Having diabetes does not mean you can’t drink alcohol. However, there are reasons to exercise caution when drinking beer, wine or other alcoholic beverages.

Some of the points to bear in mind are the effects alcohol has on glucose levels, the calories contained within alcoholic drinks, and how excessive alcohol intake can increase the chance of developing diabetes complications.

Measuring Alcohol Intake

A standard drink is equal to 14.0 grams (0.6 ounces) of pure alcohol. Generally, this amount of pure alcohol is found in

  • 12-ounces of beer (5% alcohol content).
  • 8-ounces of malt liquor (7% alcohol content).
  • 5-ounces of wine (12% alcohol content).
  • 1.5-ounces or a “shot” of 80-proof (40% alcohol content) distilled spirits or liquor (e.g., gin, rum, vodka, whiskey).
 

Calories

Alcohol is a significant source of energy and has more calories gram for gram than carbohydrate and almost as many calories as fat.

Many alcoholic drinks, including beers, ciders and cocktails often contain a significant amount of carbohydrate and/or sugar which can add significantly to the calorie content.

A single pint of lager typically has around 200 calories and therefore represents 10% of a woman’s daily calorie intake and 8% of a man’s. Having 4 pints of lager would be 40% of a woman’s daily calorie intake and 32% of a man’s.

It’s not just lager either, a moderate glass of wine (175ml) can vary between 120 and 150 calories depending on the sweetness of the wine.

Hypoglycemia

People on diabetic medication that can raise the risk of hypoglycemia need to be particularly cautious of hypos occurring during or after drinking alcohol.

These anti-diabetic medications include insulin and oral hypoglycemics such as sulfonylureas and prandial glucose regulators.

Alcohol has a number of effects on the liver and one of these is to reduce the liver’s ability to raise blood glucose levels. Alcohol can also mask the symptoms of hypoglycemia, meaning you could mistake the signs of severely low blood glucose levels with being drunk.

Preventing hypos

Hypos could occur up to a day after drinking alcohol and a particularly dangerous time is when you’re asleep (nocturnal hypos). It is therefore important to take the following measures when drinking alcohol:

  • Take sufficient carbohydrate before going to sleep
  • Test your blood glucose levels frequently during and after drinking
  • Wear diabetes identification
  • Ensure people around you know you have diabetes and know what to do if a hypo should occur

Ketoacidosis

People with type 1 diabetes can also be at risk from a condition known as ketoacidosis, which can result if important injections are missed during drinking.

People that take an injection of long term insulin before going to bed will need to ensure they carry out this injection as close to the normal time as possible.

If an injection is delayed or missed, it can cause the body to break down fat and protein into acidic ketone bodies for use as an alternative energy source. However, a quick build up of ketones in the blood can become dangerous, leading to the onset of ketoacidosis.

Medications

Alcohol can interact with a number of medications which may commonly be taken by people with diabetes.

As discussed above, alcohol can lead to a greater risk of hypoglycemia in people on insulin and diabetes drugs known as insulin secretagogues or oral hypoglycemic medications.

Alcohol may also interact with other commonly prescribed medicines including:

  • Pain killers
  • Blood pressure medication
  • Anti-inflammatory drugs
  • Anticoagulants
  • Antidepressants

It’s recommended to check the patient information leaflet provided with your medication to see if any interactions with alcohol may take place.

Greater risk of complications

Alcohol use is associated with a greater risk of developing long term complications of diabetes such as heart disease, neuropathy, kidney disease and liver disease.

The risk rises with greater alcohol dependence and so people with diabetes that drink more than the maximum recommended intake put themselves at a significantly higher risk of suffering complications.