(… or more specifically pumping tips needed for lots of beer, cocktails and a curry)
So it’s that time of year again when seasonal festivities are beginning and I start my annual stress-out at managing the evening without ending the night with a double-digit BG starting with a 2 and waking the next morning below 4.
It’s OK me thinks, I have a pump this year to provide a much easier way to manage it. now I just need tips on how to do it.
Previously despite warnings not to bolus for the lager, I find I need to to try and keep everything not too hyper. My drop-off once bed has been reached is pretty low but still slightly present.
So this is where I need the pumpers’ alcohol tested advice. I’m sure through years of dedicated research you’ll have finalised a flawless plan to manage the challenge. If however drink is viewed as a disgusting habit that should not be done, I fear I’m in the wrong place.
What a great thread Dave. I will watch with interest.
I’ve only had one proper night out (at a gig) since being plugged into Artoo and it went OK as far as I can tell (well I didn’t end up naked surrounded by paramedics at any rate).
The evening started and ended with a briskish walk into town (15 mins each way?) and I ate decent slow release meal before I went. Tested when I got into the venue and was 8.something. Then allowed a couple of 0.5u boluses to patch over the beer carbs during the night. Was 7.3 when I got in just past midnight and set a TBR for a few hours. Woke up a little under at 3.6.
I know for sure it would have gone horribly wrong if any kind of buffet had been involved. Will be interested to see how the ‘pros’ do it.
I get a post-booze drop and so I bolus for beer for the first half of the evening and then stop to allow my BG to climb up (later to drop down again). I also have to be careful to remember to lower my basals when I’m walking miles afterwards to find a taxi – if I’m pissed I usually forget to do this.
I think the only way to do it is to experiment quite a lot and find out exactly how it effects you!
Well, I’m still here so I must have managed something right
Set up a temp basal of 125%. I was tempted to go higher but as I’m still in my first month of pumping I was playing it very safe. Also bolused for 10g of carbs with every drink where I remembered – got about half of them I think.
Food was bolused as normal. Middle of the evening test came in at 12.4 and I finished the day (3am) at 14.3, a quick correction of 2 units and I was asleep..
Overnight I’d already pre-set to lower the basal to 80% but like Paul I’m not convinced I have the drop but was playing it safe.
Morning (7.30!! – had to be up for my train home) woke to a 13.8 so corrected whilst eating my pasty from Greggs. By 10am I was down to 7.6 and the rest of the day seemed to level out.
Although obviously higher than I would have like all evening it proved more successful than previous occasions which normally involved a few 20s and random boluses.
So points learnt:
Drinking and diabetes needs much more research to find my ideal TBRs and curry ratios.
A slightly higher daytime TBR and no change to the sleeping basal might work better – again more practice needed.
Pre-setting the TBRs avoids the alcohol induced confusion and I can have confidence my actions aren’t being too drink affected.
After all these years, pumping is chuffin’ fantastic for handling the not-normal stuff.
All of this is what I learnt but everyone’s diabetes is different so please don’t take my alcohol led research as gospel – do your own research. Now!!!
And if you do it by TBR it means you have to keep drinking (curses)
Since I’ve experimented I’ve been gloriously controlled on 4 hour sessions, I find longer ones I need to start reducing the TBR after 4hrs as slowing down the beer intake rate can result in a knee trembling hypo if you’re not careful!
[Ahem. Not that I ever drink more than 4 shandys, honest doc, & I spread those 4 over at least 5 days …. ]
The curry however, that sends my blood sugar all over the place, particularly when it requires judging carbs under the influence!
Hmm. Can’t comment on the overuse of alcohol, but the curries, that’s a different matter. I’ve now got a list of ‘safe’ curries I know won’t affect me too much – too hot and its upsets my stomach, too creamy and it slows my digestion down, both leading to hypos. I often find the ones with sauce seem to have an awful lot of sugar in, whic it’s impossible to count for. So I go for the drier ones. Suits me. But if you get a research grant, I’ll come and test them all out….after all, you need a control to check its not your drinking thats having the effect.
I can’t drink beer or cider which helps a lot….for other alcohol I don’t bolus unless I’m forced to drink non-diet mixers or I’m having cocktails. 35 years of diabetes and 14 years on a pump have taught me the following routine for drinking.
I don’t bolus for alcohol (but when I used to drink beer, I’d bolus approx 1 unit (15g carbs worth) per pint. Bolus as usual for any non-diet mixers. Bolus as usual for the meal. After about 3-4 hours of drinking, I probably want a slightly lower temp basal or some carb-based snacks. Bedtime – if BG is below 10, a few grams of carbs won’t go amiss (hot chocolate works well for me as it also helps battle the dehydration in the night!). If that’s a problem, e.g. I’m at someone else’s house or don’t have snacks to hand, and/or if my BG is below 5, I also set a temporary rate of zero for half an hour. More than about 4 units of alcohol, and I definitely need to turn down my nighttime basal rate by a unit/hour (typically just over 10% of my usual rate). Next day, especially in the morning, I can guarantee I’ll also be more sensitive to insulin. I usually combat this by eating more rather than the sensible solution of turning down my basal.
My solution for curries, chinese etc is simple. Either eat lots of rice and not much else (boring) or eat lots of the rest but not too many carbs (much more fun). It’s the combination of carbs+fat+protein which is a real killer.
@ Tim – happy to volunteer to join the research group into the effects of beer and curry on diabetics. I’m on MDI, though so will you let me in? Horror of horrors, I gave up alcohol completely exactly a month ago today after a session with my brother-in-law involving a whole bottle of rum, several bottles of lager and several hours of Colin McRae Rally on the PS2. It wasn’t a pretty sight and Lara retreated to her art room muttering darkly about ‘boys’ . . . thankfully me and my marriage survived the experience.
Since then I’ve noticed that without the booze at all, I’m struggling to keep the BG down. No night-time drop-off whatsoever and I’m experimenting with increased basal insulin but keeping in the back of my mind the numerous night-time hypos I used to have . . . hoping that once Christmas Day arrives and I’m back on the sauce things will stabilise
@furrypaul – a forum thread going off-topic? Who’d thought it? At least we’re not getting into a pedantic argument about the correct use of the restrictive relative pronoun
Anyway, I think as with anything diabetes you’ve just got to experiment. I usually go for thin-crust pizzas as I prefer them, so carbs aren’t too much of a problem. But with my nemesis – fish and chips – I’ll do a dual-wave with 75% in immediately and 25% over the next two hours. I seem to digest quickly, so that seems to work for me. But I know other people with stretch out their dual waves over hours and hours.
@don172 – ouch! I used to have Colin McCrea parties over at my old flat – I had a force feedback steering wheel, peddles, etc. – and it was brilliant! That must have been one hell of a hangover to give up booze for a month. The worst I’ve had say me going on the wagon for three weeks
So basically you’re saying that you need booze for the good of your health. I wonder if we can get port on prescription?
I’ll be at the clinic next Tuesday so will mention it! Real ale tends to push the BG through the roof but several glasses of expensive New Zealand Pinot Noir seem to be the best solution for good diabetic control. Don’t know if the NHS can stretch to a tenner a bottle, though
I am not a pumper, still on MDI, but it looks as though my DSN will be pushing for me to get a pump next year.
I recently had my first party night out for ages, this involved huge amounts of Southern Comfort, which I have either straight (as doubles) or with orange juice (as singles). So I injected for the orange juice and ignored the SC. Also there was a buffet – aaagh the dreaded buffet !
Got home around 1 am with a reading of 22, decided not to correct – or rather was too ratted to attempt the calculation. Woke up at 7 am with a reading of 1.2
Had glass of Lucozade and raided the christmas mince pie stash. Seemed to do the trick !
Oh I’ve never been one to do things by halves ! If you’re gonna #### up, then do it in style lol
I think that the majority view here of needing to do more research into the whole alcohol/curry/insulin thing is definitely right, and will carry out as much investigation into the subject as I can manage lol