Social drinking practices have been found to be a salient issue for young adults suffering from type 1 diabetes (T1DM), and inflammatory bowel disease (IBD), with many reporting participating in such practices in spite of the potential additional health risks (Eaton et al. 2001; Balfe 2009). Drawing on interviews with sufferers of T1DM and IBD, aged 18-29 (n = 30), this paper aims to investigate how their reasoning behind this behaviour is discursively constructed. Through using the 'Accounts' framework (Scott and Lyman 1968), sufferers were shown to construct an identity of 'good' diabetic, or IBD, sufferer. A key difference found across the two conditions was that T1DM sufferers more regularly constructed 'excuses' for engaging in potentially 'risky' behaviour, whereas IBD sufferers predominantly produced 'justifications' which framed their behaviour as not necessarily being irresponsible. This finding reflects the degree of risk at which sufferers of the respective conditions view their social drinking behaviour as placing them. The stronger biomedical evidence that alcohol has negative effects on T1DM leads sufferers to view their 'healthy body' (Balfe 2009) in terms of more serious health implications, whereas IBD sufferers view their 'healthy body' in terms of short-term exacerbation of symptoms, which they do not see as significantly affecting their general IBD-health.