Alcohol and diabetes have a complex relationship. However, if you’re living with diabetes or pre-diabetes excessive alcohol consumption is not a good idea.
In this article, we’ll look at how alcohol and diabetes interact, and we’ll give tips about how you can have a drink more safely.
What is diabetes?
Diabetes is a condition where the body is unable to keep blood glucose levels within a healthy range. This is because the body can’t create enough insulin (the hormone that helps to regulate blood glucose), can’t use the insulin that it does make, or both.
As a result, serious long-term health issues can occur, such as heart disease and kidney damage.
The prevalence of diabetes is a cause for concern—Diabetes Australia has referred to it as ‘the biggest challenge confronting Australia’s health system’. Almost 1.5 million Australians are living with one of the types of diabetes, and one person is diagnosed with the condition every five minutes.
Not only is excessive alcohol consumption a risk factor for type 2 diabetes, but it contributes to the development of other causal factors such as insulin resistance, high blood pressure and extra weight, particularly around the waist. It can also increase total cholesterol, LDL (‘bad’ cholesterol) and triglycerides (a type of fat in your blood).
The effect of excessive alcohol on blood glucose management can be dangerous to people who are living with diabetes and pre-diabetes.
Pre-diabetes: what it is, risk factors and warning signs
Pre-diabetes is a condition where a person’s blood glucose levels are higher than normal but not high enough to be diagnosed as type 2 diabetes. Pre-diabetes is a risk factor for type 2 diabetes.
However, the good news is that sustainable healthy habits can help to prevent or delay the onset of type 2 diabetes.
The exact cause of pre-diabetes is unknown, but its risk factors are similar to those for type 2 diabetes. They can be split into two groups, modifiable (they can be changed) and non-modifiable (can’t be changed).
Modifiable risk factors include your weight, your diet and the amount of exercise you do. The non-modifiables are things such as your age, ethnicity and your family medical history. A more detailed list of the risk factors can be found here.
Pre-diabetes often has no warning signs or symptoms. However, hyperglycaemia (high blood glucose), which leads to pre-diabetes, does. They include:
- increased thirst and frequent urination
- unplanned weight loss
- blurry vision
If you experience any of the above, you should see your doctor.
Alcohol and pre-diabetes interaction
Alcohol impacts blood glucose levels in a way that partially at least, seems to differ according to biological sex. In men, it can raise the risk of impaired glucose regulation, whereas in women low to moderate alcohol consumption (which equals one standard drink per day) can reduce the risk. A standard drink is one that contains 10 grams of pure alcohol. Examples are:
- a small glass of full-strength beer (285 ml)
- a 100 ml glass of wine
- 30 ml of spirits.
However, excessive drinking in either biological sex can affect blood glucose balance.
Alcohol and diabetes: risks and complications
If a person with diabetes—especially if they take medication for it—decides to drink alcohol, they need to manage their consumption carefully, not least because doing so can cause low blood glucose (hypoglycaemia). The reason this occurs is that the body preferentially metabolises alcohol over blood glucose. Some of the symptoms of hypoglycaemia, such as confusion and drowsiness, can be mistaken for drunkenness and left untreated. That can result in seizures, unconsciousness and death.
Alcohol also increases the risk of serious diabetes-related health problems, including:
Diabetic ketoacidosis—where the body breaks down increasing amounts of fat to use as a source of energy. This releases acidic substances called ketones, which build up in the blood and can cause thirst, headache, tiredness and death.
Cardiovascular disease—alcohol use raises blood pressure, increasing the risk of cardiovascular disease, which is the main cause of death in people with type 2 diabetes.
Retinopathy—retinopathy, which is caused by damage to the blood vessels that supply the retina, is the main cause of blindness in people with diabetes.
Alterations to lipid metabolism—lipid metabolism refers to the processes that create and transform lipids (fats) in the body. Alcohol can cause a potentially fatal condition called alcoholic fatty liver disease, where fats build up dangerously in the liver.
Tips for moderating alcohol consumption to maintain stable blood glucose levels
Most people with diabetes can usually safely enjoy a small amount of alcohol. However, the level of risk that alcohol poses is unique to the individual. It’s safest to have yours assessed by your doctor.
Here’s a list of things to remember if you do choose to consume alcohol:
- drink alcohol with food—drinking on an empty stomach can raise the risk of hypoglycaemia
- monitor your blood glucose levels regularly while you’re drinking
- drink slowly
- avoid binge drinking or drinking for a prolonged period of time
- avoid sweet wines or cordials and sugary soft drinks as mixers (the diet versions of soft drinks can be used as mixers).
Here are some FAQs about alcohol use and diabetes:
What are the guidelines for alcohol use in Australia?
In 2020, the National Health and Medical Research Council (NHMRC) recommended that, to reduce health risks from drinking alcohol, healthy men and women should drink no more than ten standard drinks a week and no more than four standard drinks on any one day.
Can I drink alcohol if I have diabetes?
Most people with diabetes can have a small amount of alcohol.
What type of alcoholic drink is best for people with diabetes?
The best would be low-calorie and/or low-carb alcoholic drinks such as light beer and spirits like whisky and vodka.
Does alcohol raise or lower blood glucose?
Moderate amounts of alcohol may cause blood glucose levels to rise, while excessive amounts will cause them to fall.
How does alcohol interact with diabetes medications?
Some diabetes medication lowers blood glucose levels. Combining that with alcohol can lead to hypoglycemia.
How does alcohol affect the liver’s ability to regulate blood glucose?
When you drink alcohol, your liver has to work to remove it from your blood instead of working to regulate your blood glucose. For this reason, you should never drink alcohol when your blood glucose is already low.
Tips for moderating alcohol consumption to maintain stable blood glucose levels
If you decide to drink alcohol, here are some tips for moderating your consumption to help maintain stable blood glucose levels:
- Drink alcohol with a meal/do not drink on an empty stomach.
- Drink plenty of water.
- Mix alcohol with water or low-sugar ‘diet’ mixers but don’t mix alcohol with sugary drinks.
- Sip drinks slowly.
- Avoid drinks that contain a lot of sugar, such as sweet sherries, sweet wines and liqueurs.
If you’re living with pre-diabetes or diabetes, managing your alcohol consumption is vital.
Making healthy lifestyle choices can help you prevent or delay the onset of type 2 diabetes.
Life! is a free healthy lifestyle program that helps you improve your eating habits, increase your physical activity and manage stress. You can choose from a group course or our telephone health coaching service.
Our experienced health professionals will help you make changes to your lifestyle so that you can reduce your risk of type 2 diabetes and cardiovascular disease.
Since 2007, over 75,000 Victorians have learnt more about living a healthy life with the Life! program. It is the largest prevention program of its kind in Australia.
Life! is funded by the Victorian government and managed by Diabetes Victoria.
You can take a quick online health test and check your eligibility for the program here.
Diabetes and Alcohol – Effects of Alcohol on Diabetes – WebMDAlcohol consumption and risk of pre-diabetes and type 2 diabetes development in a Swedish population – Diabetic medicine : a journal of the British Diabetic Association
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