This is the Partying with T1D guide. It is a lived-experience, harm-reduction framework for people with type 1 diabetes who are navigating alcohol, drugs, and high-risk social environments.
This page is different from most diabetes resources. It is not written from clinical trials or guidelines — because they largely do not exist for this topic. It is built from the real experiences of people living with T1D: people we’ve met, worked with, partied with, and in some cases supported through near-misses and serious consequences.
The goal is not to promote substance use or to tell you what to take. The goal is to reduce harm by helping you understand the terrain before you’re in it — when insulin, glucose, cognition, sleep, and substances collide.
Finish this page to understand the shared principles and risk models. If you already know the terrain, jump directly to the substance-specific sections.
- Part 2: Alcohol and T1D
- Part 3: Stimulants and T1D
- Part 4: Cannabis, Ketamine, and Hallucinogens
Why this matters
Partying is not a moral problem. It is a systems problem.
With T1D, substances interact with insulin on board, liver glucose output, appetite, sleep disruption, dehydration, and impaired decision-making. The risk is rarely the substance alone — it’s the timing, the stacking of effects, and the reduced ability to detect and respond to hypoglycaemia or hyperglycaemia when cognition is altered.
Most official advice stops at “don’t do it”. That advice fails the moment someone is already planning a night out, already at a festival, or already curious. This guide exists to fill that gap with honesty, realism, and harm-reduction — without judgement or shame.
The shared framework
Across all substances discussed in this guide, the same core principles show up again and again. Understanding these matters more than memorising substance-specific rules.
The inverted U. Every psychoactive substance operates on a dose–response curve. Too little does nothing. Somewhere in the middle is the effect people seek. Beyond that point, risk rises sharply — distress, confusion, loss of control, blackouts, or medical emergencies. Where that peak sits is highly individual and context-dependent.
Set and setting. Who you’re with, where you are, how safe you feel, your mood, and your expectations all shape the experience. These factors also shape diabetes risk by influencing eating, monitoring, help-seeking, and sleep.
Dose uncertainty. Unlike insulin or prescribed medications, most recreational substances are unregulated. Purity and potency are often unknown. This makes overshooting the inverted U far more likely — especially when substances are combined.
Reduced self-rescue. Substances that impair judgement, awareness, or coordination reduce your ability to recognise and treat hypos, respond to CGM alarms, or communicate that you need help.
What this guide covers
- Shared risk models used across alcohol, stimulants, and other substances
- Patterns seen repeatedly in people living with T1D
- Harm-reduction principles that apply regardless of substance
- Real-world constraints, not idealised behaviour
What this guide does not cover
- It does not provide dosing instructions
- It does not promote substance use
- It does not replace medical or clinical advice
- It does not discuss legality
Safety and context
The human brain continues developing into the mid-twenties, particularly areas involved in impulse control and long-term planning. Substances that alter dopamine, serotonin, or GABA signalling carry a higher risk during this period. This is not a moral statement — it is neurobiology.
People also differ biologically and psychologically. Some have a strong internal “off switch”. Others are more vulnerable to compulsive patterns, anxiety, or dysregulation. Trauma history, neurodivergence, and prior experiences all matter. One person’s manageable experience can be destabilising or dangerous for another.
Across lived experience, two principles consistently reduce harm:
- Test it, don’t guess it
- Start low and go slow
What happens next
Use this page to orient yourself. Then move to the substance-specific sections for pattern recognition, failure modes, and practical risk-reduction strategies.
GNL resources
References
- [1] Nutt DJ et al. Drug harms in the UK: a multicriteria decision analysis. The Lancet. Link
