Treating Comorbid Diabetes & Alcoholism
A lifelong condition that causes a person's blood glucose levels to be too high, diabetes is a relatively common condition. The National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) publishes that around 30 million Americans have diabetes.
When someone suffers from diabetes, the pancreas doesn't produce enough insulin, or the insulin that is produced naturally is not used properly. This is what causes the buildup of glucose, or blood sugar, in the body.
Insulin is a hormone that helps to convert glucose into energy that cells can then use. When glucose is not used or broken down properly, its levels can get too high, called hyperglycemia, which can have a host of dangerous side effects, including heart disease, stroke, nerve damage, blindness, kidney disease, complications that can lead to foot amputation, and even death. The National Diabetes Statistics Report, 2017 publishes that in 2015, diabetes was the seventh leading cause of death in the United States.
There are three main types of diabetes: type 1 diabetes, type 2 diabetes, and gestational diabetes. Type 1 diabetes occurs when the body can't produce enough insulin on its own while type 2 diabetics produce insulin, but it isn't used effectively. Gestational diabetes is unstable blood glucose in women while pregnant and typically does not extend beyond the pregnancy (although it may raise the risk that a woman will develop type 2 diabetes later in life).
Type 1 diabetes is rarer, likely heritable, and has no cure. Individuals with type 2 diabetes may be able to reverse the condition with smart lifestyle choices, however. There are several factors that can contribute to the onset of type 2 diabetes, the most common form of the condition, which include being overweight, unhealthy eating habits, damage to the pancreas, and alcohol consumption.
Connections between Alcohol and Diabetes
Research published in the journal Diabetes Care indicates that moderate alcohol consumption may actually decrease a person's risk for developing type 2 diabetes. The same study showed that excessive alcohol consumption increased the risk for developing the condition in women who were lean. Alcohol is full of empty calories and often leads to unhealthy eating patterns, which can lead to obesity – a major risk factor for diabetes. Alcohol may also interfere with the body's sensitivity to insulin, which can play a role in the onset of type 2 diabetes as well.
Around 15 million American adults struggled with alcohol addiction in 2016, the National Survey on Drug Use and Health (NSDUH) reports. One of the possible side effects of alcoholism is chronic pancreatitis, which can also trigger type 2 diabetes. Alcoholism and diabetes may then occur in the same person at the same time.
Continuing to drink alcohol while struggling with diabetes can be detrimental to health. The American Diabetes Association (ADA) warns that alcohol can block the production of glucose by the liver, which can cause super low blood sugar. Symptoms of low blood sugar, or hypoglycemia, are often similar to the symptoms of alcohol consumption, making it hard to know the difference between the two issues. Both low blood sugar and alcohol can make a person sleepy, have blurred vision and slurred speech, and experience impaired coordination and cognitive abilities.
Excessive alcohol consumption can also damage the liver, which helps to filter toxins out of the body and process medications, which can then contribute to more side effects when diabetes is also present since diabetics may need to take medications to control the condition. The effects of alcohol can be unpredictable and lead to unsafe fluctuations in a person's blood sugar that can continue for several hours after stopping drinking; this can be very dangerous for someone who struggles with diabetes and unstable blood glucose levels already.
A diabetic needs to control and watch their diet in an effort to maintain safe blood glucose levels. As a result, compulsive and excessive alcohol abuse, which is indicative of alcoholism, can have hazardous side effects that are heightened for diabetics.
Treatment Considerations for Co-Occurring Diabetes and Alcoholism
When someone battles alcoholism, they will struggle with controlling how much and how often they consume alcohol. This can be problematic for a person who needs to continually monitor their blood glucose level. Alcohol abuse may also contribute to even more unhealthy eating patterns, as a person may substitute alcohol for food, or eat more food to try and change their blood sugar levels.
Alcohol abuse interferes with a person's ability to think clearly and make rational decisions, which can make it difficult for a person to monitor their blood sugar levels safely and responsibly. Diabetics may have an insulin pump or need to take insulin in order to maintain a balanced and stable blood glucose level, which heavy alcohol consumption may interfere with.
Diabetes can complicate and exacerbate the potential side effects of alcoholism, and vice versa. When diabetes and alcoholism co-occur, a specialized treatment program is needed to manage both comorbid conditions at the same time.
Integrated treatment programs for comorbid diabetes and alcoholism may include:
- Medication management
- Medical detox
- Mental health support
- Medical monitoring
- Nutritional planning
- Behavioral therapy group and individual sessions
- Counseling programs that address co-occurring disorders
- Educational programs
- Tools for managing stress and minimizing relapse
- Support groups
- Exercise and fitness programs
- Family programs
- Holistic methods (e.g., chiropractic care, massage therapy, acupuncture, etc.)
- Recovery and aftercare support
A comprehensive program for co-occurring diabetes and alcoholism is often most beneficial when it is provided in an inpatient facility that can offer support and monitoring around the clock. Medical detox programs are the optimal place for individuals to allow alcohol to process out of their bodies safely, especially in the case of co-occurring disorders. During medical detox, vital signs can be monitored, and healthcare professionals can ensure that blood glucose levels remain stable. Necessary medications can be managed during medical detox as well.
During medical detox, it may be necessary to use medications to manage some of the more significant withdrawal symptoms, and it is important that medical professionals are aware of any potential co-occurring mental health or medical conditions, such as diabetes. Individuals can transition from a medical detox program directly into a specialized comprehensive care program where medical, mental health, and substance abuse treatment professionals all work together to manage both the diabetes and the alcohol abuse issue.
A treatment program for comorbid diabetes and alcoholism will include counseling and therapy for both disorders, and address the ways they may be intertwined. Support groups made up of other people who also struggle with the same comorbid conditions can be a helpful source of encouragement in recovery. Behavioral therapies can help individuals to recognize potential triggers for self-destructive behaviors, such as drinking or not managing one's diabetes properly, and develop healthy coping mechanisms going forward. In a specialized treatment program, individuals can learn how to achieve healthy physical balance, which will help with managing diabetes and promoting overall wellness.
Both diabetes and alcoholism are treatable disorders. While there is no cure, both conditions can be managed with the help of highly trained professionals in a specialized co-occurring disorders treatment program. Clients can learn how to lead healthier lives while managing both conditions.