Diabetes and Alcohol — Smart Tips to Avoid Blood Sugar Swings

People with diabetes are usually very aware of how different foods affect their blood sugar, but still have questions about alcohol. When it comes to whether or not it’s safe to drink a cocktail or two when you have diabetes, the answer is “it depends.”

When you have diabetes (type 1 or type 2), you learn how different foods affect your blood sugar. You might have noticed, for example, that a handful of Gummi Bears causes glucose to soar while an apple with peanut butter causes it to level out. Alcohol, like all things we put in our bodies, affects blood sugar levels, so it’s important to understand how it works, when it’s safe and when it might be better to skip.

When you drink alcohol, it quickly moves from the stomach into the bloodstream and is metabolized (or broken down) by the liver. One alcoholic beverage—which is 5 ounces of wine or champagne, 12 ounces of beer or 1.5 ounces of 80-proof liquor—is metabolized by the liver in approximately two hours. When you drink alcohol faster than your liver is able to break it down [more than one drink per two hours], the excess moves to other parts of the body, including the brain; the result: you begin to feel tipsy.

People with diabetes have to be concerned with more than just catching a buzz. The liver plays a role in blood sugar regulation; if you are on a diabetes medication, such as sulfonylureas (glipizide, glyburide) or insulin, drinking alcohol can divert the liver’s efforts to regulate blood sugar, causing it to drop dangerously.

To determine whether it is safe to drink alcohol, the American Diabetes Association suggests asking three basic questions:

  1. Is your diabetes under control? In other words, are your blood sugar levels typically in the normal range throughout most of the day?
  2. Do you have any diabetes complications that might be worsened by drinking alcohol, including heart disease, hypertension or neuropathy (nerve damage)?
  3. Are you aware that drinking alcohol can lower blood sugar levels?

Work with your physician, nurse practitioner, certified diabetes educator and/or registered dietitian to answer these questions. If they give you the green light to enjoy alcohol, use these guidelines to do so safely:

  • Drink in moderation. That means one cocktail per day for women, two per day for men (see what constitutes “one drink” of wine, beer, and liquor above).
  • Avoid binge drinking, which is defined as four drinks for women and five for men in approximately two hours by the National Institute of Alcohol Abuse and Alcoholism.
  • Practice mindful drinking. Savor your glass of wine, beer or cocktail and sip slowly. And stay hydrated with adequate water and other non-alcoholic unsweetened beverages before and after enjoying your cocktail.
  • Cut your cocktails. Lighten your overall alcohol intake by diluting your cocktail with club soda. Try a spritzer made with half wine and half club soda. Or enjoy a half shot of vodka with club soda and small splash of fruit juice.   And be cautious of the higher alcohol content in heavier “craft” beers and fortified wines such as port, which can contain more alcohol per ounce than their regular counterparts.
  • Don’t drink on an empty stomach. Eating food while drinking can slow the absorption of alcohol into the bloodstream. Even better, choose foods that are themselves broken down more slowly by the body, such as fiber-rich carbohydrates (whole grains and beans), protein (chicken and fish) and healthy fats (nuts, avocados and olive oil).
  • Don’t spend “food calories” on alcohol. If you follow a meal plan, don’t omit food to accommodate alcohol. And consider planning meals ahead of time if you are going to drink, as alcohol may affect your resolve to maintain a healthy diet.
  • Monitor blood glucose before, during and after drinking alcohol, and especially before going to bed. Alcohol intake can affect blood sugar levels for up to 24 hours. Have a quick source of glucose handy (such as raisins, 4 ounces of juice or skim milk or hard candies, like Lifesavers) in case you find your levels are too low.
  • Don’t mix alcohol and activity. Keep in mind, exercise can also cause blood sugar levels to drop significantly, so you can get an amplified effect if you’re drinking while being active (say, dancing) or afterwards (like enjoying a celebratory cocktail after a race).

Read about how foods affect type 2 diabetes here and learn about carb counting here.