If you have diabetes, you may know what foods to eat and which to avoid. But you may not know what to do about alcohol. For example, you may not know if you can have a glass of wine with dinner or a few drinks after work with friends. Also, you may be wondering what effect alcohol may have on your body.
First, let's look at your liver. Your liver makes and stores glucose (sugar). This glucose will be released when your body needs to raise your blood sugar levels. The liver also metabolizes, or breaks down, alcohol. When your liver breaks down alcohol, its glucose production is impaired.
Now let's look at medications you may be taking. Insulin and type 2 diabetes medications, like sulfonylureas (glipizide, glyburide) and metformin, decrease your blood sugar levels. Regular meals and a medication plan will help you keep your blood glucose at healthy levels. Habits like skipping meals can cause low blood sugar levels.
Combining already low blood sugar levels with alcohol-impaired liver function will put you at risk for dangerously low blood sugar levels, known as hypoglycemia. Hypoglycemia can occur shortly after drinking. The effect can continue for up to 24 hours afterwards. The symptoms of hypoglycemia and being drunk are similar—confusion, anxiety, and feeling faint. Be careful not to mistake hypoglycemia for drunkenness. Doing so may mean that you do not get the proper help if your blood sugar levels drop too low. Wearing a medical emergency bracelet can be very helpful to alert the people around you that you have diabetes.
Talk with your doctor to make sure alcohol is safe for you. If it is and you decide to drink, do so responsibly. Since alcohol can cause hypoglycemia, it is important not to drink on an empty stomach. Drinking alcohol on an empty stomach can lower your blood sugar to dangerous levels. Eating food, especially foods containing carbohydrates, with alcohol can keep your blood sugar levels from dropping too low.
If you have a glucose meter, be sure to check your blood sugar level before you drink. If your blood sugar is very low (below 70 mg/dL [milligrams per deciliter]), eat something to raise it before drinking alcohol. Also, if you drink before bedtime, check your blood sugar before you go to bed to make sure it is at a safe level (between 100-140 mg/dL).
Even if your doctor says it is okay to drink alcohol, you may still want to think twice if you are trying to maintain a healthy weight. Drinking alcoholic beverages can add extra calories to your diet. These calories are then stored as fat in your body. Not drinking, limiting your drinks, or choosing low-calorie drinks can help you achieve your weight-loss goals. If you have type 2 diabetes, weight management may be especially important, since maintaining a healthy weight directly relates to controlling your diabetes.
If you do decide to drink, keep these tips in mind:
Drinking alcohol is a part of many social situations—be it dinners at home, celebrations, or dining out. Talk to your doctor about the effects of alcohol on diabetes, especially if you are taking medications or have other health concerns, like high blood pressure. With guidance and careful planning, you can control your diabetes in any situation.
American Diabetes Association
National Institute of Diabetes and Digestive and Kidney Diseases
Canadian Diabetes Association
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Checking your blood glucuse. American Diabetes Association website. Available at: http://www.diabetes.org/living-with-diabetes/treatment-and-care/blood-glucose-control/checking-your-blood-glucose.html. Updated August 4, 2016. Accessed November 15, 2017.
Diabetes and alcohol. Joslin Diabetes Center website. Available at: http://www.joslin.org/info/Diabetes_and_Alcohol.html. Accessed November 15, 2017.
Dietary considerations for patients with type 2 diabetes. EBSCO DynaMed website. Available at:https://www.dynamed.com/topics/dmp~AN~T270045/Dietary-considerations-for-patients-with-type-2-diabetes. Updated February 7, 2017. Accessed November 15, 2017.
Fitting alcohol into your meal plan. Joslin Diabetes Center website. Available at: http://www.joslin.org/info/Fitting_Alcohol_Into_Your_Meal_Plan.html. Accessed November 15, 2017.
Shai I, Wainstein J, Harman-Boehm I, Raz I, et al. Glycemic effects of moderate alcohol intake among patients with type 2 diabetes: a multicenter, randomized, clinical intervention trial. Diabetes Care. 2007;30(12):3011-3016.
Last reviewed November 2017 by EBSCO Medical Review Board Michael Woods, MD, FAAP Last Updated: 12/9/2015