Introduction: Alcohol consumption is common among people with type 1 diabetes mellitus (PwT1D), with prevalence rates similar to the general population. However, it is associated with unique risks - increased risk of (delayed) hypoglycemia, diabetic ketoacidosis, and impaired ability to self-manage diabetes. In this study, we aimed to explore the knowledge and experiences of young (>16 years old) PwT1D concerning safe alcohol use. Methods: We designed an anonymous survey informed by the clinical expertise of healthcare professionals, the lived experience of people with type 1 diabetes represented within our team, and the perspective of a patient organization, which was made available in 12 languages on a dedicated website and promoted via social media. We collected data on responders' background, self-perceived safety of alcohol use, experience about the impact of specific alcoholic drinks on one's glycemia, and safety management strategies. Data collection was open from October 2022 to November 2023. Results: We analyzed complete responses from 216 PwT1D (63.4% females, 54.2% aged 16-21 years old, 29.3% with diabetes duration >15 years), who represented 23 countries (most often Italy, Poland, and the USA). Only 53.2% of PwT1Ds reported feeling safe while consuming alcohol, and 37% assessed their alcohol-related knowledge as average or lower. Only 45.8% reported that the issue of safe alcohol consumption was discussed as part of diabetes education. A total of 48.2% of participants experienced unpredictable effects of alcoholic drinks on blood glucose levels. Alcohol-related severe hypoglycemia episodes were significantly more frequent in those reporting frequent excessive drinking (>= 6 drinks >= 1/month, OR 4.19, 95% CI: 1.37-12.75) and routinely consuming >= 2 alcoholic drinks per occasion (OR 4.20, 95% CI: 1.52-11.61). Conclusions: The topic of safe alcohol consumption requires more attention in diabetes education. Developing evidence-based and easy-to-apply strategies tailored to alcohol type, amount, and technology use is essential for reducing acute diabetes-related complications. Plain Language Summary Alcohol use among young adults with type 1 diabetes (T1D) is common but carries significant risks. Our international T1Drink study surveyed 216 young adults (aged 16-35 years) from 23 countries. We found that over a half of surveyed adults lacked confidence in safely managing diabetes when drinking alcohol, and 46% reported not discussing the issue of alcohol consumption with their leading physician. The information on glucose content in alcoholic beverages is lacking, even on the labeled product. As such, the effect of alcohol on glucose level is perceived as unpredictable by over 48% of participants. This is also reflected in diabetes management, with 41% of respondents not following their own recommendations on the insulin dosing for carbohydrates in alcoholic beverages. Regarding risks of alcohol consumption on diabetes management, we found that severe hypoglycemia - a state of dangerously low blood sugar levels requiring assistance from others - was significantly more common in those who drank excessively, consumed multiple drinks per occasion, or more often drank sweet/semisweet wines, flavored vodka, premixed cocktails, and high-percentage liquors. Current diabetes education often does not sufficiently cover strategies for safe alcohol consumption, leaving young adults uncertain and potentially unsafe.Improving education and developing clear guidelines on alcohol management for individuals with T1D are crucial to help reduce these risks.
T1Drink: Education Gaps and Safety Issues Concerning Alcohol Consumption in Young Adults with Type 1 Diabetes Mellitus - A JENIOUS-Driven International Initiative Report
Claudia, Piona,;
2025-01-01
Abstract
Introduction: Alcohol consumption is common among people with type 1 diabetes mellitus (PwT1D), with prevalence rates similar to the general population. However, it is associated with unique risks - increased risk of (delayed) hypoglycemia, diabetic ketoacidosis, and impaired ability to self-manage diabetes. In this study, we aimed to explore the knowledge and experiences of young (>16 years old) PwT1D concerning safe alcohol use. Methods: We designed an anonymous survey informed by the clinical expertise of healthcare professionals, the lived experience of people with type 1 diabetes represented within our team, and the perspective of a patient organization, which was made available in 12 languages on a dedicated website and promoted via social media. We collected data on responders' background, self-perceived safety of alcohol use, experience about the impact of specific alcoholic drinks on one's glycemia, and safety management strategies. Data collection was open from October 2022 to November 2023. Results: We analyzed complete responses from 216 PwT1D (63.4% females, 54.2% aged 16-21 years old, 29.3% with diabetes duration >15 years), who represented 23 countries (most often Italy, Poland, and the USA). Only 53.2% of PwT1Ds reported feeling safe while consuming alcohol, and 37% assessed their alcohol-related knowledge as average or lower. Only 45.8% reported that the issue of safe alcohol consumption was discussed as part of diabetes education. A total of 48.2% of participants experienced unpredictable effects of alcoholic drinks on blood glucose levels. Alcohol-related severe hypoglycemia episodes were significantly more frequent in those reporting frequent excessive drinking (>= 6 drinks >= 1/month, OR 4.19, 95% CI: 1.37-12.75) and routinely consuming >= 2 alcoholic drinks per occasion (OR 4.20, 95% CI: 1.52-11.61). Conclusions: The topic of safe alcohol consumption requires more attention in diabetes education. Developing evidence-based and easy-to-apply strategies tailored to alcohol type, amount, and technology use is essential for reducing acute diabetes-related complications. Plain Language Summary Alcohol use among young adults with type 1 diabetes (T1D) is common but carries significant risks. Our international T1Drink study surveyed 216 young adults (aged 16-35 years) from 23 countries. We found that over a half of surveyed adults lacked confidence in safely managing diabetes when drinking alcohol, and 46% reported not discussing the issue of alcohol consumption with their leading physician. The information on glucose content in alcoholic beverages is lacking, even on the labeled product. As such, the effect of alcohol on glucose level is perceived as unpredictable by over 48% of participants. This is also reflected in diabetes management, with 41% of respondents not following their own recommendations on the insulin dosing for carbohydrates in alcoholic beverages. Regarding risks of alcohol consumption on diabetes management, we found that severe hypoglycemia - a state of dangerously low blood sugar levels requiring assistance from others - was significantly more common in those who drank excessively, consumed multiple drinks per occasion, or more often drank sweet/semisweet wines, flavored vodka, premixed cocktails, and high-percentage liquors. Current diabetes education often does not sufficiently cover strategies for safe alcohol consumption, leaving young adults uncertain and potentially unsafe.Improving education and developing clear guidelines on alcohol management for individuals with T1D are crucial to help reduce these risks.
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