Diabetes and Alcohol

Diabetes and Alcohol

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The decision to use or not use alcoholic beverages must be made by each individual. To help you make this decision, you need to be aware of the effects of alcohol on blood sugar levels.

The overall effect of alcohol is to lower the blood sugar level. This occurs especially if you have not eaten in several hours, because under these circumstances the liver normally has to make sugar in order to keep the blood sugar normal. Alcohol is broken down in the liver and when the liver is processing alcohol, the formation of sugar from other sources is blocked.

Hypoglycemia (low blood sugar) can occur even before a person is aware of being mildly intoxicated. Two ounces of alcohol (two drinks) is enough to produce hypoglycemia (low blood sugar) in a person who hasn’t eaten for several hours.

Sometimes large doses of alcohol cause a small but short-term rise in blood sugar, but this is followed a couple of hours later by a fall in blood sugar to below normal levels.

The carbohydrate in some alcoholic beverages, such as sweet wines, mixed drinks and beers, will tend to raise the blood sugar, making the overall effects of the drink quite unpredictable, with an increase in blood sugar early and drop later being common. The early sugar rise could tempt you to take more diabetes medication or insulin, which would make matters even worse.

Alcohol is also a concentrated source of calories, providing seven calories per gram. Alcohol provides energy, but has no other nutritional value. One ounce of 86 proof liquor contains 70 calories. Sweet wines and beers contain carbohydrates in addition to alcohol, so they have even more calories. Thus drinking alcohol makes it more difficult to control your weight.

Guidelines for Use of Alcohol:

If you choose to use alcohol –

  1. Limit yourself to two ounces of alcohol per day. No food should be omitted because of the possibility of alcohol-induced hypoglycemia. One ounce of alcohol is contained in each of the following amounts of alcoholic beverages:
    - 1.5 ounces of distilled beverage - whiskey, scotch, rye, vodka, gin, cognac, rum, dry brandy, etc.
    - 4 ounces of dry wine; 2 ounces of dry sherry
    - 12 ounces of beer, preferably “light”
  2. Never drink on an empty stomach. Two ounces of alcohol taken shortly before, with, or directly after a meal should be safer. And, if you are at a party or a bar, eat food along with the alcohol. Good choices are “slow” carbohydrates with protein and fat, like popcorn, nuts, or dip on vegetables. Avoid the pretzels and chips.
  3. Use alcohol only in moderation. Sip slowly and make a drink last a long time. Since symptoms of alcohol intoxication and hypoglycemia are similar, it is easy for you to mistake a low blood sugar for intoxication and delay necessary treatment. The same is true of other people. Even one drink is enough to give your breath the smell of alcohol. If you lose consciousness due to hypoglycemia, people might think you have had too much to drink and be reluctant to help you.
  4. Carry or wear identification. Visible medical emergency identification should be carried or worn especially when drinking alcohol.
  5. Avoid drinks containing large amounts of sugar. Liqueurs, sweet wines, and sweet mixes (such as tonic, soda pop or fruit juices) are examples of drinks containing sugar. Drink mixes, if used, should be sugar-free. Light beer is recommended because it has less carbohydrates per can than regular beer. Dry wines are also better choices than a sweet wine.
  6. Don’t let a drink make you careless. Alcohol can have a relaxing effect and may dull judgment. Be sure meals and snacks are taken on time and selected with the usual care.
  7. If you are taking diabetes pills, be aware of the possible effect of alcohol with some of these pills. In some 10-30 percent of people the sulfonylurea diabetes pills interact with alcohol to produce deep flushing, nausea, quickened heart beat and impaired speech. Excessive drinking of alcohol, but not just a couple of drinks, can lead to serious problems if you take metformin (Glucophage).

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