There are many difficulties facing people with diabetes, the most obvious being the change in diet or having to administer injections everyday.

Drinking

It is illegal in Ireland for persons under the age of 18 to purchase or consume alcohol.

Remember to eat your regular meals if you plan to drink alcohol. If you are going to a party, eat beforehand or bring extra food. If no regular meal will be served, you may eat salty snacks. Never go to bed after drinking alcohol without eating a carbohydrate rich snack such as bread. You must, of course, remember to test your blood sugar before going to sleep.

If you drink too much:

• You will not be able to recognise your normal symptoms of low blood sugar.
• Your friends may think that unusual behaviour, such as staggering, is the result of drunkenness. Tell them in advance that unusual behaviour may signal low blood sugar and that they must call for help.
• Always be careful when drinking alcohol. Carry your diabetes identification with you, and tell your friends how to help you if necessary.

Alcohol . . .

• Affects glucose metabolism.
• Drinking may lead to delayed hypoglycaemia; it is important to measure blood glucose before bed and to eat before going to sleep to minimise the risk of hypoglycaemia during the night.
• If you are going to drink, eat food while drinking and drink plenty of water to avoid becoming dehydrated.

Smoking . . .

• Increases the risk of heart attacks and strokes by 4 to 10 times.
• Increases the risk of kidney failure.
• Increases the chance of developing eye damage and blindness.
• Makes it much harder to control blood glucose levels because it makes insulin absorption more erratic and unpredictable.

Dave's Story

Here's a real life story about the effects of drinking and diabetes. It represents the importance of notifying friends on nights out if drinking is involved.

Dave had said he had a free house for the night, so we went up there for a party. A few of us had been drinking beforehand and there was plenty of booze. Everyone was feeling really great and up for a good night. Then it all went wrong. The music was on, the drink was flowing and we were getting really drunk.

Dave was drinking with us and was getting pretty out of control but then he decided that he had had enough. We didn’t let him stop though. We just offered him more. If only we had known. The reason Dave was refusing more alcohol was because he had diabetes and drinking too much can lower sugar levels. But we kept on at him; you know the way people do. “Go on you can handle it”. In the end he just kept on drinking with us. Sometime later we noticed that Dave was completely out of it lying down. We thought that he was just really drunk and we laughed it off saying that he couldn’t handle his drink after all.

It was only when his parents arrived home earlier than expected that we discovered that Dave would not wake up. He was unconscious. When they got him to the hospital, they found that his blood sugar was so low from drinking alcohol and eating nothing that he had lost consciousness and almost died. We all felt really bad, especially me, I mean; I am supposed to be his pal. I should have known what to do. I knew vaguely about his diabetes but it wasn’t something that we talked about...

The Trouble with the Teenage Years

The teenage years are a challenge for any child as you goe through the sexual and emotional changes of puberty. It can be an especially stressful time for teens with diabetes; stress makes diabetes worse, and diabetes makes everything more stressful.

Teenagers who followed their diabetes management plans for years may now become rebellious and refuse to comply. They may go through denial and act increasingly aggressively in reaction to the stress of puberty and diabetes.

Blood glucose control gets even harder during these years, perhaps because the growth hormone produced during adolescence negatively affects insulin usage. It's not uncommon for blood glucose levels to swing from too high to too low, adding to the frustration.

This is particularly true for girls around the time of their menstrual period. Hormone fluctuations during the menstrual cycle also affect blood glucose levels. Some girls and women with diabetes notice an increase in blood glucose a few days prior to the beginning of their period and then a decrease after the period begins. In some, the changes are considerable, while others do not notice any difference at all. High blood glucose levels may also cause menstrual periods to be irregular.

Most teens with diabetes want desperately to "fit in", and being different from peers may be especially stressful in these years. Having to eat meals, test blood glucose, and inject insulin "on time" all violate the desire to conform to one's peer group. Having diabetes and injecting insulin can have a negative effect on self-image and self-esteem, which are fragile enough during this time. In short normal teens don't act like adults.

It's important to know how serious the complications of diabetes can be. If you have diabetes, you will be the person most responsible for working to avoid the worst effects of the disease. You will want to know about these problems so that you can be alert to detecting them and preventing them. Diabetes is a 24-hour-a-day effort, and preventing complications is worth establishing good self-care routines. The most effective way to avoid complications from either type of diabetes is to keep your blood sugar levels as close to normal as you can.

Statistics

• Diabetes is now considered as a growing epidemic by the World Health Organisation (WHO) with present numbers of people with diabetes set to double over the next 10 years to 240 million worldwide.
• At present in Ireland it is estimated that 200,000 people have diabetes and that 50% of those are unaware they have the condition.
• Heart disease is the leading cause of diabetes-related deaths. Adults with diabetes have heart disease death rates about two to four times higher than adults without diabetes.
• The risk of stroke is two to four times higher.
• An estimated 60 to 65 percent of people with diabetes have high blood pressure.
• Diabetes is the leading cause of new cases of blindness in adults 20 to 24 years old.
• More than half the limb amputations in the United States occur among people with diabetes.
• Type 2 Diabetes among children increased 33% nationally