 Hello everyone, this is Dr. Ahmet Ergen. I am an endocrinologist and today I am going to talk to you about alcohol and diabetes. Let's get started. Alright, before we get started guys, please subscribe. If you like this video, give it a thumbs up and remember to share. Can you really drink alcohol if you have diabetes? I'm gonna tell you how to do this right. If you have a habit or if you have a social habit, it's okay sometimes and how it is okay will just get on it right now. So, I'll tell you a couple quick guidelines guys. If you listen to this, you will never get into trouble. Now, if you're an endocrinologist, this is how you do it. You have diabetes and you want to have a couple of drinks with your friends. Just limited to two drinks total. Okay, if you are really having fun, I'll give you one more. Okay, so, and always have that drink with a meal and try to avoid this high carb or carb-y cocktails. Why is that? I mean, think about this. You have diabetes and if they are putting a bunch of orange juice and a little bit of vodka in it, you're gonna have problems, right? So, vodka is not gonna really do anything too much if you're just having two drinks, but orange juice can spot your blood sugar immediately. Now, on the other hand, if you're having a relatively, let's say you're having a diet sprite with some vodka, you know, let's say New York diet sprite and some vodka here. That will be fine because actually studies show that a moderate drinking, like two drinks with your meal, can actually reduce your fasting blood sugars and can actually reduce your insulin levels and insulin resistance. Hmm, isn't that surprising? It's all about how much you are drinking and how you're drinking it. So, if you are not having a lot of sugar when you drink alcohol and you're limiting your alcohol to two drinks and maximum three drinks, especially for women, I wouldn't exceed two because they're less tolerant to alcohol. Men generally can't have one or two more drinks, but two to three is pretty much max, okay? Now, why is that? Now, the alcohol can actually help the insulin resistance at a low level, but then you increase the alcohol consumption. We call this acute alcohol consumption. And if you go crazy and drink like 10 to 16 drinks in one night, what you're doing there is basically you are paralyzing your liver. Your alcohol is very toxic to your liver. So what happens is, and if you didn't really eat well and you kept drinking, what's going to happen is the next morning, normal people like use their liver to keep having some glucose in their system because the glucose that comes with the food pretty much disappears within three to four hours. And then after that, you are relying on your liver to give you some glucose from the storage, right? But if you are locking the door of the storage, then even if your blood sugar is going down, there will be no sugar coming out of your liver because of this acute toxicity. And this becomes a real problem if you're just on a diabetic pill or something, that may not be a big problem. But if you're on a sulfonylurea, such as glupazide, glibri, glupri, that increases your insulin levels, or if you're on just purely on insulin, like a lung-acting insulin, so what does the insulin do? Remember, when you take insulin or any medication that chronically increases your insulin level like sulfonylurea drugs, if they increase your insulin level, and that insulin level will basically reduce the sugar coming out of your liver, okay? So your liver will not release that sugar when you have too much insulin in your body. And then you drink excessive alcohol, and you shut down your liver even more, then there will be really nothing coming out of your liver. And after three, four hours, there is no sugar from the food either. Then what are you left with? Then you may have like a severe low blood sugar, and it may be difficult to recover. Now, we're talking about type 2 diabetes here, but type 2, type 1 diabetes actually patients with type 1 diabetes are at greater risk. Why? Because they don't even have a hormone called glucagon, especially if they haven't diabetic for a while. Which is the hormone that tells your liver to make sugar, to make glucose. So think about this. And then if you're a type 1 diabetic, your insulin, you know that, you have to be. And your insulin, and insulin reduces the sugar that comes from your liver. And alcohol stops your liver from making sugar. Plus, you don't even have a messenger. You don't even have a hormone to tell your liver to make sugar. Then you're basically negative. You can go in a hyperbolicemic coma, low blood sugar coma, if you drink a lot. Now again, the drinking 1 to 2 alcoholic drink is not necessarily going to put you in coma. Okay, that's okay as I said, even for type 1 diabetics, if you're drinking 1 or 2 drinks. And type 1 diabetics are a little bit different. So every type 1 diabetics is a little bit different. Some type 1 diabetics are more insulin resistant than the others. So the more insulin resistant you are, the luckier you are when it comes to low blood sugar potential. But if you're a brutal diabetic, if you tend to go low very easily, then I would be very careful. Even if I had only 2 drinks, I would be constantly watching my blood sugars to make sure. Now the problem is, with the alcohol, if you're going to a bar, if you're going to a place and you start drinking, yeah, you start with 1, you'll go there and say, oh, I'll just have 1. And the next thing you know, you'll go for 2, then a 3, then a 4, then you open your eyes and here you are. So that's not, if you don't think that you have a really good willpower and if you have type 1 diabetics, I would not step into a bar. If you're in a restaurant, you ask for a glass of wine, fine, you'll be okay. Glass of wine is not really going to drop your blood sugar. Another thing that you have to, before we close, another thing you have to be monitoring is alcoholic ketoacidosis. So alcohol, when it shuts down your liver, your body starts turning the wheel for the fatty acids and ketosis can develop. That can happen for both type 1 and type 2. Typically it happens with the excessive alcohol consumption and it can definitely put you in the hospital. And if you're in metformin, definitely that is something you have to pay attention because metformin doesn't necessarily increase your risk of going into metabolic acidosis or ketoacidosis unless you have risk factors. But if you combine metformin and excessive alcohol drinking, you are basically multiplying risk factors, which may not be the best idea. The bottom line for pretty much everybody, avoid excessive drinking. One to two drinks if you want to drink is the way to go. See you in the next video.