Memories from years back that suddenly become relevant and powerful, connecting what I did “back then” to what I do “these days”. And what are the conclusions those memories allow me to draw? More is needed than awareness raising…

For ten months, as my civil service, I worked in a primary school in Germany. My main task was to take care of a (back then) little boy who was really smart, well brought up and came from a stable and caring home with two fantastic parents. Why would he need support?

Diabetes type 1.

As he went through primary school on his way to adolescence, learning all the lessons of for example Mathematics, German, English, or Polish (as it often is the case where I come from) like all his peers, he also had to learn how to deal with his disease. And I was there to assist, support, take care or even rescue if needed. That was many years ago and since then we two have made our own little journey through life together. We became friends and we remain friends, even as I live abroad now and his schedule is that of a late teenager and not of a primary school pupil anymore.

And today is World Diabetes Day.

So, I come to think of my friend and his disease, and how he is managing every day to not be daunted by it but acknowledge it and embrace it and live the best live possible. From time to time we also still talk about it: blood sugar concentration, insulin, hypoglycaemia, the effects of candy or cake, or certain drinks and how to manage and deal with those. We talk about ways that society supports people with diabetes or fails to support. And we sometimes talk alcohol.

The world is suffering from an epidemic of NCDs. Noncommunicable diseases. Lifestyle diseases. Diabetes is among the four major NCDs such as heart disease, stroke, cancer, and chronic respiratory diseases. They are by far the leading cause of mortality in the world, representing 60% of all deaths. And alcohol is one major risk factor for NCDs.

If you do just a little research, you’ll find out that alcohol is not usually mentioned in relation to Diabetes – and that’s also what my friend tells me when it comes to how he and his peers are being educated on how to best deal with their diabetes. I think that this is a  shortcoming because all the aggressive alcohol marketing largely targeted at my friend’s age group and the overall alcohol culture push teenagers into taking up alcohol use, exposing them – especially those with conditions like diabetes – to many health and social risks.

Alcohol and diabetes facts

Here are some connections of alcohol and diabetes:

  • Alcohol use makes hypoglycaemia (low blood glucose levels) more likely.
  • There is a U-shaped relationship between the average amount of alcohol consumed per day and the risk of type 2 diabetes.
  • Alcohol use can reduce the body’s sensitivity to insulin, which can trigger type 2 diabetes.
  • Alcohol use can lead to an increased calorie intake, which can cause obesity and higher risk of diabetes. Excessive alcohol use and binge alcohol use can lead to stroke.
  • Diabetes is a common side effect of chronic pancreatitis, which is overwhelmingly caused by alcohol use.

More needed than awareness raising

It’s World Diabetes Day and – as it is tradition on such days – time to raise awareness. That’s important. Always.

But I also think it’s important to start doing something more, doing something better than we as a society are currently doing. I had the privilege to learn a lot about diabetes during civil service, through my (not so) little buddy. And he, surely, is more lucky than many of his peers in Germany and in other countries around the world when it comes to the environments and support structures that his fantastic parents were and are able to provide.

I learned for example that alcohol use – especially at those parties of teenagers where alcohol already has become the norm – makes it impossible to predict how the blood sugar level is going to develop. Thinking about my friend, knowing some of the risks, that scares me.

It’s World Diabetes Day and here’s what the industrialised world, societies in low- and middle income countries, children and youth and my friend do in fact need:

  1. More environments that are free from alcohol, that promote healthy choices and enable party, creativity, and a feeling of belonging for all youth.
  2. More alcohol-free drinks.
  3. A ban of alcohol advertising.
  4. Higher prices for alcohol and less availability of alcohol, which means for example more freedom from the pressure of alcohol shops.
  5. More independent research on the effects of alcohol use on diabetes, especially in young people.
  6. More and better education and information for young people with diabetes about the effects of alcohol. And empowerment to make their own choices, outside the intoxicating alcohol culture, allowing them a lifestyle of health and well-being.