Let's Be Real About the Effect of Alcohol on Diabetes

I had the best time at this amazing woman’s bachelorette party this weekend, but we all know that bachelorette parties mean lots and lots of alcohol. Alcohol use in people with diabetes is a difficult and often controversial topic. May clinicians advise abstinence, but let’s be real… that’s kind of like asking someone to abstain from sex until marriage. It’s a good idea… in theory, but will it work for everyone? Nope. So instead, let’s talk about how to manage.

First of all, everything suggested in this article, as with my other posts, is solely for general education and information purposes. It is not intended to provide any medical advice and cannot replace or be a substitute for your relationship with your healthcare provider. Now let’s get on with it… I am personally a firm believer in the “everything in moderation” philosophy when it comes to my diabetes. I don’t like being told that I “can’t” do things or am restricted by my diabetes in any way. I especially don’t like being told I shouldn’t do things without being given an explanation as to why. I also try to avoid this with my patients as much as possible.

With that in mind, there are many things to consider regarding blood sugar control if you do choose to drink alcohol from time to time.

First, understanding how alcohol affects your body and therefore your blood glucose (BG) level is imperative. There is a common misconception that alcohol causes hyperglycemia due to its high sugar content; however, it is frequently the opposite. Alcohol has been known to cause very serious hypoglycemic events.

Why?

The liver’s job is to regulate BG levels by releasing “emergency stores” of glucose when our BGs drop below certain levels. The liver’s other job is to process alcohol. High ingestion of alcohol can therefore block the liver’s production of glucose (the liver is too busy processing the alcohol to make new glucose stores). Therefore, when someone is on insulin or an insulin stimulating agent like a sulfonylurea (glipizide, glimepiride, etc.) they can experience very severe lows up to 24 hours after alcohol ingestion. Additionally, if you are taking medications that are processed by your liver, drinking alcohol can increase your risk of liver damage.

Now, if you are thinking about using alcohol to lower a high BG (I know some of you are…), don’t! Alcohol’s effect on BG levels is unpredictable. It therefore should not be used in this way!

Here are some sipping tips… never drink alcohol on an empty stomach. This increases your risks of lows while drinking. If you do decide to drink alcohol, make sure that you have not skipped any meals and do not plan to
skip them the following day (remember alcohol can affect your BGs for up to
24 hours).

Also, remember to moderate! One drink of alcohol per day may be OK, but more than one could put you at serious hypo risk. It is recommended that women should not have more than one drink of alcohol per day and men two drinks per day. So, drink slowly! It’s not a race!

Make sure to test your BG before, during, and after you drink alcohol. Do not go to bed with a low BG. Also, keep in mind that the symptoms of hypoglycemia can easily be confused with the symptoms of alcohol intoxication (confusion, fatigue, dizziness). It is always a good idea to wear
a medical alert bracelet while drinking that way if you do have a hypo event,
you will not be perceived as drunk, but will instead receive proper medical attention. Avoid mixed drinks high in sugar (opt for low carb or diet mixers).  And lastly, don’t drink and drive!

Anyone else have tips? Leave them below!