Alcohol and Diabetes

Diabetes and Alcohol: Will Alcohol Raise Blood Sugar Levels?

Drinking alcohol may impact blood sugar levels for individuals living with diabetes, especially if the health condition and sugar levels are not monitored or under control. 

It is always recommended to consult a healthcare professional before consuming alcohol to avoid any possible risk. 

Even in moderation, regular alcohol use can have some effects on diabetic blood sugar control, however. These effects of alcohol will vary according to two primary bodily states:

  • Fed individuals who have recently eaten will have high blood sugar levels. 
  • Fasting individuals who have an empty stomach will have low blood sugar levels. 

When blood sugar levels are not under control, individuals run the risk of serious health problems. These complications may include: 

  • Impotence
  • Peripheral neuropathy (a condition in which individuals suffer nerve damage and have trouble controlling their muscles and feeling different sensations like pain or temperature)
  • Retinopathy (an eye condition that can result in blindness). 

Other complications of diabetes include:

  • Diabetic ketoacidosis this condition is more common in those with type 1 diabetes. It occurs when there is a total or almost-total lack of insulin and glucagon levels are too high. Glucagon is a hormone that helps prevent blood glucose levels from dropping too low. When this happens, the body has an excessive build-up of certain acids called ketone bodies and experiences symptoms like nausea, vomiting, coma, or even death. 
  • Heart disease —  this condition is the primary cause of death in individuals with type 2 diabetes. Although the relationship between alcohol use and cardiovascular disease in this population needs further studying, alcohol is known to increase blood pressure. High blood pressure is a risk factor for the illness. 
  • Hypertriglyceridemia this condition also poses another risk factor for heart disease. It occurs when triglyceride (the most common type of body fat) levels are high. It can result in severe inflammation of the pancreas and even death. 

In the United States, more than 34 million people have diabetes. However, only 4 in every 5 of these individuals are aware that they have the condition. 

Other factors may influence whether an individual has diabetes, including the type of alcoholic beverage and the frequency of drinking. Additional risk factors such as being overweight and a family history of diabetes may also have a role in diabetes development. Knowledge of risk factors for type 1 and 2 diabetes varies. 

Type 1 Diabetes and Alcohol

Type 1 diabetes is considered an autoimmune reaction, in which the body stops making insulin on its own. Insulin is an essential hormone in the body. It helps transport blood sugar into cells to be used later for energy. Without insulin, the bloodstream can experience hyperglycemia (a build-up of blood sugar) when the body is in the “fed” state, or when you have just eaten. This could result in harm to organs. 

Those with type 1 (approximately 5 to 10% of all people with diabetes) will undergo diabetes treatment such as daily insulin injections. Healthcare providers will recommend adjusting meal plans to help control blood glucose levels. 

When it comes to alcohol consumption and diabetes, an occasional alcoholic drink may be beneficial. Studies have suggested that a standard alcoholic beverage may lower blood sugar levels that tend to get too high. 

However, like in those with type 2 diabetes, long-term alcohol consumption, e.g., alcohol abuse, could increase blood sugar levels during the fed state. This could bring about serious health complications for those with type 1, as blood sugar levels tend to be already higher than average. 

More studies are needed, though, to consider all the variables that affect blood sugar levels and understand the exact role of alcohol in individuals with type 1 diabetes.  

Type 2 Diabetes and Alcohol 

Type 2 diabetes affects around 90 to 95% of adults diagnosed with diabetes in the United States. 

It occurs when the body has trouble using insulin properly and cannot regulate blood sugar levels. Prediabetes (when blood sugar levels are higher than average yet not as much as in those with type 2 diabetes) is a risk factor for type 2 diabetes. 

Those with type 2 diabetes may experience much of what was mentioned above for individuals with type 1 diabetes. 

Individuals with type 2 diabetes and alcohol dependence have a higher risk of hypoglycemia. This may be due to both the effects of alcohol on the body and lack of motivation to make recommended lifestyle changes. 

As part of a diabetes care plan, a health professional may prescribe insulin, other injectable medications, or oral diabetes medications to manage blood sugar levels. 

Alcohol, like any other substance, may interact with these drugs and cause unwanted side effects. For example, a medication called troglitazone (used to treat the body’s weak response to insulin production) may impair liver function. As this organ is responsible for metabolizing alcohol, there is the risk of further damage and scarring. 

It is recommended to avoid heavy or binge drinking to prevent complications that arise due to unstable blood sugar levels. 

Symptoms of Low Blood Sugar From Alcohol

In the fasting state, for those with type 1 diabetes, especially, alcohol consumption may result in a delayed response to hypoglycemia (a reduction in blood sugar levels). This means that individuals can remain affected by the hypoglycemic episode for a longer time and experience:

  • Hypoglycemic unawareness — most individuals with diabetes recognize symptoms caused by low levels of blood sugar. However, in hypoglycemic unawareness, individuals do not know that warning signs such as vomiting, sweating, and shakiness indicate a more serious, underlying problem. 
  • Severe hypoglycemia — symptoms may include incontinence (when the body lacks full control over the bladder), disorientation, perseveration (when an individual repeats behavior beyond what is considered appropriate due often to damage to the brain), and impairment of recent memory. 

Food choices like a carb-rich meal and alcohol can result in an excessive insulin response. Hypoglycemia could arise 2 to 3 hours after eating. 

Guidelines For Drinking Alcohol With Diabetes 

As mentioned above, an occasional standard alcoholic drink should not have any serious effect on blood sugar levels. Blood sugar levels may either go higher or lower depending on if an individual has eaten or not. 

 In most cases, one drink is: 

  • 12 ounces (oz.) of beer
  • 5 oz. of wine
  • 1.5 oz. of whiskey or other spirits

Excessive drinking (including heavy or binge drinking) may upset blood sugar levels dramatically and result in serious health complications. 

It is advisable to consult a healthcare professional first before drinking any type of alcohol. Although many live with diabetes, each person is unique, and a doctor can best determine if alcohol consumption is a possibility. 

Alcohol and Diabetes FAQ

Can alcohol cause diabetes? 

Type 1 and 2 diabetes have different, sometimes overlapping risk factors. Family history and age are two primary risk factors for type 1. 

Risk factors for Type 2 diabetes include prediabetes, overweight, low physical activity, and much more. 

It is essential to understand that while alcohol does not cause diabetes, it may worsen other health conditions that lead to the disease. For example, heavy drinking may cause pancreatitis (inflammation of the pancreas) and lead to an impairment of insulin production. 

What other effects can alcohol have on diabetes besides raised blood sugar? 

Heavy drinking can result in ketoacidosis (an excessive build-up of certain acids called ketone bodies).

Individuals with this condition may experience symptoms like nausea, vomiting, coma, or even death. 

Alcohol may also worsen weight gain and elevate blood pressure, increasing the already existing risk of cardiovascular disease.
 
Finally, alcohol may increase the likelihood of an individual developing a diabetes-related eye disease. 

Which alcohol is better for diabetes?

Overweight is a risk factor for diabetes. Avoiding alcohol (which has at least 100 empty calories) is, therefore, the ideal option for preventing weight gain.
 
In other cases, it is best to opt for these alternatives:
- Light beers
- Dry wines
- Non-sugary cocktails 

Resources

“Diabetes Quick Facts.” Centers for Disease Control and Prevention, Centers for Disease Control and Prevention, 11 June 2020, www.cdc.gov/diabetes/basics/quick-facts.html.

“What Is Diabetes?” Centers for Disease Control and Prevention, Centers for Disease Control and Prevention, 11 June 2020, www.cdc.gov/diabetes/basics/diabetes.html.

Updated on: October 5, 2020
Author
Anthony Armenta
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Medically Reviewed
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Annamarie Coy,
BA, CADACII/ICADC, ICPR, MATS
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