What to Know About Alcohol and Diabetes, According to an Expert

Living with diabetes doesn't mean you have to live a life of deprivation and misery, but you'll need to play it smart when it comes to drinking.

Alcohol can have an impact on blood sugar, and you should be aware of its effects. Here are some facts on alcohol and the impact drinking has on the health and safety of a person with diabetes.

What is diabetes?

Diabetes is a chronic condition that affects how your body turns food into energy, according to the U.S. Centers for Disease Control and Prevention. Your body converts food into glucose (sugar) that goes into the bloodstream. The pancreas reacts by releasing insulin. When an individual has diabetes, insulin isn't released or isn't processed correctly, resulting in too much glucose in the bloodstream. High blood sugar or glucose levels can be dangerous and result in serious health conditions.

Can you drink alcohol with diabetes?

The topic of diabetes and alcohol is discussed in a 2021 Mount Sinai Health Library article. The article suggests it's safe to drink alcohol if:

Your diabetes is under control.
Your healthcare provider has given you the OK to drink moderately.
You understand how alcohol can affect your blood sugar and the precautions to take to prevent problems.

How does alcohol affect diabetes?

To understand how alcohol affects blood sugar levels, it's important to first understand how what you eat and drink is processed in the body.

The liver processes what you consume and converts it into glucose. This is the body's main source of energy. Glucose is then released into the bloodstream throughout the day when your body needs it, according to the U.S. National Library of Medicine.

Dr. Matthew Freeby, director of the Gonda Diabetes Center at the University of California, Los Angeles, explains the role alcohol plays in this process.

"When alcohol is consumed, it may reduce the liver's ability to produce glucose," he said. "There's a risk for low blood sugars, because essentially the liver is trying to metabolize the alcohol rather than produce glucose."

The result is less glucose in your bloodstream, causing low blood sugar or hypoglycemia.

Signs of hypoglycemia can look similar to those of someone who's had too much to drink. This includes "confusion, slurred speech and imbalance," Freeby said. Left untreated, hypoglycemia can cause seizures or even unconsciousness.

Conversely, alcoholic drinks high in carbohydrates such as beer, sweet wines or mixed drinks can raise blood sugar levels causing hyperglycemia. Untreated hyperglycemia can lead to serious health conditions that affect the eyes, kidneys, nerves and heart. It may require emergency medical care, the Mayo Clinic warns.

So should someone with diabetes avoid drinking alcohol? The old saying, "Everything in moderation," might be key.

"Every patient is a little bit different," said Freeby, "And I do think in moderation for many of our patients with diabetes it can be done safely without any immediate as well as long-term safety concerns."

What does drinking in moderation mean?

The CDC defines drinking in moderation as two drinks or fewer a day for men and one drink or less a day for women. It defines one drink as:

12 ounces of beer
5 ounces of wine
1.5 ounces of 80-proof distilled spirits

The CDC warns you shouldn't drink alcohol if:

You’re pregnant or might be pregnant.
You have a medical condition that prohibits drinking alcohol.
You’re taking medication that interacts with alcohol. (Look at the label or ask your doctor.)
You’re recovering from an alcohol disorder or can’t control the amount you drink.

Drinking alcohol when you have diabetes

For people with diabetes who would like to have a drink now and then, Freeby offers these recommendations:

Consult with your healthcare provider first to discuss the health and safety risks of consuming alcohol.
Avoid drinking on an empty stomach.
Stick to low-carb drinks whenever possible. (Johns Hopkins Medicine notes that light beers, dry wines, and drinks mixed with diet soda or seltzer are good choices. Sweet wines and mixed drinks like piña coladas and wine coolers are not.)
Consume food with carbs while drinking. Try snacks such as half a sandwich; yogurt; or cereal with milk, cheese with crackers, or apple with peanut butter, Hopkins Medicine suggests.
Monitor your glucose levels before, during and after drinking.
When possible, share your glucose monitoring data with a person you’re with while drinking.
Consume a snack before bedtime to reduce the risk of low blood sugar overnight.
Carry a rescue agent like glucose with you. Individuals known to have dangerously low blood sugars may also carry a rescue agent called glucagon (GlucaGen) that can increase sugars in an emergency situation.
The American Diabetes Association has more on drinking with diabetes.

Freeby repeats the importance of drinking alcohol in moderation.

"Generally, for our patients with diabetes we really try to encourage them to live their lives, do what they want to do within reason, and learn how to do it safely," he said.

By Jessica Daniels, BDO Staff Writer | Published August 28, 2023