Levemir & alcohol - is it a problem?

I was only ever on levemir for 8 weeks but can't say I noticed it dropping my bg; in answer to your question only you can decide if a few drinks are worth the low's later on, the only solution if you do decide to stay on levemir is to eat some slow-acting when you do drink alcohol.

Hey Mon!

I switched to Levemir from Insuman Basal about a year ago. Levemir certainly drops my BG several hours after drinking wine. If I know I'm going to drink I drop my evening Levemir by 1 unit. If not, I eat something before bed and set the alarm to test between 2 and 3 in the morning. My BGs are very unpredictable overnight, so the Levemir might not be entirely to blame, but I didn't have this problem with Insuman.

Actually, my BGs are suppressed most of the following day, so I reduce my Apidra doses the following day as well. For this reaso, I never have a drink if I have to drive the following day. So yes, you can drink, but be sensible about it.

Smidge

Re: Levemir & alcohol - is it a problem?

I know I keep preaching about not drinking if you're diabetic but it's up to you if you think the lows and rebound highs are worth it. My BS drops to just LO on the meter and up to nearly 20 after drinking and I don't even take any medication. You are literally poisoning yourself and your liver is too busy rectifying that to watch blood sugar. I like the taste of booze, Im sure you do too but think about what could happen. Too many times my t1 friend has passed out drunk and ended up in DKA later. i feel like I've been hit by a truck after an alcohol-induced hypo without having EVER been drunk in my life (and I'm a college student) a glass or two of wine is enough to screw things up. It's up to you what you want to do...


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LittleWolf said:

I know I keep preaching about not drinking if you're diabetic but it's up to you if you think the lows and rebound highs are worth it. My BS drops to just LO on the meter and up to nearly 20 after drinking and I don't even take any medication. You are literally poisoning yourself and your liver is too busy rectifying that to watch blood sugar. I like the taste of booze, Im sure you do too but think about what could happen. Too many times my t1 friend has passed out drunk and ended up in DKA later. i feel like I've been hit by a truck after an alcohol-induced hypo without having EVER been drunk in my life (and I'm a college student) a glass or two of wine is enough to screw things up. It's up to you what you want to do...


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I'm in France and wine is even part of the dinner menu when in hospital. (my dietitian just pointed out that it was a poor quality wine!) I have just finished dinner accompanied by a couple of glasses of red wine. I will not get drunk, I will not have a rebound high.
Some people are indeed adversely affected by alcohol and need to be aware of his. I also know that when I had very high glucose levels before diagnosis then I reacted to alcohol in the same way that I did when I was 14 years old (ie couldn't tolerate it) Some people also have a genetic heritage that means that they are less alcohol tolerant than others.
I would never advocate drinking alcohol in excess but I see nothing problematic with drinking wine with meals, (you need some carbs)
We all have to be guided by our own results.

Re: Levemir & alcohol - is it a problem?

True, we have to be guided by our own results and we react so differently to foods, medication and even exercise...

It's not about getting drunk though. I never drank often as I didn't see the point, because I appeared to have an abnormal tolerance for it. For a small person, on the rare occasion taut friends would try and get me drunk, or see if I could get drunk, a bottle of wine, 5 or 6 rum and comes an even 85% abv rum didn't do anything to me. Nowadays (Ive been experimenting as my boyfriends family are quite posh, so like drinking wine and whiskey with meals) If I keep an eye on BG I am still totally unimpaired by alcohol but when I test I a see a continual drop and no matter how many sweets or carbs I load it keeps dropping (not far below 4 though) then goes high later. If I don't feed carbs I will just have an actual hypo and go high later.

It was my abnormally high tolerance to alcohol that alerted me to the fact I was NOT drunk after one can of cider, but in fact having a hypo, the first time it happened really bad... Scary. The room was getting dark and spinny and I could barely think straight.

Clearly not everyone reacts this way but yeah, I just want people to know it could happen and there might not be anyone to know the difference between you being drunk and hypo, you might do damage with rebound highs etc. Especially if you live alone and have a drink in the evening. My friend was convinced he knew the ins and outs of his diabetes but still ended up in a bad way more than once. Thank god I got worried and sounded the alarm when he wouldnt pick up the phone.

Not condemning anyone or trying to be a killjoy. Just saying, ethanol is a serious chemical to be putting in your body. It tastes good and to some I feels good, just be aware of all it can do even if you don't binge drink or get drunk ever x

Best of luck xx


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I have Levemir and haven't noticed any real problems with alcohol and BS drop. My BS does drop a bit after a couple of drinks but not a problem. I've not had a hypo since starting insulin 6 months ago and running quite low sugar levels.

I've been on Levemir for three months now and have no issues with alcohol. I tend to have one or two glasses of wine or a beer with dinner mosts nights, one or two nights off a week.

Since being diabetic I've been careful not to get drunk, but have had no lows that I would attribute to alcohol. I'm with Phoenix on this one.

I just want people to know it could happen and there might not be anyone to know the difference between you being drunk and hypo, you might do damage with rebound highs etc

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Actually the problem from too much alcohol, and injected insulin, is that a persons liver won't produce glucose when levels drop too low. Unfortunately in this situation a glucagon injection may not work either. That's why it's good practice to eat some carbs when drinking alcohol.
Going high after a hypo for someone with T1 normally seems to occur from over treating the hypo rather than any 'rebound' effect. *
This piece describes the potential dangers of alcohol but also contains sensible advice including the advice to learn from experience and being proactive about adjusting insulin when drinking ; exactly what the original poster is doing by considering lowering her basal dose.
http://iddt.org/about/living-with-diabe ... d-diabetes

*Do high fasting glucose levels suggest nocturnal hypoglycaemia? The Somogyi effect-more fiction than fact?
http://www.ncbi.nlm.nih.gov/pubmed/23672623

I've been on Levemir for 4 years and I dont drink every night by any means but I have not noticed anything to worry about concerning bg levels with wine and beer. Although if you end up on a binge be wary of a potential hypo the next morning so I agree with the previous poster on that one.

phoenix said:

*Do high fasting glucose levels suggest nocturnal hypoglycaemia? The Somogyi effect-more fiction than fact?
http://www.ncbi.nlm.nih.gov/pubmed/23672623

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Thanks for that article, Phoenix. That's of real interest to me as I have very unpredictable night time levels (even without the wine!) My consultant is adamant that when I wake with high levels (e.g. 13) it means I've gone low overnight and therefore need to reduce the Levemir - I disagree. There are other mornings where I wake with pretty low levels (e.g 4 and below) and my levemir dose was the same. Other times my BG stays static overnight and I wake on exactly the same level I went to bed at. When I've woken and tested in the early hours, it gives a pretty good indication of what the fasting level will be - if it's risen since bed time it will go higher; if it's fallen since bed time it will go lower. Eventually I'll get a loaned continuous glucose monitor attached for a week or two and then I guess we'll see what's happening. Until then, it's all a bit of a mystery and i've no idea if I should be increasing, decreasing or leaving alone the night time Levemir dose!

Smidge

Sorry, we've really gone off topic
Smidge,
I used a continuous monitor to find out what was happening at night. Quite frequently I would wake with low symptoms (particularly sweats) but when I tested found I was I OK; it could have been menopausal sweats or hypos.
I found I did go low on some nights but the level rose again, to a normal, not a high level. ie my liver worked just as it should do. It was quite weird to watch because of the quarter hour time lag on the monitor. It alarmed to say I was low, my finger prick reading would show I was OK and then the monitor would turn to show the upward movement. One night it happened twice and I didn't even wake with the alarm on the second occasion. I was waking with levels in the low 4s
My doctor did ask me to go to bed with slightly higher levels than I had been doing just to be on the safe side.

I understand that some long standing T1s don't have very good alpha cell function and that may be, alcohol apart, why the liver doesn't always kick in. I've noticed that children/young people or those diagnosed when young seem to have more problems with dangerous lows at night .I wonder if that is because their system is less mature at the onset of diabetes It could also be a difference between LADA and 'classic' T1 .(that's just speculation!)