Diabetes and Alcohol: Is It Safe to Drink?

One-fourth of the 26.9 million American adults who have diabetes report using alcohol. Peer pressure and work-related stress are the two main reasons for this. 

Unfortunately, diabetes can cause complications such as kidney and heart disease. In 2018 alone, 8.25 million patients with diabetes needed hospitalization due to associated complications with their condition. There is now also evidence that suggests alcohol misuse may potentially speed up the process of bodily impediment.

What Is Diabetes?

Diabetes refers to a medical condition in which the body cannot regulate its blood sugar levels within the normal range.

Doctors diagnose individuals with diabetes if they have:

• An HbA1c (a blood marker for diabetes) level equal to or greater than 6.5%
• A fasting blood sugar level equal to or greater than 126 mg/dl
• An oral glucose tolerance test value greater than or equal to 200 mg/dl

Types of Diabetes

Insulin is a hormone produced by the pancreas that helps lower blood sugar levels following a meal. In patients with diabetes, the body is either unable to produce insulin (type 1 diabetes) or resistant to insulin’s effects (type 2 diabetes). 

As a result, the blood sugar levels of these patients remain elevated for longer. 

Diabetes Symptoms

• Frequent urination
• Increase in thirst and hunger
• Weight loss
• Blurred vision
• Numbness (or tingling) in hands and feet
• Fatigue
• Skin dryness
• Slow wound healing
• Susceptibility to infections

Can Alcohol Cause Diabetes?

Research shows that alcohol raises the risk of developing diabetes. This occurs because alcohol misuse: 

• Increases insulin resistance by disrupting signaling among cells in the body.
• Causes pancreatic inflammation (i.e., chronic pancreatitis) by thickening pancreatic secretions that accumulate and block pancreatic ducts. As a result, pancreatic secretions remain in the pancreas, leading to inflammation and a decrease in the organ’s ability to produce insulin.  
• Causes weight gainsince alcohol is calorie-dense and promotes hunger by inhibiting satiety hormones such as leptin. The resulting blood sugar spikes increase the risk of developing diabetes. 

Alcohol and Diabetes: A Dangerous Combination?

Consuming low quantities of alcohol is safe for those with diabetes. Some studies suggest it may also reduce the risk of diabetic complications. For example:

• In a large-scale systematic review of research, taking small quantities of alcohol was shown to reduce risk of heart disease for patients with diabetes. Another meta-analysis reported similar results. This is because alcohol (in small quantities) lowers blood pressure and lowers fat deposition in blood vessels, which improves blood circulation. 
• A narrative review shows that the occasional drink may improve blood sugar control. 

It’s important to note that researchers observed these benefits only in those patients who consumed less than the recommended quantities of alcohol (discussed below). Beyond these limits, alcohol also puts diabetic patients at risk of:

Hypoglycemia Due to Alcohol Misuse With Diabetes

Patients with diabetes who misuse alcohol often replace their meals with alcoholic drinks. This puts them in a calorie-deficient state, which the body tries to correct by turning to energy sources other than sugar (namely, proteins and fat). Eventually, these reserves run out, leading to hypoglycemia (i.e., low blood sugar levels). 

Prolonged hypoglycemia can cause nerve and brain damage, leading to life-long complications such as incontinence, issues with memory, and other cognitive impairments. 

Hyperglycemia to Excessive Alcohol-Intake With Diabetes

In well-nourished patients with diabetes, alcohol misuse raises blood sugar levels; that is, it causes hyperglycemia (due to the three reasons discussed in the Can Alcohol Cause Diabetes? section above). 

Complications From Mixing Alcohol and Diabetes

Consuming alcohol in greater-than-recommended quantities increases risks of complications in patients with diabetes. These risks include:

• Diabetic ketoacidosis– Since alcohol misuse can lead to malnourishment, the body uses proteins and fats for energy, which produces chemicals (specifically ketones) that increase acidity in blood. This, in turn, can lead to vomiting, abdominal pain, irregular heart rhythms, confusion, and even death. 
• Nerve damage (neuropathy) – Alcohol consumption damages nerves by triggering an inflammatory reaction and reducing the absorption of the gut’s ‘nerve-friendly’ vitamins, such as thiamine. As a result, patients with diabetes who misuse alcohol are significantly more likely to experience neuropathies than those who do not drink. 
• Vision impairment – Alcohol negatively affects vision in patients with diabetes by damaging nerves in the eye and accelerating cataract development. 
• Liver dysfunction – When patients with diabetes drink too much alcohol, it overwhelms the overworked liver as it metabolizes alcohol and controls sugar production and storage. Understandably, this can cause liver failure. 
• Dangerous drug interactions – Some anti-diabetic medications (such as chlorpropamide) can cause unpleasant and potentially dangerous side effects when taken with alcohol. As always, please consult your healthcare provider before taking any medication. 

How Much Alcohol Can Patients With Diabetes Consume?

The American Diabetes Association and the UK Chief Medical Officers have designed alcohol intake recommendations meant to ensure safe alcohol use in all patients. Sticking to the limits outlined in these recommendations is research-proven to minimize the risk of complications while also potentially providing some cardio-protective benefits. 

The alcohol intake recommendations are as follows:

• No more than one alcohol-containing drink per day for women 
• No more than two alcohol-containing drinks per day for men
• Fewer than 14 units of alcohol per week (spread over a minimum of three days).

Please note one drink is equivalent to 12 ounces of beer, five ounces of wine or 1½ ounces of distilled spirits. Similarly, one unit of alcohol refers to 10 ml of pure alcohol. 

What Alcoholic Drinks Can Patients With Diabetes Drink?

Alcohol-containing drinks vary considerably in terms of calorie density and their effects on blood sugar levels. Considering this, the following drinks may be safer for patients with diabetes:

• Light beer
• Dry wines
• Drinks that include diet soda and juices

Alcohol Misuse Has Long-Term Consequences: Let Us Help You Quit!

Alcohol misuse can negatively impact your physical, mental, and social health, but you don’t have to go through all that. Let us help you reclaim your life with our evidence-based treatments. Click here to learn more.