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Alcohol and Diabetes: What You Need to Know

Here's what you should know about drinking alcohol with a diabetes diagnosis.

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If you’re living with diabetes, drinking alcohol can seem like a daunting prospect.

What will alcohol do to my blood sugars? How will I be able to manage my drinks? A ton of questions may come to mind.

But it’s important to remember that you can still enjoy a drink or two – in moderation – as long as you take some precautions.

In this article, we’ll discuss how alcohol can affect blood sugar levels, and give you some tips for drinking safely and responsibly with diabetes.


What happens if you drink alcohol when you have diabetes?

hand-drawn illustration of an alcoholic drink with ice and a lime wedge

It’s all about the liver.

Between meals and while you sleep, the liver makes new glucose and then sends this sugar into the bloodstream as a way to regulate your body and prevent or slow down a low blood sugar reaction.

When you drink, the alcohol disrupts the process.

Substances form when alcohol breaks down in the liver. and those substances block the liver from making new glucose.

Blood sugars fall and you can quickly experience hypoglycemia.

This doesn’t mean that you can’t drink at all, but it’s really important to drink in an environment where you feel safe, with others who know what to do just in case your hypos are severe.

There is also a difference in outcomes for blood glucose depending on whether you’re fasting, or you’ve eaten.

Studies show for people with type 2 diabetes who’ve eaten prior to consuming alcohol fasting blood sugar levels of those who drank were significantly higher than those who did not.

On later days, no significant differences in fasting blood sugar levels existed between the two groups of diabetics.

If you were fasting prior to drinking, you may experience hypoglycemia, but also a delayed glucose recovery from hypoglycemia.

This means that after an episode of hypoglycemia, glucose levels return to normal more slowly after drinking.

How much can you drink when you have diabetes?

The ADA recommends no more than one alcoholic drink per day for women and two for men.

That “drink” smaller than expected: just five ounces of wine, a 12-ounce beer, or one and a half ounces of 80-proof spirits.

A daily cocktail or two may improve blood sugar (blood glucose) management and insulin sensitivity. If you have one or more drinks a day, you may find that your A1C is lower than during times you weren’t drinking.

It’s important to consult your doctor if you’re thinking about consuming alcohol.

Why is it dangerous to drink alcohol and take some diabetes medications?

Many diabetes medications promote hypoglycemia.

Drinking alcohol on top of drugs that cause low blood sugar can be extremely dangerous because drinking slows down the absorption of foods and sugars.

Alcohol also affects your judgment and makes it much easier to make poor health decisions like eating sugary snacks or drinking more alcohol.

The combination may produce drinking too much or drinking while feeling sleepy, which put you at risk of hypoglycemia symptoms such as confusion and dizziness, seizures, depression, severe headaches, rapid heart rate and coma.

When should I test my blood sugar after drinking alcohol?

Drinking can affect your blood sugar for up to 12 hours according to Hopkins Medicine.

It’s advised to test your blood sugars prior to drinking and before going to bed. If it is in the 100 – 140 mg/dL range, you may be fine. If it is lower, eat a snack to raise it, so it doesn’t dip lower while you sleep.

If possible, having a Continuous Glucose Monitor with alarms on can be helpful, so that the alarms wake you if your blood sugar is going low. You can also have someone stay with you

The bottom line on drinking alcohol with diabetes

When drinking alcohol, people with diabetes should be aware of how it will affect their blood sugar.

Alcohol blocks the liver from making new glucose, leading to a drop in blood sugar levels.

It’s important to drink in an environment where you feel safe, with others who know what to do just in case your hypos are severe.

Additionally, drinking can have an effect on blood sugar for up to 12 hours. Before drinking, it’s advised to test blood sugars and keep tabs.

More tips on living with diabetes

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Mila Clarke, MS, NBC-HWC

Mila Clarke is a Board Certified Health and Wellness Coach, an author, self-taught cook, nutritionist and Integrative Nutrition Diabetes Health Coach, diabetes advocate and founder of Hangry Woman and The Glucose Guide App. Hangry Woman aims to take away the shame and stigma that comes with a diabetes diagnosis and covers topics like diabetes management, cooking, and self-care from the perspective of someone living with the chronic condition. Her book –– The Diabetes Food Journal –– Is one of the most sought after diabetes self-management tools for patients. Her online community – Glucose Guide – offers affordable health coaching, hundreds of diabetes-friendly recipes and community peer support. Mila has been featured by CNN, The New York Times, Eat This Not That, USA Today, Good Housekeeping and WebMD. She contributes to Healthline, The Washington Post, DiaTribe, and EatingWell Magazine. Mila lives in Houston, Texas with her Miniature Poodle, Noodle.

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