Diabetes type 2 and alcohol

For people who have diabetes type 2, and have had to learn about sugar control, glycemic index, insulin, insulin sensitivity, there is a lot of worry about what does alcohol intake mean for those who suffer from diabetes ? There are so many conflicting trends with alcohol -
- Supposedly, alcohol in small quantities is helpful, especially drinks such as wine
- If you are drinking alcohol, then drinking a small amount of alcohol on a regular basis has positive effects on the chance of getting heart attacks, strokes, etc.
- Drinking beer (along with the associated fast food, chips, etc) can be bad for your health because of the calorific intake of food that is not healthy
- Drinking more than moderate amounts of alcohol on a regular basis (especially binge drinking) is harmful

This complicates life for diabetics, who need to figure out whether they can drink harmful. So, is there a simple answer ? Well, guess you expected it - No. The simple answer is that it depends on what your complications are from diabetes; so if you are getting your diabetes checked on a regular basis with a doctor, questions about alcohol intake should be checked with a doctor. Below are some generic notes on the subject to help your awareness level.

- Drinking moderate amounts of alcohol (such as wine, or hard drinks such as whiskey, rum, vodka, etc) is fine. In fact, small quantities of alcohol on a regular basis can help in terms of decreased risk for coronary disease, strokes, and help with insulin sensitivity. However, keep in mind that there is right now not much in terms of cause and effect medical studies to explain this; these conclusions are based on doing statistical analysis on a large number of patients (in the above case, moderate means 2 12oz amounts of beer, or 2 pegs of hard alcohol)
- Drinking larger amounts of alcohol on a regular basis is harmful
- Because the liver helps in generating glucose if blood sugar levels drop, this helps in preventing low blood sugar levels. However, with alcohol in the body, the liver treats this alcohol as a toxin and switches to cleaning the blood as a top priority. This means that if the blood sugar level drops, the liver will not help, and this increases the change of ending up with low levels of blood sugar. If you are drinking, make sure that you are not doing this on an empty stomach, and it may help to actually consume a light snack before going to sleep.
- Exercise helps in reducing blood sugar, so if you are going in for heavy exercise, followed by some time at the club consuming some type of alcohol, you could be risking low levels of blood sugar (since in both cases, you blood sugar level would drop)
- When you drink, especially something like beer (which is mostly empty calories), and you are trying to lose weight, you are actually under-cutting your weight reduction efforts
- When people drink stuff other than beer or wine, they usually add something to their drink (this could be a soda to the drink, or a cocktail), then unless you are adding a diet drink, you could be actually consuming a fair amount of sugar that you don't even think about
- Heavy drinking has bad effects on your liver, and decreases the effectiveness of the liver in being able to pump glucose into your blood stream when the blood sugar level decreases
- In some cases, alcohol should not be drunk at all
A) When you are having nerve damage due to diabetes; in such cases the alcohol attacks the nerves causing more pain and damage. This is not related to high levels of drinking, and happens even when you are drinking moderately
B) If you have eye damage due to diabetes, reduce the alcohol intake, or cut it out altogether
C) For diabetics, there is a worry about a type of fat in the blood called triglyceride. These need to be under control, but for a number of diabetics, this is not the case. Alcohol intake causes more problems with triglyceride; hence alcohol intake should be cut or stopped.
D) If you have high blood pressure, then reduce or cut the alcohol intake.

Diabetic Retinopathy - Eye disease

Diabetic retinopathy is a complication common in uncontrolled diabetes and a leading cause of blindness. It occurs when diabetes damages the tiny blood vessels inside the retina, the light-sensitive tissue at the back of the eye. Given that a healthy retina is necessary for good vision, damage to the blood vessels will affect your eyesight. At first you may notice no changes to your vision. But over time, diabetic retinopathy can get worse and cause vision loss. Diabetic retinopathy usually affects both eyes. All people with diabetes—both type 1 and type 2—are at risk. That's why everyone with diabetes should get a comprehensive dilated eye exam at least once a year.



Diabetic retinopathy has four stages:
1. Mild Nonproliferative Retinopathy. At this earliest stage, microaneurysms occur. They are small areas of balloon-like swelling in the retina's tiny blood vessels.
2. Moderate Nonproliferative Retinopathy. As the disease progresses, some blood vessels that nourish the retina are blocked.
3. Severe Nonproliferative Retinopathy. Many more blood vessels are blocked, depriving several areas of the retina with their blood supply. These areas of the retina send signals to the body to grow new blood vessels for nourishment.
4. Proliferative Retinopathy. At this advanced stage, the signals sent by the retina for nourishment trigger the growth of new blood vessels. These new blood vessels are abnormal and fragile. They grow along the retina and along the surface of the clear, vitreous gel that fills the inside of the eye. By themselves, these blood vessels do not cause symptoms or vision loss. However, they have thin, fragile walls. If they leak blood, severe vision loss and even blindness can result.




Signs and Symptoms
The affect of diabetic retinopathy on vision varies widely, depending on the stage of the disease.
* Blurred vision (this is often linked to blood sugar levels
* Floaters and flashes
* Sudden loss of vision
What are the symptoms of proliferative retinopathy if bleeding occurs?
At first, you will see a few specks of blood, or spots, "floating" in your vision. If spots occur, see your eye care professional as soon as possible.

How does diabetic retinopathy cause vision loss?
1. Fragile, abnormal blood vessels can develop and leak blood into the center of the eye, blurring vision. This is proliferative retinopathy and is the fourth and most advanced stage of the disease.
2. Fluid can leak into the center of the macula, the part of the eye where sharp, straight-ahead vision occurs. The fluid makes the macula swell, blurring vision. This condition is called macular edema. It can occur at any stage of diabetic retinopathy, although it is more likely to occur as the disease progresses.

How is diabetic retinopathy treated?
During the first three stages of diabetic retinopathy, no treatment is needed, unless you have macular edema. To prevent progression of diabetic retinopathy, people with diabetes should control their levels of blood sugar, blood pressure, and blood cholesterol.
Proliferative retinopathy is treated with laser surgery. This procedure is called scatter laser treatment. Scatter laser treatment helps to shrink the abnormal blood vessels. Scatter laser treatment works better before the fragile, new blood vessels have started to bleed. That is why it is important to have regular, comprehensive dilated eye exams. The doctor places 1,000 to 2,000 laser burns in the areas of the retina away from the macula, causing the abnormal blood vessels to shrink. Because a high number of laser burns are necessary, two or more sessions usually are required to complete treatment.

How is a macular edema treated?
Macular edema is treated with laser surgery. This procedure is called focal laser treatment. Your doctor places up to several hundred small laser burns in the areas of retinal leakage surrounding the macula. These burns slow the leakage of fluid and reduce the amount of fluid in the retina. The surgery is usually completed in one session. Further treatment may be needed.

What can be done if somebody has already lost some vision from diabetic retinopathy?
An eye care professional about low vision services and devices that may help you make the most of your remaining vision.

NOTE : Visit your eye doctor frequently. Do not wait for symptoms to occur.