Updated 17 November 2017

‘Can I drink alcohol if I have diabetes?’

For anyone – whether you have diabetes or not – the key word when consuming alcohol is moderation.

If you have diabetes, should you say no to a beer or glass of champagne when you're at a party or celebrating with friends?  

The answer is that a moderate amount of alcohol will not have a serious effect on the blood sugar levels of people with type 1 or 2 diabetes.

Experts, however, caution that people with diabetes should always be very careful when consuming alcohol. Most alcoholic drinks contain no nutrients and are high in calories.

According to registered dietitian and Association for Dietetics in South Africa spokesperson Ria Catsicas one gram of alcohol contains approximately 29.3 kJ of energy and one standard drink about 600 kJ.

“It is more important to control how much we drink, rather then what we drink,” she says. 

pull quote, Health24

Mixing alcohol and diabetes

Alcohol affects everyone differently depending on their age, gender, body weight and capacity. Catsicas points out that the liver gives preference to detoxifying the blood of alcohol over metabolising food, and therefore excessive consumption can contribute to weight gain.

“Alcohol inhibits the liver’s ability to release glucose into the bloodstream and can cause a low blood sugar attack (hypoglycaemia),” she explains. “As alcohol lowers blood glucose levels, people with diabetes should never consume alcoholic drinks on an empty stomach.”

If you have diabetes, always eat something while you are drinking and avoid consuming sugar-based drinks such as dessert wines or fruity alcoholic drinks (e.g. ciders or Smirnoff Spins).

“People on insulin can experience a low blood glucose attack at night. They need to adjust their insulin when consuming alcoholic drinks and/or eat while consuming alcohol.”

The effect of alcohol on blood glucose levels

According to the American Diabetes Association, alcohol can cause hypoglycaemia shortly after drinking and for up to 24 hours after drinking.

They advise you check your blood glucose levels before drinking and especially before you go to sleep. It needs to be at a safe level of between 5.5 and 7.7mmol/L – if it’s too low, make sure you eat something to raise it. 

The danger is that symptoms of consuming too much alcohol and hypoglycemia can be similar, i.e. sleepiness, dizziness or disorientation. You do not want someone to confuse the two in case they give you the wrong assistance and treatment. 

Staying safe

The American Diabetes Association offers the following tips:

  • Do not drink on an empty stomach or when your blood glucose level is low.
  • Do not replace food with alcohol.
  • Drink slowly and always have a zero-sugar and zero-alcohol drink (water, diet soda, iced tea) by your side to keep you hydrated.
  • Opt for light beer or wine.
  • Add sugar-free and calorie-free mixers to hard liquor. 

Reduce your consumption

“The quantity of alcoholic beverages we usually consume socially is often a function of the time spent at social events,” says Catsicas. There are ways to reduce your consumption:

  • Swap some alcoholic drinks for non-alcoholic, non-sugar drinks such as sugar-free frizzy drinks and/or sugar-free cordials such as lime/ passion fruit / cola tonic mixed with soda water.
  • Choose lower-alcohol and lower-calorie drinks.
  • Supplement your intake of alcohol with plenty of water, as alcohol dehydrates your body.

alcohol, table

When to say no

There are times when you should avoid drinking alcohol when you have diabetes. These include:

  • When your blood sugar is uncontrolled
  • If you have a history of alcohol abuse or binge drinking
  • If you suffer from liver disease, pancreatitis, advanced neuropathy (nerve problems caused by diabetes) or severe hypertriglyceridemia (elevated triglycerides)

The bottom line

“You cannot swap food for alcohol,” says Catsicas. “Always eat while drinking alcohol and avoid sugar-based drinks. You also need to be smart and limit the number of alcoholic drinks you consume – enjoy non-alcoholic sugar free drinks between your alcoholic drinks, and by the end of the party you will have consumed 50% less alcohol without anyone noticing.”


Ask the Expert

Diabetes expert

Dr. May currently works as a fulltime endocrinologist and has been in private practice since 2004. He has a variety of interests, predominantly obesity and diabetes, but also sees patients with osteoporosis, thyroid disorders, men's health disorders, pituitary and adrenal disorders, polycystic ovaries, and disorders of growth. He is a leading member of several obesity and diabetes societies and runs a trial centre for new drugs.

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