Dear Reader,

As someone who is hypoglycemic (has low blood sugar), it is smart for you to be attentive to how foods and drinks can affect your condition. In some ways, all alcoholic beverages have the same effect: while your liver is processing the alcohol you drink, it stops releasing glucose, the sugar that floats around in your bloodstream. For the entire time the alcohol stays in your body — and it takes your body an hour to break down about one ounce of alcohol (the amount in a standard drink) — the only glucose circulating through your system will be from the food and drinks you consume at the same time. The American Diabetes Association explains that this glucose-lowering effect can last for as long as eight to twelve hours after drinking.

For people with diabetes who, like you, must also keep track of their blood sugar levels, almost all alcoholic beverages count for the same thing: two fats in their food exchange system. Only regular beer is counted as two fats, plus one starch. The American Dietetic Association states that wine, hard liquor, and light beers all have similar caloric contents for one drink: a 5 oz. glass of wine, 1-1/2 oz. of hard liquor (including scotch), 12 oz. of light beer. Regular beer, wine coolers, and mixed drinks all pack a more powerful calorie and sugar content punch; wine coolers have almost twice as many calories as a glass of dry table wine. Liqueurs and sweet wines have higher than average sugar levels, too.

Keep in mind that many alcoholic drinks are not just alcohol — mixed drinks, spritzers, coolers, and frozen daiquiris all contain additional ingredients, such as juice and soda, which can add a significant amount more sugar and calories to your drink. If you're looking to keep sugar levels low, stick with diet (no-calorie) soda or tonic water, seltzer, club soda, or water to mix in drinks.

Sometimes alcohol can cause blood sugar levels to go up, instead of down. This usually happens if someone eats a meal shortly after, or while drinking, particularly if they consume drinks high in carbohydrates, like beer and juice-alcohol mixers. This is particularly of concern for people with diabetes.

Interestingly, the signs of intoxication and too low blood sugar are the same: feeling dizzy, lack of coordination, and confusion. Because of this, you might not realize that you need to eat something. The people surrounding you also might not know you have low blood sugar and assume your behavior is simply the result of drinking too much. It's important to inform someone you'll be hanging out with of your hypoglycemia, so that s/he can get you appropriate help and/or food if necessary. You may even want to wear an I.D. that identifies you as hypoglycemic. Also, since low blood sugar, as well as alcohol, can affect your coordination, perceptions, and reflexes, you'll need to be doubly careful by not driving or doing anything else requiring quick thinking and reflexes.

Here are some strategies to try to make sure your blood sugar levels don't dip too low:

• Eat a meal before drinking. Never drink on an empty stomach.
• Sample plenty of finger foods throughout the night, particularly those high in carbohydrates, such as pretzels and crackers. Avoid foods high in simple sugars, such as candy.
• If possible, mix your own drink, avoiding high sugar juices and sodas. Always measure the amount of alcohol that goes into your drink.
• Sip your drinks and follow the other Hangover Helper guidelines for healthy drinking.

So, you're right, your hangover symptoms might be more or less intense depending on what kind of drink you've had the night before. In fact, you may even be waking up with extremely low blood sugar, while blaming your headache, drowsiness, and confusion on too many drinks. (Although it's a good idea to drink in moderation anyway.) If you're concerned about your blood sugar level dipping to uncomfortable levels while you sleep, you can have a snack before going to bed, or even wake up in the middle of the night to eat something.

For more information about sugar and hypoglycemia, check out the following questions in Alice's Fitness and Nutrition archive:

• Hypoglycemia [Classic Alice!]
• Diets and treatments for hypoglycemia (low blood sugar)
• Sugar and its effects

For more ideas on healthy drinking and hangover helpers, read other questions in Alice's Alcohol, Nicotine, and Other Drugs archive.

Alice