I Would Drink To That: How to Safely Consume Alcohol with Diabetes

Supriya Lal

2022 Feb 01

15 min read

Contrary to the opinion of many, alcoholic drinks are not necessarily forbidden for people with diabetes.

While it’s true that drinking alcohol may have unfavorable effects on the blood sugar levels of people with diabetes, it doesn’t have to be completely removed from the diet.

It could even be added to the diet of people with diabetes, as some evidence has shown that alcohol consumption may even help with blood sugar control.

So, who decides on whether you drink alcohol as a person with diabetes? Well, the first choice should be your healthcare provider.

But if you do have to drink, it’s important to know the risks and benefits that are associated with alcohol consumption by people with diabetes. And that’s precisely what we’ll be exploring in this article.

We’ll be looking at the different ways alcohol consumption affects your blood sugar levels, and whether or not it can lead to severe health consequences when one doesn’t pursue a policy of moderate drinking.

Here’s what this article will cover;

  • What The Body Does With Alcohol
  • How Drinking Alcohol Can Affect People With Diabetes
  • Alcohol and Diabetes; What You May Stand To Gain
  • How To Manage Diabetes And  Alcohol
  • Food Diabetics Should Avoid
  • Best food For Diabetics
  • Conclusion

What The Body Does With Alcohol

Before we can talk about what alcohol abuse can do to the body, we need to first understand what happens to alcohol once it gets into the body.

First off, the body doesn’t treat alcoholic drinks the same way it treats all other drinks.

When alcohol is introduced to the body, it first goes down to the belly. What happens there depends on whether it meets an empty stomach or not.

If it doesn’t meet an empty stomach, the pyloric valve, which is the valve that separates the stomach from the small intestine, will be shut to allow the food to be digested, which would trap the alcohol in the stomach.

However, if the stomach isn’t empty, the valve would be open and the pure alcohol would go directly into the small intestine.

Once in the small intestine, the alcohol is immediately absorbed right into the bloodstream. Since alcohol has very small molecules that can easily be absorbed, this ends up being no problem.

After that, alcohol travels all around the body through tiny blood vessels and eventually ends up in the liver, which is the only organ that can break down alcohol.

It’s when alcohol gets to this point that it can start affecting your blood sugar levels. This part is especially important for people with diabetes.

Now, the liver doesn’t just exist for breaking down alcohol. It also performs other important functions in the body.

The liver is where excess sugar glucose is stored as glycogen.

But stored glycogen has to be turned into glucose before the body can use it. When the blood sugar levels of the body lowers, the liver tries to balance the lower blood glucose level by turning some of that glycogen into glucose.

But here’s the problem; the liver can only do one of those things at once. And when given a choice, the liver would choose to abandon the low blood sugar problem, and would instead try to break down the alcohol.

Introducing alcohol into the body will give the liver extra work to do and will stop it from being able to deal with low blood sugar levels.

How Drinking Alcohol Can Affect People With Diabetes

Alcohol and diabetes have an interesting relationship. Firstly, diabetes refers to a situation where the body is unable to regulate high blood sugar levels.

The disease is divided into two types. The first type is type 1 diabetes, which means that the body doesn’t produce insulin, which is the main way for the body to lower high blood sugar levels.

The second type is called type 2 diabetes, which is what happens when the body produces insulin but it isn’t enough. It can also be a situation where the body doesn’t react to insulin as it’s supposed to.

Insulin is a hormone created by the pancreatic cells that helps the body absorb the glucose they need for energy. That’s why it becomes a problem when insulin production is nonexistent if the body isn’t making enough, or if the body is suffering from insulin resistance.

Since alcohol intake can have a huge effect on your blood sugar levels, people with diabetes who engage in alcohol consumption might have to deal with health complications that other healthy people might not have to face.

Some of these health complications are mild, while others are a bit more severe.

Excess Weight

People with diabetes who have high alcohol intake levels run the risk of getting obese.

Alcohol might not taste like it, but it’s quite fattening. Pure alcohol contains about 7 calories per gram, which is just a little lower than fat — which contains 9 calories per gram, and a lot more than carbohydrate, which is about 4 calories per gram.

When alcohol gets to the liver, the body converts it into pure fat. That means drinking a lot of alcohol can make one obese, which is one of the risk factors for developing diabetes.

Of course, this can be avoided with moderate drinking habits, but too much alcohol consumption would inevitably lead to excess weight gain.


Hypoglycemia, otherwise known as low blood sugar, can be a by-product of heavy alcohol consumption.

Sustained drinking of alcohol will make it difficult for the body to increase blood sugar levels. Of course, hypoglycemia is its own disease and comes with its own peculiar set of symptoms. Some of which include tiredness, weight loss, and blurred vision.

Interestingly, even people with diabetes can suffer from hypoglycemia. It’s quite common with people who suffer from type 1 diabetes.

The cause is usually the insulin medication that these people take, as insulin taken in excess can lower blood sugar levels past the recommended level.

It’s less common amongst people with type 2 diabetes as they usually have better control over their blood sugar levels.

Thankfully, there are ways to manage hypoglycemia. There are glucagon kits that people with type 1 diabetes who suffer from blood sugar levels can use to quickly correct the problem.

Eating healthy food can also help them manage the problem.

According to The American Diabetes Association and the National Institute of Diabetes and Digestive and Kidney Diseases, people living with diabetes need to understand how to manage hypoglycemia, especially if they are using insulin medication.


Hyperglycaemia, which is the medical term for high blood glucose levels, can also be an effect of heavy alcohol consumption.

Several studies argue that acute alcohol consumption, even in well-nourished diabetics, can lead to insulin resistance and may make it harder for diabetics to control their blood glucose levels.

Of course, this can lead to a host of other problems like thirst, frequent urination, and blurred vision.

This means that even people with type 2 diabetes, who already have to deal with elevated glucose levels, have to be very careful with how they drink alcohol because it could quite literally make their symptoms worse.

Alcohol and Diabetes; What You May Stand To Gain

It’s not all gloom and doom for people living with diabetes who love drinking alcohol.

While alcohol can hinder insulin production in the body, it can also lower blood glucose levels by preventing the liver from creating glucose.

It may sound unlikely, but this is a position backed by many studies on the subject. For example, one study has shown that for people with type 2 diabetes, occasional drinks can help to lower their blood glucose levels.

Alcohol might not be the healthiest drink, but like many other classes of food, it does offer some benefits of taking moderately.

Some research has shown that people who drink red wine may be protecting their cells since red wine contains antioxidants that help prevent cell damage.

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However, even this supposed benefit of alcohol is still a theory. There are still no concrete links that tie intake of red wine with reduced risk of cell damage. There’s also little evidence that alcohol intake makes it easier for people to deal with diabetes.

How To Manage Diabetes And  Alcohol

If you are the type that loves to drink alcohol but are living with diabetes, you don’t have to stop drinking totally.

As long as you don’t fall into the trap of alcohol use disorders, you can maintain great alcohol health without giving up the bottle entirely.

The only thing is that you’d have to adhere to some important rules.

Don’t Drink Alcohol While Hungry

The first is to ensure that you drink alcohol with only food. Stop drinking on an empty stomach, as that makes it more difficult for the liver to break down the alcohol.

And as you know, if your liver cannot break down alcohol in the system quickly, it could lead to your blood sugar level going haywire.

One easy way to do this is to make sure you have a snack or some fruit to eat as you take your drink. That way, you can always be sure that your stomach isn’t empty, and your body will be able to deal properly with the alcohol you’re ingesting.

When possible, try to ensure that the meals you consume right before drinking or during drinking are ones with carbohydrates. This lowers the chance of your blood sugar going so low that the body would have to produce glucose to raise the blood sugar.

Drink Safely

At this point, you should forget about drinking alcohol to get drunk. It’s just not healthy to indulge in binge drinking anymore.

Specifically, this means that you should limit yourself to one drink per day if you’re a woman, and never more than two drinks if you’re a man.

This may be a difficult lifestyle to adjust to, but it’s the only way to stay safe and still enjoy drinking. The transition from being heavy drinkers to being moderate drinkers may be hard for some people to make, but it’s still a lot easier than the health problems they might have if they continue to drink.

Importantly, this advice should be taken by everyone, irrespective of whether they are diabetic or not. Drinking too much alcohol is a risk factor for many illnesses, and even the National Institute of Diabetes and Digestive and Kidney Diseases claims that there’s an increased risk of developing kidney disease for diabetics who continue to drink alcohol.

Another thing to note is that all acholic drinks are not created equal. Some drinks are ridiculously high in carbs and sugar and may contribute to your high blood sugar more than others.

It’s your responsibility to figure out what drinks are low in carb, as such will be great for you, and which ones are high in it and thus should be avoided.

Mix Your Drinks

If you insist on drinking more alcohol than is necessary, then you should learn to dilute the drinks with non-alcoholic drinks like diet soda, club soda, or even water.

This helps to reduce the concentration of alcohol you take in and would go a long way in helping you manage your blood glucose levels.

Identify Yourself

If you’ve got a medical bracelet, make sure you keep it on at all times, as it will help medical personnel help you if you ever have to deal with a medical emergency.

Alcohol’s Effects on Complications of Diabetes


Retinopathy is a troublesome eye disease that’s usually a result of diabetes. Today, retinopathy is the leading cause of blindness in America.

Thankfully, it isn’t unavoidable. Good blood sugar control, when coupled with regular eye examinations and blood pressure control can make all the difference in the world.

However, some studies suggest that heavy drinking can be a contributing factor for developing this disease. Interestingly, these studies argue that heavy alcohol consumption negates all the benefits of good blood sugar and blood pressure control.

Alterations of Lipid Metabolism

People who live with diabetes usually have abnormalities in their lipid levels and metabolism. These abnormalities often contribute to their risk of developing cardiovascular disease. That’s why so many diabetics suffer from cardiovascular disease after years of battling diabetes.

Sadly, consumption of alcohol can further exacerbate these diabetes-related lipid abnormalities. That’s because drinking more than three drinks per day has proven to contribute to lipid abnormalities, even in non-diabetics.

This means that diabetics who drink alcohol are at a greater risk of developing cardiovascular disease.

Cardiovascular Disease

Despite cardiovascular diseases being the leading killer of humans worldwide, the relationship between the disease and diabetes is yet to be properly studied.

However, one study raises important questions about the effects of alcohol on the health of diabetics and their chances of developing cardiovascular diseases.

For example, a ten-year study of over a thousand men (and an unknown percentage of diabetics), showed that overall death rates, after adjustment for age, was lowest among men who drink about 0.1 to 34 grams of alcohol per day, which is around a drink per month and less than three drinks per day.

Interestingly, the death rate amongst men who drank more than three drinks per day and men who completely abstained was higher than that of the first group of men.

Another important thing to note is that the men who abstained from alcohol completely had the highest death rate from cardiovascular disease, while the ones that drank more than 34 grams of alcohol per day had the highest death rate from the non-cardiovascular disease.

This study seems to be suggesting that alcohol consumption could have a positive effect on cardiovascular disease.

However, this finding is not definite as correlation doesn’t necessarily mean causation. The fact that the men who drank alcohol in this study were less likely to die from cardiovascular disease doesn’t unilaterally mean that alcohol is great for diabetics who already have an increased risk of developing this disease.

Peripheral Neuropathy

Peripheral neuropathy is a condition that is characterized by the damage of the nerves that extend from the spinal cord to the different muscles in the body and control muscular function. It could also refer to the damage of motor nerves that transport different sensations from the muscles back to the brain.

Many patients who suffer from peripheral neuropathy have to deal with symptoms like pain, burning, and numbness.  Now, the thing about this disease is that diabetes and alcoholism are the two most common underlying causes of the illness.

Diabetics who have the disease tend to see their symptoms worsen over time, and research has reliably shown that diabetics who drank more than three drinks per day.

Excessive consumption of alcohol has also been revealed to be an underlying cause of the illness.

All this tells us is that diabetes and alcohol may work together to cause nerve damage, or exacerbate it.

Reduced LDL Cholesterol Levels

Not all cholesterol is bad for you. For example, having a high level of high-density lipoprotein is great for you. However, having a high level of low-density lipoprotein has been reliably linked to a higher risk of heart disease.

Interestingly, it has been proven that LDL cholesterol is usually higher in nondrinkers than in alcoholics. That means that drinking alcohol might have a beneficial effect on your LDL levels, even as a diabetic.

Elevated HDL Cholesterol Levels

HDL cholesterol is called good cholesterol as it has a good effect on the heart. It also has a protective effect against cardiovascular disease.

According to studies, the HDL levels in a person are usually elevated after chronic drinking and then return to normalcy after a period of abstinence from the bottle.

Asides from that, epistemological data has shown that drinking no more than three drinks per day is associated with a reduced risk of cardiovascular diseases like heart attacks and high blood pressure.

Medication interactions

Asides from all the other diabetic complications that alcohol may worsen, or improve, there are also complications caused by medication interactions.

For example, chlorpropamide, a medication used to treat type 2 diabetes by increasing pancreatic insulin secretion, can cause an unpleasant reaction when used by patients who drink alcohol.

Another example is troglitazone, a medication that decreases insulin resistance. This drug must not be used by people with liver disease, and should also never be used by people who drink excessive alcohol. Asides from that, the drug itself could impair liver function, and drinking alcohol might make this problem even worse.


Diabetes is a very dangerous illness and is among the leading causes of death in the world. However, it isn’t a death sentence, and most mild cases can be effectively managed.

However, for it to be managed properly, people living with diabetes also have a part to play. For one, they have to remain physically active and have to take extra care with the meals they eat.

If they do not take this extra care and live recklessly, they would increase their risk of developing serious health complications as a result of their diabetes.

The great news is that diabetics aren’t alone in this fight. It might look like a lot, but the help they need to make the lifestyle changes that will help them live long and fulfilled lives even with diabetes is certainly not out of their reach.

For example, they can reach out to companies like Klinio that will not only help them manage their diabetes and plan their meals but will also help them lose unhealthy weight and live a fitter and healthier lifestyle.

Written by

Supriya Lal

Supriya Lal is a Registered Dietitian based in New York City. She completed her training at Duke University Hospital System and has specific interests in personalised nutrition therapy, nutritional counseling, and sustainability related to food and nutrition. She is currently completing her Master's in Public Health at New York University.

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