. The diagram on this link helps to explain what insulin does.
http://biomed.brown.edu/Courses/BI108/B ... ucagon.htm

As you can see the liver plays an important role in releasing glucose when needed and insulin helps to control this release. It can also manufacture 'glucose'.
There are several possible problems that can lead to hypos, all to do with the liver.

1)Alcohol is metabolised in the liver. You can process about 1u an hour. Whilst this is going on the liver doesn't make any glucose .This may be a problem If someone hasn't been eating for a while (or has exercised) as their stores of glucose may be very low this applies to non Ds as well and malnourished alcoholics can suffer from hypos
2) Alcohol makes the liver more sensitive to insulin ie you need less. If you have too much injected insulin present it may act to prevent the release of glucose.
3) The mechanism that releases glucose at very low blood glucose levels may also not work well in people with T1.
4) The behaviour altering effects of too much alcohol can also cause a person to be unaware of their normal hypo feelings and so not treat in good time to prevent glucose falling further.
5) There is an increased risk of hypos the next day; probably because glucose reserves have been used up and not fully replaced.

Sounds dreadful but basically it means that you have to take care, drink moderately and try to eat something whilst drinking.
 
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