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Last Updated on September 21, 2023 by Randy Withers, LCMHC
In healthcare, the term co-morbidity refers to the simultaneous presentation of two or more medical conditions. The implication is often that these problems are somehow related. In this article, we’re going to talk about the co-morbidity of alcoholism and diabetes, with an emphasis on how the former affects the latter.
Excessive alcohol use or chronic alcoholism may cause inflammation of the pancreas. It impairs the ability to secrete insulin, potentially leading to diabetes when this occurs.
Diabetes is a chronic medical condition. Unfortunately, it is common for alcoholics to have diabetes or have developed the disease during their addiction. In other words, alcoholism and diabetes often share co-morbidity.
Overall, alcohol has a significant effect on blood sugar levels. Here is why there is an increased risk associated with alcohol abuse.
The Correlation Between Alcoholism and Diabetes
The National Institute of Diabetes and Digestive and Kidney Disease states an estimated 34.2 million people have diabetes, 10.5% of the U.S. population.
Kidney disease is just one of many consequences associated with excessive alcohol use. The 2020 National Survey on Drug Use and Health states that 22% of people aged 12 and older are binge alcohol users, while 6.4% are heavy alcohol users. Roughly over 10% had a past-year alcohol use disorder.
Research published in Diabetes Care indicates the following:
- Moderate alcohol consumption may decrease a person’s risk of developing type 2 diabetes.
- Excessive alcohol consumption increased the risk of developing the condition in women who were lean.
- Alcohol interferes with the body’s sensitivity to insulin.
Moreover, chronic or heavy drinking disrupts various metabolic processes within the body. It could in itself be a risk factor for developing type 2 diabetes. Heavy alcohol use leads to impaired glucose tolerance—impaired secretion of insulin, and reduced insulin sensitivity or resistance.
Risks of Alcohol Use for Diabetics
Being diabetic and drinking alcohol can make controlling your blood sugar more difficult.
People with diabetes develop dangerously high blood sugar when consuming alcohol. In addition, diabetics who are undernourished develop dangerously low blood sugar levels.
Drinking alcohol also increases the risk for other diabetes-related health conditions, such as severe cardiovascular and neurological issues.
The American Diabetes Association states the biggest concern is hypoglycemia (low blood sugar). Alcohol and the combination of diabetes medication like insulin and sulfonylureas result in low blood sugar.
The liver metabolizes the alcohol first over maintaining blood sugar, which leads to hypoglycemia.
What are the Health Risks While Diabetic?
Alcohol use among diabetics and non-diabetics is common. Unfortunately, heavy and binge alcohol use is also common.
Numerous studies have shown alcohol’s effects on controlling blood sugar levels in people with diabetes. Yet, research has also shown that the effects differ and are based on:
- Whether alcohol consumption occurs when a person has just eaten, and blood sugar levels are high, or
- The person has not eaten for several hours, and blood sugar levels are relatively low.
The following are some of the health complications caused by alcohol among diabetics:
Diabetic Ketoacidosis—The problem primarily occurs in diabetics. It is characterized by excessive levels of certain acids called ketone bodies in the blood. Heavy alcohol consumption causes this problem in both diabetics and non-diabetics.
Alterations of Lipid Metabolism—Alcohol consumption exacerbates diabetes-related lipid abnormalities. Studies have shown heavy drinking can alter lipid levels even in non-diabetics.
Cardiovascular Disease—One of the leading causes of death in America and a leading cause of death in people with type 2 diabetes.
Diabetic Eye Disease—Heavy alcohol consumption may increase a person’s risk of developing this disease.
The Harsh Reality of Alcoholism
Alcoholism is a significant public health problem. It is the third leading preventable cause of death in the United States. An estimated 68,000 men and 27,000 women die from alcohol-related causes annually.
Alcohol contributes to roughly 18% of emergency department visits and 22% of overdose deaths related to opioids. In addition, it contributes to overwhelming mental health problems.
Statistically, someone with an alcohol use disorder is more likely to seek care from a primary care physician for an alcohol-related medical problem rather than for drinking too much alcohol.
Unfortunately, diabetes and alcoholism can go undiagnosed until it is too late.
About one in five people with diabetes do not know they have it. Men are three times as likely as women to die as a consequence of alcohol abuse. Overall, Americans lose over 2.7 million years of potential life due to excessive drinking.
Early intervention is critical at this stage as severe alcoholism would also create co-occurring disorders such as anxiety or depression. It can often be challenging to diagnose co-occurring conditions as the symptoms are much of the same.
Alcoholism Worsens Mental Health Among Diabetics
Living with diabetes can create problems with anxiety and depression. Adding alcohol abuse into the mix makes these issues much worse.
According to the CDC, people with diabetes are two to three times more likely to have depression than people without diabetes.
Moreover, anxiety and stress become constant. Individuals with diabetes often become discouraged, worried, frustrated, and stressed from dealing with their condition daily. Alcohol becomes an unhealthy way of coping.
Alcohol is a severe depressant. Someone already struggling with depression is adding to their problem with alcohol abuse.
The rehabilitation process would involve a dual-diagnosis program addressing alcoholism and other disorders.
Diabetes and Illicit Drug Use
It is not uncommon for alcoholics to abuse other drugs, such as illicit street drugs or prescription narcotics. Unfortunately, research has shown that illegal drug use speeds along the onset of type 2 diabetes. It is also associated with decreased insulin sensitivity.
Overall, illicit drugs also increase the risk of severe mental health issues and other health complications. Most recreation drugs affect blood glucose control. Yet, the effects are not as well documented as with alcohol and tobacco.
It becomes a deadly mix for someone with diabetes when a mixture of alcohol and illicit or licit drugs is misused.
Rehabilitation for Patients Struggling with Alcoholism and Diabetes
The combination of alcoholism and diabetes is problematic for anyone who continually monitors their blood glucose levels. Alcohol abuse contributes to an unhealthy lifestyle.
However, integrated treatment programs exist for comorbid diabetes and alcoholism. Treatment approaches are specific and include some of the following:
- Medication management
- Medical monitoring
- Nutritional planning
- Counseling and therapy
- Exercise and fitness regiments
- Recovery and aftercare support
Ideally, finding the proper help is crucial, and programs should specialize in co-occurring medical problems. For example, this includes inpatient and outpatient resources. Alcohol use has been identified as a barrier to diabetes self-care adherence, making this an essential part of rehabilitation.