Alcohol and drug use in young adults with type 1 diabetes

This article examined the prevalence of alcohol and drug use in young adults with type 1 diabetes (T1D). They also investigated the ways these substances can affect the health of young adults with T1D. 

Alcohol and drug use peaks in young adulthood. This is no different for young adults with T1D. Young adults with T1D have a higher mortality rate than people with T1D in general. It has been suggested that this can be explained by alcohol and drug use. However, research in this area is limited. 

This study examined 69 studies that investigated alcohol and drug use in young adults with T1D.

Rates of alcohol and drug use were similar in young adults with and without T1D.

Being intoxicated was shown to likely affect blood glucose monitoring, delay response to changing blood glucose levels, and increase risk-taking behavior. Alcohol and drug use may also contribute to many mental health problems, including depression and anxiety. These mental health problems may influence the ability and motivation to manage blood glucose levels.

Alcohol was found to be able to cause delayed hypoglycemia (dangerously low blood glucose). This was especially likely in people who were malnourished, or when it was not consumed with a carbohydrate. Stimulant drugs (like cocaine, amphetamine, and ecstasy) may cause hyperglycemia (dangerously high blood glucose). However there is not enough evidence to be certain.

Alcohol and drug use also have an affect on the complications of T1D. Recreational drugs, especially cocaine, have been found to contribute to some cases of diabetic ketoacidosis (a life-threatening emergency). Alcohol, and rarely cannabis, contributed to some episodes of hypoglycemia that required hospitalization.

Heavy alcohol consumption may also contribute to long-term complications of diabetes. These include nerve damage, heart disease, and stroke.

Asking young adults with T1D about their alcohol or drug use, and informing them of the risks of these substances may help to promote healthier behaviors.

The study concluded that alcohol and drug use in young adults with T1D was similar to people without T1D. However, alcohol and drug use in young adults with T1D was seen to negatively affect blood glucose control, contribute to hypoglycemia, hyperglycemia, and diabetic ketoacidosis, and worsen the long-term complications of diabetes. 

The studies examined in this study were all performed in different ways, so they may be difficult to compare to each other. Furthermore, ‘young adult’ is a general term that was not precisely defined in this study.

Discuss the effects of alcohol and drug use in diabetes with your physician.