Diabetes Edutool: Tutorial 5

The effect of alcohol on blood glucose

Excess glucose from the blood is stored in the liver

This glucose is then gradually released during the day for energy as needed

When the blood glucose level tends to fall, the liver releases more glucose

This helps to prevent low blood glucose, for example when we sleep

When we drink alcohol, it lowers our liver’s counterregulation ability

The risk for low blood glucose then increases, as the liver cannot prevent it

Let’s use the Edutool to explain how this works

The liver will release glucose when the blood glucose is low

Maximum amount of normally

available from liver

When alcohol is consumed, the liver’s counterregulation ability is reduced

Reduced amount of available from liver in the presence of

alcohol

Let’s use an example

• Arnold goes to a party, and has 2 light, low-

calorie beers

• He goes home and sleeps

• While he sleeps, his body requires glucose

• His liver cannot make enough glucose,

• and he goes into a “hypo”

Arnold starts with a blood glucose in the normal range

Normal blood glucose of 5 mmol/L

At the party he has 2 light beers

After the beers, the liver’s counterregulation ability has reduced

Reduced amount of available

from liver

The beers did not contain any

His blood glucose is still

normal

During sleep, the body uses energy to sustain life (Sleep ≈ “exercise attempted”)

≈ 1.5 /hour

Arnold goes to bed and sleeps for 8 hours; this requires 13

His liver cannot release the energy required by the body

Maximum amount of available

from liver

Arnold’s blood glucose is now dangerously low

He experiences a hypo

This can be avoided by eating a small snack before going to bed

If Arnold had consumed 4 before going to sleep, his waking blood glucose would be normal

Normal blood glucose of 5 mmol/L

Lessons:

- The liver helps to counteract low blood glucose

- There is a limit to the liver’s counteracting ability

- Alcohol reduces the liver’s counterregulation ability

- When you have consumed alcohol, eat a snack before going to bed

-- End of Tutorial 5 --