Does having diabetes mean you can’t enjoy a glass of wine with dinner or a cold beer with friends? Not necessarily. Having a drink occasionally does not impact diabetes, but one must carefully understand how much alcohol is right for you, and when to stop. Talk with your Nutrition coach about how alcohol fits into your diabetes care plan.

Research indicates that alcohol consumption has U-shaped association with risk of diabetes, with least in people consuming moderate amounts of alcohol compared to non-drinkers or heavy drinkers. Remember, drinking too much can lead to serious problems, including dangerously low blood glucose.

What does moderate alcohol intake imply

Alcohol in moderation implies not more than one drink per day for women or two drinks per day for men. One drink refers to about 350 ml of beer or 240 ml of malt liquor or 100 ml of wine or 30ml of a hard liquor (vodka, gin, whiskey etc.). However, if a person with diabetes already has hypertension, nerve damage, or eye problems, the consumption of alcohol is not recommended at all.

How does alcohol spike blood sugar level?

Alcohol consists of carbohydrates. The core of meal management in diabetes control is monitoring the carbohydrate intake, which leads to higher blood glucose levels. Drinking results in slight peaking in blood glucose levels based on the amount of alcohol consumed.

Additionally, alcohol interferes with liver’s release of glucose as once liver detects alcohol, it gives preference to first clearing the alcohol, putting glucose production and release on hold. Such a lack of glucose release from liver can cause hypoglycemia or low blood sugar. Hence it is important to know when to stop as well as consume alcohol slowly along with some food/snacks.

Adverse impact of high levels of alcohol on a diabetic are as follows:
    • Too much alcohol can lead to hypoglycemia, i.e., abnormally low blood glucose. It can occur immediately or up to 8 – 12 hours after drinking.
    • Mixing alcohol with diabetes pills may increase risk of side effects like hypoglycemia, nausea, vomiting, headache, rapid heartbeat, or sudden changes in blood pressure.
    • For example, FDA has a black box warning for diabetics to avoid excessive alcohol intake while taking metformin, as latter is metabolized by liver resulting in fluctuating blood glucose levels.
    • If a diabetic has pain due to nerve damage, alcohol can dramatically increase the amount of pain felt, as drinking alcohol leads to sustained increase in activity of the nervous system, which further intensifies pain signaling.
    • Drinking may lead to slacking on self-care: Overindulging in alcohol can weaken your resolve to make healthy choices, making you less likely to follow your meal plans and exercise routines. This can lead to spikes in your blood glucose levels, further worsening your diabetes.

 

To ensure that your alcohol intake does not interfere with diabetes, remember to:
  1. Test your glucose levels before, during and after drinking. Also check your blood sugar in the 12 hours following your alcohol consumption to ensure that your levels are in the normal range.
  2. Not drinking alcohol on an empty stomach. Some good snack choices are plain pop-corns, unsalted nuts and chana, raw vegetables or salads, steamed chicken/ fish and a low-fat yogurt / curd / salsa dip. It helps in preventing hypoglycemia.
  3. Know carbohydrate content of your drink especially mixing cocktails with fruit juice or regular soda, all of which typically increase the carbohydrate content drastically. A good option to lower carb count is to take these with plain water rather than in form of cocktails.

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