EMS differential diagnosis: Drunk or diabetic emergency?

February 3, 2022
Category: Sober Homes

These medical reviewers confirm the content is thorough and accurate, reflecting the latest evidence-based research. While alcohol can act as a social lubricant and may provide “liquid courage” for people who are otherwise anxious or shy, Pagano warned against relying on it too much. “If drinking allows you to engage in behavior you wouldn’t engage in otherwise, maybe you shouldn’t be doing it,” said Pagano. “And if you always use it to have a good time, you won’t learn how to be okay in social situations without it.” But if you have a response to alcohol that’s noticeably different from other people’s, it may be time to reexamine your relationship with drinking, advised Pagano. The Centers for Disease Control and Prevention defines heavy drinking for women as consuming eight or more drinks per week and for men as consuming 15 or more drinks per week. Temporary anterograde amnesia, also known as alcohol-induced blackouts, refers to the loss of ability to create new memories which occurs when a person is intoxicated. Learn more about how this medication works and how to stop taking it here. If you have low blood pressure, you may want to consider changing your diet. Healthline has strict sourcing guidelines and relies on peer-reviewed studies, academic research institutions, and medical associations.

Is drinking every night an alcoholic?

‘While there are a number of variables, typically having a drink every night does not necessarily equate to alcohol use disorder, but it can increase the risk of developing alcohol-related health problems,’ Lawrence Weinstein, MD, Chief Medical Officer at American Addiction Centers tells WebMD Connect to Care.

Art Hsieh, MA, NRP teaches in Northern California at the Public Safety Training Center, Santa Rosa Junior College in the Emergency Care Program. An EMS provider since 1982, Art has served as a line medic, supervisor and chief officer in the private, third service and fire-based EMS. He has directed both primary and EMS diabetes and alcohol blackouts continuing education programs. Art is a textbook writer, author of “EMT Exam for Dummies,” has presented at conferences nationwide and continues to provide direct patient care regularly. Contact Art at and connect with him on Facebook or Twitter. It should – this is a scene that is played out often in EMS systems.

Differentiating the patient with “intoxicated” symptoms

Additionally, if you have an underlying health condition like heart disease or high blood pressure , mixing alcohol with your medications can put you at risk for complications. Some medications, like high blood pressure drugs and antidepressants, affect the way your heart and blood vessels act when you stand. Insulin used to lower blood sugar when you have diabetes might cause hypoglycemia that also leads to fainting. In older people, different drugs sometimes combine with illness and the situation you’re in — like standing in a hot room — to make you faint. If not treated, it can cause troubling symptoms, and even serious health problems. Fortunately, you can avoid hypoglycemic episodes by monitoring your blood sugar. You can also make small adjustments to eating and exercising routines. In the most extreme cases, drinking too much alcohol too fast can cause a loss of consciousness. “So we also worry about brain damage—and with multiple episodes of heavy drinking, that damage can have long-term consequences for learning and memory.” These effects range in severity from momentary “slips” in memory to permanent, debilitating conditions.
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Those findings suggest that alcohol consumption, particularly moderate consumption, may have a protective effect against cardiovascular disease. Alcohol consumption can exacerbate the diabetes-related lipid abnormalities, because numerous studies have shown that heavy drinking can alter lipid levels even in nondiabetics. When you’re not drinking, your liver’s primary role is to store glycogen so that you have a source of glucose during periods of time between eating. This helps regulate your blood sugar and stabilizes levels throughout the day. Since the primary problem in people living with diabetes is making sure that blood sugar levels remain stable, alcohol consumption is problematic. Heavy alcohol consumption (i.e., 200 grams of pure alcohol, or approximately 16 standard drinks, per day) can cause ketoacidosis in both diabetics and nondiabetics (Wrenn et al. 1991). People who consume those high amounts of alcohol typically have been drinking and not eating for days and/or have vomited or developed other illnesses from drinking. As a result, those patients frequently have very low blood sugar levels .

Over-the-Counter Pain Medications

Some of the effects, like slurred speech and loss of balance, can be very obvious. You’re are less likely to suffer alcohol-induced blackouts. If you drink alcohol as a diabetic, here are seven facts that you need to know to ensure that you drink safely and responsibly. If your doctor does tell you that it’s safe for you to drink alcohol, remember the precautions above and keep in mind that moderation is the key. Stay hydrated by drinking plenty of water while drinking alcohol.

Do alcoholics drink in the morning?

Someone who is heavily into the second stage of alcoholism will likely experience withdrawal symptoms. This can include uncontrollable shakes in the morning because the body is dependent on alcohol. This is why alcoholics will drink in the morning because they are going through withdrawal.

Lin RC, Dai J, Lumeng L, Zhang M. Serum low density lipoprotein of alcoholic patients is chemically modified in vivo and induces apolipoprotein e synthesis by macrophages. If you had an alcoholic beverage and are not sure if you should take an OTC pain reliever, you can ask your local pharmacist or primary care provider if it is safe to do so. Be especially careful with any drug or multi-symptom remedy containing acetaminophen or ibuprofen. It’s possible that if you use them together, antibiotics may be less effective at clearing up the infection that you are being treated for. Alcohol might affect how well some antibiotic medications work. Buddy T is an anonymous writer and founding member of the Online Al-Anon Outreach Committee with decades of experience writing about alcoholism. It happens mostly in kids between ages 6 months and 5 years. They cry hard enough to cut off oxygen and trigger an automatic response that makes them faint. They may turn blue, pass out for about a minute, and seem groggy afterward. Though it’s scary to see at first, it’s nothing to worry about and might even happen repeatedly.

If you take metformin to treat your type 2 diabetes, you may wonder how this drug affects your ability to drink safely. Drinking alcohol can affect your diabetes directly, but you may face additional risks if you drink alcohol with metformin. If you have diabetes, it’s important to make sure your blood sugar levels are normal before you get behind the wheel. If you start to feel like your blood sugar is rising or dropping, pull over and test. Over time, heavy drinking can cause involuntary rapid eye movement as well as weakness and paralysis of your eye muscles due to a deficiency of vitamin B-1 . A thiamin deficiency can result in other brain changes, such as irreversible dementia, if not promptly treated. Excessive drinking can lead to high blood pressure and increases your risk of an enlarged heart, heart failure or stroke. Even a single binge can cause serious irregular heartbeats called atrial fibrillation.

While this article centers on the diabetic patient, there are other causes of altered mental status, including seizure, brain injury, stroke, drug overdose and psychological conditions. In other words, if your initial impression is that the patient is intoxicated, pause for a few minutes and completely assess for other possible conditions. If you can’t be absolutely certain about the underlying cause, don’t make a risky decision – transport to an appropriate medical facility. A 2015 meta-analysis reviewed 38 cohort studies to determine whether alcohol is a risk factor for diabetes.

The dangers of mixing alcohol with prescription drugs are well known. When you pick your prescription up at the pharmacy, chances are the label or package insert will come with a warning if it is not safe to consume alcohol while you are taking the medication. Mixing these medications with alcohol intensifies the side effects and increases the risk of a fatal Sober House overdose. Combining alcohol with medications used to treat hypertension can cause dizziness, fainting, drowsiness, and arrhythmia . You might not need to completely avoid alcohol if you are taking a blood thinner. The American Heart Association recommends limiting your intake to no more than one or two occasional drinks if you are on anticoagulant therapy.

Drinking too much on a regular basis for an extended period or binge drinking on a regular basis can lead to alcohol-related problems or alcohol use disorder. Alcohol withdrawal can occur when alcohol use has been heavy and prolonged and is then stopped or greatly reduced. Signs and symptoms include sweating, rapid heartbeat, hand tremors, problems sleeping, nausea and vomiting, hallucinations, restlessness and agitation, anxiety, and occasionally seizures. Symptoms can be severe enough to impair your ability to function at work or in social situations.

Diabetes Medications

Excessive drinking lowers blood sugar levels, which can cause liver problems and other health effects. To avoid these consequences, diabetics should closely monitor their glucose levels and refrain from heavy drinking. Over time, the excessive consumption of alcohol can contribute to several different problems and conditions. It can increase your risk for developing chronic diseases and serious problems that can make managing diabetes increasingly difficult.

  • Drinking to avoid feeling bad leads to higher and higher levels of consumption, which can cause greater damage to the brain and the rest of the body.
  • When you pick your prescription up at the pharmacy, chances are the label or package insert will come with a warning if it is not safe to consume alcohol while you are taking the medication.
  • Because alcohol can have an unpredictable effect on your blood sugar, have a snack or a meal when you drink alcohol, if you choose to drink at all.
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  • Consequently, the patient essentially experiences total insulin lack.