Can I Drink Alcohol If I Have Type 2 Diabetes?

A Guide to Imbibing Safely

Moderate alcohol consumption is believed to have health benefits for some people, such as raising good cholesterol (HDL) levels and lowering the risk of cardiovascular disease, but are those with type 2 diabetes among them? Research shows moderate drinking and diabetes often can safely mix. In fact, there is some research to show that moderate drinking can have positive health effects on people with type 2 diabetes.

The important word here is "moderate": Excessive alcohol drinking can increase the risk of conditions such as heart disease and metabolic syndrome. What's more, drinking too much can be a cause of type 2 diabetes by leading to weight gain and insulin resistance. 

According to the American Heart Association, moderate alcohol consumption is defined 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.). Excessive or binge drinking is defined as more than five alcoholic beverages in a two-hour time span for men and four for women.

If you have type 2 diabetes, in order to have your beer or pinot and drink it too without creating further health problems, it's important to understand how drinking affects your body and to know which types of alcohol, and how much, are likely to be safest for you.

Effects of Alcohol on Type 2 Diabetes

For people with type 2 diabetes, isolated episodes of drinking alcohol over the short term may cause slightly increased insulin production, which in turn lowers blood sugar—which is why some studies have found that a drink with a meal for a well-nourished person with diabetes can be considered beneficial.

That being said, 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. Because drinking can lower blood sugar, a phenomenon called hypoglycemia unawareness can easily occur. This typically happens when people who tightly control their blood sugar levels with insulin drink alcohol and fail to notice the symptoms of hypoglycemia or may not recognize that the symptoms they're experiencing are due to low blood sugar. 

Chronic or long-term alcohol use may be more dangerous for people with diabetes, as this may result in increased blood sugar levels (hyperglycemia). Regular consumption has been shown to lead to increased insulin resistance, which may further destroy glycemic control in those with the disease.

Best Types of Alcohol

For people with type 2 diabetes, some options are better than others—especially wine, champagne, and distilled alcohol—straight up or with a sugar-free mixer such as club soda.

Beer tends to be higher in carbs, though it is lower in sugar, while dessert wines such as port 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
12 ounces spiked seltzer 5g 5g

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 up to 30g sugar per serving. Instead, try the newer spiked or hard seltzers hitting the market, or just stick to club soda or plain seltzer water with a squeeze of lime.

Swap This For That

  • Swap: Frozen margarita (made with 2 ounces tequila, 1 ounce triple sec, 1 ounce lime juice, and 3 cups fresh/frozen fruit): 187 calories and 42g sugar.
  • Choose: Tequila on the rocks with a twist of lime (made with 1.5 ounces tequila): 100 calories, 0g sugar.

You save 87 calories and 42g sugar.

General Drinking Tips

When you're planning to imbibe alcohol, keep these tips in mind to help keep your blood sugar under control.

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 fill you up and tamp down the desire to overeat.

Drink with food: 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 low blood sugar.

Safety Considerations for People With Diabetes

When you're getting ready to meet for drinks, be sure to wear your medical ID bracelet so if an emergency arises medical personnel will know you have diabetes. Beyond that, there are other ways to drink safely.

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, such as taking in extra calories to counteract the drop.

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, such as 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).

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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  5. McCulloch, DK, Nathan, DM, Mulder, JE. Patient education: Hypoglycemia (low blood sugar) in diabetes mellitus (Beyond the Basics). UpToDate. Updated Sept. 27, 2019.

  6. Emanuele NV, Swade TF, Emanuele MA. Consequences of alcohol use in diabetics. Alcohol health and research world. 1998;22(3):211.

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