Diabetes and alcohol: is it a factor in Deputy Mayor Redon’s DWI?

On Wednesday night, March 19th, Rochester’s Deputy Mayor was pulled over for doing 70 in a 55 and later found by a breathalyzer to have a .13BAC. He was arrested for DWI, speeding and also for an unrelated expired inspection. On Thursday, spox for the Mayor’s Office made the statement that “alcohol and diabetes don’t mix,” per @ashleyzilka of News 8:

Reports go on to state that Redon was recently diagnosed with diabetes, the potential explanation for the arrest being that perhaps being newly diagnosed, he may not have known what the consequences of drinking would be. @rachbarnhart summed up nicely:

I was diagnosed diabetic about five or six years ago. And with the necessary caveat that I am certainly not a doctor, I think I can add a bit of context to the situation. But there’s a lot to parse, here:

  1. Is Redon Type I or Type II?
  2. How does having diabetes affect drinking alcohol?
  3. Can you, as suggested by one source, test positive for intoxication without being drunk when you are a diabetic?

On the issue of whether Redon is Type I or II, we can certainly make the educated guess that he’s Type II. Type I, or juvenile diabetes, is usually diagnosed when a person is young. I don’t think I’ve encountered anyone who told me they were diagnosed with Type I later in life, only Type II.

Also worth noting that he appears to have lost some weight. That’s a pretty classic sign of late-diagnosis diabetes.

The type of diabetes is significant for two main reasons. The first is that Type II diabetics, at least of the untreated variety, have a problem with too much glucose in the blood stream, not too little. With treatment, however, the short-term effect is an extremely wonky blood sugar level that does fluctuate pretty wildly. So it is entirely plausible that a recently-diagnosed, recently medicated person can experience sudden drops in blood glucose.

But the second, related reason Type II diabetes is significant is because those sudden drops in glucose are scary as hell. Imagine going from perfectly sober to three-shots-of-tequila buzzed in about five minutes – without drinking – and you’ll see what I mean. Even if you are “used” to that feeling, it still causes panic attacks, because low blood sugar and anxiety are also related. My thinking is that most people would just pull over and panic, not speed up to 70.

Our second question is equally important. How does alcohol affect diabetics? While it is true that alcohol generally lowers blood suger, the real answer isn’t quite that straight forward. One important clue is what you drank. Brews and ferments like beer and wine tend to have enormously high levels of sugar and carbs, which means that in the short term, your blood sugar levels will go up, not down. Distilled spirits like vodka or whiskey have exceptionally low sugar content, and therefore are likely to lower your blood sugar.

So, the closest thing to a straight answer is that, if Redon had a beer or two, he would not have appeared drunk. If he had hard alcohol, well,.. maybe.

The final, and to me most intriguing, question is the whether a person can fail a breathalyzer test because they have low blood sugar? Is that really possible? Like a lot of lawyer tricks, this comes down to a pretty ambiguous “maybe.” There is scientific data to back up the basic claim, so let’s start there.

Hypoglycemia, or low blood sugar, occurs in all people, not just diabetics. When hypoglycemia happens, the body turns to alternative fuel sources. It begins converting fatty acids in the body into acetone, among other chemicals, which can be used by the brain as a fuel source. This condition is called Ketosis.

In this state, a breathalyzer will recognize the acetone incorrectly as alcohol.  According to one study, subjects tested showed as much as a .06 BAC which was actually acetone, not alcohol:

Hypoglycemia as a cause of acetone in the breath is well known and research has demonstrated that diabetics can have levels of acetone in the breath sufficiently high to register false readings of .06.

However, here come the caveats.

First, while hypoglycemia happens to everyone, Ketosis does not. It takes a fairly sustained or routine lowering of blood sugar for your body to hit the panic button like that. Wikipedia notes specifically that ketosis is more common among Type I diabetics. That makes sense, because they have been struggling with blood sugar for their entire lives. It’s worth noting here that it is the acetone created by ketosis that causes diabetics to go into comas, not the lowered blood sugar itself. So in order for Mr. Redon to have shown signs of ketosis, he would have had to be well past the point of being able to drive.

Finally and most damagingly to his case, while acetone could potentially get read as alcohol in a breathalyzer, the study I link to above only shows an increased reading of .06BAC. Mr. Redon’s breathalyzer came in at .13BAC. If we subtract our “handicap,” we still come out at .07, which would still get you a DUI. And of course, he has admitted to drinking, anyway.

Drinking and driving is no joke. Diabetes is no joke. Mayor Warren has not had a good run so far, and this isn’t even her appointment. But trying to paper over wrong doing by spreading misinformation about diabetes is not going to help anyone.


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Paula Deen, her diabetes, my diabetes and the responsibility of the microphone

Turk Hill Rd leading away from Casa Larga Vineyards is a very steep hill, and I felt like I was falling.

My wife and I had decided to spend a little time at our local vineyard, just to waste a little time tasting wines and chatting with people on an otherwise-uneventful Saturday afternoon. But as we sipped wine, I noticed with alarm that my hand was shaking again. You see, the glimiperide that I’d recently been prescribed for my recently-diagnosed diabetes causes this shaking when my blood sugar gets low. We had to leave, and quickly.

At this point in my diagnosis, this shaking was a major red flag and of course, I’d left my meter at home. I had no idea at what level my blood sugar was. I was once again without control. I was panicking.

My life at this point was full of red flags. One hour, I might be sitting down and feeling like I was covered in heavy motor oil. My blood sugar would be well over 300 and I’d be beating myself up for my lack of self-control; hating myself for my irresponsibility; screaming into the void because no one can change the fact that the body I used to take for granted now requires constant surveillance and a team of doctors to keep running. At 34.

The next hour, my blood sugar would reach dangerously-low levels, my hands shaking, suffering with anxiety and panic attacks – to this day, a constant and unwelcome companion. And in my unstable condition at the time, there seemed to be a very real possibility that I really could have slipped into a coma.

My wife did the best she could for me. My family did they best they could for me. I did the best I could for myself, however much I hated myself at the time. We really could have used some help.

That was three years ago. It now turns out that, at the same time, Paula Deen was getting the same diagnosis. We’re just finding this out, now that she has (maybe?) become a spokesperson for some sort of diabetic medication. Three years. At first, it was hard to qualify just what it was that got under my skin about this.

I could easily identify with Anthony Bourdain’s criticisms. There is no question that, irrespective of her own health condition or mine, the food that she’s been encouraging people to eat is just disgusting. And an affront to the South with which I have no particular affiliation, but which even I know is not the land of cheeseburgers in doughnut buns. Had she been as healthy as a thoroughbred on race day, she would still have a debt to pay our society for the bilge she’s foisted on well-meaning people just trying to educate themselves about food.

I could be angry that she’s using her diagnosis to profit. Or maybe she is, though Novartis now denies that fact. But the truth is, I don’t begrudge anyone the ability to make a profit. Especially off such a common illness: if you can educate people and make money, that seems to be the perfect fit for “good works.” It seems to me that waiting to announce your condition until the contract is signed is a bit dishonest and unscrupulous, somehow. But the profit? I don’t mind that.

No, in the end, what really goads me is that my moment on the top of Turk Hill Road and so many others over the years have completely changed my world. They’ve completely changed my way of thinking. They’ve completely changed food for me. Nothing is or will ever be the same again. My diabetes and my general health are now a constant subliminal hum, if I may borrow from William Gibson. Even if dealing with my condition is now old-hat and merely a rational decision rather than the constant freak-out of the past, no meal is eaten without considering my sugar levels.

But nothing, nothing, nothing whatsoever changed about Paula Deen. I’m sure things changed about Paula Deen the woman, but the persona we saw on television for the last three years? Same shitty food. Same “budder, ohl and baicin” recipes that clog your arteries, swamp your system with carbohydrates and generally fuck up your health and lead to the very same Type II diabetes that she has.

While her team of doctors – whom I have no doubt are the best money can buy – hastily arranged her life to fit the healthier style we all aught to be following, she marched her viewers lemming-like to the top of that very same hill I found myself on. Why? How is that even possible? Her world and her livelihood is food. How can that not change radically?

To be clear: no one understands the need for privacy with something like this better than I do. I don’t expect her to immediately shout to the world that she has an illness. Not at all. And I understand that perhaps there are pressures of being a TV food host whose “cuisine,” such as it is, drives a lot of sales for the Food Network. But I am genuinely disturbed by the idea that a person can go through the radical changes I did and not have it reflect in their work, especially when that work is about food.

An opportunity was lost, here. The opportunity to let the process that she and I both have had to go through be a means to help others back down off that hill. Instead, we have three years of silence and then – presto, change-o – a healthy-living Paula Deen who hawks medicine for the condition she “suffers from.” Hell, anybody can stand in front of a camera and sell product. Paula, you had a responsibility as a host and a diabetic. And you skipped over the hardest part.