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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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Has Diabetes And Unable To Manage. Is Overweight And Alcoholic. Has Hypertension. Treatment?

Hi,my husband is 65 years old and has bn a diabetic since 1991.lately he has not bn managing it well,he is overweight and alcoholic.he also has hypertension and taking medication .on several occasions,he has had hypos and has had to be rushed to hospital.when his sugar is low,he acts really confused,and almost in a paranoid mad mental case,,,,,,I need to understand why and if there is a treatment to end his state of confusion and aggressiveness.
Sat, 30 Mar 2013
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General & Family Physician 's  Response
Hello.
If a diabetic drinks too much, it could have very serious consequences because of  the high sugar content in many alcoholic drinks.
Normally, when blood glucose levels drop, the liver converts the body's stored carbohydrate into glucose. Sent into the bloodstream, this glucose helps avoid or slow down a low blood glucose reaction (hypoglycemia).This process is interrupted when alcohol enters your system. The liver's first priority is to clear the alcohol from your blood quickly, and it will not put more glucose into the bloodstream until it has detoxified the alcohol. As blood glucose levels fall, you can quickly become hypoglycemic

Some early warning signs of low blood glucose levels, such as dizziness, disorientation and sleepiness, can mimic drunken behavior. This could cause others to mistake your hypoglycemic symptoms for the effects of alcohol, and they may not realize they need to seek help. 
Uncontrolled sugar causes worsens your hypertension and increases your triglycerides level.
Your husband must quit alcohol for proper control of diabetes.
Must take proper anti diabetics in consultation with your doctor,to keep sugar levels in strict control.
Go for regular aerobic exercises like walking for at least 45 minutes a day.
Must reduce his weight.
Must take proper anti hypertensives to keep his BP below 120/80.
Must control his cholesterol levels by taking statins
Thanks
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General & Family Physician Dr. Michelle Gibson James's  Response
HI, thanks for using healthcare magic

The main treatment for the confusion and aggressiveness would be to improve his blood sugar control so that the episodes of high and low blood sugars are eliminated.

It would be best for him to try to reduce his alcohol intake to an absolute minimum. He should consume no more than 2 alcoholic drinks a day( this would be a 5 ounce glass of wine, 1 1/2 ounce of liquor and 12 ounces of beer).
Alcohol effects blood sugar readings, in the short term it would contribute to the low blood sugars that he is experiencing.
It may be difficult to do this on his own and he may need professional help.

In addition to reducing alcohol use, he may need to look at his meals in relation to his diabetic medication. It is possible his diet may need adjusting or his medication. The times at which the low readings occur should be noted and the medication that would affect the blood sugar at that time, adjusted.
For example if the blood sugars are consistently low in the morning then he needs to his nightime medication.
You need to speak to his doctor so that he or she can make the necessary changes.

I hope this helps
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General & Family Physician Dr. Gopal Krishnam Raju's  Response
diabetics should never drink alcohol meds decrease sugar levels + alcohol it decreases further hence he went into hypoglycemia so stop alcohol for ever he will be good :)
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Note: For further follow-up, discuss your blood glucose reports with our diabetologist. Click here.
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Has Diabetes And Unable To Manage. Is Overweight And Alcoholic. Has Hypertension. Treatment?

Hello. If a diabetic drinks too much, it could have very serious consequences because of  the high sugar content in many alcoholic drinks. Normally, when blood glucose levels drop, the liver converts the body s stored carbohydrate into glucose. Sent into the bloodstream, this glucose helps avoid or slow down a low blood glucose reaction (hypoglycemia).This process is interrupted when alcohol enters your system. The liver s first priority is to clear the alcohol from your blood quickly, and it will not put more glucose into the bloodstream until it has detoxified the alcohol. As blood glucose levels fall, you can quickly become hypoglycemic Some early warning signs of low blood glucose levels, such as dizziness, disorientation and sleepiness, can mimic drunken behavior. This could cause others to mistake your hypoglycemic symptoms for the effects of alcohol, and they may not realize they need to seek help.  Uncontrolled sugar causes worsens your hypertension and increases your triglycerides level. Your husband must quit alcohol for proper control of diabetes. Must take proper anti diabetics in consultation with your doctor,to keep sugar levels in strict control. Go for regular aerobic exercises like walking for at least 45 minutes a day. Must reduce his weight. Must take proper anti hypertensives to keep his BP below 120/80. Must control his cholesterol levels by taking statins Thanks