Diabetes and Alcohol: Tips for Drinking

Medically Reviewed By William C. Lloyd III, MD, FACS
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What About Wine?

Enjoying a glass of wine, fruity margarita, or frosty pint of beer requires a little forethought if you have diabetes. Before you indulge, make sure you have a tasty appetizer or healthy salad to go along with your drink. And talk to your doctor about drinking alcohol. The answer to whether you can or should not will depend on your specific circumstances.

How Does Alcohol Affect Blood Sugar?

The way alcohol affects your blood sugar comes down to whether you’ve eaten, and how much and how often you drink. A standard drink contains 0.6 fluid ounces of alcohol. This means that a 12 ounce beer (about 5% alcohol) is equivalent to a 5 ounce glass of your average table wine (about 12% alcohol) or a shot of hard liquor such as vodka. Here’s the scoop on how much and how often:

  • When you have an occasional drink with food, alcohol generally has little effect on your blood sugar. This is the safest way to enjoy alcohol.
  • When you have an occasional drink without any food, alcohol can cause your blood sugar to fall to dangerously low levels. You should never drink alcohol on an empty stomach.
  • If you are a habitual drinker (3 or more drinks a day), alcohol increases your blood sugar no matter what you eat. If this describes you, consider talking to your doctor about ways to cut back or stop your alcohol use.

Can You Drink Alcohol With Diabetes?

If you get your doctor’s okay, here are some tips to drink by:

  • Never drink alcohol on an empty stomach.
  • Always drink alcohol with a meal or food.
  • Always test your blood sugar before you drink. If it’s low, you shouldn’t drink. Eat something to raise your blood sugar before having an alcoholic drink.
  • If you’ve had any alcohol, always check your blood sugar before you go to bed. If it’s low, you should eat something before you go to sleep. This will help you avoid dangerously low blood sugar during the night.
  • Be aware that the symptoms of low blood sugar are very much the same as those of drunkenness. You should make sure that someone with you knows that you are diabetic and can help you. It’s also a good idea to wear some sort of medical identification jewelry, such as a bracelet or necklace that says you have diabetes.
  • Don’t drink alcohol before, during or right after exercise or physical activity.
  • Remember that alcoholic drinks are empty calories, supplying extra calories with little or no nutritional value. If you want to drink alcohol, ask your healthcare provider for help working alcohol into your meal plan.
  • Limit the amount you drink to one drink per day for women and two drinks per day for men.
  • Sip your drink to make it last.
  • If you have a mixed drink, choose mixers that are calorie free, such as club soda or diet sodas. Avoid juices and sugary syrups.

What Are the Risks?

Drinking alcohol always carries risks. The risks are even greater when you have diabetes. Consider these risks if you’re thinking about drinking alcohol:

  • Diabetic ketoacidosis (DKA) is a serious condition that can lead to coma and death. Heavy drinking, especially with no food or when it leads to vomiting, can cause DKA.
  • Cardiovascular disease can worsen if you drink more than the recommended amount per day.
  • Peripheral neuropathy and nerve damage are more common in people who drink more than the recommended amount per day.
  • Diabetic eye disease is more likely to develop if you are a moderate to heavy drinker.
  • Medication interactions are a concern with alcohol. Talk with your doctor about all of your medications before drinking alcohol.
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Medical Reviewer: William C. Lloyd III, MD, FACS
Last Review Date: 2020 Aug 4
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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.