Blood sugar issues? And alcohol

My blood sugar stays low-70-90 all day because I do carnivore/keto. I have to do this for autoimmune and pcos reasons. This weekend I plan to have a few plain vodka waters for social purposes. If you don’t drink or eat people get really really weird about you sitting at the table….my blood sugars will be in the 60s if I do this due to IF and keto. Is this a problem/danger or concern? I usually feel ok….but my doc got really scared when he saw I had done IF and then had drank the night before and my sugars were in the 60s before breakfast. Idk what to do. I want to have two drinks. I don’t want to eat. It makes me even less hungry when I drink. Is blood sugar in the 60s really a problem when it’s 80-90 after food anyways?

Answer

I agree with your doc. I would be concerned too.

60 is hypoglycemic. Just because you felt fine doesn’t mean it wasn’t dangerous to be there. Different people have different thresholds where low blood sugar starts to be a big problem.

Look up guconeogenesis and alcohol if you want to understand what’s going on here and why fasting + keto + alcohol can make your blood sugar drop like this. The most concerning thing is the interference with gluconeogenesis can extend to processing regular carbs and if it gets bad enough, eating carbs may not raise your blood sugar rapidly. T1 diabetics are often warned about this, but it can affect anyone.

There are no loopholes. You shouldn’t drink while fasted. On the other hand, drinking at the end of an eating window can be ok. I will drink a unit or two of scotch at the end of my eating window and it’s fine.