Can I Drink Alcohol If I Have Type 2 Diabetes?

A Guide to Safe Alcohol Consumption

With the popularity of the Mediterranean diet and recent studies showing that moderate alcohol consumption may have favorable effects, such as reducing the risk of developing type 2 diabetes, raising good cholesterol (HDL) and lowering the risk of cardiovascular disease, it seems that alcohol can have a place as part of a healthy lifestyle, even if you have diabetes.

But the most important rule is to keep consumption moderate. The American Heart Association defines moderate alcohol consumption as one drink per day for women and two drinks per day for men. One alcoholic beverage is measured as a 12-ounce beer, 5-ounce glass of wine, or 1.5-ounce distilled spirits (vodka, whiskey, gin, etc.).

On the other hand, excessive alcohol consumption, or binge drinking, defined as more than five alcoholic beverages in a two-hour time span for men and four for women, can increase the risk of heart disease, type 2 diabetes, and metabolic syndrome. Excessive consumption can also make glucose control a challenge by increasing weight and leading to insulin resistance. 

How Alcohol Affects the Body

If you have diabetes, there are certain considerations you must take in order to stay safe. Alcohol consumption may result in increased insulin production, which can lower your blood sugar. The American Diabetes Association recommends that people with diabetes be educated on the recognition and management of delayed hypoglycemia (low blood sugar) when drinking alcohol, especially if those people are using insulin or other medications that can cause blood sugars to drop.

Types of Alcohol to Choose

If you do decide to drink alcohol, some options are better than others. Choose beverages like wine, champagne, or distilled alcohol with sugar-free mixers like club soda. Beer tends to be higher in carbs, though it is lower in sugar, while dessert wines such as port wine can be very high in sugar.

Comparison of Different Types of Alcohol

Alcohol Carbs Sugar
12 ounces beer 13g 0g
12 ounces light beer 6g 0.3g
5 ounces red wine 4g 0.9g
5 ounces white wine 4g 1.4g
1.5 ounces distilled spirits 0g 0g
2 ounces port wine 7g 20g

Types of Alcohol to Avoid

It’s wise to avoid sugary mixed drinks made with juice mixers, added sugar, and syrups, especially if you have diabetes because they can add excess calories and sugar. These types of beverages can spike blood glucose levels and can cause weight gain. Watch out also for things like spiked cider and hard lemonade, which are both high in carbs and added sugars.

Mixed drinks such as margaritas and daiquiris may contain as much as 30g sugar per serving. Instead, stick to club soda or seltzer water or tonic water.

For Example

  • Vodka with cranberry (made with half-ounce vodka and 6 ounces juice): 200 calories and 23g sugar.
  • Vodka with club soda and a twist of lime (made with half-ounce vodka and 6 ounces seltzer): 100 calories, 0g sugar.

You save 100 calories and 23g sugar.

General Drinking Tips

Hydrate: For each alcoholic beverage you drink, down one glass of water or seltzer—this will help you stay well hydrated and consume less alcohol. Alcohol can increase your appetite too, so drinking water between beverages can distract you from overeating.

Drink with food: If you are going to drink alcohol, do not drink on an empty stomach. Aim to drink with your meal or eat something before you drink to reduce your risk of hypoglycemia. When you are eating, be sure to choose something that has some carbohydrates, so that you have some glucose in your system and therefore are at lower risk of having a low blood sugar.

Safety Considerations for People With Diabetes

Prioritize food: If you are following a fixed carbohydrate meal plan you may need to eat a little extra when drinking. Do not replace food with alcohol and do not count alcohol as part of your carbohydrate choices. The only way to really gauge what works for you is to monitor your blood sugar more often when you are drinking alcohol.

Test your levels: Alcohol can cause your blood sugar to drop even 24 hours after you have consumed it. Check your blood sugar before heading to bed. Make sure it's in a safe range 100-140mg/dL. If your blood sugar is low, follow what your physician recommended for treatment. Taking in extra calories before bed is not ideal, but safety comes first.

Carry snacks: If you have diabetes and are taking insulin or other oral agents that may cause hypoglycemia, you should always carry snacks. Meals can sometimes be delayed and you need to be prepared. Carry snacks that contain some carbohydrate, a piece of fruit, whole grain crackers, or a meal replacement bar. In the event that your sugar does drop to <70mg/dL, you must treat with 15g of fast-acting carbohydrates, such as 3-4 glucose tablets, 4 ounces of juice (one small juice box), or five pieces of hard candy (not chocolate).

Wear your medical ID: You may want to wear a medical ID stating you have diabetes at all times. In the case of a medical emergency, health professionals should know that you have diabetes.

A Word From Verywell

Studies show that there are benefits to drinking alcohol, specifically red wine. But whether or not you have diabetes, alcohol should be consumed in moderation. Because alcohol can cause hypoglycemia, if you're on diabetes medication, it's especially important to talk to your doctor about your drinking habits and potential risk.

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Article Sources

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  1. Gepner Y, Golan R, Harman-Boehm I et al. Effects of Initiating Moderate Alcohol Intake on Cardiometabolic Risk in Adults With Type 2 DiabetesAnn Intern Med. 2015;163(8):569. doi:10.7326/m14-1650

  2. American Heart Association. Alcohol and Heart Health AHA Recommendation. Updated August 15, 2014.

  3. Lindtner C, Scherer T, Zielinski E, et al. Binge drinking induces whole-body insulin resistance by impairing hypothalamic insulin action. Sci Transl Med. 2013;5(170):170ra14. doi:10.1126/scitranslmed.3005123

  4. Richardson T, Weiss M, Thomas P, Kerr D. Day after the night before: influence of evening alcohol on risk of hypoglycemia in patients with type 1 diabetes. Diabetes Care. 2005;28(7):1801-2. doi:10.2337/diacare.28.7.1801

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