Wondering if alcohol is off limits with diabetes? Research has shown that there can be some health benefits such as reducing risk for heart disease. But, there are also risks. Drinking alcohol can cause a drop in blood glucose because alcohol blocks the production of glucose in the liver. (The liver contains “emergency stores” of glucose to raise your blood sugar if it drops too low.) Once the liver's stores of glucose are used up, a person who has drank a lot of alcohol can't make more right away, and that can lead to dangerously low blood glucose or even death.
Also, alcohol is processed by your liver, which is responsible for removing toxins (like alcohol or drugs) and processing medication, so if you are taking other pills, drinking too much alcohol can cause damage to your liver. If you have any questions about whether alcohol is safe for you, check with your doctor. People with diabetes need to use the same guidelines as those without diabetes if they choose to drink:
- Women: no more than 1 drink per day.
- Men: no more than 2 drinks per day.
*One drink is equal to a 12 oz beer, 5 oz glass of wine or 1 ½ oz distilled spirits (vodka, whiskey, gin, etc.).
Some Tips to Sip By
- If you have diabetes, do not drink on an empty stomach or when your blood glucose is low, since your risk of low blood glucose increases after drinking.
- If you choose to drink, follow the rules above and have it with food. This is mainly important for those on insulin and other diabetes pills that can lower blood glucose by making more insulin.
- Don’t skip a meal if you are going to drink. (If you use carbohydrate counting to plan meals, it is important to understand how the drinks you choose affect your blood glucose and often your insulin dose will need to be decreased if having more than one drink)
- Wear an I.D. that notes you have diabetes. If you are in a setting where people are drinking alcohol, hypoglycemia may be mistaken for being drunk.
- Watch out for craft beers, which can have twice the alcohol and calories as a light beer.
- For mixed drinks, choose calorie-free drink mixers like diet soda, club soda, diet tonic water or water.
- As with anyone with or without diabetes, do not drive or plan to drive for several hours after you drink alcohol.
Alcohol can cause hypoglycemia shortly after drinking and for up to 24 hours after drinking. If you are going to drink alcohol, check your blood glucose before you drink while you drink and regularly for up to 24 hours. Also check your blood glucose before you go to bed to make sure it is at a safe level – between 100 and 140 mg/dL. If your blood glucose is low, eat something to raise it and be sure to check again before you go to sleep and again in the night to be sure it’s not dropping too low.
The symptoms of too much alcohol and hypoglycemia can be similar – feeling sleepy, dizzy and confused. The one way to get the help you need is to always wear an I.D. that says "I have diabetes." Also, be sure that your family and friends know to be aware of your symptoms of hypoglycemia and what to do.
Wondering if adding a glass of wine or beer might help lower your blood glucose if it is high? The effects of alcohol can be unpredictable and it is not recommended as a treatment for high blood glucose. The risks likely outweigh any benefit that may be seen in blood glucose alone.
- If you choose to drink alcohol, follow the rules above and have it with food to help prevent a low blood sugar. Talk with your health care team about whether alcohol is safe for you.
- If you drink alcohol several times a week, make sure your doctor knows this before he/she changes the dose or type of diabetes pills and/or insulin as well as changes to other medications including adding or changing other pills or injectable medication. See "What Can I Drink?" for non-alcoholic drinking guidelines.
Adapted from the book Diabetes Meal Planning Made Easy, 4th Edition, written by Hope S. Warshaw, MMSc, RD, CDE, a nationally recognized expert on healthy eating and diabetes.