A Guide to Alcohol and Diabetes: Safe Drinks and What to Avoid

Alcohol and diabetes

Diabetes, marked by fluctuating blood sugar levels, demands careful attention, especially when it comes to what you eat and drink. Alcohol, like any other dietary choice, can impact glucose levels. If you’re scratching your head about how alcohol interacts with diabetes, this guide is here to clear things up.

Now, for many, a drink or two at the end of the day or during social gatherings is a norm. Having diabetes shouldn’t necessarily disrupt this routine unless advised otherwise by a medical professional. However, the dynamics of drinking change slightly when you have diabetes. The burning question: “Is it safe to drink alcohol if I have diabetes, and how much is alright?”

The answer: Yes, moderate drinking is permissible, but with an asterisk. You need to know the effects of alcohol on your body and how to manage them. Drinking can increase the risk of hypoglycemia (low blood sugar) since alcohol hampers the liver’s glucose release. Plus, let’s not forget the sneaky calories packed in those drinks which could contribute to weight gain, adding another layer to diabetes management.

Also, if you’re on diabetes medications, alcohol might reduce their effectiveness or even dangerously plummet your blood sugar levels. So, always be cautious.

Interestingly, statistics suggest that folks with diabetes tend to drink half as much as their counterparts. The reasons vary: doctor’s advice, existing health conditions, or perhaps worries about calories and carbs.

But the occasional drink isn’t a complete no-no. There are some benefits to enjoying a drink once in a while. However, as with anything in life, moderation and understanding are key. So, as you raise that glass, be informed and drink responsibly.

Is Alcohol Really Beneficial for Health?

We’ve all heard the old belief: a little alcohol can be good for the heart. But recent studies have started to challenge this notion. While it’s true that alcoholic drinks contain antioxidants, it turns out that the benefits might have been overstated. In fact, if you’re looking for antioxidant-rich sources, your plate is a better place to start than your glass.

Why? Alcohol, despite any potential upsides, is a substance with a plethora of associated health risks. As such, new guidelines recommend caution. Gone are the days when daily alcohol consumption was seen as a health move. Now, it’s suggested that if you do choose to drink, limiting it to 2-3 drinks a week is a safer bet.

So, while a casual drink now and then might still be enjoyable, it’s essential to approach it with a renewed understanding of its health implications.

Does Alcohol Cause Diabetes?

Wine and alcohol drinks

When considering the myriad factors that could contribute to type 2 diabetes, such as family history, age, and ethnic background, we often wonder: where does alcohol fit into the equation?

It’s clear that carrying excess weight increases the risk for developing diabetes. Alcohol plays a part here, not just because of its association with type 2 diabetes, but also due to its high-calorie content. Regular drinking can lead to weight gain, making it challenging for individuals to maintain a healthy weight.

But the relationship between alcohol and diabetes is intricate. Moderate alcohol consumption might cause a spike in blood sugar levels, while binge drinking can drastically lower it. This seesaw effect is particularly perilous for those with type 1 diabetes.

Further complicating matters is the content of the drink itself. Beers and sweet wines, for instance, have carbohydrates that can elevate blood sugar levels. Moreover, alcohol can stir up your appetite, possibly leading to overeating, which again, influences blood sugar control. In moments of lowered judgment – perhaps due to the alcohol – one might opt for unhealthy food choices, negatively impacting overall health and diabetes management.

Alcohol also poses challenges to diabetes medications. It can negate the beneficial effects of oral diabetes treatments and insulin. Moreover, it’s been linked to increased triglyceride levels and higher blood pressure.

In terms of immediate effects, alcohol can cause symptoms like flushing, nausea, an accelerated heart rate, and slurred speech. Intriguingly, these can be misinterpreted or overshadow the signs of low blood sugar, making it crucial for individuals, especially those with diabetes, to be aware and cautious when consuming alcohol.

The Risks of Alcohol Consumption

Navigating the world of alcohol when you have diabetes is like walking a tightrope. While a casual drink here and there might not sound alarming, combining it with certain diabetes medications can be a cocktail for trouble.

Let’s break it down. The most significant concern when consuming alcohol for someone with diabetes is hypoglycemia, or low blood sugar. This becomes particularly problematic when you’re on insulin or sulfonylureas, medications that encourage the pancreas to release insulin. So while indulging in a glass of wine at dinner could be okay, having a mojito on an empty stomach? Not so much.

Your liver, the unsung hero, is at the center of this. It has a day job of stabilizing glucose levels by storing carbohydrates and releasing them when necessary, like between meals. However, it also doubles as a detox hub, breaking down toxins, including alcohol. But juggling both tasks? Not its forte. If you drink, especially without having eaten, your liver prioritizes metabolizing the alcohol over balancing your blood sugar, which can lead to a dip in glucose levels. In short, if you decide to enjoy a drink, it’s wise to accompany it with a snack.

Here’s where it gets a bit tricky: the symptoms of hypoglycemia—drowsiness, slurred speech, confusion, and difficulty walking—mirror those of intoxication. Differentiating between being tipsy and having a dangerously low blood sugar level becomes challenging. It’s even riskier if you’re prone to hypoglycemia unawareness, where you don’t notice your dropping sugar levels. Plus, the risk of a hypo isn’t just immediate—it can hit hours post-drinking, especially if you’ve been active.

Given these complexities, it’s crucial to consult your doctor about your drinking habits, ensuring it doesn’t clash with your medications or aggravate any related conditions. Whether it’s diabetic nerve damage, eye disease, or elevated blood triglycerides, it’s always better to sip informed.

Alcohol and Diabetes: Navigating the Hypo Minefield


Understanding the relationship between alcohol and hypoglycemia (low blood sugar, commonly known as “hypos”) is crucial for anyone with diabetes. If you use medications such as insulin or sulphonylureas, alcohol can up the ante on your hypo risk, but why?

Here’s the lowdown:

Your liver plays a vital role in maintaining your blood sugar levels. Normally, when your blood sugar drops, your liver releases stored glucose to balance it out. But introduce alcohol, and the liver gets distracted. It prioritizes breaking down alcohol over stabilizing glucose levels. This can cause a significant drop in blood sugar, especially if you’re drinking on an empty stomach.

Consider this: each alcoholic drink takes the liver about 1 to 1.5 hours to process. During this period, your risk for hypos is heightened. So, if you sip on two drinks, that risk extends to 2 to 3 hours. The more you drink, the higher the danger.

To safeguard yourself:

Never drink on an empty stomach. Always pair your drink with a carb-rich meal or snack. And remember, alcohol shouldn’t replace a meal.

Stay aware and alert. Hypo symptoms can mimic drunkenness. To avoid confusion, always wear medical ID and inform your companions about your condition. It’s essential they know how to assist if a hypo occurs.

Always be prepared. Keep carbohydrate sources, like glucose tablets, handy. If a hypo hits, you need quick access to a sugar boost.

Monitor your blood sugar frequently. Alcohol can mask hypo symptoms, making it harder to recognize a drop in blood sugar.

Be cautious with exercise. Physical activity generally lowers blood sugar. If you’ve had a drink, monitor your levels more closely and be ready with a carb snack.

A special note for severe hypo episodes: glucagon injections, a standard treatment, might not be effective. This is because glucagon stimulates the liver to release glucose, and alcohol hampers that function.

And lastly, if you’re unsure about how alcohol interacts with your medication or if your meds heighten hypo risk, always consult your healthcare team. Safe drinking is informed drinking!

Navigating Alcohol with Health in Mind

If you’re contemplating that drink, there’s a bit more to consider, especially for those with specific health concerns or life situations.

  1. Pregnancy and Fertility: If you’re trying to conceive, it’s worth noting that alcohol can affect fertility in both men and women. Considering starting a family soon? Cutting back might increase your chances. Pregnant or think you might be? It’s safest to abstain from alcohol entirely. Especially during the initial three months, alcohol consumption could heighten the risk of miscarriage. In fact, consistent heavy drinking during pregnancy can lead to multiple complications, from premature birth to more severe conditions like foetal alcohol syndrome.
  • Diabetes and Alcohol: For those managing diabetes, understanding alcohol’s broader impact is pivotal. Beyond the previously discussed risks of hypoglycemia, consider the following:
  • Blood Pressure: Overindulgence can raise your blood pressure, which isn’t ideal when aiming for stable health metrics.
  • Neuropathy: Got nerve damage concerns? Alcohol might exacerbate the issue.
  • Sleep and Hydration: Alcohol can meddle with your sleep cycle and dehydrate you. Quality sleep and hydration are vital, more so when juggling a condition like diabetes.
  • Other Health Concerns: Chronic heavy drinking has associations with several cancers and heart diseases. It’s essential to be aware and moderate your intake accordingly.

Safety First: Remember, regardless of your health status, moderation and responsibility are key. Never mix drinking with driving or activities demanding your full attention and coordination. Oh, and while that hot tub or sauna might seem tempting post-drinks, combining heat with alcohol can drastically drop your blood pressure.

Alcohol’s Impact on Weight and Carbohydrates: What You Need to Know

Body weight

Seeking to shave off some pounds? You might want to reassess your alcohol intake. Why? Alcohol packs calories without offering much nutritionally – often dubbed “empty calories.” It’s a sneaky contributor to weight gain. For perspective, alcohol comes in at 7 calories per gram, closing in on fats which have 9 calories per gram. It’s not just about the immediate calorie count; when your liver processes alcohol, it’s often converted into fat. The result? Potential weight gain, and perhaps even that notorious “beer belly”. Plus, regular consumption can spike blood fats (triglycerides), upping the risk of heart disease.

Navigating the intricate relationship between alcohol, carbs, and calories can be challenging, especially if you’re diligent about counting carbohydrates. A common misconception is that most alcoholic beverages are loaded with carbs. However, spirits are practically devoid of them, and a standard five-ounce glass of wine only contains around four grams of carbs. The real outlier is the sweet dessert wines, which carry a substantial 14 grams of carbs in a mere 3.5-ounce serving.

If you’re on insulin or certain diabetes medications, it’s crucial to be cautious when consuming alcohol. Although some drinks can be rich in carbs, you might find you don’t need your usual insulin dose post-drink. This is because of the heightened risk of hypoglycemia or “hypos”. Factors such as the type of drink, the quantity consumed, and even concurrent activities, like snacking or dancing, can shift this balance.

You might think that opting for a high-carb drink is a wise choice to ward off hypoglycemia. However, the body absorbs liquid sugars swiftly, offering minimal defense against a hypo that might emerge hours after drinking. In contrast, food, with its gradual digestion process, provides a more sustained and reliable protection against these lows.

On the topic of alcohol, it’s essential not to overlook the calorie factor. Alcohol contains calories, and when we drink, we might lose sight of our calorie count, especially when the munchies strike. Added to this, the inebriated state can make it challenging to remember or correctly administer medications, which can be particularly concerning for some.

Lastly, it’s worth noting that drink sizes and their respective carb and calorie contents can vary. Being aware of what and how much you’re consuming can be enlightening.

Navigating the Day After Drinking: A Quick Guide

1. Hydration is Key: After a night of overindulgence, before hitting the hay, grab a pint of water. Not only does it combat dehydration, but it might just fend off that dreaded hangover. If morning still brings that groggy, headache-ridden feeling, continue sipping water throughout the day.

2. Don’t Skip Breakfast: While the thought of food might be less than appealing, it’s crucial for blood sugar management. If you can’t stomach solids or if you’ve had an upset stomach, aim for fluids. Consider sugary (non-diet) beverages if you notice your blood sugar dipping.

3. Monitor Your Blood Sugar: If you own a blood sugar meter, it’s essential to keep tabs on your levels the next day. Beware: hangover symptoms can be eerily similar to a hypo, so it’s vital to differentiate between the two. Regardless of how terrible you feel, if it’s a hypo, it requires immediate attention.

4. Insulin Adjustments: For those on insulin, monitor your blood sugar and adjust doses as necessary. If you’re unsure, a chat with your healthcare team can provide guidance tailored to your situation. Remember, staying informed and prepared is crucial after a night of drinking.

Handling Emotions and Alcohol: A Balanced Approach

For some, a glass of wine or a beer can seem like a temporary solution to stress or emotional lows. While alcohol might offer a momentary feeling of relaxation, it’s essential to recognize it’s not a sustainable or healthy method for emotional management.

If you’re feeling overwhelmed or anxious, consider healthier alternatives to help alleviate these feelings:

Get Moving: Physical activity, whether it’s a brisk walk, yoga, or a gym session, can do wonders for your mood and stress levels.

Engage in Relaxing Activities: Diving into a hobby, indulging in a good book, or even a calming bath can be therapeutic.

Open Up: Never underestimate the power of conversation. If things feel heavy, chat with someone you trust—be it a close friend, family member, or your healthcare team. They can offer advice, support, or simply a listening ear.

Balancing the Bottle: A Diabetic’s Guide to Safe Alcohol Consumption


When it comes to choosing your drink, there isn’t a one-size-fits-all ‘best’ option for diabetics. However, awareness can be your best buddy. You might want to sidestep those low-sugar beers and ciders. While they might seem like the diabetic-friendly option due to reduced sugar, they often compensate with a higher alcohol content. Low-alcohol wines can be tricky too; they sometimes pack more sugar than their regular counterparts. On the flip side, spirits, dry wines, and Prosecco have minimal carbs. If carb content is a concern, these could be your go-to drinks.

Another angle to consider is your overall health goals. If weight loss is on the agenda, limiting or even sidestepping alcohol might be wise, given the empty calories it introduces into your diet. And for mixers? Stick to the diet variants of sodas, juices, and tonic water. If beer’s your thing, light beer is less burdensome on your system than regular beer. Dry wines are also a more sensible pick over their sweet or sparkling counterparts.

Now, there are certain drinks that are just not great for your blood sugar. Sugary cocktails, like mojitos and margaritas, regular beer, sweet wines, and regular mixers can cause blood sugar levels to spike.

While the relationship between alcohol and diabetes can feel like a maze, knowledge is your compass. With a balance of caution and information, you can enjoy a drink without jeopardizing your health. Remember, it’s all very individual. What works for one person might not for another. So, beyond these general guidelines, a chat with your doctor about how to tailor your approach can be incredibly valuable.

Interestingly, while occasional drinking might not throw your blood sugar control off balance and might even offer some benefits, daily moderate drinking can muddy the waters. Sure, it’s linked to a decreased risk of heart attacks in the general population, but the jury’s still out on its full effects on diabetics. Until we know more, heavy drinking is a definite no-go for diabetics, as it can exacerbate certain complications. Always prioritize your health. With the right strategy, you can strike a balance between occasional enjoyment and maintaining optimal well-being.

Living with diabetes doesn’t mean forsaking all indulgences; it’s about informed choices and moderation. When it comes to alcohol, knowledge, and vigilance ensure you can enjoy a drink without compromising your health.

Gianluca Tognon

Gianluca Tognon

Gianluca Tognon is an Italian nutrition coach, speaker, entrepreneur and associate professor at the University of Gothenburg. He started his career as a biologist and spent 15 years working both in Italy and then in Sweden. He has been involved in several EU research projects and has extensively worked and published on the association between diet, longevity and cardiovascular risk across the lifespan, also studying potential interactions between diet and genes. His work about the Mediterranean diet in Sweden has been cited by many newspapers worldwide including the Washington Post and The Telegraph among others. As a speaker, he has been invited by Harvard University and the Italian multi-national food company Barilla.

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About Me

I’m an Italian nutrition coach, speaker, entrepreneur and associate professor at the University of Gothenburg. I started MY career as a biologist and spent 15 years working both in Italy and then in Sweden.

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