AIBU to question in my head a Type 2 diabetes diagnosis , if you continue to drink copious amounts of alcohol with no ill effect and think it’s probably a borderline diabetes diagnosis instead?

[Marmaladelover]

No I am not a doctor but do have 2 brothers with diabetes type 2 who have had to make significant changes to their lifestyle.

My BIL was “diagnosed” last year and I am questioning it in my head anyway , not outloud. MIL and BIL have considerable form for exaggerating or inventing illnesses ( MIL especially , to feel special and get attention. ) A bit of Munchenhauses by proxy from her too ( if he was a child and not a fully independent man of 60 that he is ) with MIL who will feel special at the association with her also coming into play. She has form for this with FIL ( now passed) . I have no doubt he may have had a diagnosis of borderline type 2 but not actual and as such is seeing the diabetic nurse occasionally.

But he has hardly changed his lifestyle at all , apart from eating rich tea biscuits rather than custard creams! He still drinks like a fish: always has done - nothing has changed there ( a bottle of wine a night , when he can ) I suppose i have a jaded view because the BIL was encouraging my DH to drink last year at a time when my DH was under treatment for a drink problem ( not total alcoholism but close ) last year. Then MIL bought alcohol for Xmas for me having been specifically told not to. I was furious with both of them and have a very low contact with both of them now.

Surely if he was drinking this much with diabetes he would be very unwell?
He also told me that the problem he has is with too little sugar and often gets lows. Which I think is probably bollocks and allows him to continue with his present lifestyle without alteration whilst still having a diagnosis both he and MIL can feel “proud of “ !

If you haven’t experienced relatives with hypochondria or factitious disorder ( latter with MIL , former with BIL ) then you probably think I am a cow , even questioning it in my own mind. But having seen this with them for so many years I generally know the signs and usually when MIL is called out on one, she starts a new one . Now BIL has his she is fairly silent on hers ( this happened before with FIL too) . This is one reason I am keeping this information in my head and not calling it out . If I do then MIL will invent something else which as I have more contact with her ( which is minimal ) and DH will worry about her which I would rather avoid.

So maybe anyone familiar with type 2 diabetes could tell me whether you can still binge drink with it. .

It is absolutely not about whether you ‘can’ drink copious amounts of alcohol. It’s not compulsory to alter your lifestyle with a diagnosis of anything.

you need to mind your own business though, stop thinking about it, not your circus, not your monkeys.

DH has 2 relatives diagnosed with it and neither of them have changed their lifestyles. I bought one of them diabetic chocolate once thinking I was being thoughtful and they got angry and told me to buy them normal chocolate in future!
Both heavily drink alcohol and go-to drinks are sugary tea and cola. Both barged their way to the front of the queue for covid jabs when they came out though because of their diabetes!
People with type 2 bring it on with lifestyle choices, I think it’s a mentality they can’t shake. But it does make it seem like a non-issue that they are dramatising when they do absolutely nothing to help themselves.

Very familiar with type 2.
Yes, in my experience they can binge drink and eat like rubbish.
Is it healthy long term? Nope... but they can get away with for a long time.

He is very, very unlikely to be going low unless on Insulin.
Maaaaaaybe if he is on Metformin and exercising like crazy and eating keto.
Alcohol and Metformin can also interact causing sugar to go low (but this is very rare).

So, it's possible he is diagnosed Type 2, but the "going low" part doesn't make much sense.

Type 2 diabetics starting medication can also feel like they are going low when they actually aren't, it's just their body getting used to a normal blood sugar after years of being high.

My DM has type 2. My understanding is you can change your diet and should really and that will keep the worst of the symptoms at bay but it will likely get more severe as you get older and far more quickly if you don't change your diet. I think DM was told to change diet, if not she would go on tablets and if they didn't work then into injections. Her diet changes staved off the tablets for years but she finally had to go onto them.

He doesn’t HAVE to quit drinking or make any lifestyle changes. Your brothers have chosen to make these changes for the sake of their health. My Mum made changes on diagnosis and still drank too much and ate biscuits/cake when in the company of others. You’ll never really know if your BIL has it or not. If you don’t give it any attention, they’ll just move on.

I was diagnosed with T2 a couple of years ago and would have done quite a bit of heavy drinking and overeating in the years leading up to the diagnosis (when I'd also have had the illness). I've never had a single symptom. So I think it's possible that your BIL has it, but if there's form for inventing things in the family, I guess that could be the case too.

He can eat or drink what he wants, but he might regret it in ten years when he’s blind and having his feet amputated.

https://www.diabetes.org.uk/guide-to-diabetes/enjoy-food/what-to-drink-with-diabetes/alcohol-and-diabetes

If he's on Gliclazide or Semaglutide and drinking alcohol he's likely to have low blood sugar to dangerous levels. The liver doesn't produce glucose while processing alcohol and the effects last for up to 12 hours. Drinking daily with diabetes and taking blood sugar lowering medication is stupid.

Metformin is less likely to let blood sugar fall so low.

I know someone with t2 diabetes who continues to drink and also eats chocolate/cake/carbs at a rate of knots. I guess she just adjusts her insulin? Is it a good idea? Possibly not but her choice.

You've got this somewhat wrong OP.

Type 1 diabetes is where the body makes no insulin. Blood glucose levels rise rapidly to dangerous levels and the individual will become very acutely unwell if they are not taking appropriate amounts of insulin.

Type 2 diabetes is where the body becomes less sensitive to insulin. Blood glucose levels are chronically raised. They are rarely high enough to cause someone to become acutely unwell (even in the case of binge drinking) and instead the damage (such as cardiovascular damage) happens over a longer time frame. The difference between borderline diabetes and a diagnosis is dependent on the exact blood glucose levels, so the diagnosis would still be made even if there is a possible reversible element (e.g. in this case, blood glucose levels could possibly be lowered back into the borderline or even normal range through lifestyle changes).

However, someone with type 2 diabetes will not have low blood glucose unless they are taking a treatment that lowers blood glucose (i.e. insulin or certain antidiabetic medications) so this bit does sound dubious.

Anyine with any disease can continue a lifestyle to which they are accustomed, whether that lifestyle caused the illness or not
However, long-term, it will fuck them and their disease.
So, yes, because alcohol changes chemically in the blood, it will affect their type 2, but not necessarily immediatelu

People with diabetes can eat what they choose. Someone with type 1 diabetes will need to take appropriate amounts of insulin to avoid becoming hyperglycaemic and will usually avoid eating large quantities of sugary foods to mitigate this risk. Someone with type 2 diabetes will have been advised to make lifestyle changes to try and manage their blood sugars but they will likely not become acutely unwell if they do continue to eat lots of sugary foods - the damage will be over a longer time period.

Well, yes, you can drink to excess with diabetes and not necessarily have any issues, but obviously, you shouldn't, as with the rest of us.
BTW diabetic products aren't recommended anymore www.diabetes.org.uk/about-us/about-the-charity/our-strategy/position-statements/diabetic-foods

So maybe anyone familiar with type 2 diabetes could tell me whether you can still binge drink with it.

Yes, you absolutely can. What you can do and what you should do (and what the repercussions for doing what you like in the long term) are very different.

Hmmm, my other half is Type 1, and there are big differences in the way alcohol affects their blood sugar - cider causes a crashing low, spirits a high, then they will dose-adjust their insulin but find that a typical reaction is affected by tiredness, etc. It's tricky to handle, and harder for Type 2 where much of the emphasis is on dietary management, weightloss, exercise, and so forth; you don't mention whether your person is medicated for their diabetes.

I don't think it matters so much about whether this person is Type 2 or not. Whether they are or they aren't, they have a problem with alcohol. Type 2 diagnosis would rarely be a sufficient catalyst for an addict to change their behaviour. It also sounds like the alcoholism may be a product of familial trauma, which is ongoing...so much here that will be impacting on everyone's healh which means making healthier, safer choices is the hardest thing in the world.

But, it's not for you to solve. You cannot rescue anyone, not even by being 'right'.

MIL is type 2 diabetic. She's 77 and slightly underweight. She has a blood sugar captor on her arm which FIL monitors; a nurse visits 3 times a day to read her blood sugar level and give her an insulin injection (if needed). After her morning injection she has bread (50% sugar) (plus black coffee and butter but they have no sugar).

Sometimes mid-morning her blood sugar will drop and so she will eat some bread.

After her lunchtime injection she will have 1 or 2 glasses of rosé, and a meal with 1 or 2 pieces of bread and a dessert...she loves anything chocolatey so could be a chocolate éclair, chocolate mousse, slice of chocolate cake, possibly an ice-cream, and or some fruit.

In mid-afternoon her blood sugar always dips, often very low. She is supposed to have bread and usually does, but often adds a few squares of dark chocolate too.

In the evening she has an injection then a dinner the same as lunch with 1 or 2 glasses of rosé, bread, dessert, etc. Sometimes a few squares of dark chocolate before bed too.

She has dementia and a sweet tooth so sometimes her blood sugar is too high but essentially by monitoring it and injecting insuline she can eat and drink what she wants.

I guess every patient is different?

Thanks everyone who has posted above. Pps who said not my business, you may be right, but as I said the thoughts are in my head only. Knowing that he may simply be doing something which is not in the long term good for him is easier to know than thinking he is feigning it which I find much more difficult .

BIL is not on insulin , no idea about tablets . The pp who said that going on medication may produce feelings of a low when really what you are experiencing is a normal sugar after a long time of it being abnormally high , this does make sense.

@Marmaladelover It is perfectly possible for anyone who drinks alcohol to excess to have low blood sugar (hypoglycemia) whether or not they have diabetes. So I don't think that bit of it is bollocks at all, from what you say about his drinking habits.

As far as 'borderline Diabetes' is concerned that almost certainly means his blood sugars are in the 'pre-diabetes' range and he doesn't actually HAVE Diabetes yet - just well on the way to it. When Type 2 Diabetes occurs, it usually happens slowly and over quite a long period of time and Blood sugars creep up. Levels of 42 - 47 mol/mol are considered to be above normal and therefore are pre-diabetic indicators. 48 and above is Type 2 Diabetic. I would suspect that his blood sugar levels are around 46 or 47 if they told him they are borderline.

Yes excess drinking will be doing his health no good at all, And if he doesn't change his life style his Diabetes will get steadily worse, but as he is used to drinking a lot his body will be used to it and binge drinking once he has Type 2 won't suddenly of itself cause him to collapse as a direct result of having Diabetes when he does it. It will just make everything gradually worse for him in the long run ( including the Diabetes)

You can't make him do anything that he doesn't want to though.

@Silvers11
i didn’t say that they had diagnosed borderline , just that I suspect that is what it is , rather than full blown diabetes. both wanting the attention for having it whilst simultaneously ignoring any difficult lifestyle choices. You and others have said that will affect him in the longer term. Fine., that’s on him.

I am a type 2 diabetic- although hopefully on the way to remission.

Alcohol can lower blood sugars - had quite a frightening experience of that recently - I don't binge drink though.

Many don't change their diet and don't realise the damage they are doing by not trying to control their blood sugar until it's too late.

I was lucky in that mine was caught at the lower end of the scale so has been easy for me to monitor my intake of carb and sugar and I'm really hopeful that my next blood test will show that it's in remission. I don't need to take medication.

But really op, it's not something you need to worry about. If they are lying, they are lying but it doesn't affect you.

@Marmaladelover I somehow managed to misinterpret what you said. Although I did wonder why he was seeing the diabetic nurse occasionally, as here you only get referred to the Diabetes Nurse if you actually have it! My sincere apologies

If he IS seeing the diabetic nurse, then it does sound like they are telling the truth to be honest. I presume he is not on medication at the moment? Metformin is usually the first line of defence?

EDIT - sorry again. Just saw that you don't know about the tablets

If your BIL is taking metformin it can cause his blood sugar to drop if he is drinking alcohol.
Unfortunately, without the lifestyle changes the medication is pointless. His risk of heart disease and stroke is high and there is an increase in peripheral atherosclerosis leading to foot problems ( ultimately amputation if gangrene occurs) and most significant for men they will develop erectile disfunction.
In addition their eyesight can be affected.
Unfortunately your MIL is likely to have plenty to stress about in the near future.
Your BIL is unlikely to listen to you and I would stay out of it. But since most type 2 diabetics have a genetic predisposition to the disease and the related heart disease ( it’s all about inflammation resulting from the way our bodies process glucose) then I would be encouraging your DH to have screening tests and concentrate on his health. Type 2diabetes is often hidden in the otherwise healthy individual.

It’s really on him if he is stirring up significant issues for later . My only concern would be any impact it has on my DH . Throw into the mix the fact my BIL has a very disabled adult son ( and an ex wife with her own health issues ) , this does not bode well for the future.

@Angrymum22
my mil is 85 and now getting frail. She does not help herself in her lifestyle choices sometimes. Eg eating food that has gone off with inevitable effects and currently only body washing from the waterbutt in the garden “ to save money” !
Thanks for the advice about my own DH though.
sorry two largish drip feeds .