If you have diabetes, you may be wondering, "Can a person with diabetes drink alcohol?" The main concern when drinking alcohol with diabetes is that it can cause your blood sugar to drop very low — below 70 milligrams/deciliter (mg/dL) — known as hypoglycemia. Some alcoholic drinks also have a lot of calories, which can cause weight gain. And alcohol may reduce the effectiveness of some of your diabetes medications.
So, it's a good idea to drink in moderation and only when your diabetes and blood sugar levels are well managed. You may want to talk to your doctor to see if drinking alcohol is safe for you and get guidelines based on your specific health concerns.
Effects of Alcohol on Diabetes
If you have diabetes, it is pretty common for your blood sugar to be low at times. Things that cause this include:
- Not eating enough carbohydrates
- Taking more insulin than you need
- Being in a high-altitude area
- Having your period
It's important to keep your blood glucose levels stable because when they drop below 70 milligrams/deciliter, it can cause headaches, irregular heartbeat, anxiety, and confusion. If levels are low enough, it may even cause seizures.
Alcohol can also affect your body's ability to regulate blood sugar. It can make it drop, especially if you haven't eaten enough. If you've had a big meal and a lot of alcohol, it can also raise your levels too high.
Effects of alcohol on blood glucose
Your liver is the organ that stores and releases glucose (sugar) into your bloodstream. It does this between meals and while you sleep to help maintain healthy blood sugar levels. The liver is also in charge of breaking down toxins so they can be flushed out of your body by your kidneys.
When you drink alcohol, the liver has a difficult time doing both of these jobs at the same time. It ends up breaking down alcohol instead of releasing glucose regularly. When this happens, your blood sugar levels aren't steady and can drop too low. This is even more likely to happen when you drink without eating any food.
Your liver takes about 1 to 1.5 hours to process each alcoholic drink, and during that time, you may be at risk of low blood sugar. The risk multiplies with each additional drink you have. The risk can be lowered if you take alcohol along with food. If you've had alcohol close to bedtime, you should test your glucose level; if it’s low, consume a carbohydrate-rich snack before bed.
Aside from causing low blood sugar, drinking alcohol can also affect people with diabetes in several other ways.
Increased weight gain. Alcohol stimulates your appetite and may affect your judgment, which may cause you to overeat and disrupt your blood sugar control. Alcoholic drinks often have a lot of calories, making it more difficult to lose excess weight.
Physical impacts. Small amounts of beer and sweet wines can be high in carbohydrates, which can raise blood sugar temporarily. Drinking too much alcohol can increase triglyceride levels (fat in the blood) and your blood pressure.
Hypoglycemia. Alcohol can cause flushing, nausea, increased heart rate, and slurred speech. These symptoms can be confused with or mask the symptoms of low blood sugar. This can make it difficult to tell if you've had too much to drink or if your blood sugar is dropping to dangerously low levels.
Diabetes medications: Alcohol can interfere with the positive effects of oral diabetes medicines or insulin. This is because alcohol can keep your liver from turning proteins and fats into carbohydrates when your body needs energy, such as during exercise or between meals.
Drinking alcohol can also make some of the symptoms of diabetes worse. These include:
Alcohol and Diabetes: Dos and Don’ts
If you have diabetes, it may be best to avoid drinking alcohol. If you'd like to have the occasional drink, talk to your doctor first. They can tell you if alcohol might interfere with your medications or cause other health issues.
If you have diabetes, you should drink in moderation. Do not drink more than two drinks of alcohol in a day if you are a man or person assigned male at birth, or one drink if you are a woman or person assigned female at birth. (Example: one alcoholic drink = a 5-ounce glass of wine, a 1.5-ounce shot of liquor, or a 12-ounce beer).
When drinking, you should:
- Drink alcohol only with food, and make sure to include some carbs.
- Drink slowly.
- Mix liquor with low-calorie options such as water, club soda, or diet soft drinks.
- Wear a medical alert piece of jewelry that says you have diabetes.
- Monitor your blood sugar levels before, during, and after drinking.
- Make sure to have a carbohydrate source, such as glucose tablets, with you when you are drinking.
Things to avoid when drinking include:
- Combining alcohol with exercise because it increases your chances of low blood sugar
- Sweet wines or drinks mixed with sugary mixers, juice, or soda
- Drinking if your blood sugar is low
- Drinking if you are trying to lose weight
The best alcoholic beverages if you have diabetes include:
- Red wine/dry white wine
- Prosecco
- Distilled spirits such as gin, tequila, vodka, or whiskey
- Light beer
- Hard seltzer
- Low-carb cocktails such as dry martinis, vodka soda, bloody Marys, or Manhattans
Can Alcohol Cause Diabetes?
No research shows a direct link between alcohol and diabetes. But studies have found that drinking, especially heavy drinking, can increase your risk of having diabetes. Heavy drinking is considered to be at least five drinks per day (or 15 per week) for a man or person assigned male at birth, and four drinks a day (or eight per week) for a woman or person assigned female at birth.
It's not fully understood why drinking can increase your risk of getting diabetes, but it is known that alcohol can reduce the function of different organs including your liver and pancreas. When these two organs don't work well, it can make your glucose control worse.
Takeaways
Alcohol isn't off-limits if you have diabetes. Talk with your doctor before drinking alcohol to make sure alcohol won't reduce the effectiveness of your medication. It's also best to have a meal or snack that includes carbohydrates when you are drinking alcohol. This will help reduce the risk that your blood sugar will drop too low.
Alcohol and Diabetes FAQs
What are the risks of drinking alcohol with diabetes?
Drinking alcohol can reduce your liver's ability to regulate the release of carbohydrates into your bloodstream. When this happens, your blood sugar can drop too low, which is known as hypoglycemia. Eating food when you drink can help stop this from happening. On the other hand, if you have lots of food and then drink too much, your blood sugar can get too high.
What alcohol can people with type 2 diabetes drink?
No alcohol is completely off-limits for people with diabetes. You are probably better off, however, if you choose drinks that have fewer carbohydrates, such as light beers, dry wines, and seltzers. Avoid drinks that contain sweet mixers or juices, such as a margarita or tequila sunrise.
