Alcohol abuse has numerous physical and mental consequences, including cirrhosis of the liver (when the liver loses its ability to function properly and you die of hemorrhage or liver failure) and degeneration of the brain (when you lose coordination and develop severe emotional instability). Alcohol also is a home wrecker.
For the person with T1DM, alcohol abuse makes it impossible to control the blood glucose to prevent complications. The abuser takes in enormous quantities of empty (non-nutritious) calories and usually fails to eat good food. He fails to take his insulin either because he's drunk or because he forgets to take it when sober. All this is a prescription for diabetes disaster.
How do you know if you have a serious problem with alcohol? Here are the key tip-offs that suggest you need help with a drinking problem:
i You crave alcohol.
i You have tolerance to alcohol, so you require more alcohol than a nonalcoholic to reach the same state of inebriation.
i You have a physical dependence on alcohol and go through withdrawal symptoms like nervousness, shakiness, and headaches if you don't drink.
^ You can't stop drinking after you start.
You can stop your heavy drinking, but you need help to do it. Only a small percentage of alcoholics stop on their own, but 90 percent of alcoholics who go through a combination of the following are typically sober after one year:
^ Treatment, which is an intervention during which the patient totally gives up alcohol
^ Aftercare, which consists of attending regular weekly meetings in which the patient's alcohol abuse continues to be addressed
There are a number of drugs that the alcohol abuser with T1DM can use to avoid drinking, particularly disulfiram and varenicline. If you're a heavy drinker and a smoker, which is a common combination, varenicline may allow you to kill two birds with one stone. (See the later section "Kicking the habit" for more about this drug.)
The resources for the alcohol abuser are enormous. Here are the best (in addition to talking to your doctor):
il Alcoholics Anonymous offers publications and instructions for finding meetings that take place everywhere. Call 212-870-3400 or visit www. alcoholics-anonymous.org for more information.
I The Internet Alcohol Recovery Center has resources on everything you need to know about alcohol abuse and treatment. Call 215-243-9959 or visit www.uphs.upenn.edu/recovery.
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