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Cited by 117Diabetes Management and ResearchAlcohol Consumption and Health EffectsDiabetes, Cardiovascular Risks, and Lipoproteins

Alcohol Causes Hypoglycaemic Unawareness in Healthy Volunteers and Patients with Type 1 (Insulin-Dependent) Diabetes

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Kerr, D., Macdonald, I. A., Heller, S. R., Tattersall, R. B.·1990·Diabetologia
DOI 10.1007/bf00404799
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Abstract

Both hypoglycaemia and alcohol consumption affect cognitive function but it is unclear whether moderate drinking alters awareness of hypoglycaemia. We have examined this in a single blind randomised hyperinsulinaemic clamp study in eight non-diabetic subjects and seven Type 1 (insulin-dependent) diabetic patients. After 30 min of euglycaemia (blood glucose 4.5 mmol/l) subjects drank either 0.75 g/kg ethanol or a placebo drink after which blood glucose was lowered to 2.5 mmol/l for 40 min. Awareness of hypoglycaemia, reaction time and physiological responses were measured before and after ethanol. At a blood glucose concentration of 4.5 mmol/l, ethanol (producing peak blood levels of 20-25 mmol/l) caused a transient increase in systolic blood pressure (p less than 0.05), a sustained increase in heart rate (p less than 0.01) and a slowing of reaction time in both normal subjects and diabetic patients. During hypoglycaemia in both groups, the slowing of reaction time and increase in sweating were more marked after ethanol than placebo (both p less than 0.05), while the increase in finger tremor (p less than 0.05) was blunted after ethanol, in both groups. Counter regulatory hormone secretion was not affected by ethanol. Despite increases in symptoms during hypoglycaemia, only 2 of 15 individuals "felt hypoglycaemic" after ethanol compared to 11 out of 15 after placebo. We conclude that after moderate drinking non-diabetic subjects and Type 1 diabetic patients are less aware of hypoglycaemia despite exaggerated physiological changes.

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  • Alcohol intake can impair cognitive function, resulting in decreased awareness of hypoglycemia symptoms, which may exacerbate its danger.

    “Furthermore, alcohol intake can impair cognitive function, resulting in decreased awareness of hypoglycemia symptoms, which may exacerbate its danger [20].”

    From Non-Diabetic Hypoglycemia: Evaluation and Management in Adults (2025) · cites this paper as [20]

    The Discussion reports that moderate alcohol intoxication slowed reaction time and reduced recognition of hypoglycaemia in both groups. It offers cognitive impairment as one possible explanation for the reduced awareness, rather than establishing that mechanism. It also notes that patients might consequently fail to take action. (LLM, conf=0.85)

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Research works printed but not linked: 2

  1. Finn R Platt J (1972) Alcohol and alcohol safety, a curriculum manual for senior high level: US Dept of Transportation, Na- tional Highway Traffic Safety Administration, Washington, DC. Vol 1, pp 178-187
  2. Marks V (1981) Alcohol and hypoglycaemia. In: Marks V, Rose FC (eds) Hypoglycaemia. Blackwell, Oxford London, pp 387-398

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Authors
Kerr, D., Macdonald, I. A., Heller, S. R., & Tattersall, R. B.
Affiliations
University of Nottingham (GB)
ORCID
Venue
Diabetologia
Publisher
Springer Science and Business Media LLC
Published
1990-04
Volume
33
Issue
4
Pages
216-221
ISSN
  • 0012-186X (ISSN-L)
  • 1432-0428
DOI
10.1007/bf00404799
OpenAlex
W2055717798
Cited by
117
References
25
Citations by year
2026: 1 · 2025: 3 · 2024: 4 · 2023: 1 · 2022: 3 · 2021: 2 · 2020: 3 · 2019: 3 · 2018: 5 · 2017: 5 · 2016: 1 · 2015: 2 · 2014: 4 · 2013: 8 · 2012: 4
FWCI
1.82
Type
journal article
Language
en
Open access
Licence
www.springer.com/tdm (tdm)
Locations
  • Diabetologia (publishedVersion)
  • PubMed (publishedVersion)
Topics
  • Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Research
  • Health Sciences › Medicine › Pathology and Forensic Medicine › Alcohol Consumption and Health Effects
  • Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes, Cardiovascular Risks, and Lipoproteins
Keywords
alcohol, ethanol, hypoglycemia, type 1 diabetes, reaction time, counterregulatory hormones, sweating, finger tremor, blood pressure, heart rate, cognitive function
MeSH terms
Adult, Alcohol Drinking, Ethanol, Awareness, Blood Glucose, Cognition, Diabetes Mellitus, Type 1, Female, Humans, Hypoglycemia, Kinetics, Male, Reference Values, Sweating

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