Can You Drink Alcohol if You Have Diabetes?

What is Diabetes?

Diabetes is a chronic disease characterized by hyperglycemia or high blood sugar. When a person has diabetes, their body cannot use sugar for energy, causing an excess of blood glucose.

Having too much sugar in the blood can lead to serious health problems, including:

• Cardiovascular disease
• Nerve damage (neuropathy)
• Kidney disease
• Eye problems

Can Alcohol Cause Diabetes?

Excessive alcohol consumption can cause diabetes in three ways:

1. Alcohol Contributes to Weight Gain

Alcohol contains 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

Calories can quickly add up if you consume excess amounts of alcohol. This may cause the body to store calories as fat, leading to weight gain.

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. Alcohol Can Lead to Insulin Resistance

When you develop insulin resistance, your 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:¹⁵

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

3. Alcohol Can Cause Pancreatitis

Excessive alcohol consumption may cause chronic inflammation of the pancreas (pancreatitis), impairing its function and preventing insulin production. The lack of insulin then causes an increase in blood sugar levels, leading to type 2 diabetes.

4 Ways Alcohol Affects People with Diabetes

Here are some fast facts on alcohol and diabetes:

1. Alcohol Prevents Glucose Production

If you have type 1 diabetes, you rely on gluconeogenesis to maintain blood sugar levels when you’re not eating. Gluconeogenesis is the process of producing glucose for energy.

Drinking alcohol can inhibit this process by up to 45%, reducing the glucose released into the bloodstream and resulting in hypoglycemia or low blood sugar.³ This effect can be dangerous for people with diabetes.

2. Alcohol Causes A Drop in Blood Sugar Levels

Initially, alcohol causes an increase in blood glucose, but it will drop after a few hours. This effect is known as delayed hypoglycemia.

Alcohol-related hypoglycemia can cause dangerously low blood sugar levels in people with diabetes, especially if you take medication for your condition.

3. Alcohol Interacts with Diabetes Medications

People with type 1 diabetes manage their blood glucose with insulin injections. Meanwhile, people with type 2 diabetes 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 can produce similar or opposite effects on a person’s blood sugar as their diabetes medication. So, these effects can add up or contradict each other.⁹

4. Alcohol Can Cause Type 2 Diabetes

Alcohol consumption does not cause type 1 diabetes. Researchers believe it to be a hereditary autoimmune disorder, explaining its early onset in children and adolescents. Unhealthy drinking is associated with risk factors for type 2 diabetes.²

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Side Effects of Drinking With Diabetes

Most alcoholic drinks will initially cause your glucose levels to rise. However, alcohol inhibits liver function and prevents it from releasing a steady dose of glucose into your bloodstream.

Eventually, the drop in blood sugar can cause a hypoglycemic event that can last several hours. Typically, a healthy person will only experience mild symptoms from hypoglycemia, such as:

• Hunger
• Sweating
• Sleepiness
• Pale Skin
• Dizziness

If you’re on diabetes medication, drinking alcohol can pose serious risks. If you’re on insulin treatment, you won’t have enough sugar to convert into energy. In some cases, it may even require immediate medical treatment. 

Risks & Dangers of Drinking With Diabetes 

Excess insulin can result in dangerously low blood sugar levels.

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 an emergency and requires immediate medical care. It can potentially lead to comatose and death if not averted. 

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

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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Can You Still Drink Alcohol if You Have Diabetes? 

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

1. Drink Alcohol Moderately

Avoid excessive alcohol consumption. Experts recommend that you consume alcohol as follows:¹⁵

• 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, 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.

Exercise increases the body’s sensitivity to insulin by up to 48 hours. Drinking alcohol after exercise causes a surplus of insulin.

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

Eat simple carbs to prevent hypoglycemia if your blood sugar levels drop. If you experience a lower blood sugar of less than 54 mg/dL, get help immediately.

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
• A glucagon emergency kit, a prescription-only treatment for severe hypoglycemia
• Adjusting your insulin dose

Is Alcohol-Induced Diabetes Treatable and Reversible?

Diabetes is a lifelong disease that currently has no cure. However, long-term diabetes management is possible with a 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
• The American Diabetes Association recommends losing at least 7% of body weight and exercising for at least 150 minutes each week to prevent the onset of type 2 diabetes.⁸
• Insulin resistance caused by excessive alcohol consumption can be reversible, especially when paired with weight loss.^9,10 

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

• Reducing alcohol intake does not affect 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

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Treatment for Alcohol Addiction in Diabetics 

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

If you’re struggling with diabetes and alcoholism, you might make unhealthy decisions often. This can cause your diabetes to worsen. 

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:

• Medical detox: Medically supervised detox used to avoid harmful withdrawal effects
• Cognitive behavioral therapy: A short-term therapy technique that explores the link between thought patterns and addiction
• Mental health support: Therapies that involve understanding the root cause of addiction
• Medication management: A strategy for engaging with patients and caregivers to create a complete and accurate medication list

Types of Diabetes

There are two main types of diabetes:

Type 1 Diabetes

Juvenile diabetes, or type 1 diabetes, is a hereditary illness where your body doesn’t produce enough insulin. It is also known as insulin-dependent diabetes mellitus (IDDM).

This type of diabetes can affect anyone regardless of age. However, it is more common in children ages 0 to 14.¹

Type 2 Diabetes

Adult-onset diabetes, or type 2 diabetes, is an acquired condition where the body doesn’t respond to insulin (insulin resistance). It is also known as non-insulin-dependent diabetes mellitus (NIDDM).

Type 2 diabetes is common in people aged 45 and above. You have a higher risk of having type 2 diabetes if you’re obese or overweight.²

Symptoms of Diabetes

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
• Skin darkening in the neck and armpits

Summary

Diabetes is a chronic disease characterized by hyperglycemia or high blood sugar. Although there is no cure for diabetes, it is usually managed by making healthy decisions.

Diabetes can be worsened by alcohol in several ways. It can lower blood sugar levels, interact with medication, and increase the risk of type 2 diabetes.

If you want to keep drinking despite being diabetic, you must drink moderately. Before you drink, make sure you talk to a healthcare professional.

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