Can I Drink Alcohol If I Have Type 2 Diabetes?

In most cases, people with type 2 diabetes can drink alcohol in moderate amounts. As you may well know, living with type 2 diabetes often means cutting out or cutting back on foods and beverages that can affect sugar (glucose) levels in the blood. But alcohol doesn't necessarily have to be one of them.

In fact, some evidence shows that many people with type 2 diabetes can safely enjoy drinking alcoholic beverages, and it may even bring about some benefits. Your healthcare provider can best determine what's right for you. But if you do drink, know that not all alcoholic beverages are created equal when it comes to diabetes.

This article explains how alcohol affects blood sugar levels. It addresses some of the risks as well as some of the benefits of drinking alcohol when you have type 2 diabetes. It also provides guidelines for how to safely include alcohol in a type 2 diabetes diet (if you so choose).

How Alcohol Affects People With Type 2 Diabetes

Alcohol is absorbed directly into the bloodstream from the stomach or the small intestine, carried through the body, and delivered to the liver.

At this point, alcohol can affect blood sugar in ways that are especially important for people with type 2 diabetes. This is because the liver is where excess glucose is stored in a form called glycogen.

When blood sugar levels dip too low, the liver converts glycogen into glucose. This glucose is released into the bloodstream to bring levels up to normal.

However, the liver can't do this and metabolize alcohol at the same time. So it will focus on dealing with alcohol first rather than converting glycogen to glucose. As a result, blood glucose levels remain low.

Risks of Alcohol in Type 2 Diabetes

Insulin is a hormone produced by the pancreas that helps cells absorb the sugar they need for energy.

Type 2 diabetes involves having too much blood glucose. This happens when the body doesn't produce enough insulin or does not respond to insulin as it should. This is known as insulin resistance.

Because of the effects alcohol can have on blood sugar control and other aspects of the disease, you face certain risks by drinking alcohol if you have type 2 diabetes that otherwise healthy people may not.

As you mull these ideas, keep in mind that much remains to be learned about how alcohol affects people with diabetes.

Hypoglycemia Unawareness

Hypoglycemia (low blood sugar) unawareness occurs when someone with diabetes has a drop in blood sugar but doesn't recognize the symptoms.

It's most common among people with type 1 diabetes who take medication such as insulin to control their blood glucose. The drugs keep their blood sugar levels in such tight control that they rarely experience dips.

But even those who have type 2 diabetes who take medication may be vulnerable to hypoglycemia unawareness, even though their blood sugar levels are more likely to skew high than low.

Glucagon kits, widely used to treat hypoglycemia in type 1 diabetes, do not work as well if someone has alcohol in their system. Eating food will help to correct this problem.

Hyperglycemia

While alcohol can lower blood sugar levels, it also has the potential to increase them. Regular, long-term use of alcohol has been shown to increase insulin resistance.

The increase in blood sugar levels gives way to hyperglycemia, or too-high blood sugar. This can cause a host of symptoms, from thirst and frequent urination to slow-healing wounds and disorientation.

This means drinking can make it even harder for people with type 2 diabetes—which is defined by elevated glucose levels—to manage their blood sugar.

Weight Gain

All alcohol contains about 7 calories per gram, which is more than carbohydrates (4 calories per gram) and only slightly less than fat (9 calories per gram).

What's more, when the liver breaks down alcohol, it converts it to fat, which can contribute to weight gain. Excess weight can contribute to the onset of type 2 diabetes, and it can make the condition worse.

Benefits of Alcohol in Type 2 Diabetes

Alcohol can lower blood sugar. And those with diabetes need to bring down elevated glucose levels. It makes sense, then, that drinking could play a role in preventing and treating type 2 diabetes.

Some evidence supports this stance. For example, studies have shown that for people who have type 2 diabetes, occasionally drinking alcohol may slightly reduce glucose levels.

Drinking alcohol in moderation has also been linked to a number of other health benefits, such as increasing the amount of good cholesterol (HDL) in the blood. This may help lower the risk of heart disease, which you're at greater risk for if you have type 2 diabetes.

People who drink red wine may derive another benefit. According to the American Heart Association, red wine contains antioxidants, which are compounds in certain foods that help prevent cell damage.

They do this by counteracting free radicals, which are unstable molecules that can cause disease. People with type 2 diabetes tend to have especially high levels of free radicals. (They sound wild because they are; they're unstable molecules that damage the cells in your body.)

The important thing to understand, though, is that this presumed benefit is just a theory. There is no research to show a definite link between drinking red wine and improved diabetes management.

With all of this in mind, the risks of drinking alcohol when you have type 2 diabetes may outweigh any benefits. It's important to keep your personal health top-of-mind, right along with the advice of your healthcare provider.

Can You Drink Safely With Type 2 Diabetes?

If you don't drink, there's no reason to start. It may sound harsh, but it's advice that any healthcare provider is likely to give.

If you do drink alcohol, and don't wish to stop, some strategies can help you drink safely:

Identify Yourself

Before heading out to a bar or restaurant where you plan to have a drink, put on your medical ID bracelet. This way, if an emergency arises, medical personnel (who are trained to look for IDs) will know you have diabetes.

Eat First

Alcohol takes longer to be absorbed into your bloodstream if you have food in your stomach.

Have a snack or meal as you sip or immediately beforehand to lower the risk of hypoglycemia. Choose foods that contain carbohydrates so that you have some glucose in your system (meaning, you will be at lower risk of having low blood sugar).

It's smart to bring a snack with you to a bar or cocktail party. A piece of fruit, whole-grain crackers, or a meal replacement bar are good choices.

If your glucose drops to less than 70 milligrams per deciliter (mg/dL), you'll need to down 15 grams of fast-acting carbohydrates. This could be three or four glucose tablets, 4 ounces of juice (a small juice box), or five pieces of hard candy (and not chocolate).

Choose Wisely

Some alcoholic drinks are worse than others when you have type 2 diabetes. Certain types of alcohol are especially high in carbs and sugar, even if you drink them straight.

The same is true of cocktails made with regular soda or mixers, simple syrup, and other types of added sugar, or fruit juice. Dessert wines contain considerably more sugar than other types of wine.

You can reduce the carb and sugar content of a drink to a minimum by having it straight or mixing it with club soda, plain seltzer, diet soda, or a squeeze of fresh lemon or lime.

Do Not Overindulge

Even for people who don't have diabetes, drinking too much, too often, can be risky. You should drink in moderation. The Centers for Disease Control and Prevention (CDC) and other federal agencies define that as one drink per day or less for women and two drinks per day or less for men.

One drink is defined as containing 14 grams (0.6 ounces) of pure alcohol: 12 fluid ounces of regular beer (5% alcohol), 5 fluid ounces of wine (12% alcohol), or 1.5 fluid ounces of 80 proof distilled spirits (40% alcohol), such as rum, vodka, whiskey, or gin.

Excessive or binge drinking is defined as having more than five alcoholic beverages in a two-hour time span for men, or four for women.

These guidelines are the maximum amount of alcohol to drink. Drinking less—as any healthcare professional will tell you—is better.

Test Your Blood Sugar

After you drink alcohol, your blood sugar levels can drop up to 24 hours later. Check your blood sugar before and while you're drinking and then again before you go to bed.

A healthy range is between 80 mg/dL and 130 mg/dL before bed. If yours is low, follow your physician's recommendations, such as consuming some carbs to counteract the drop.

Summary

Your body processes alcohol differently than most foods and beverages. And if you have type 2 diabetes, drinking alcohol may have some benefits—such as lowering glucose levels in the blood—and some real risks, like driving glucose levels down too low.

The safest approach to drinking alcohol if you have type 2 diabetes is to drink in moderation, choose beverages that are low in sugar and carbs, never drink on an empty stomach, and keep close tabs on your blood sugar levels before, during, and after drinking.