Getting the Right Diabetes Treatment

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4 Ways Alcohol Affects Diabetes

Medically Reviewed By William C. Lloyd III, MD, FACS
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If you have diabetes and drink alcohol, it’s especially important to do so responsibly. Here are four effects of drinking to consider.

glasses of red and white wine on table

Does having diabetes mean you can’t enjoy a glass of wine with dinner or a cold beer with friends? Not necessarily. Moderate drinking may even reduce the risk for heart and kidney complications.

However, drinking too much may lead to serious problems, including dangerously low blood glucose and harmful interactions with your diabetes medication. Be aware of these effects.

1. Moderate drinking may have health benefits.

A published study in Diabetes Care included more than 11,000 people with type 2 diabetes from 20 countries. All were at least 55 years old and had either heart disease or a heart risk factor in addition to diabetes. When the study began, participants reported how much alcohol they drank during a typical week. During the next five years, those who said they drank alcohol in moderation had a lower risk for heart attacks, strokes, and early death than those who abstained completely.

Other studies have shown that moderate drinking is associated with a lower risk for unhealthy cholesterol levels and kidney disease in people with diabetes. The key word here is moderate. That means no more than two drinks per day for men and one drink for women. Heavy drinking can cause a host of health problems, including high blood pressure, liver damage, and several types of cancer.

2. Drinking alcohol can cause hypoglycemia.

When you have diabetes, drinking alcohol can sometimes lead to hypoglycemia — abnormally low blood glucose. To help prevent this, don’t drink alcohol on an empty stomach or when your blood glucose isn’t under control. For added safety, your doctor might recommend testing your glucose level before, during and after drinking.

3. Alcohol can interact with many diabetes pills.

Mixing alcohol with diabetes pills may increase the risk for harmful side effects:

  • If you take sulfonylureas, which help the pancreas produce more insulin, it’s more likely that alcohol will cause hypoglycemia. Examples of sulfonylureas include chlorpropamide (Diabinese), glipizide (Glucotrol), and glyburide (DiaBeta, Glynase, Micronase).

  • The combo of sulfonylureas and alcohol occasionally causes flushing, nausea, vomiting, headache, rapid heartbeat, or sudden changes in blood pressure.

  • Combining the medication metformin (Glucophage) with alcohol raises the risk of developing lactic acidosis. This rare but very serious side effect may cause weakness, tiredness, dizziness, chills, trouble breathing, muscle pain, stomach problems, and sudden changes in heart rate or rhythm.

Be honest with your doctor about how much alcohol you drink, because that might affect which diabetes medication you’re prescribed. This also applies to clinical decisions regarding the newer injectable non-insulin diabetes medications. Talk about the possible side effects. Know what to watch for and how to react if a complication occurs.

4. Drinking may lead to slacking on self-care.

Overindulging in alcohol can weaken your resolve to make healthy choices. In a study of more than 3,900 men with diabetes, those who abused alcohol were less likely to follow a meal plan and more likely to smoke than nondrinkers.

In other studies of people with diabetes, heavy drinkers were less likely to consistently check their blood glucose, take their diabetes medication, get A1c tests, and exercise. This is one reason heavy drinkers with diabetes often have a lot of trouble controlling their glucose levels.

For help with cutting down on drinking, talk with your doctor or visit the Rethinking Drinking  website, sponsored by the National Institute on Alcohol Abuse and Alcoholism.

Key Takeaways:

  • Moderate drinking may have health benefits for people with diabetes, including lower risk for heart attack and stroke.

  • Drinking alcohol can lead to hypoglycemia — abnormally low blood glucose. Don’t drink on an empty stomach or when your blood glucose isn’t under control.

  • Mixing alcohol with diabetes pills may increase the risk for harmful side effects.

  • Overindulging in alcohol can weaken your resolve to follow your meal plan, take your medication, and make other healthy choices.
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Medical Reviewer: William C. Lloyd III, MD, FACS
Last Review Date: 2022 Sep 26
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THIS TOOL DOES NOT PROVIDE MEDICAL ADVICE. It is intended for informational purposes only. It is not a substitute for professional medical advice, diagnosis or treatment. Never ignore professional medical advice in seeking treatment because of something you have read on the site. If you think you may have a medical emergency, immediately call your doctor or dial 911.
  1. Blomster JI, et al. The relationship between alcohol consumption and vascular complications and mortality in individuals with type 2 diabetes mellitus. Diabetes Care. 2014;37(5):1353-9.
  2. Dunkler D, et al. Diet and kidney disease in high-risk individuals with type 2 diabetes mellitus. JAMA Internal Medicine. 2013;173(18):1682-92.
  3. Engler PA, et al. Alcohol use of diabetes patients: the need for assessment and intervention. Acta Diabetologica. 2013;50(2):93-9.
  4. Shimomura T and Wakabayashi I. Inverse associations between light-to-moderate alcohol intake and lipid-related indices in patients with diabetes. Cardiovascular Diabetology. 2013;12(104).
  5. Thomas RM, et al. Association between alcohol screening scores and diabetic self-care behaviors. Family Medicine. 2012;44(8):555-63.
  6. Diabetes Medicines. National Institutes of Health. National Institute of Diabetes and Digestive and Kidney Diseases.
  7. Mixing Alcohol with Medicines. National Institutes of Health. National Institute on Alcohol Abuse and Alcoholism.
  8. Alcohol and Public Health: Frequently Asked Questions. Centers for Disease Control and Prevention.
  9. Stay Healthy. Centers for Disease Control and Prevention.
  10. Finding a Balance. Centers for Disease Control and Prevention.
  11. Nielsen SJ, et al. Calories consumed from alcoholic beverages by U.S. adults, 2007-2010. Centers for Disease Control and Prevention, National Center for Health Statistics Data Brief. November 2012;110. 
  12. Alcohol. American Diabetes Association.
  13. Blomster AI, et al. The Relationship Between Alcohol Consumption and Vascular Complications and Mortality in Individuals With Type 2 Diabetes. Diabetes Care 2014 May; 37(5): 1353-1359.