Diabetes is, of course, a very common disease in American society. By most estimates, 15-20% of all drivers on the road are diabetics. Unfortunately, the similarity between the symptoms of alcohol intoxication and those of a diabetes attack are striking, and commonly lead to easy — but false — conclusions by law enforcement officers. (See my earlier post, “Diabetes and the Counterfeit DUI”.)
The symptomatic reactions of a person in the early stages of a diabetic attack include dizziness, blurred vision, numbness of lips, weakness, loss of coordination, slurred speech and confusion. These are, of course, symptoms which the patrol officer is looking for: the clear signs of a person under the influence of alcohol. And the officer’s observations are quickly followed by a failing performance on field sobriety tests. To make matters worse, a diabetic who is suffering from an insulin reaction will experience production of acetone in the breath. And acetone is one of those chemical compounds which most breath machines will “see” as alcohol, resulting in a falsely high blood-alcohol test result. (See “Why Breathalyzers Don’t Measure Alcohol”.)
The following is excerpted from an article entitled “Hypoglycemia: Driving Under the Influence”, 8 Medical and Toxicological Information Review 1 (Sept. 2003) by Dr. John Arnold, reproduced in my book Drunk Driving Defense, 6th edition:
Hypoglycemia (abnormally low levels of blood glucose) is frequently seen in connection with driving error on this nation’s roads and highways, including accidents with personal and material damage. Even more frequently are unjustified DUIs or DWIs, stemming from hypoglycemic symptoms that can closely mimic those of a drunk driver…. With the numbers of people with blood sugar problems and other errors of metabolism rising, it is becoming more important that ever for individuals, medical professionals and law enforcement personnel to recognize both the danger signals of hypoglycemia and to understand that although the condition mimics closely those who irresponsibly abuse alcohol, judicious use of sound science principles can ensure that a health-compromised individual is not unjustly punished for a pre-existing physical condition.
Actually, you don’t even need to be a diabetic to display hypoglycemic-induced symptoms of intoxication. Perfectly normal, healthy individuals can experience temporary conditions of low blood sugar after consuming small amounts of alcohol, resulting in exaggerated but false symptoms of intoxication.
According to Dr. Keith Ryan in his article “Alcohol and Blood Sugar Disorders”, 8(2) Alcohol, Health and Res. World (1983), consumption of even small amounts of alcohol can produce hypoglycemia — either fasting glycemia or reactive glycemia. Fasting glycemia can exist where a person has not eaten in 24 hours or has been on a low-carbohydrate diet. Production of glucose in the liver is stopped while the alcohol is broken down. Result: the blood sugar level will drop, affecting the central nervous system — and producing symptoms of intoxication.
Reactive glycemia occurs when consuming alcohol increases the production of insulin by the pancreas. This rise in insulin causes a drop in blood sugar — again, with the attendant false signs of inebriation. Interestingly, this reaction to alcohol is commonly encountered in chronic alcoholics.