Alcohol and Diabetes: What to Know

For people with diabetes, drinking too much alcohol may lead to low blood sugar levels and interactions with diabetes medication. However, drinking in moderation might be safe. Your doctor can explain the risks associated with alcohol consumption. Everyone is different, so consult your healthcare professional to determine whether drinking alcohol is safe for you.

Read on to learn more about four possible effects of alcohol on people with diabetes.

Drinking alcohol can cause hypoglycemia, or low blood sugar levels. A 2017 research review concluded that consuming ethanol, which is present in alcoholic beverages, increases the likelihood of developing hypoglycemia in people with type 1 diabetes.

Additional research concluded that, for people with type 2 diabetes, light to moderate alcohol consumption doesn’t significantly increase hypoglycemia risk, and the risk for people with type 1 diabetes is uncertain.

According to the Centers for Disease Control and Prevention (CDC), blood glucose levels are considered low when they drop below 70 milligrams per deciliter (mg/dL). To help prevent this, consider avoiding alcohol on an empty stomach or when your blood glucose isn’t optimal.

Your doctor might recommend checking your glucose level before, during, and after drinking for added safety.

Mixing alcohol with diabetes medication may increase the risk of harmful side effects:

• If you take sulfonylureas or use insulin, drinking alcohol may likely cause hypoglycemia, according to the American Diabetes Association (ADA). Examples of sulfonylureas include glimepiride (Amaryl), glipizide (Glucotrol), and glyburide (DiaBeta).
• The combination of some sulfonylureas and alcohol can cause facial flushing. Other side effects may include nausea, headache, diarrhea, and dizziness.
• Combining the medication metformin (Glucophage) with alcohol raises the risk of lactic acidosis. This rare but serious side effect may cause weakness, trouble breathing, muscle pain, and sudden changes in heart rate or rhythm.

Be sure to tell your healthcare professional how much alcohol you drink. The amount you consume may affect which diabetes medications you are prescribed. Also, ask about the potential side effects, so you’ll know what to watch for and how to react if complications arise.

A 2020 study published in the Journal of the American Heart Association evaluated the effects of alcohol consumption on hypertension in people with type 2 diabetes. The study concluded that:

• Light drinking, defined in the study as 1–7 drinks weekly, did not cause elevated blood pressure.
• Moderate drinking, defined as 8–14 drinks weekly, correlated with higher blood pressure.
• Heavy drinking, defined as 15 or more drinks weekly, was associated with higher blood pressure.

A drink can be defined as 5 ounces (oz) of wine, 12 oz of beer, or 1.5 oz of distilled spirits.

The study’s authors noted that the degree of hypertension increased with the amount of alcohol consumed. Because diabetes is already associated with an increased risk of high blood pressure and heart disease, your healthcare professional may advise limiting your alcohol intake.

Diabetes requires mindful self-care habits and management. The ADA notes that drinking alcohol may make it difficult to keep track of your calorie intake and take your medications as needed.

However, drinking in moderation may be safe for some people with diabetes. The Dietary Guidelines for Americans defines moderate drinking as:

• 2 drinks or fewer daily for people assigned male at birth
• 1 drink or fewer daily for people assigned female at birth

Many factors can influence the effects of alcohol on people with diabetes. Talk with your doctor about the risks.

For people with diabetes, heavy drinking may lead to serious side effects and health issues. Talk with a healthcare professional about ways to safely consume alcohol.