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Updated on August 9, 2022
10 min read

Alcohol & Diabetes

Diabetes & Its Symptoms

Diabetes is a chronic disease characterized by hyperglycemia or high blood sugar

When a person has diabetes, their body is unable to use sugar for energy. This causes an excess of blood glucose.

Having too much sugar in the blood can lead to serious health problems. Some of which include cardiovascular disease, nerve damage (neuropathy), kidney disease, and eye problems.

woman checking blood sugar level though device

There are two main types of diabetes:

  • Type 1 diabetes — Also known as juvenile diabetes or insulin-dependent diabetes mellitus (IDDM). It is a hereditary illness where the body doesn’t produce enough insulin. Type 1 diabetes can affect anyone regardless of age. However, it is more common in children ages 0 to 14.1
  • Type 2 diabetes — Also known as adult-onset diabetes or non-insulin-dependent diabetes mellitus (NIDDM). It is an acquired condition where the body doesn’t respond to insulin (insulin resistance). It is common in people aged 45 and above. People who are obese or overweight also have a higher risk for type 2 diabetes.2

Common symptoms of type 1 or type 2 diabetes include:

  • Polydipsia or extreme thirst
  • Polyuria or frequent urination
  • Polyphagia or extreme hunger
  • Sudden weight loss
  • Fatigue and weakness
  • Blurred vision

A type 2 diabetic may also exhibit symptoms that are unique to their condition. These include frequent infections, slow-healing wounds, numbness or tingling in the hands or feet, and skin darkening in the neck and armpits.

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5 Facts About Alcohol and Diabetes

Drinking alcohol can affect your blood sugar levels, among other things. Here are some fast facts on alcohol and diabetes:

Fact #1: Alcohol prevents the liver from producing glucose

The liver is responsible for producing glucose for energy. This process is known as gluconeogenesis.

When you consume alcohol, the body metabolizes it into ethanol. Ethanol inhibits gluconeogenesis by up to 45% in healthy individuals. It reduces the amount of glucose released by the liver into the bloodstream.

Diabetics are more sensitive to the effects of ethanol. This is especially true for type 1 diabetics who mostly rely on gluconeogenesis for energy.3

Fact #2: Alcohol causes a significant drop in blood sugar levels

Alcohol affects a person’s blood glucose in different ways. It depends on the type of drink, how much alcohol you consume, and your current health status

Initially, alcohol causes an increase in blood glucose. But after a few hours, these levels will start to drop. This is known as delayed hypoglycemia.

Alcohol-related hypoglycemia doesn’t have a significant impact on normal and healthy people. But for diabetics who can’t utilize glucose for energy, it can be devastating. Especially if they take diabetes medications. 

Fact #3: Alcohol interacts with diabetes medications

Type 1 diabetics manage their blood glucose with insulin injections. Meanwhile, type 2 diabetics usually take oral medications such as sulfonylureas or meglitinides.

These medications help the body metabolize excess sugars in the bloodstream. That way, people with diabetes can keep their blood glucose under control.

Alcohol produces similar effects on a person’s blood sugar. So if you drink alcohol while taking diabetes medications, these effects can add up.

Fact #4: Drinking alcohol if you have diabetes can lead to death

While it is generally safe to consume alcohol if you have diabetes, there are some precautions you need to take. Keep in mind that alcohol inhibits the production of glucose. It also has similar effects as diabetes medications.

If you aren’t careful, you may experience a significant drop in blood sugar levels. Severe hypoglycemia is a medical emergency that can prove fatal if it isn’t treated in time.

(See: Risks and Dangers of Drinking with Diabetes)

Fact #5: Alcohol can cause some types of diabetes but not others

Alcohol misuse increases a person’s risk for type 2 diabetes. However, it does not cause type 1 diabetes. 

Alcohol misuse is when a person drinks excessively. Examples include binge drinking, heavy drinking, and chronic alcohol consumption (e.g., daily drinking).

Unhealthy drinking is associated with risk factors for type 2 diabetes. These include:

  • Weight gain
  • Decreased insulin sensitivity
  • Impaired liver
  • Poor pancreatic function

Meanwhile, type 1 diabetes is believed to be a hereditary autoimmune disorder. This explains its early onset in children and adolescents, and why alcohol is not a possible cause.

How Can Alcohol Cause Diabetes?

Excessive alcohol consumption can cause diabetes in three ways:

  • By contributing to weight gain
  • Decreasing your sensitivity to insulin
  • Interfering with pancreatic function

1. Alcohol and your weight

Many alcoholic drinks such as beer and wine are made of sugar and starch. They contain an average of 7 calories per gram. Cocktails hold even more calories due to added ingredients like soda, juice, cream, and ice cream.

Here are some popular drinks and their average calories:4

  • Regular beer: 153 calories per 12 ounces
  • Distilled spirits: 106.5 calories per 1.5 ounces
  • Margarita: 168 calories per 4 ounces
  • Mai Tai: 306 calories per 4.9 ounces
  • Wines: 128 calories per 5 ounces

Calories can quickly add up if you consume excess amounts of alcohol. This may cause the body to store calories as fat and for you to put on weight.

Weight gain is associated with an increased risk for type 2 diabetes. About 30% of overweight people have type 2 diabetes, and 85% of people with diabetes are overweight.5

2. The Effects of Alcohol on Insulin Resistance

Insulin is responsible for the metabolism of sugar. When a person develops insulin resistance, their fats, muscles, and liver stop responding to insulin. This prevents the body from using sugar for energy and causes glucose levels to rise.

Binge drinking can cause insulin resistance and lead to type 2 diabetes.6 Binge drinking can be defined as:

  • Men who have 5 drinks in 2 hours
  • Women who have 4 drinks in 2 hours

Unhealthy drinking patterns and weight gain may also cause insulin resistance. This can lead to symptoms of type 2 diabetes.

3. The Effects of Alcohol on the Pancreas

Excessive alcohol consumption may cause pancreatitis or chronic inflammation of the pancreas. This condition impairs pancreatic function and prevents the production of insulin. 

The lack of insulin then causes an increase in blood sugar levels, leading to type 2 diabetes.

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Is Alcohol-Induced Diabetes Treatable & Reversible?

Diabetes is a lifelong disease. There is no cure for it. However, long-term management of diabetes is possible with good diet, exercise, and medications. 

Evidence suggests that alcohol-induced diabetes is reversible under certain conditions. These include weight gain and insulin resistance due to lifestyle changes. 

Here are the studies to prove it:

  • Moderate weight loss (at least 5% body weight) in people who are obese or overweight has been shown to help maintain their blood glucose.7 
  • To prevent the onset of type 2 diabetes, the American Diabetes Association recommends losing at least 7% body weight and exercising for at least 150 minutes each week.8
  • Some studies suggest that insulin resistance caused by excessive alcohol consumption is reversible, especially when paired with weight loss.9,10 

Not all types of alcohol-induced diabetes are reversible. If it involves pancreatitis and insulin resistance, it may or may not be reversed. According to studies:

  • Reducing alcohol intake has no effect on a person’s insulin resistance and risk for type 2 diabetes.11
  • Type 2 diabetes caused by acute pancreatitis is treatable. However, if it is caused by chronic pancreatitis, it can no longer be reversed and requires long-term management.12

How Does Alcohol Affect Blood Sugar Levels?

In general, most alcoholic drinks will initially cause your glucose levels to rise. These include beers, lagers, wines, liqueurs, and sherries. However, the alcohol found in these drinks also inhibits liver function and prevents it from releasing a steady dose of glucose into your blood.

Eventually, this will cause your blood glucose levels to drop, placing you at risk of low blood sugar. This hypoglycemic event can last for several hours after your last drink. 

For a healthy person, hypoglycemia is sometimes normal. It can cause mild symptoms such as hunger, sweating, sleepiness, pale skin, and dizziness. 

But for a diabetic who is on medications, drinking is associated with more dangerous health risks. In some cases, it may even require immediate medical treatment.

Side Effects of Drinking with Diabetes

People with diabetes usually receive insulin injections or medications that trigger the production of insulin. This is so their bodies can convert glucose into usable energy.

Unfortunately, drinking stops the liver from releasing glucose into the bloodstream. So if a diabetic person is on insulin treatment, they won’t have enough sugar to convert into energy.

If you’ve been exercising, the risk for hypoglycemia is even greater. Exercise increases the body’s sensitivity to insulin by up to 48 hours. Drinking alcohol after exercise causes a surplus of insulin.

Risks & Dangers of Drinking With Diabetes 

Excess insulin can result in dangerously low blood sugar levels.

1. Severe hypoglycemia

Drinking if you have diabetes puts you at risk of severely low blood sugar levels. Symptoms include:

  • Extreme confusion and disorientation
  • Slurred speech
  • Seizures and convulsions
  • Sudden loss of consciousness or passing out

Severe hypoglycemia or “insulin shock” is a medical emergency. It requires medical immediate care. It can potentially lead to comatose and death if not averted. 

If your doctor prescribed a glucagon emergency kit, use it as specified.

2. Nocturnal hypoglycemia

Another possible consequence of drinking is nocturnal hypoglycemia. This is low blood sugar that occurs at night. Symptoms include:

  • Experiencing intense nightmares
  • Unusual sleeping behavior (e.g., talking and making unusual noises)
  • Restlessness or difficulty staying asleep
  • Waking up tired or with a headache
  • Wet clothes and bed linens from night sweating

Having low blood sugar when you’re sleeping is potentially dangerous. If you have difficulty waking a person up, call 911 immediately

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Should You Drink if You Have Diabetes? 

Despite the risks, people with diabetes may continue to drink alcohol. However, there are a few things to keep in mind so your blood sugar stays within normal range.

1. Drink alcohol moderately

Avoid excessive alcohol consumption. Experts recommend that you consume alcohol as follows:

  • No more than two drinks per day for men
  • No more than one drink per day for women

2. Eat food before or while you drink alcohol

Do not drink on an empty stomach to prevent the quick absorption of alcohol into your blood. If possible, eat some food before or while drinking. 

Food slows down the absorption of alcohol and prevents the sudden drop in blood sugar levels.

3. Eat carbs before going to bed

Nocturnal hypoglycemia is common in people with diabetes who are taking medications to regulate their blood sugar. 

If you’ve been drinking, make sure to eat some carbs before going to bed. This will keep your blood sugar levels stable throughout the night.

4. Avoid exercising and alcohol consumption

If you plan to drink alcohol, do not exercise for the day. You should also avoid strenuous activity for at least 48 hours before drinking.

5. Monitor your blood sugar levels

Check your blood sugar before, during, and after drinking alcohol. The American Diabetes Association (ADA) recommends keeping it within 80 to 130 mg/dL.13

If your blood sugar levels start to drop, eat simple carbs to prevent hypoglycemia. Should you experience a lower blood sugar of less than 54 mg/dL, get help right away.

6. Talk to your doctor about drinking alcohol

Get medical advice before you drink alcohol. Ask your doctor about the following:

  • Personal recommendations on what blood sugar levels to maintain. You may have special needs that your doctor will take into consideration.
  • A glucagon emergency kit. Glucagon is available as a prescription-only treatment for severe hypoglycemia.
  • Adjusting your insulin dose. Reducing your insulin before drinking can help prevent your blood sugar levels from dropping.

Treatment for Alcohol Addiction in Diabetics 

Diabetes and alcohol use disorders may sometimes co-occur. Unfortunately, both conditions exacerbate one another.

Diabetes is a chronic disease that can only be managed with a healthy diet, exercise, and medications. 

Diabetics struggling with alcohol misuse or addiction are usually unable to make healthy decisions. This can cause their diabetes to worsen. 

Diabetes is associated with serious health problems. These include cardiovascular disease and neuropathy (nerve damage). Consequently, worsening diabetes increases the health risks associated with excessive drinking. Some of which are heart disease, high blood pressure, and liver damage.

As such, treatment should address both diabetes and alcohol use disorders. Patients with diabetes and alcohol use disorders can benefit from the following treatment options:

  • Medication management
  • Medical detox
  • Mental health support
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Updated on August 9, 2022
13 sources cited
Updated on August 9, 2022
  1. Fluctuations in the incidence of type 1 diabetes in the United States from 2001 to 2015: a longitudinal study.” BMC Medicine.
  2. Type 2 Diabetes.” Centers for Disease Control and Prevention.
  3. The Effect of Evening Alcohol Consumption on Next-Morning Glucose Control in Type 1 Diabetes.” Diabetes Care Journals. 
  4. Calorie count - Alcoholic beverages.” Medline Plus.
  5. Obesity? Diabetes? We’ve been set up.” The Harvard Gazette.
  6. Binge Drinking Induces Whole-Body Insulin Resistance by Impairing Hypothalamic Insulin Action.” National Center for Biotechnology Information. 
  7. The importance of weight management in type 2 diabetes mellitus.” National Center for Biotechnology Information.
  8. Standards of Medical Care in Diabetes—2013.” National Center for Biotechnology Information.
  9. Alcoholism and Diabetes Mellitus.” National Center for Biotechnology Information.
  10. Effects of body weight and alcohol consumption on insulin sensitivity.” BioMed Central.
  11. The Effect of Alcohol Intake on Insulin Sensitivity in Men.” Diabetes Care Journals. 
  12. Alcoholic Pancreatitis.” National Center for Biotechnology Information.
  13. Monitoring Your Blood Sugar.” Centers for Disease Control and Prevention.

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