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Drug And Alcohol Use With Diabetes

Drug And Alcohol Use With Diabetes

Comprehensive Guide to Research on Risk, Complications and Treatment Substance abuse is described as the excessive use of a substance such as alcohol or drugs that results in significant clinical impairments as well as the loss of ability to function academically, professionally, and socially [1]. An individual who was healthy before the substance abuse began will typically begin to experience serious health problems over time, but extensive damage may be avoided or reversed if effective substance abuse treatment is received. This is not the case, however, for individuals who have been diagnosed with diabetes, and although this is a manageable disease with proper treatment, substance abuse may cause it to become life-threatening. This guide will discuss, in detail, how substance abuse can negatively impact the life and health of a person with diabetes. Diabetes, also referred to as diabetes mellitus, is a condition in which the body is unable to properly regulate blood sugar levels. There are two forms known as type 1 and type 2 diabetes, but in order to better understand the difference between the two types, the role that insulin plays in the regulation of healthy blood sugar levels will be briefly described. During the digestive process, carbohydrates are broken down into glucose, which is a form of sugar that easily enters the bloodstream and is used by the body for energy. The pancreas normally responds to increasing blood sugar levels by initiating the production of the hormone known as insulin. As insulin levels increase, it signals the transfer of glucose into cells throughout the body and it also ensures that excess glucose will be stored in the liver in order to prevent high blood sugar levels. Type 1 diabetes, which is also called juvenile or insulin dependent Continue reading >>

Diabetic Ketoacidosis

Diabetic Ketoacidosis

Diabetic ketoacidosis (DKA) is an abnormal form of ketosis. It a danger mostly to people with type 1 diabetes, but it can also happen to people with type 2 diabetes under certain circumstances. DKA is is the most common cause of death for people with type 1 diabetes mellitus (T1DM), and the condition is especially dangerous for children with T1DM. Many children end up in the hospital with DKA before receiving a diagnosis of T1DM. The problem begins in the pancreas. The human pancreas secretes insulin, a hormone that helps the body manage blood sugar and fat storage. Without insulin, the body cannot use glucose for fuel in the cells, and fat cannot be stored in the fat cells. This is why one of the symptoms of Type 1 diabetes is unexplained weight loss. Type 1 diabetics develop pancreatic damage which results in a complete lack of insulin production, and as a consequence, their fat cells have no insulin message telling them to keep the fatty acids stored. Without that message from insulin, vast quantities of fatty acids flow out of the fat cells and are broken down in the liver into acetate, acetoacetic acid and D-3-hydroxybutyric acid (ketones). The danger of this kind of ketoacidosis is in the amounts of the ketone bodies being released. Because ketone bodies are slightly acidic in nature, and so many are released at once, they build up in the bloodstream. The sheer volume quickly overwhelms the delicate acid-base buffering system of the blood, and the blood pH drops to become more acidic than normal.The low blood pH (acidosis) is the condition which is dangerous, not the ketones themselves. Ketoacidosis symptoms include: Fruity breath Nausea and vomiting Hyperventilation (deep, rapid breathing) Dehydration Low blood pressure Diabetics can develop this condition if the Continue reading >>

Diabetic Ketoacidosis: Evaluation And Treatment

Diabetic Ketoacidosis: Evaluation And Treatment

Diabetic ketoacidosis is characterized by a serum glucose level greater than 250 mg per dL, a pH less than 7.3, a serum bicarbonate level less than 18 mEq per L, an elevated serum ketone level, and dehydration. Insulin deficiency is the main precipitating factor. Diabetic ketoacidosis can occur in persons of all ages, with 14 percent of cases occurring in persons older than 70 years, 23 percent in persons 51 to 70 years of age, 27 percent in persons 30 to 50 years of age, and 36 percent in persons younger than 30 years. The case fatality rate is 1 to 5 percent. About one-third of all cases are in persons without a history of diabetes mellitus. Common symptoms include polyuria with polydipsia (98 percent), weight loss (81 percent), fatigue (62 percent), dyspnea (57 percent), vomiting (46 percent), preceding febrile illness (40 percent), abdominal pain (32 percent), and polyphagia (23 percent). Measurement of A1C, blood urea nitrogen, creatinine, serum glucose, electrolytes, pH, and serum ketones; complete blood count; urinalysis; electrocardiography; and calculation of anion gap and osmolar gap can differentiate diabetic ketoacidosis from hyperosmolar hyperglycemic state, gastroenteritis, starvation ketosis, and other metabolic syndromes, and can assist in diagnosing comorbid conditions. Appropriate treatment includes administering intravenous fluids and insulin, and monitoring glucose and electrolyte levels. Cerebral edema is a rare but severe complication that occurs predominantly in children. Physicians should recognize the signs of diabetic ketoacidosis for prompt diagnosis, and identify early symptoms to prevent it. Patient education should include information on how to adjust insulin during times of illness and how to monitor glucose and ketone levels, as well as i Continue reading >>

What Is The Difference Between Hyperglycemia And Hypoglycemia?

What Is The Difference Between Hyperglycemia And Hypoglycemia?

By Debra A. Sokol-McKay, MS, CVRT, CDE, CLVT, OTR/L, SCLV What Is Hyperglycemia? In relation to diabetes, hyperglycemia refers to chronically high blood glucose levels. Most medical professionals define hyperglycemia by using the blood glucose goals that you and your physician have established and combining those goals with the blood glucose target ranges set by the American Diabetes Association. It's important to understand that you'll probably experience high blood glucose levels from time to time, despite your best efforts at control. As with any chronic disease, talk with your physician and diabetes care team if the pattern of your blood glucose readings is consistently higher or lower than your blood glucose goals. Complications from Hyperglycemia Persistent hyperglycemia can cause a wide range of chronic complications that affect almost every system in your body. When large blood vessels are affected, it can lead to: Stroke (cerebral vascular disease) Heart attack or Congestive Heart Failure (coronary heart disease) Circulation disorders and possible amputation (peripheral vascular disease) When smaller blood vessels are affected, it can lead to: Kidney disease (nephropathy) Nerve damage (neuropathy) Diabetic eye disease (retinopathy) Joseph Monks: Writer, Producer, and Film Director Joseph Monks, who has diabetic retinopathy, creates and produces films for his production company Sight Unseen Pictures. He is also the first blind filmmaker to direct a feature film. Says Joe, "I'm not uncomfortable with the term 'blind.' I'm not thrilled about it, of course, but it's accurate. The lights went out for me in early 2002 as a result of diabetic retinopathy—the death of my retinas. It is what it is, so when it happened, I decided that I wasn't going to let it put an en Continue reading >>

Metabolic Acidosis - Dka (exam 4)

Metabolic Acidosis - Dka (exam 4)

Transcript of Metabolic Acidosis - DKA (Exam 4) ATI Metabolic Acidosis ATI Client Education - ATI The following are the five classic types of ABG results demonstrating balance and imbalance. ATI Metabolic Acidosis Laboratory Tests and Diagnostic Procedures • To determine the type of imbalance, follow these steps: Metabolic Acidosis - DKA Patient-Centered Care • For all acid-base imbalances, it is imperative to treat the underlying cause. Exam 4 Results from - ›› Excess production of hydrogen ions »»Diabetic ketoacidosis (DKA) »»Lactic acidosis »»Starvation »»Heavy exercise »»Seizure activity »»Fever »»Hypoxia »»Intoxication with ethanol or salicylates ›› Inadequate elimination of hydrogen ions »»Kidney failure ›› Inadequate production of bicarbonate »»Kidney failure »»Pancreatitis »»Liver failure »»Dehydration ›› Excess elimination of bicarbonate »»Diarrhea, ileostomy ›› Vital signs: bradycardia, weak peripheral pulses, hypotension, tachypnea ›› Dysrhythmias ›› Neurological: muscle weakness, hyporeflexia, flaccid paralysis, fatigue, confusion ›› Respiratory: rapid, deep respirations (Kussmaul respirations) ›› Skin: warm, dry, flushed • Step 1: Look at pH. - If less than 7.35, diagnose as acidosis . • Step 2: Look at PaCO2 and HCO3 - simultaneously. Determine which is in the expected reference range. Conclude that the other is the indicator of imbalance. Diagnose less than 22 or greater than 26 HCO3 - as metabolic in origin. Step 3: Combine diagnoses of Steps 1 and 2 to name the type of imbalance. - If greater than 7.45, diagnose as alkalosis. Diagnose less than 35 or greater than 45 PaCO2 as respiratory in origin. Step 4: Evaluate the PaO2 and the SaO2. • If the results are below the expected refe Continue reading >>

Diabetic Emergencies

Diabetic Emergencies

AUTHORS Jeremy Rohrlich, MD, Emergency Medicine Resident, Department of Emergency Medicine, University of Texas Southwestern, Parkland Hospital, Dallas. Richard Williams, DO, Emergency Medicine Resident, Department of Emergency Medicine, University of Texas Southwestern, Parkland Hospital, Dallas. Fernando Benitez, MD, Professor, Department of Emergency Medicine, University of Texas Southwestern, Dallas. Larissa Velez, MD, Program Director and Vice-Chair for Education, Department of Emergency Medicine, University of Texas Southwestern, Dallas. PEER REVIEWER Catherine A. Marco, MD, FACEP, Professor, Emergency Medicine and Surgery, Wright State University, Dayton, OH. Statement of Financial Disclosure To reveal any potential bias in this publication, and in accordance with Accreditation Council for Continuing Medical Education guidelines, we disclose that Dr. Farel (CME question reviewer) owns stock in Johnson & Johnson. Dr. Schneider (editor), Dr. Stapczynski (editor), Ms. Fessler (nurse planner), Dr. Rohrlich (author), Dr. Williams (author), Dr. Benitez (author), Dr. Velez (author), Dr. Marco (peer reviewer), Ms. Mark (executive editor), and Ms. Coplin (executive editor) report no financial relationships with companies related to the field of study covered by this CME activity. EXECUTIVE SUMMARY Suspect diabetic ketoacidosis (DKA) or hyperglycemic hyperosmolar state (HHS) in an ill patient with hyperglycemia. In DKA, the acidosis is prominent. In HHS, volume contraction and hyperosmolality are prominent. DKA treatment sequence is fluids, potassium (if low), and insulin. Identify and treat precipitating causes. Point-of-care glucose testing devices may give false values, especially using capillary blood. In the treatment of an unresponsive hypoglycemic patient, consider Continue reading >>

Peer Reviewers

Peer Reviewers

Pediatric Diabetic Ketoacidosis: An Outpatient Perspective On Evaluation and Management Abstract Diabetic ketoacidosis is a common, serious acute complication in children with diabetes mellitus. Diabetic ketoacidosis can accompany new-onset type 1 diabetes mellitus or it can occur with established type 1 diabetes mellitus during the increased demands of an acute illness or with decreased insulin delivery due to omitted doses or insulin pump failure. Additionally, diabetic ketoacidosis episodes in children with type 2 diabetes mellitus are being reported with greater frequency. Although the diagnosis is usually straightforward in a known diabetes patient with expected findings, a fair proportion of patients with new-onset diabetes present in diabetic ketoacido- sis. The initial management of children with diabetic ketoacidosis frequently occurs in an emergency department. Physicians must be aware that diabetic ketoacidosis is an important consideration in the differential diagnosis of pediatric metabolic acidosis. This review will acquaint emergency medicine clinicians with the pathophysiology, treatment, and potential complications of this disorder. Author William Bonadio, MD Attending Physician, Pediatric Emergency Medicine, Maimonides Medical Center, Brooklyn, NY Arleta Rewers, MD, PhD Associate Professor of Pediatrics, University of Colorado, Denver, School of Medicine, Aurora, CO Joseph I. Wolfsdorf, MD Clinical Director, Division of Endocrinology, Boston Children’s Hospital, Professor of Pediatrics, Harvard Medical School, Boston, MA CME Objectives Upon completion of this article, you should be able to: 1. Describe the pathophysiology of DKA and the associated clinical signs and symptoms of this disorder. 2. Discuss management of DKA to restore metabolic hom Continue reading >>

What Is Ketoacidosis? A Comprehensive Guide

What Is Ketoacidosis? A Comprehensive Guide

Ketoacidosis is lethal. It is responsible for over 100,000 hospital admissions per year in the US with a mortality rate of around 5%. In other words, ketoacidosis is to blame for about 5,000 deaths per year. The cause? A deadly combination of uncontrolled hyperglycemia, metabolic acidosis, and increased ketone body levels in the blood (more on this deadly combination later). Luckily, this lethal triad rarely affects individuals who don’t have diabetes. However, the majority (80%) of cases of diabetic ketoacidosis occur in people with a known history of diabetes mellitus (any form of diabetes). Ketoacidosis vs. Diabetic Ketoacidosis — What’s The Difference? At this point, you may have noticed that I used ketoacidosis and diabetic ketoacidosis interchangeably. This is because it is difficult for the body to get into a state of ketoacidosis without the blood sugar control issues that are common in people with diabetes. Hence, the term diabetic ketoacidosis. (However, there is another form of ketoacidosis called alcoholic ketoacidosis. This occurs in alcoholics who had a recent alcohol binge during a period of time when they didn’t eat enough.) Ketoacidosis tends to occur the most in people who have type 1 diabetes. Somewhere between 5 and 8 of every 1,000 people with type 1 diabetes develops diabetic ketoacidosis each year. Type 2 diabetics also run the risk of ketoacidosis under stressful situations, but it is much rarer because type 2 diabetics have some remaining insulin production (type 1 diabetics do not). If you are not part of the 422 million people worldwide that have diabetes, your risk of getting ketoacidosis is negligible. You would have to put yourself through years of stress, inactivity, and unhealthy eating habits before you experience ketoacidosis. ( Continue reading >>

Diabetes Mellitus

Diabetes Mellitus

Return to The Medical Biochemistry Page Diabetes is any disorder characterized by excessive urine excretion. The most common form of diabetes is diabetes mellitus, a metabolic disorder in which there is an inability to oxidize carbohydrate due to disturbances in insulin function. Diabetes mellitus is characterized by elevated glucose in the plasma and episodic ketoacidosis. Additional symptoms of diabetes mellitus include excessive thirst, glucosuria, polyuria, lipemia and hunger. If left untreated the disease can lead to fatal ketoacidosis. Other forms of diabetes include diabetes insipidus and brittle diabetes. Diabetes insipidus is the result of a deficiency of antidiuretic hormone (ADH, also referred to as vasopressin or arginine vasopressin, AVP). The major symptom of diabetes insipidus (excessive output of dilute urine) results from an inability of the kidneys to resorb water. Brittle diabetes is a form that is very difficult to control. It is characterized by unexplained oscillations between hypoglycemia and acidosis. Criteria, which clinically establish an individual as suffering from diabetes mellitus, include: 1. having a fasting plasma glucose level in excess of 126mg/dL (7mmol/L). Normal levels should be less than 100mg/dL (5.6mmol/L) or: 2. having plasma glucose levels in excess of 200mg/dL (11mmol/L) at two times points during an oral glucose tolerance test, OGTT, one of which must be within 2 hrs of ingestion of glucose. Different clinical labs may use different units for the measurement of serum glucose concentrations, either in mmol/L or mg/dL. One can easily interconvert these values using the following formulas: mg/dL x 0.0555 = mmol/L (or simply divide mg/dL by 18) mmol/L x 18.0182 = mg/dL (or simply multiply mmol/L by 18) The earlier a person is dia Continue reading >>

Role Of Beta-hydroxybutyric Acid In Diabetic Ketoacidosis: A Review

Role Of Beta-hydroxybutyric Acid In Diabetic Ketoacidosis: A Review

Go to: Diabetic ketoacidosis (DKA), a complication of diabetes mellitus, is a severe metabolic disease that often requires intensive treatment. Diagnosis of ketosis associated with DKA can be difficult due to variability in the metabolic state of DKA patients. Recognition of the clinical signs and definitive diagnosis are essential for proper treatment. This article reviews the formation of ketoacids during DKA and the role of β-hydroxybutyric acid in the diagnosis and monitoring of DKA. Go to: Introduction Diabetic ketoacidosis (DKA) is a severe and life threatening metabolic disease caused by an absolute or relative deficiency of insulin in the body (1). A disease of middle-aged dogs and cats, DKA occurs as a complication of diabetes mellitus (1). The clinical presentation can range from ketotic patients that are eating, drinking, and maintaining hydration on their own to the more common ketoacidotic patients that are dehydrated and have other signs such as vomiting, anorexia, and lethargy (1). The intensity of treatment is therefore variable and depends on the severity of clinical signs and the degree of metabolic derangement. Most DKA patients require intensive, in-hospital treatment. Go to: Pathophysiology Decreased insulin production by pancreatic beta cells, decreased activity of insulin receptors at the cellular level, or both, are responsible for the abnormal glucose metabolism and resulting hyperglycemia (1,2). One consequence of this disregulated glucose metabolism is that glucose transport from serum into the cells is inadequate, leading to cellular starvation (1–3). In order to satisfy its cellular energy requirements and maintain cellular integrity, the body utilizes adipose tissue as the main energy source (1,4). This is a protective mechanism designed Continue reading >>

Diabetes Mellitus (dm) In Children And Adolescents

Diabetes Mellitus (dm) In Children And Adolescents

Diabetes mellitus is a disorder in which blood sugar (glucose) levels are abnormally high because the body does not produce enough insulin or fails to respond normally to the insulin produced. Treatment depends on the type of diabetes but includes changes in diet, exercise, weight loss (if overweight), and insulin injections or drugs taken by mouth. The symptoms, diagnosis, and treatment of diabetes are similar in children and adults (see Diabetes Mellitus (DM)). However, management of diabetes in children may be more complex. It must be tailored to the child’s physical and emotional maturity level and to constant variations in food intake, physical activity, and stress. Blood sugar Diabetes is a disorder that affects the amount of sugar in the blood. There are many kinds of sugar. The white granules of table sugar are known as sucrose. Sucrose occurs naturally in sugar cane and sugar beets. Another kind of sugar, lactose, occurs in milk. Sucrose consists of two different simple sugars, glucose and fructose. Lactose consists of the simple sugars glucose and galactose. Sucrose and lactose must be broken down by the intestine into their simple sugars before they can be absorbed. Glucose is the main sugar the body uses for energy, so during and after absorption, most sugars are turned into glucose. Thus, when doctors talk about blood sugar, they are really talking about blood glucose. Types of Diabetes The types of diabetes in children are similar to those in adults. The types include Prediabetes is a condition in which blood glucose levels are too high to be considered normal but not high enough to be considered diabetes. Prediabetes is more common among obese adolescents. It is temporary in over half of adolescents, but the remainder develop diabetes, especially those Continue reading >>

Incidence Of Diabetic Ketoacidosis Among Patients With Type 2 Diabetes Mellitus Treated With Sglt2 Inhibitors And Other Antihyperglycemic Agents

Incidence Of Diabetic Ketoacidosis Among Patients With Type 2 Diabetes Mellitus Treated With Sglt2 Inhibitors And Other Antihyperglycemic Agents

Highlights • Overall, unadjusted DKA incidence were similar between SGLT2 and non-SGLT2 agents. • Overall, unadjusted DKA incidence dropped by ∼50% when excluding potential autoimmune diabetes. • Primary analysis found no statistically significant increased risk of DKA with SGLT2 inhibitors. • No increased risk of DKA with SGLT2 inhibitors when excluding potential autoimmune diabetes. • More than half of the DKA cases met the definition of potential autoimmune diabetes. Abstract To estimate and compare incidence of diabetes ketoacidosis (DKA) among patients with type 2 diabetes who are newly treated with SGLT2 inhibitors (SGLT2i) versus non-SGLT2i antihyperglycemic agents (AHAs) in actual clinical practice. A new-user cohort study design using a large insurance claims database in the US. DKA incidence was compared between new users of SGLT2i and new users of non-SGLT2i AHAs pair-matched on exposure propensity scores (EPS) using Cox regression models. Overall, crude incidence rates (95% CI) per 1000 patient-years for DKA were 1.69 (1.22–2.30) and 1.83 (1.58–2.10) among new users of SGLT2i (n = 34,442) and non-SGLT2i AHAs (n = 126,703). These rates more than doubled among patients with prior insulin prescriptions but decreased by more than half in analyses that excluded potential autoimmune diabetes (PAD). The hazard ratio (95% CI) for DKA comparing new users of SGLT2i to new users of non-SGLT2i AHAs was 1.91 (0.94–4.11) (p = 0.09) among the 30,196 EPS-matched pairs overall, and 1.13 (0.43–3.00) (p = 0.81) among the 27,515 EPS-matched pairs that excluded PAD. This was the first observational study that compared DKA risk between new users of SGLT2i and non-SGLT2i AHAs among patients with type 2 diabetes, and overall no statistically significant differen Continue reading >>

Phd Public Health, Suez Canal University, Egypt

Phd Public Health, Suez Canal University, Egypt

Diabetes mellitus (DM) is a group of diseases characterized by high levels of blood glucose resulting from defects in insulin production, insulin action, or both. The term diabetes mellitus describes a metabolic disorder of multiple aetiology characterized by chronic hyperglycaemia with disturbances of carbohydrate, fat and protein metabolism resulting from defects in insulin secretion, insulin action, or both. The effects of diabetes mellitus include long–term damage, dysfunction and failure of various organs. Diabetes mellitus may present with characteristic symptoms such as thirst, polyuria, blurring of vision, and weight loss. In its most severe forms, ketoacidosis or a non–ketotic hyperosmolar state may develop and lead to stupor, coma and, in absence of effective treatment, death. Often symptoms are not severe, or may be absent, and consequently hyperglycaemia sufficient to cause pathological and functional changes may be present for a long time before the diagnosis is made. The long–term effects of diabetes mellitus include progressive development of the specific complications of retinopathy with potential blindness, nephropathy that may lead to renal failure, and/or neuropathy with risk of foot ulcers, amputation, Charcot joints, and features of autonomic dysfunction, including sexual dysfunction. People with diabetes are at increased risk of cardiovascular, peripheral vascular and cerebrovascular disease. The development of diabetes is projected to reach pandemic proportions over the next10-20 years. International Diabetes Federation (IDF) data indicate that by the year 2025, the number of people affected will reach 333 million –90% of these people will have Type 2 diabetes. In most Western societies, the overall prevalence has reach Continue reading >>

Clinical Applications Of Diabetes Antibody Testing

Clinical Applications Of Diabetes Antibody Testing

Context: Autoantibodies to glutamate decarboxylase, islet antigen-2, insulin, and zinc transporter-8 are characteristic of type 1 diabetes. They are detectable before clinical onset and define the subgroup of patients with latent autoimmune diabetes in adults. Autoantibody assays are increasingly available to clinicians. This article reviews the prognostic significance of autoantibodies and considers the utility of diabetes antibody testing in routine clinical practice. Evidence Acquisition: The medical literature to May 2009 was reviewed for key articles and consensus statements covering use of islet autoantibody testing for prediction and classification of diabetes and implications for therapy. Evidence Synthesis: Sensitive and specific glutamate decarboxylase and islet antigen-2 antibody assays are widely available, although to insulin autoantibody assays remain variable. Islet autoantibodies appear early in life, and testing for multiple antibodies identifies unaffected individuals at very high risk of type 1 diabetes with high sensitivity. This is important for research, but currently no intervention prevents or delays diabetes, and evidence of benefit from awareness of risk is weak. In non-insulin-treated diabetes, patients with autoantibodies progress to insulin requirement more rapidly, but evidence that testing benefits the individual patient is limited. Antibody testing is useful in classifying diabetes of other types. Conclusions: Islet autoantibody testing allows prediction of type 1 diabetes and definition of the latent autoimmune diabetes in adults subgroup of non-insulin-treated patients. Although useful for research, until therapies modulating the disease process become available, the benefit to individual patients is generally questionable. With a few e Continue reading >>

Diabetes, Alcohol, And Social Drinking

Diabetes, Alcohol, And Social Drinking

People with diabetes should be particularly cautious when it comes to drinking alcohol because alcohol can make some of the complications of diabetes worse. First of all, alcohol impacts the liver in doing its job of regulating blood sugar. Alcohol can also interact with some medications that are prescribed to people with diabetes. Even if you only rarely drink alcohol, talk with your healthcare provider about it so that he or she knows which medications are best for you. Here’s what you need to know: 1. Alcohol interacts with diabetes medications Alcohol can cause blood glucose levels to rise or fall, depending on how much you drink. Some diabetes pills (including sulfonylureas and meglitinides) also lower blood glucose levels by stimulating the pancreas to make more insulin. Combining the blood-sugar-lowering effects of the medication with alcohol can lead to hypoglycemia or “insulin shock,” which is a medical emergency. 2. Alcohol prevents your liver from doing its job The main function of your liver is to store glycogen, which is the stored form of glucose, so that you will have a source of glucose when you haven’t eaten. When you drink alcohol, your liver has to work to remove it from your blood instead of working to regulate blood sugar, or blood glucose. For this reason, you should never drink alcohol when your blood glucose is already low. 3. Never drink alcohol on an empty stomach Food slows down the rate at which alcohol is absorbed into the bloodstream. Be sure to eat a meal or snack containing carbohydrates if you are going to drink alcohol. 4. Always test blood sugar before having an alcoholic beverage Alcohol impairs your liver’s ability to produce glucose, so be sure to know your blood glucose number before you drink an alcoholic beverage. 5. Al Continue reading >>

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