Diabetes: Alcohol in the Diet

If I have diabetes, is it OK for me to drink alcohol?

If you have diabetes, it may be OK for you to drink alcohol sometimes. You need to be cautious because alcohol can make your blood sugar level too low.

• If you haven’t eaten anything recently, drinking even a small amount of alcohol can lead to a very low blood sugar.
• Alcohol increases the effects of diabetes medicine. If you take insulin or diabetes pills, you are especially at risk for low blood sugar.
• Some diabetes medicines can interact with alcohol and cause serious health problems. Always ask your healthcare provider about possible drug interactions if you drink alcohol.
• Alcohol can make some diabetic health problems worse. If you have nerve damage in your arms or legs, eye disease, or liver disease, drinking alcohol can make these problems worse.
• Drinking too much alcohol increases blood pressure. High blood pressure can worsen problems caused by diabetes, such as kidney failure, retinopathy, and heart disease.
• If you have high levels of triglycerides in your blood, you should not drink alcohol. Drinking even small amounts of alcohol can cause the liver to make even more triglycerides. High triglycerides can cause more problems.

What are the guidelines for drinking alcohol if I have diabetes?

You should never drink alcohol if:

• You have trouble controlling your blood sugar level.
• You have complications from diabetes.

If you don’t have any complications and your blood sugar is in good control, follow these tips:

• Never drink alcohol on an empty stomach. Always eat a meal or a snack that contains carbohydrate (starch, fruit, or milk) before or with your drink. This is especially important if you are involved in a physical activity, such as dancing.
• The general guidelines for how much alcohol is safe to drink are the same as for people who don't have diabetes. Drinking alcohol is a personal choice that should be based on your current health, other risk factors, and your healthcare provider's advice. If you choose to drink alcohol, do so in moderation. Moderate levels are:
  • 1 drink a day if you are a woman
  • 2 drinks a day if you are a man.

  One drink equals one 12-ounce beer, one 5-ounce glass of wine, or a shot of one and a half ounces of spirits.

• If you cook with alcohol, use regular drinking wine, not cooking wine. There is less sodium in the drinking wine. Cook the food slowly so that the alcohol has time to burn off.
• Always wear a diabetes alert bracelet or necklace. The signs and symptoms of low blood glucose and intoxication from alcohol are similar.
• Alcohol can affect your body's ability to get over a low blood sugar level. If you have low blood sugar while you are drinking, you may need to treat it more than once. Check your blood sugar often. Keep a high-carb snack or glucose tablets on hand to treat low blood sugar.
• If you have been drinking, always check your blood sugar before you go to sleep. It should be at least 100 to 140 milligrams per deciliter (mg/dL). Eat a snack before bedtime to keep from having low blood sugar while you sleep.
• Combining alcohol with exercise can cause blood sugar to go dangerously low. This can happen even hours after the physical activity. It is better to quench your thirst with water rather than alcohol before, during, and after exercise.

How do I fit alcoholic beverages into my meal plan?

Drinking alcohol can make it harder to lose weight. Alcohol is high in calories. If you are also getting extra calories from eating snacks, meals, or mixers to avoid low blood sugar, you can easily go over your calorie limit. Either avoid alcohol completely or use the following tips to fit the added calories better into your meal plan.

• If you don’t take insulin, the calories from alcohol can be substituted for some of the fat portions in your meal plan. (Most diabetic meal plans allow for 3 to 6 fat portions a day.) Your body breaks down alcohol in a way similar to how it breaks down fat. Most drinks are equal to about 2 fat portions, or about 100 calories. Watch out for sweet/frozen drinks, such as margaritas and daiquiris. They can have hundreds of calories and lots of added sugar.
• If you take insulin, you can occasionally include 1 or 2 drinks in your daily meal plan. Don’t leave out any foods from your usual meal plan. When you are using insulin, you have a greater risk for low blood sugar.
• There are ways you can make your drink last longer. For example, you can mix wine with no-calorie mixers such as club soda, sparkling water, or diet soda. You can also try to drink slowly.
• Try to choose drinks and mixers that are not too high in alcohol, carbohydrates (sugars), and calories. Examples are dry or light wines; light beers; and sugar-free mixers such as diet soda, water, seltzer, club soda, and low-salt vegetable juice. Avoid sweet wines, wine coolers, and sweet liqueurs, such as Irish Cream.
• Good alternatives to alcohol are nonalcoholic beer or wine, Count every 15 grams of total carbohydrate in a nonalcoholic beverage as 1 carb choice in your food plan.

For more information, visit the American Diabetes Association Web site at http://www.diabetes.org or call 1-800-342-2383.