The Diabetic Who Looks Drunk
A woman in her 50s at a Fairbanks tavern has had two glasses of wine over two hours - a modest amount for her size. At 9:00 p.m. she becomes confused, sweaty, shaky, and her speech is slurred. She is irritable when you ask if she is okay and insists she has 'only had two.' She is a known regular who sometimes mentions 'my sugar.' Her friend says she 'gets like this sometimes.' She asks for another glass of wine.
1. Why should you not simply assume she is intoxicated, and what should you do first?
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Her symptoms - confusion, sweating, shakiness, slurred speech, irritability - overlap with intoxication but also match hypoglycemia (low blood sugar), which can be life-threatening. Two glasses of wine over two hours is a modest amount, and she is a known regular who has mentioned her sugar. The safe assumption is medical, not drunk.
First: do not serve the wine. Ask calmly whether she is diabetic and whether she needs sugar - offer juice, regular soda, or food. Stay with her, involve the manager, and if she does not improve quickly or loses consciousness, call emergency services. Never give more alcohol to someone who may be hypoglycemic; alcohol can worsen low blood sugar.
2. Her friend says 'she gets like this sometimes.' How does that change your decision, and what is your service decision for the rest of the night?
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The friend's comment is useful context but not a diagnosis and not permission to keep serving. 'Gets like this sometimes' could mean recurrent hypoglycemia - which makes it more important, not less, to treat it as medical. It does not mean she is fine to drink.
Service decision: no more alcohol tonight, regardless of how the episode resolves. If it is hypoglycemia, she needs sugar and monitoring, not wine. If it turns out to be impairment, she is cut off anyway. Either way the outcome is the same: stop service, address the medical possibility first, document what you observed and did, and follow up with the manager.