Alcohol can affect your blood sugar levels when you live with diabetes, so it’s important to know how to drink it safely.
How does alcohol affect your blood sugar?
Having diabetes doesn’t necessarily mean you can’t drink alcohol. But that means you need to be smart about drinking.
Moderate alcohol intake can help reduce blood sugar levels slightly in people with type 2 diabetes and improve insulin sensitivity. This effect is usually observed at moderate consumption, which can promote insulin action and lower blood glucose levels.
However, alcohol can have a negative effect on blood sugar levels in people with type 1 and type 2 diabetes if not consumed responsibly. Effects such as excessive drinking and drinking on a fasting can lead to both hypoglycemia (hypoglycemia) and hyperglycemia (hyperglycemia) immediately after drinking.
Furthermore, alcohol interacts with diabetic drugs, further complicating blood glucose control.
Hypoglycemia (hypoglycemia)
Blood sugar levels may drop immediately after drinking alcoholic beverages (especially on an empty stomach). This is because the liver is busy processing alcohol and is not paying attention to blood sugar levels, which stops glucose release.
This effect can lower blood sugar levels and sometimes too quickly. People taking insulin or diabetic tablets called sulfonylureas are more likely to experience hypoglycemia compared to people taking metformin or other types of diabetic medication.
Symptoms of hypoglycemia can include unclear speech, behavioral changes, drowsiness, or difficulty walking, and can also be caused by drinking too much alcohol. If you need help treating hypoglycemia in this situation, the concern is that your other people may not be aware that your blood glucose levels are low, and that you may need help.
Other concerns about alcohol and hypoglycemia include:
- Recognition of hypoglycemia and the absence of the typical symptoms of hypoglycemia. This means you don’t realize you need to treat something low.
- Hypoglycemia (and continues to occur as well) that occurs a few hours after your last drink.
Drinking too much alcohol can be particularly concerning if you’ve used glucagon to treat hypoglycemia. Glucagon is a hormone that raises blood glucose levels and is often used in people with type 1 or type 2 diabetes.
If you are drinking alcohol with your glucagon pointed towards your nose or by injection, it may not help you raise your blood sugar levels (especially if you are drinking too much). It’s because your liver is not paying attention to the release of glucose – it’s busy detoxifying alcohol.
Hyperglycemia (High blood sugar)
Alcohol can lead to an initial reduction in blood sugar levels, but drinking can also lead to an increase in blood sugar levels. Here’s why:
- Some alcoholic drinks, especially mixed drinks, are high in carbohydrates (carbohydrates). For example, a 6-ounce chocolate martini contains 33 grams of carbohydrates, while a 12-ounce pina colada contains 85 grams of carbohydrates.
- You can drink alcohol while eating high-carb foods, especially if you are at a special event such as a party or wedding.
- Alcohol interacts with diabetic drugs and can be at risk of hypoglycemia or hyperglycemia, depending on the type of medication you take and the alcohol you take.
read more: The best and worst alcoholic beverages for people with diabetes.
How to drink alcohol safely if you have diabetes
If you are currently drinking alcohol or are unsure whether alcohol is safe to drink, it is best to talk to your healthcare provider about the risks and benefits. Your provider should consider your overall health, how well your diabetes is managed, the medication you are taking, and other health issues you may be experiencing.
Many health experts agree that diabetics can drink alcohol in moderation. Below are additional steps you can take to ensure safety if you choose to drink:
- Avoid drinking alcohol if you are under the age of 21, or if you have health conditions such as alcohol use disorders, liver disease, pancreatitis, heart disease, certain digestive disorders, or some mental disorders.
- Avoid drinking alcohol if your blood sugar levels are low or if you are at a high risk of hypoglycemia.
- For example, if your blood sugar levels fluctuate frequently due to start new diabetes medications or changing your diet or physical activity plan, it may be best to avoid alcohol until your blood sugar levels stabilize.
- Avoid drinking alcohol, defined as having more than five drinks for men, and capable of four drinks for women.
- Be careful when drinking if you are exercising or physically active. The combination of exercise and alcohol use significantly increases the risk of hypoglycemia.
- If you are taking it, take moderate amounts of foods and drink alcohol in carbohydrate-containing foods and snacks, especially if you are taking insulin or sulfonyluria. Don’t drink it on a hungry day.
- Choose alcoholic drinks wisely. Better choices include light beer, white, red, or sparkling wine, or distillation spirits (gin, vodka, rum) mixed with ice or water, sparkling water, or diet soda.
- If you plan on drinking slowly and enjoy additional drinks, alternate the drinks with water or sparkling water.
- If you are at risk of hypoglycemia, it always has a source of rapidly acting carbohydrates, such as glucose tablets and glucose gels.
- Wear or carry a medical ID to let people know that they have diabetes, especially if they need help due to hypoglycemia.
- If you are planning to drink with others, let someone know you have diabetes just in case you need help.
- Carefully monitor your blood sugar levels, especially before, inside, and after drinking alcohol.
- If you are taking insulin, talk to your healthcare team or diabetic educator about how and when you drink alcohol, how to adjust your insulin dose as needed. This is especially important if you have hypoglycemia overnight after drinking.
- If you are eligible, consider using CGM if you are consuming alcohol regularly. This is because it helps you manage your blood sugar levels more effectively.
Other safety precautions when drinking
Consider the following steps to keep you safe when drinking.
- Wear a medical ID: Let people know you have diabetes, especially if you need help due to hypoglycemia.
- Educate others: Tell the person you are with about the signs of hypoglycemia and how to help treat it.
- Use a continuous glucose monitor (CGM). CGM allows you to monitor your blood sugar levels more effectively, especially if you consume alcohol regularly.
- Trained support: Stay with someone who has CPR, AED, and first aid training if possible.
How does drinking alcohol affect your health?
Harvard Chan School of Public Health eloquently states, “It’s safe to say that alcohol is both a tonic and a poison.” Why is this? Many of the harmful effects of alcohol are based on dose. In other words, it is the amount of alcohol a person drinks.
Moderate drinking is defined as:
- Up to 1 drink per day for women
- Up to 2 drinks per day for men
Heavy or excessive drinking is defined as:
- Drinks at least 8 times a week for women
- Over 15 drinks per week for men
It’s one drink:
- 12 oz beer (regular or light)
- 5oz wine
- 1.5 oz spirit (gin, whiskey, vodka, rum)
Although moderate drinking is considered safe for most people, heavy drinking can lead to short-term health risks such as:
- Injuries (car accident, fall, driving, burns)
- violence
- Alcohol poisoning
- Miscarriage and stillbirth
- Weight gain
The long-term consequences of excessive alcohol intake can lead to chronic illness and other problems.
Notably, alcohol affects women who are different from men. why? Women tend to be smaller than men, with less water overall and more body fat. This increases blood alcohol levels more rapidly, with women longer than men. As a result, women are more susceptible to long-term health problems caused by alcohol than men.
Some health experts and health organizations (including the World Health Organization) say there is no health-safe alcohol.
However, some studies have pointed to increased HDL (“good”) cholesterol, reducing arterial plaque accumulation, and alleviating the potential protection from heart disease by preventing blood clots. Moderate drinking may further reduce the risk of type 2 diabetes.
If you have diabetes, what are the other risks of drinking alcohol?
In addition to being at a high risk of heart disease, stroke and cancer, drinking alcohol can lead to other health issues for diabetics.
Weight gain
Drinking excessive alcohol can lead to weight gain. A 12-ounce light beer bottle with occasional 100 calories is unlikely to lead to weight gain, but drinking a few bottles over a week can add up calories quickly.
On the other hand, if your favorite drink is leaning towards fruity or very sweet cocktails, enjoying these drinks regularly can also contribute to weight gain. For reference, margaritas weigh more than 300 calories, while white Russians can contain around 400 calories.
See more details: How many calories and carbohydrates do different types of alcohol come in?
Drinking alcohol can also cause increased hunger, thanks to its effects on certain hormones and neurotransmitters. This means that you are unlikely to make healthy food choices or limit the portion when drinking alcohol.
Ultimately, weight gain can lead to insulin resistance and higher blood sugar, especially if you have type 2 diabetes.
Liver disease
Liver disease can be derived from a variety of factors, including too much weight around the central region, high cholesterol, high blood pressure, and type 2 diabetes. Also, blood glucose levels that stay high for long periods of time can cause liver damage.
Excessive alcohol intake can also affect liver health, leading to conditions such as fatty liver, alcoholic hepatitis, and cirrhosis.
If you have diabetes and have any type of liver disease, the risk of further liver problems increases dramatically. This is because both diabetes and liver disease can worsen each other’s effectiveness, leading to the more rapid progression of liver damage.
Neuropathy
Certain diabetic complications, such as neuropathy (neurological damage), can be exacerbated by drinking alcohol.
Symptoms such as numbness, tingling, and pain are common in neurological disorders caused by both diabetes and alcohol, and can be hardly discernible from each other. According to a survey published in the journal in 2021 Diabetes therapyIf a person with a neuropathy continues to drink alcohol, the nerve damage continues to progress.
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