Diet and Nutrition

Alcohol and Diabetes

October 20, 2017   /
Elaine M. Hinzey, RD, LDN
Nutrition411 Staff

Enjoying a glass of wine at a special dinner or drinking a beer while watching football is a tradition for many people. Luckily, most people with diabetes still can enjoy an occasional drink, but before you do, you should first speak to your doctor or a registered dietitian nutritionist to make sure it is safe for you. 

The following tips will help you understand the impact that alcohol has on diabetes, and how to drink sensibly and still stay healthy. 

Potential health benefits of alcohol
Some studies have shown that light to moderate alcohol consumption may reduce the risk of cardiovascular disease; however, the results are mixed. It seems that most of the positive effects from drinking alcohol involve increasing high-density lipoprotein (HDL) cholesterol levels by up to 12%. It appears that red wine is the most cardioprotective form of alcohol. 

Another study that looked at 38,500 people found that those people who drank a moderate amount of alcohol had the best A1C (average blood glucose) levels, when compared to people who either abstained from alcohol or drank heavily. Some evidence also shows that moderate drinking may reduce the risk of diabetes development by 33-56%. 

A safe amount of alcohol
No one would ever suggest to people who currently do not drink alcohol that they should pick up the habit. However, if you already drink alcohol, you must limit yourself to one or two drinks per day.

A drink is:

  • 12 fluid ounces (fl oz) of beer
  • 5 fl oz of wine
  • 1½ fl oz of 80-proof distilled spirits
  • 1 fl oz of 100-proof distilled spirits

Individuals who absolutely should not drink
It is recommended that people with the following conditions abstain from alcohol consumption:

  • If you have a tendency to become hypoglycemic or were unable to recognize symptoms of hypoglycemia in the past
  • If you have diabetic complications, such as neuropathy or retinopathy, because alcohol is proven to worsen these conditions
  • If you have cardiovascular disease or high blood pressure, because alcohol consumption increases triglycerides and blood pressure, which increases the risk of heart disease and stroke. In addition, research has shown that there is an increased risk of heart attack and stroke in the 24 hours immediately following the consumption of alcohol. This risk is diminished after 24 hours for moderate drinkers, but remains high for heavy drinkers.
  • If you are trying to lose weight, because alcohol is a concentrated source of calories and can increase appetite

How to drink sensibly
The following suggestions can help you drink sensibly.

  1. Food: Never drink alcohol on an empty stomach (make sure to consume at least 15 grams (g) of carbohydrate before or while having a drink), and only drink alcohol if your blood glucose level is between 100-140 milligrams (mg)/deciliter (dL).
  2. Hours later: Understand that alcohol can cause hypoglycemia for up to 12 hours after drinking. 
  3. Fat servings: Know that a drink generally counts as 2 fat servings.
  4. Blood sugar: Test your blood glucose 1 or 2 hours after drinking and again before going to bed.
  5. Diabetes alert jewelry: Always wear your diabetes alert jewelry. The symptoms of hypoglycemia and intoxication can mimic each other, making it less likely that you will receive the care that you need for hypoglycemia in a timely manner.
  6. Mixed drinks: Avoid mixed drinks, such as margaritas and piña coladas, which can contain an astounding amount of carbohydrates. They also can cause your blood glucose levels to swing wildly from high to low.
  7. Insulin and medications: Know that insulin or medications, such as sulfonylureas or glitinides, increase the release of insulin and raise the risk of hypoglycemia. Metformin usually has a warning label about excessive alcohol intake because the combination of alcohol and the drug can lead to harmful lactic acid buildup in the blood.
  8. Exercise: Do not exercise before drinking alcohol, because this will increase the likelihood of you becoming hypoglycemic.
  9. Number of drinks: Do not drink more than two drinks in a 24-hour period if you are male or one drink if you are female. Drink slowly.
  10. Water: Drink plenty of water.