Having diabetes does not mean you have to give up alcohol – not if your diabetes is well controlled. In fact, adults with diabetes should follow the same guidelines as the general public. Do not drink alcohol on an empty stomach. Have a small meal or snack before drinking. Limit alcohol to 1 to 2 drinks per day.
However, there are some potential risks to keep in mind.
Hypoglycemia
When diabetes is well controlled, blood glucose levels are not significantly affected by the moderate use of alcohol. But drinking more than three drinks per day over time is associated with worsening glucose control.
If you take insulin or other diabetes medication that increases the amount of insulin your body makes, you may have an increased risk of hypoglycemia – also called low blood sugar. Under normal circumstances when blood glucose levels drop the liver responds by producing glucose. The liver stores glucose to raise your blood sugar if it drops too low. If the liver has depleted its glucose stores and can't make more glucose right away, blood glucose levels can drop.
“Alcohol makes it harder for your liver to make glucose which could make someone's blood glucose very low, leading to dangerously low blood sugars or even death,” says Dr. Mohamed Jalloh, spokesperson for the American Pharmacists Association (APhA). It's important to monitor blood glucose and never drink on an empty stomach to avoid hypoglycemia. Doctor Jalloh recommends checking blood glucose before drinking, while drinking and at least one more time within 24 hours of drinking. Also, have a small meal or snack before you drink.
When you drink in the evening, there is an increased risk of overnight hypoglycemia. To help prevent overnight hypoglycemia monitor blood glucose before bed and be sure to eat an evening snack with carbohydrate if your blood glucose is less than 100 mg/dl.
Symptoms of hypoglycemia, such as slurred speech or unsteadiness when standing or walking, are similar to alcohol intoxication. If you are in a setting where people are drinking alcohol, hypoglycemia may be mistaken for being drunk. Wearing diabetes medical identification can help you get the proper care.
You might be wondering if a glass of wine or beer is a good way to lower your blood glucose if it is high. Doctor Jalloh says absolutely not. "I always tell my patients not to drink alcohol to lower their blood sugars! Alcohol is too unpredictable when in the body and is not recommended for treating high blood sugar readings.”
Medication Interaction
In addition to storing glucose, your liver is responsible for removing alcohol and other drugs from your body. It is also responsible for processing medication. If you are taking medication, drinking too much alcohol can cause damage to your liver.
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You should avoid binge drinking if you are taking metformin to control your diabetes. Doctor Jalloh says, “Drinking alcohol while taking metformin can increase the risk of metformin's infamous rare side effect of lactic acidosis. Patients should avoid excessive amounts of alcohol (i.e., more than 2 drinks a day for men or 1 drink a day for women) while taking metformin. One drink is equal to a 12 oz beer, 5 oz glass of wine, 1 ½ oz distilled spirits such as vodka, whiskey or gin.”
Tips for Drinking Alcohol
- Do not drink alcohol if you have:
- Hypoglycemia or hypoglycemia unawareness
- Elevated triglyceride levels
- Pancreatitis
- Neuropathy
- Abstain from alcohol if you are pregnant or attempting to become pregnant.
- Avoid high calorie, sugar-laden mixers. Opt for diet soda, club soda, diet tonic water or water.
- “Make simple swaps for traditional favorites—think rum and diet coke instead of rum and coke,” says Theresa Link, RD, CDE, a clinical dietitian at VirtaHealth.com, an online specialty clinic for reversal of type 2 diabetes. If you prefer a sweet drink, Link suggests you try her recipe for low-carb Kahlua: ¼ cup strong brewed coffee, ¼ cup Splenda, 1 tsp vanilla, 4 oz vodka, and 4 oz brandy.
- If beer is your beverage of choice, watch out for craft beers. They can have twice the alcohol and calories as a light beer.
- Link says, “Choose dry wines and distilled spirits instead of sweet wine because they have the least amount of carbohydrate."
