4 Ways Alcohol Affects Diabetes


Linda Wasmer Andrews

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Does having diabetes mean you can’t enjoy a glass of wine with dinner or a cold beer with friends? Not necessarily. Moderate drinking may even reduce the risk for heart and kidney complications.

But drinking too much may lead to serious problems, including dangerously low blood glucose and harmful interactions with your diabetes medication.

If you have diabetes and drink alcohol, it’s especially important to do so responsibly. Talk with your doctor about how alcohol fits into your diabetes care plan. Here are four effects of drinking that you may want to discuss.

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Medical Reviewer: William C. Lloyd III, MD, FACS Last Review Date: Aug 13, 2015

2016 Healthgrades Operating Company, Inc. All rights reserved. May not be reproduced or reprinted without permission from Healthgrades Operating Company, Inc. Use of this information is governed by the Healthgrades User Agreement.

1. Moderate drinking may have health benefits.

A published study in Diabetes Care included more than 11,000 people with type 2 diabetes from 20 countries. All were at least 55 years old and had either heart disease or a heart risk factor in addition to diabetes. When the study began, participants reported how much alcohol they drank during a typical week. During the next five years, those who said they drank alcohol in moderation had a lower risk for heart attacks, strokes, and early death than those who abstained completely.

Other studies have shown that moderate drinking is associated with a lower risk for unhealthy cholesterol levels and kidney disease in people with diabetes. The key word here is moderate. That means no more than two drinks per day for men and one drink for women. Heavy drinking can cause a host of health problems, including high blood pressure, liver damage, and several types of cancer.

2. Drinking alcohol can cause hypoglycemia.

When you have diabetes, drinking alcohol can sometimes lead to hypoglycemia—abnormally low blood glucose. To help prevent this, don’t drink alcohol on an empty stomach or when your blood glucose isn’t under control. For added safety, your doctor might recommend testing your glucose level before, during and after drinking.

3. Alcohol can interact with many diabetes pills.

Mixing alcohol with diabetes pills may increase the risk for harmful side effects:

  • If you take sulfonylureas, which help the pancreas produce more insulin, it’s more likely that alcohol will cause hypoglycemia. Examples of sulfonylureas include chlorpropamide (Diabinese), glipizide (Glucotrol), and glyburide (DiaBeta, Glynase, Micronase).

  • The combo of sulfonylureas and alcohol occasionally causes flushing, nausea, vomiting, headache, rapid heartbeat, or sudden changes in blood pressure.

  • Combining the medication metformin (Glucophage) with alcohol raises the risk of developing lactic acidosis. This rare but very serious side effect may cause weakness, tiredness, dizziness, chills, trouble breathing, muscle pain, stomach problems, and sudden changes in heart rate or rhythm.

Be honest with your doctor about how much alcohol you drink, because that might affect which diabetes medication you’re prescribed. This also applies to clinical decisions regarding the newer injectable non-insulin diabetes medications. Discuss the possible side effects. Know what to watch for and how to react if a problem occurs.

4. Drinking may lead to slacking on self-care.

Overindulging in alcohol can weaken your resolve to make healthy choices. In a study of more than 3,900 men with diabetes, those who abused alcohol were less likely to follow a meal plan and more likely to smoke than nondrinkers.

In other studies of diabetes patients, heavy drinkers were less likely to consistently check their blood glucose, take their diabetes medication, get A1c tests, and exercise. This is one reason heavy drinkers with diabetes often have a lot of trouble controlling their glucose levels.

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Medical Reviewers: William C. Lloyd III, MD, FACS Last Review Date: Aug 7, 2016

© 2016 Healthgrades Operating Company, Inc. All rights reserved. May not be reproduced or reprinted without permission from Healthgrades Operating Company, Inc. Use of this information is governed by the Healthgrades User Agreement.

View Sources

Medical References

  1. Blomster JI, et al. The relationship between alcohol consumption and vascular complications and mortality in individuals with type 2 diabetes mellitus. Diabetes Care. 2014;37(5):1353-9.
  2. Dunkler D, et al. Diet and kidney disease in high-risk individuals with type 2 diabetes mellitus. JAMA Internal Medicine. 2013;173(18):1682-92.
  3. Engler PA, et al. Alcohol use of diabetes patients: the need for assessment and intervention. Acta Diabetologica. 2013;50(2):93-9.
  4. Shimomura T and Wakabayashi I. Inverse associations between light-to-moderate alcohol intake and lipid-related indices in patients with diabetes. Cardiovascular Diabetology. 2013;12(104).
  5. Thomas RM, et al. Association between alcohol screening scores and diabetic self-care behaviors. Family Medicine. 2012;44(8):555-63.
  6. Diabetes Medicines. National Institutes of Health. National Institute of Diabetes and Digestive and Kidney Diseases. http://diabetes.niddk.nih.gov/dm/pubs/medicines_ez/meds_508.pdf
  7. Mixing Alcohol with Medicines. National Institutes of Health. National Institute on Alcohol Abuse and Alcoholism. http://pubs.niaaa.nih.gov/publications/Medicine/medicine.htm
  8. Alcohol and Public Health: Frequently Asked Questions. Centers for Disease Control and Prevention. http://www.cdc.gov/alcohol/faqs.htm
  9. Stay Healthy. Centers for Disease Control and Prevention. http://www.cdc.gov/diabetes/managing/health.html
  10. Finding a Balance. Centers for Disease Control and Prevention. http://www.cdc.gov/healthyweight/calories/index.html
  11. Nielsen SJ, et al. Calories consumed from alcoholic beverages by U.S. adults, 2007-2010. Centers for Disease Control and Prevention, National Center for Health Statistics Data Brief. November 2012;110. 
  12. Alcohol. American Diabetes Association. http://www.diabetes.org/food-and-fitness/food/what-can-i-eat/making-healthy-food-choices/alcohol.html
  13. Blomster AI, et al. The Relationship Between Alcohol Consumption and Vascular Complications and Mortality in Individuals With Type 2 Diabetes. Diabetes Care 2014 May; 37(5): 1353-1359.

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