• Diabetes and Alcohol: Caution When Mixing

     If you have diabetes, you may know what foods to eat and which to avoid. But what about alcohol? Can you have a glass of wine with dinner or a few drinks after work with friends? And what are the effects of alcohol on your body if you have diabetes?

    How Does Alcohol Affect Blood Sugar?

    First, let's look at your liver. Your liver makes and stores glucose (sugar). This glucose will be released when your body needs to raise your blood sugar levels. The liver also metabolizes, or breaks down, alcohol. When your liver breaks down alcohol, its glucose production is impaired.
    Now let's look at medicines you may be taking. Insulin and other diabetes medicines, like sulfonylureas ( glipizide , glyburide ) and metformin , decrease your blood sugar levels. Regular meals and a medicine plan will help you keep your blood glucose at healthy levels. However, habits like skipping meals can cause low blood sugar levels.
    Combining already low blood sugar levels with alcohol-impaired liver function will put you at risk for dangerously low blood sugar levels, known as hypoglycemia . Hypoglycemia can occur shortly after drinking. The effect can continue for 8-12 hours afterwards. The symptoms of hypoglycemia and being drunk are similar—confusion, anxiety, and feeling faint. Be careful not to mistake hypoglycemia for drunkenness. Doing so may mean that you do not get the proper help if your blood sugar levels drop too low. (Wearing a medical emergency bracelet can be very helpful to alert the people around you that you have diabetes.)

    So Can I Drink Alcohol?

    Talk with your doctor to make sure alcohol is safe for you. If it is and you decide to drink, do so responsibly. Since alcohol can cause hypoglycemia, it is important not to drink on an empty stomach. Drinking alcohol on an empty stomach can lower your blood sugar to very low levels. Eating food (especially foods containing carbohydrates) with alcohol can keep your blood sugar levels from dropping too low.
    If you have a glucose meter, be sure to check your blood sugar level before you drink. If your blood sugar is very low (below 70 mg/dl [milligrams per deciliter]), eat something to raise it before drinking alcohol. Also, if you drink before bedtime, check your blood sugar before you go to bed to make sure it is at a safe level (between 100-140 mg/dl).

    What About Alcohol and Weight Gain?

    Even if your doctor says it is okay to drink alcohol, you may still want to think twice if you are trying to maintain a healthy weight. Drinking alcoholic beverages can add extra calories to your diet. These calories are then stored as fat in your body. Not drinking, limiting your drinks, or choosing low-calorie drinks can help you achieve your weight-loss goals. If you have type 2 diabetes , weight management may be especially important, since maintaining a healthy weight directly relates to controlling your diabetes.

    Guidelines When Drinking Alcohol

    On occasions when you do decide to drink, keep these tips in mind:
      Limit the amount you drink. Women should drink one or fewer alcoholic beverages a day. Men should drink two or fewer drinks a day. One drink is equal to a:
      • 12-ounce beer,
      • 5-ounce glass of wine, or
      • 1-½-ounce of distilled spirits, like vodka, whiskey, or gin.
    • Do not drink on an empty stomach. Alcohol should be consumed with food, either at a meal or with a snack. Some healthy snack options are pretzels, popcorn, and raw vegetables.
    • If you drink alcohol several times a week, make sure your doctor knows this before she prescribes you diabetes medicine.

    Other Helpful Tips

    • Drink only when and if your blood glucose is under control.
    • Test your blood sugar levels:
      • Before drinking
      • Before going to bed
    • Sip your drink slowly to make it last.
    • Have a no-calorie beverage with you to quench your thirst.
    • Try wine spritzers (wine with club soda). Wine spritzers have less alcohol content than straight wine.
    • Avoid drinks with a lot of sugar. These are usually mixed drinks that have high-carbohydrate mixers. These drinks may cause high blood glucose levels. Try using calorie-free drink mixers like diet soda, club soda, diet tonic water, or water.
    • Wear a medical alert bracelet. If you drink, people with you will be aware of your condition. They will be able to respond properly if you need help.
    • Carry glucose tablets or another sugar source. Glucagon shots may not work in cases of hypoglycemia that are due to alcohol.
    • Do not mix alcohol and exercise. This will increase your chances of having low blood sugar.
    • Do not drive for several hours after you drink alcohol.
    Drinking alcohol is a part of many social situations—be it dinners at home, celebrations, or dining out. Talk to your doctor about the effects of alcohol on diabetes, especially if you are taking medicines or have other health concerns, like high blood pressure . With guidance and careful planning, you can control your diabetes in any situation.

    RESOURCES

    American Diabetes Association http://www.diabetes.org/

    National Diabetes Information Clearinghouse http://diabetes.niddk.nih.gov/

    CANADIAN RESOURCES

    Canadian Diabetes Association http://www.diabetes.ca/

    Health Canada http://www.hc-sc.gc.ca

    References

    Alan R. Hypoglycemia. EBSCO Health Library website. Available at: http://www.ebscohost.com/healthLibrary/ . Updated September 1, 2011. Accessed May 30, 2012.

    Alcohol. American Diabetes Association website. Available at: http://www.diabetes.org/food-and-fitness/food/what-can-i-eat/alcohol.html . Accessed May 30, 2012.

    Dietary considerations for patients with type 2 diabetes. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed/what.php . Updated May 16, 2012. Accessed May 30, 2012.

    Joslin Diabetes Center. Diabetes and alcohol. Joslin Diabetes Center website. Available at: http://www.joslin.org/info/Diabetes%5Fand%5FAlcohol.html . Accessed May 30, 2012.

    Joslin Diabetes Center. Fitting alcohol into your meal plan. Joslin Diabetes Center website. Available at: http://www.joslin.org/info/Fitting%5FAlcohol%5FInto%5FYour%5FMeal%5FPlan.html . Accessed May 30, 2012.

    Shai I, Wainstein J, Harman-Boehm I, et al. Glycemic effects of moderate alcohol intake among patients with type 2 diabetes: a multicenter, randomized, clinical intervention trial. Diabetes Care . 2007 Dec; 30(12): 3011-3016. Available at: http://care.diabetesjournals.org/content/30/12/3011.full . Accessed May 03, 2012.

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