Alcohol health literacy in young adults with Type 1 diabetes and its impact on diabetes management

Abstract

Novelty statement (100 words max): The study identifies the extent of low alcohol health literacy in young adults with Type 1 diabetes, with less than 10% of participants able to identify the alcohol and carbohydrate content accurately in more than half of commonly consumed drinks.  Alcohol consumption amongst participants was common with almost a third of women (32.9%) and over a fifth of men (22.6%) engaged in increased risk drinking.  Strategies to minimise alcohol-associated risk were inconsistent and so young adults are at increased risk for diabetes mis-management when consuming alcohol. Abstract:Aims: Alcohol-specific health literacy is poor in the general population and this is also likely to apply to young adults with type 1 diabetes (T1DM). Alcohol directly affects glycaemic control and accurate estimation of alcohol intake can support effective diabetes management. Little is known about alcohol knowledge accuracy and management strategies of young adults with T1DM when consuming alcohol. The study investigated knowledge of alcohol and carbohydrate content of commonly consumed beverages among young adults with T1DM and explored alcohol consumption while identifying diabetes self-management strategies for minimising alcohol-associated risk.Method: An open-access, multiple-choice web-survey investigating knowledge of alcohol and carbohydrate content of typical alcoholic drinks using images. Participants also recorded current alcohol consumption and diabetes selfmanagement strategies when drinking.Results: 547 participants aged 18-30 years participated (341 women; 192 men; mean age 24.5 SD 3.7 years), of whom 365 (66.7%) drank alcohol. 84 (32.9%) women and 31 (22.6%) men scored above the cut-off for increased risk drinking. Knowledge accuracy of alcohol units was poor: only 7.3% (n=40) correctly identified the alcohol content of ≥6 of ten drinks. Carbohydrate content was also poor: no participant correctly identified the carbohydrate content of ≥6 of ten drinks. Various and inconsistent strategies to minimise alcohol-associated risk were reported. Conclusions:Alcohol consumption was common, however, knowledge of alcohol and carbohydrate content were poor. Greater alcohol related health literacy is required to minimize alcohol-associated risk. Further research should develop effective strategies to improve health literacy and support safe drinking for young adults with T1DM.

Self-reported regular alcohol consumption in adolescents and emerging adults with type 1 diabetes: A neglected risk factor for diabetic ketoacidosis? Multicenter analysis of 29 630 patients from the DPV registry

“…In conclusion, our study including young patients with type 1 diabetes revealed that higher alcohol consumption is associated with worse glycemic control, in particular with significantly higher rates of DKA. A recent study observed poor knowledge of alcohol and carbohydrate content of alcoholic beverages in young adults, making it even more important that information about diabetes‐related consequences of alcohol use is part of diabetes education in this age group. To prevent diabetes complications caused by alcohol use, adolescents and young adults with type 1 diabetes should be trained to consume alcohol responsibly (eg avoid binge drinking and large amounts of alcohol, keep blood glucose levels within the recommended range by ingesting carbohydrates while drinking).…”

Type 1 Diabetes in Young Adulthood

“…Alcohol use increases the risk for acute hypoglycemia, and many young adults are unaware of how to adjust insulin for alcohol use [88]. Tobacco use is associated with poorer glycemic control, lower self-reported rates of physical activity, and increased risk for chronic complications [89].…”

The Role of Mobile Applications in Improving Alcohol Health Literacy in Young Adults With Type 1 Diabetes

“…It is necessary to know the level of alcohol as well as the carbohydrate content, which varies widely, to be able to accurately react and either administer the appropriate dose of insulin or consume an appropriate amount of carbohydrates to maintain safe blood glucose levels. 3 None of the appraised apps featured both the carbohydrate and alcohol contents of popular drinks. There have been calls for the government to require all alcoholic drinks to display their nutritional information on the bottle label.…”

“…2 Excessive alcohol consumption is associated with suboptimal glycemic control and specific diabetes related risks. 3 Previous research has shown that young people use social media and mobile technologies to seek information regarding diabetes self-management and alcohol education. 4 However the medical relevance or accuracy of information cannot be guaranteed.…”

“…Previous studies have demonstrated the distinct lack of effective interventions to help combat the risks of drinking for young adults with T1DM. 3 …”