Can I Drink Alcohol?

October 30, 2024

With Diabetes, you need to consciously make lifestyle choices especially when it comes to food and beverage intake. There is one question many people with diabetes often ask: Can I drink alcohol? It isn’t so much as a simple yes or no answer. Moderate drinking may be okay for some, but heavy drinking or otherwise reckless drinking can be very unhealthy for diabetics.

In this blog, we will cover everything from how alcohol affects diabetes, to the precautions that should be taken, and how you can enjoy alcohol responsibly while living with diabetes.

Understanding Diabetes and Alcohol

Diabetes is a disease in which the body does not make or properly use the hormone insulin, causing, among other things, high blood sugar. The two main types of diabetes are:

Type 1 Diabetes

A disease where the body cannot produce insulin. Type 1 diabetes means people with the condition need to inject insulin or use an insulin pump.

Type 2 Diabetes

A disease where the body isn’t responsive to insulin, doesn’t produce enough insulin or both. Diet, exercise and medication can often manage this type, but some people may need insulin as well.

Blood sugar levels are affected by alcohol, and it can interfere with your diabetes management, so it’s important to understand how alcohol works.

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How Alcohol Impacts Blood Sugar

The liver not only processes alcohol, but is also responsible for making glucose (sugar) to stabilise your blood sugar levels, particularly between meals or when fasting. Your liver will preferentially metabolise the alcohol you drink instead of producing glucose, causing your blood sugar levels to drop (hypoglycemia). For people with diabetes, this is dangerous, especially if they’re on insulin or medications that lower blood sugar.

Short-term Effects of Alcohol on Blood Sugar

Hypoglycemia

Drinking alcohol, especially on an empty stomach, can result in a very significant decline in blood sugar levels. Hypoglycemia occurs because alcohol inhibits the liver’s ability to release glucose. The risk of hypoglycemia is even higher in those taking insulin or other diabetes medications.

Hyperglycemia

Some alcoholic beverages can even spike your blood sugar levels as they have a high sugar content, especially cocktails or mixed drinks. If you drink too much wine or beer, they may also contain carbohydrates that can kick up blood glucose levels.

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Long-term Effects of Alcohol on Diabetes

Weight Gain

Alcohol is calorie dense and excess consumption can cause you to gain weight. That’s of particular concern for people with Type 2 diabetes, because being overweight or obese can worsen insulin resistance and complicate diabetes management.

Liver Damage

People with diabetes are already at increased risk for liver complications and chronic alcohol consumption can result in liver disease, so this is problematic.

Can You Drink Alcohol if You Have Diabetes?

Yes, people with diabetes can drink, but only if the drink is consumed carefully. The key is drinking alcohol in moderation and you always have to take into account how alcohol can interact with your medications, your blood sugar levels and your entire diabetes management plan.

General Guidelines for Drinking Alcohol with Diabetes

Here are some general guidelines for people with diabetes who choose to consume alcohol:

Moderation is Key

The American Diabetes Association (ADA) advises moderate drinking for people with diabetes. For women, that’s up to one drink a day, and for men that’s up to two drinks a day. One drink is typically defined as:

12 ounces of beer
5 ounces of wine
1.5 ounces of distilled spirits like whiskey, rum, or vodka

Never Drink on an Empty Stomach

Alcohol without food can quickly drop your blood sugar, especially if you are on insulin or some oral medications that can stimulate the release of insulin. It’s better to have a meal or snack with carbohydrates before drinking alcohol.

Monitor Your Blood Sugar

Before, during and after you drink, always check your blood sugar levels. This will tell you how your body handles alcohol and if corrections need to be made to ensure a safe environment. If you have hypoglycemia, it’s important to keep glucose tablets on hand as a source of fast acting sugar to help stabilise your blood sugar levels.

Be Aware of Your Medications

Combining some types of diabetes medications with alcohol increases your risk of getting hypoglycemia. Your healthcare provider can tell you whether or not you should adjust your medication when you drink.

Stay Hydrated

Dehydration is worsened by alcohol, and dehydration can make the symptoms of high blood sugar worse. If you’re drinking alcohol, be sure to drink some water as well to stay hydrated.

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Choosing Alcohol Wisely

Alcoholic beverages are not all equal, and some are more potentially harmful to people with diabetes than others. Here’s a breakdown of the types of alcohol and their potential impact on blood sugar:

Beer

Beer is high in carbohydrates and can raise your blood sugar levels. If you’re diabetic or counting carbs, choose lower carb light beer options. But you should always be careful with how much beer you drink and how it affects your blood sugar.

Wine

Red wine has been proved to have some health benefits when consumed in moderation. In addition, some studies indicate that moderate wine consumption may enhance insulin sensitivity and decrease the risk for heart disease — a common concern of people with diabetes. But wine still has sugar, and can have blood sugar consequences, so moderation is required.

Spirits and Cocktails

In general, low carbohydrate spirits such as vodka, whiskey, and gin are a better choice for people with diabetes. Mixers, though, need to be handled carefully. For instance, sugary fizzy drinks, fruit juices, and syrups used in cocktails can make your blood sugar rise. Choose diet drinks, sparkling water or water as your mixer to keep your drink low in sugar.

Risks and Complications of Alcohol with Diabetes

While moderate alcohol consumption may be safe for some people with diabetes, excessive drinking can lead to serious complications:

Severe Hypoglycemia

Drinking alcohol can also cause a delayed hypoglycemia, meaning that your blood sugar may drop hours after the consumption of the alcohol. And if you are asleep, this is especially dangerous because you may not be able to wake up to treat low blood sugar levels.

Liver Disease

Heavy drinking compounds the problems that people with diabetes already have with their liver. Fatty liver disease and liver failure that can occur as a result of chronic alcohol use can make it more difficult to control diabetes.

Heart Disease

People with diabetes face an increased risk of heart disease, and so do heavy drinkers because alcohol can raise the risk of high blood pressure, obesity, heart attacks and strokes.

Special Considerations for People with Type 1 Diabetes

Type 1 diabetics must be very careful with how they consume alcohol. Hypoglycemia is much of a concern since they manage blood sugar using insulin. It can also impair judgement, making it hard to know when your blood sugar is low like feeling dizzy, confused, or shaky. And always let people know you have diabetes, and teach them what to do if your blood sugar gets too low.

Alcohol and Social Situations

Alcohol is often present in social situations and managing diabetes with alcohol is tricky. Here are some tips to help you stay in control while still enjoying the moment:

Plan Ahead

If you know that you will be drinking, plan your meals and your medications accordingly. Remember portion sizes and do not ingest sugary cocktails.

Stay Active

Engage in light physical activities like walking which helps regulate blood sugar levels.

Have a Support System

Tell friends or family members about your condition and how they can help if they see you having a low blood sugar episode.

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Conclusion

Can you drink alcohol if you have diabetes? Yes, but with caution and careful consideration. You can drink alcohol and minimise risks by drinking in moderation, monitoring your blood sugar, and choosing lower carb alcoholic beverages. Discuss your options with your healthcare provider who can help you find the right way to navigate alcohol consumption with diabetes, always being mindful and doing it in moderation.

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