October 11, 2023/Diabetes & Endocrinology

Diabetes and Alcohol: Do They Mix?

Blood glucose monitoring and drinking in moderation can help you avoid hypoglycemia

beer glass sitting beside diabetes testing equipment

Alcohol comes with a warning label in the United States and many other countries. It’s a reminder that consumption should come with a degree of caution.


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That’s true for all drinkers — but it’s especially true if you have diabetes.

Beer, wine and liquor can interfere with diabetes medications (like insulin), disrupt condition management plans and cause other complications that could take a dangerous turn for your health.

Now, does that mean that someone with diabetes can’t drink alcohol? Not at all. But if you have diabetes and want to enjoy happy hour, it’s best to take an approach that offers you some protection.

Let’s get a plan together with diabetes educator Andrea Harris, RN, CDCES.

Is it safe to drink alcohol with diabetes?

Maybe … but maybe not, too. There’s no one answer. That’s why it’s best to talk with your healthcare provider about drinking alcohol when you have diabetes and how (or whether) you can do it safely.

“You need to know if your medications or any diabetes-related conditions you have could be seriously affected by alcohol consumption,” emphasizes Harris.

How alcohol affects diabetes

When it comes to alcohol and diabetes, two related factors come into play — how diabetes medications and alcohol coexist in your system and the effect that drinking has on your liver. Let’s look at both.


Alcohol and diabetes medications

Most diabetes medications work to lower your blood sugar (glucose) levels — and they’re particularly good at the job. The problem? Alcohol does the same thing, especially when consumed in larger quantities.

That sort of double impact can cause blood sugar levels to drop to dangerously low levels, a condition known as hypoglycemia.

What’s particularly concerning is that drunkenness and hypoglycemia can look and feel similar, notes Harris. Shared symptoms include:

  • Blurred or double vision.
  • Slurred speech.
  • Clumsiness or difficulty with coordination.
  • Being disoriented.
  • Dizziness.
  • Sweating.

One last concern, too: The effects of alcohol on your blood sugar can last as long as 24 hours.

Alcohol and your liver

Warehousing glycogen, the stored form of glucose, is among the many tasks your liver performs. The glycogen stays there until your liver breaks it down for release to address low blood sugar.

But when you drink alcohol, your liver neglects its blood sugar duties while turning its attention to another one of its jobs — removing toxins from your blood. (And alcohol, as we all know, is a toxin.)

Basically, it’s another path toward hypoglycemia.


Drinking with diabetes: What to keep in mind

To safely consume alcohol while managing diabetes, Harris offers these six tips:

  1. Check your blood glucose levels. Monitor your blood sugar closely if you’re planning to drink. Consider checking your blood glucose levels before, during and after consuming alcohol to make sure you’re staying in your target zone. (If your blood sugar drops, stop drinking and eat something to bring your glucose level up.)
  2. Never drink on an empty stomach. Eating before drinking slows down the rate of alcohol absorption into your bloodstream, which can help keep your glucose levels from plummeting.
  3. Don’t combine drinking with exercising. Exercise brings a drop in glucose. Consuming alcohol near or during a workout can double that downward push.
  4. Drink in moderation. Potential issues grow with every drink ordered. It’s best to follow the recommended rules of moderation — no more than one drink per day for women and no more than two drinks for men. One drink is equal to 5 ounces of wine (12% alcohol content); 12 ounces of beer (5% alcohol content — so make adjustments for higher alcohol brews); or 1 1/2 ounces of distilled spirits such as vodka or gin (80 proof alcohol).
  5. Watch for excess sugars and carbohydrates. Sweetened cocktails and carb-heavy drinks can cause spikes in your blood sugar. Consider leaning toward “plain” drinks (without sugary mixers), light beers and dry wines.
  6. Wear diabetes medical identification. A medical ID can be lifesaving if you develop a severe case of hypoglycemia and pass out. Wear it.

Final thoughts

Drinking alcohol isn’t truly “good” for anyone. It can raise your blood pressure and drive up your heart rate. It can fuel anxiety, disrupt sleep and leave your body dehydrated. It can become addictive.

But if you have diabetes, there’s an extra layer of concern that demands attention.

The keys to safely drinking if you have diabetes are to drink in moderation and check your blood sugar regularly, advises Harris. Those two steps will go a long way toward keeping you healthy. Cheers!

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