AskNadia: Diabetes and Addiction

Dear Nadia,

My husband is an alcoholic and smokes a pack of cigarettes a day. I am scared his newly diagnosed type 2 diabetes is going to kill him.

Olympia WA

Dear JS,

If your husband is 40 and older and smokes, he has a 50% chance of having a cardiovascular episode. His type 2 diabetes also increases his chances of having a cardiovascular event; creating a double whammy. Adding alcohol abuse to his diabetes will affect his blood sugar and liver creating a lethal combination.

What You Can  Do

First line of order? As a family member who lives with someone that has a substance abuse issues, you need to learn to take care of yourself. Join an Al-Anon group where you have the support you need. This excellent organization is built on family and friends who live or interact with alcoholics. The popularity of this nonjudgmental support group is built on compassion and understanding.

What You Can Expect to Experience

First and foremost everything you share in the group is anonymous. Everyone that attends a meeting is not allowed to share any personal information about any one group member or their family outside of the meetings. The cornerstone of one of their rules is allowing attending members transparency, support, and confidentiality.

Listen to This Short Al-Anon Podcast

What you will experience at your first meeting.

Al-Anon’s support is not limited to family and friends routinely interacting with an alcoholic. You can also expect to find parents of children with substance abuse or parents with in-laws that have substance abuse issues. Over the last three decades, I have attended these meetings for various friends and family members who made me feel like I was the crazy person. The conversations I had with family and friends who were substance abusers always morphed into me being accused of overreacting to their addictions. These discussions usually ended with; it’s my problem, not theirs.

Al-Anon taught me the surrender and to understand that I cannot change the behavior of the substance abuser, but I can change how I respond and react to them.

Jut a few days ago, one of my closest friends, a man I considered a brother passed away at 56 from alcohol and nicotine addiction. He had one  cancerous lung removed at the hospital. Once he was released from the hospital and returned home, he went back to smoking and drinking.

It pained me to see how alcohol and cigarettes turned this vibrant, loving man into a fragile, helpless person, who ended up passing away prematurely because of his lifestyle choices.

Start getting the support you need today. Go to Al-Anon to look for a meeting near you.

Let’s Talk Diabetes

How your husband manages his diabetes will affect both of you. Drinking can cause over eating shooting his blood sugar up or drinking and not eating while taking medication can give him a low blood sugar. As his wife, willing or unwilling, you may end up caring for him.

We recently published an article that reports men with diabetes tend to deal with stress by drinking and smoking. I can tell you, my brother who passed away from diabetes complications did manage his stress with alcohol and nicotine.

Over time, unmanaged high blood sugars correlate with specific complications. The closer your husband’s A1C is to normal, the less likely he is to experience diabetes complication in his eyes (retinopathy), kidney’s (nephropathy), nerve’s (neuropathy) and heart disease.

A1C Recommendations

The NIH recommends an A1C of 6.5 on the low end while the American Diabetes Association recommends an A1C of 7. Different factors play into these recommendations. I would ask your husband’s physician what range is appropriate for him.

New England Journal of Medicine  recommends a healthy blood sugar range of 70- 120 mg/dL for a Pre- Meal ( pre-prandial) blood sugar reading and less than 180 mg/dL1 after-meals (post-prandial) blood sugar reading.
Nicotine Addiction

The Centers for Disease Control and Prevention (CDC) reports that people that smoke have a 30-40% chance of being diagnosed with type 2 diabetes.

People diagnosed with type 1 or type 2 diabetes who smoke, will  have a difficult time managing their diabetes. They are more likely to experience diabetes complications.

The CDC reports, “Smokers with diabetes have higher risks of serious complications, including:
• Heart and kidney disease
• Poor blood flow in the legs and feet that can lead to infections, ulcers, and possible amputation (removal of a body part by surgery, such as toes or feet)
• Retinopathy (an eye disease that can cause blindness)
• Peripheral neuropathy (damaged nerves to the arms and legs that cause numbness, pain, weakness, and poor coordination)”

No Quick Solution

Your concerns for your husband, in this case, is real. If he continues to drink and smoke, his diabetes self-management puts him at risk for a multitude of complications. It’s for this reason; I am recommending that you learn to take care of yourself and find the support you need.

As for your husband, hopefully, he will find a reason to quick drinking and smoking cigarettes. This is something he needs to come to on his own.  Meantime, get the support and friendship from your Al-Anon family that intimately understand what you are going through. Just remember, you are not alone.



New England Journal of Medicine


Nadia’s feedback on your question is in no way intended to initiate or replace your healthcare professionals therapy or advice. Please check in with your medical team to discuss your diabetes management concerns.
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About Nadia:

Nadia was not only born into a family with diabetes but also married into one. She was propelled at a young age into “caretaker mode,” and with her knowledge of the scarcity of resources, support, and understanding for people with diabetes, co-founded Diabetes Interview now Diabetes Health magazine.
Nadia holds 11 nominations for her work as a diabetes advocate.
Her passion for working in the diabetes community stemmed from her personal loss. She has used her experience as a caretaker to forge a career in helping others.
For 25 years, Diabetes Health contributes free copies of the magazine to healthcare professionals and pharmacies that use the publication as an educational resource for patients living with diabetes.

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