Highs at night- alcohol related

Hi there- I notice when I drink alcohol my sugar sky rockets at night and seriously no matter how much insulin I take, it doesn’t lower- typically I am really reactive to insulin- if I took the amounts during the day I take at night to try and lower these highs, I’d be in a hypo coma- what is going on? I hate knowing my sugar was over 300 all night for hours. :fearful:

@Mlp1124 hi Michelle, alcohol interferes with your liver. To be overly simple, while your liver processes alcohol, sugar is stored, when it’s done with the booze, (probably 1hour per ounce of ethanol) then it dumps sugar.

Normals experience this as just waking up at 2:30 am, a bunch of sugar hitting your blood tends to wake you up. We (T1’s) experience it as delayed high blood sugar. If you are very sensitive to this you should probably avoid alcohol after 6pm. A newer pump with closed loop may help, if it works right (a mad-sized if).

You have to be open to experiment and be open to intake modifications, especially if this is (and it sounds like) a pronounced effect. One starting strategy is to set an alarm for 1-2 am to test and to bolus for a correction if needed.

Good luck

Hi Michelle @Mlp1124, based on my lifestyle back when, 50 or 60 years ago, I probably experienced the sky-rocketing BS levels that you are experiencing but I didn’t really know because CGMs and BG meters hadn’t yet been invented. So this is only a theoretical solution extending what @Joe said.

If you are using a pump [even an old one and not one of the new “smart” pumps], I suggest that you add and use a “Party” profile or pattern that has significantly higher basal rates for times like 10 PM until 5 AM - you will need to experiment. An alternative with the pump is to put in a temporary basal of something greater than 100% for late-evening and early morning hours; say 175% for 6 hours beginning at 10:30 PM.

Being a cautious old guy having learned the “hard way”, add the increased insulin carefully over time and find what YOUR body tolerates and be extra cautious if you will be alone.

Thanks and it’s funny you say because I woke up at 2:35 am- my issue is I don’t wear a pump and when I give that extra dose it does literally nothing. I also appreciate your response as normally people say well don’t drink- I am fairly young and enjoy going out and having some drinks. Appreciate the advice.

Thanks for the response as well- I can always count on you two! I don’t wear a pump and when I do the extra dose nothing happens. I know drinking is unhealthy to begin with but I do I’m occasion enjoy a night out I just feel super unhealthy when my sugar gets so out of control for hours. Thanks for the advice and not the simple “don’t drink.” Maybe I’ll try to extra dose before I go to bed I just get nervous if I do too much I don’t want to be hypo and go into a deep sleep.

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It’s really interesting to see how different people have different reactions to alcohol. I drink alcohol occasionally, but, my experience is that it causes my BG to go down. So much, in fact, that I have to let mine be a little high and eat carbs with protein, before I drink it. Even then, it’ll often go low. I will normally awake during the night to a low, even if I’m okay when I go to bed. I really rely on my CGM for times like this.

Hi Michelle. May I ask what you are drinking your alcohol with? For me, it’s not the alcohol that raises my blood sugar, it’s the mix used. I’ve been a Type 1 for 40+ years and used to drink vodka and 7-up or vodka and cranberry. It was the pop/juice that raised my sugars. As another responder said in this stream, alcohol itself actually lowers your blood sugar because the liver, which produces sugar, is a dumb organ and can only do one thing at a time. If it’s processing alcohol, it’s not making sugar. My endo’s advice back then was to be sure to eat when I’m drinking. (BTW This is the first doctor I found in my 20’s who didn’t tell me to not drink!) Maybe change what you’re mixing it with and see if that helps?

PS I strongly suggest getting on a pump! Take it from someone who started out taking a single shot of time-released insulin back in the day to taking 4 shots of mixed short-acting and time-released on a sliding scale while I was pregnant. The pump is a life-changer!

This is something I know quite a bit about.

When I was younger like you I liked to drink too. And did frequently.

It just caused me too many problems like you are experiencing. I would usually drink beer. My BS would not rise much while drinking. I would not take as much insulin at night and have a big snack. This would keep my BS up so that when the inevitable crash happened I had a cushion. I would then also be prone to lows for the next 24 - 48 hours after. And they were the freaky ones.

I tried for years to figure out how to handle it but never really came with a fool proof system. Finally I gave it up. It was just too much of a hassle to handle with T1D.

I know this is probably not what you want to hear, but it’s just one diabetics experience.

I don’t know where you live, but in my state, marijuana is legal and doesn’t cause ANY of these problems. I’m not trying to advocate it, but when I do it I have no BS problems as I did with alcohol.

What worked for me in regards to alcohol was just don’t.

Hey thanks for the reply! I actually only drink champagne or vodka and seltzer. No juice no mixers no nothing. I think it is what I eat when I drink that raises my sugar idk. I don’t drink all the time and even when I don’t I am noticing a pattern of spikes every night. I have to take a few short acting units on top of my long acting. Strange :woman_shrugging:t2:

Michelle Pacione

Actually Michelle @Mlp1124 it really isn’t strange that you BG might spike during the night and that you may need to take a couple of units of short-acting insulin along with your background insulin.
I don’t know the time of your evening meal, or if you might snack during the evening, but depending on the types of foods you eat there could very well be a delayed release of the glucose content - I experience this after having eaten a really awesome pizza loaded with cheese.
The human body is not an android that follows a set pattern, and there really isn’t a standard operating manual; you are really doing what each of us blessed with diabetes must do. You are being observant, able to recognize how your body reacts to foods and insulin and taking action to best manage your diabetes. Great Work!

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Thank you! That is a good point I am not a snacked but we do eat dinner a bit later so it may catch up to me later on.

Michelle Pacione

Thanks so much I appreciate the feedback. I’m from NY honestly not sure it’s legal here. Medically yes but recreationally, I don’t believe so. can totally understand why you stay away from alcohol— it’s a blood sugar battle :tired_face:

Michelle Pacione

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I drink as well as being T1D. I have a cgm and that helps a lot! What I have found is that certain flavored drinks make me go high. For a short time. Hour or two. Tried a butter nut moonshine and went up about 100 pts. But I don’t often drink liquors. Bourbon doesn’t really affect me. Slight rise maybe 20-30 pts.
Beer however, my normal, mixed bag of effects. Dark beers make BS go up. I’ll hit 175 or so for an hour or two, then drop to my normal somewhere around 100-120. Lighter beers (color), usually up about 50 pts. But in all cases, I eat a meal too. But if I have 3 or 4 beers in say a 5 hour period, I go listen to local bands, before I leave I most often have to eat or I’m headed for a low. So I eat before bed and no issues with drops, but a little weight gain is there with this.
But the most interesting fact is this for the next 3-4 days, my BS stay really easily regulated. Why, go figure!
Most important of all this is do what your doing, continue to be observant of your reactions when you do drink. Knowing what your body does is probably the most important part.
Hope it helps

Hi @Mlp1124. Are you checking for ketones and clearing them from your urine? If I’m running ketones; or if I’m over 300 (your number may be different) and am not able to check for them - I find that no amount of insulin will start bringing my numbers down until I’ve started clearing any possible ketones out of my body. Even one or two glasses of water helps start the process for me, although it may take a while to get back in or near my normal range.

Nut butter moonshine? I’m intrigued!

It’s a moonshine made by the guys from the tv show Moonshuners. It’s put out by Sugarland Distillers. Mark from the show had some samples of new flavors that they were developing and I got to try some. He lives near where I do. It’s a different flavor to be honest. But two shots of it sent my BS way high. Over 200 if I remember right.
As I said it’s all about learning how your body reacts to foods, drinks etc. Then how you react to the changes. For me I will drop naturally within an hour or two. So I don’t bolts for that. Now getting a cold and being on antibiotics is a whole mother story. Prednisone puts me up around 250 and I stay there for days. No matter what insulin level I give myself. Scary cause I was afraid to give too much fast acting to bring it down. After a week, I started to react normally, but at higher doses of insulin on a regular basis.
Way different for me! But it’s all about how our bodies react to chemical input. I say it that way because everything we eat or drink is a chemical reaction sooner or later. It’s how our bodies react to the chemical changes due to those influences that we have to be aware of. In a way, I think being T1D is more like being a grand chemistry experiment. If I do this I get this reaction or I do this and I get that reaction. Up to me to drive the experiment in the right direction for the expected reaction. Of course being such a complex machine, our bodies, always react just a little bit differently every time. I’m always amazed at what happens. Never a predictable reaction always random. Hardly ever repeatable and of course, completely different from person to person. Just like results in chemistry class back in High School! When you were learning how to make reactions work. Wildly unpredictable results.
Just my thoughts on a very complex issue. Hope it helps

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Ah, a local beverage! Enjoy.

Yeah. Generally you can look up carb values for foods and beverages - and even if your body reacts a bit more strongly to something (you consistently need more or less insulin for the serving than the carbs indicate), at least you can tweak what you need to take for it with some practice. My husband makes ginger juice, but it’s never the same twice so it’s definitely an experiment to adjust for it, which I imagine it’s the same with “moonshine.”

Well for me “ everything” does that. Always a little different, always a new reaction to a food, a drink, I swear the Air!:-).
I’ve taken the time to kinda test foods because of this. See most people basically react the same to…(fill in the name), but me, I don’t.
Can eat exact same meals, three days in a row, nothing different. Each day different result to the same amount of insulin. It’s a real PITA. Because I never know what’s gonna happen. Makes life exciting to say the least. Don’t get me wrong now. I stay well managed, at least according to Drs. I usually stay in range 90% of the time. My numbers till last year never were higher than 5.9. However, I increased to 6.2 on purpose. So I can try and sleep thru the night. Problem was if I didn’t drop, I wouldn’t sleep more than 2-3 hrs at a time. But if I had a beer or two. Slept 3-4. But middle of night bathroom runs cause of having a beer or two woke me up. Then no sleep for a couple of hours. Then exhaustion kicked in 2-3 hrs of sleep. Few hrs awake, then sleep. No way to live and do anything. Exhausted all the time. So I increased the A1C a few tenths and I’m mostly getting 6 straight hours of sleep.
Overall, life little better, I sorta can join the real world. Not a walking zombie anymore.
So I’ve had to learn to eat, sleep and drink all over again! Special!!:-).
Stuff like that happen to you? Mostly I stay way out in left field with reactions to everything, so it’s difficult to be part of “life”.

Wow, I’m amazed you can keep your A1C so good given the unpredictability of your responses! I run in the mid 7s and am looking forward to Tandem’s control IQ in a few weeks. 6.2 is still excellent as fast as I’m concerned - especially if it gives you peace of mind as you sleep.
Keep up the good work (and work it is), and stay well.