How much alcohol and what type is best with diabetes?
Editor’s Note: This content has been verified by Marina Basina, MD, a Clinical Associate Professor at Stanford University. She’s a clinical endocrinologist and researcher with a focus on diabetes management and diabetes technology. Dr. Basina is an active member of multiple medical advisory boards and community diabetes organizations, and she is on the Beyond Type 1 Science Advisory Council.
So, you are going to drink alcohol. But what type is best to drink with diabetes? And how much can you drink? Before choosing what types of alcohol you want to be drinking, make sure that you understand the risks of drinking with diabetes and how to drink safely.
How much alcohol?
If you’re going to drink, exercise moderation. According to the CDC, women with diabetes should consume no more than one serving of alcohol a day. Men with diabetes should consume no more than two servings per day. One serving of alcohol typically looks like the following:
- 12 ounces of beer
- 5 ounces of wine
- 1 ½ ounces of distilled spirits
What type of alcohol?
The type of alcohol that you choose to drink can influence how your night turns out if you have diabetes. Different drinks will affect your body with diabetes wildly differently. This is because there are two competing factors. On one hand, alcohol alone inhibits the steady release of glucose from the liver, which can cause low blood sugar. Read more about why that is here.
On the other hand, the sugar and carbs in many drinks can cause high blood sugar. Because of how volatile your body’s reaction to drinking can be, make sure to be constantly checking your blood glucose levels (BGLs). Be cognizant of what is in whatever you are drinking.
Beer is a popular drinking choice, whether it be while social drinking or just cracking open an ice cold bottle in front of the television on game night. However, one important thing to consider when drinking beer with Type 1 diabetes is the carb content. A light beer contains between 3-6 grams of carbs per serving. Non-light beer contains between 10-15 grams of carbs. Then take into account the fact that many people don’t just drink one can of beer (the alcohol content of beer is 4-7%), and you can have a lot of carbs on your hand that you are going to have to account for with diabetes. This doesn’t mean that drinking beer is out of the question; in fact, alcohol’s tendency to lower BGLs might actually make these carbs helpful, but this is just something to keep in mind.
Wine is another popular choice of alcohol, kinda like beer’s classier sibling. The alcohol content of wine ranges from 12-15%, and therefore, the serving size for wine is a smaller 5 oz. Much like with beer, when drinking wine, it is important to factor in the carb content, which can vary wildly with different types of wine. Most red wines have less than 5 grams of carbs per serving. However, one 3.5 oz serving of dessert wine clocks in at 14 grams of carbs. Check the carb chart at the end of this article for more information.
Mixed drinks are notoriously hard to track, which is especially important with diabetes. This is because unless you are informed, the amount of alcohol and carbs between different mixers and alcohols can be completely different. For example, a typical serving of rum and diet coke has only 2 g of carbs, while a rum and a regular coke has 26 g of carbs. Because of this, make sure you know what is in the drink you are drinking so that you can adjust accordingly. So if you are going to completely stay away from any drink, it would be the infamous punch bowl; who knows how much alcohol or carbs could be in that vaguely tropical-colored concoction?
Finally, hard alcohol. The pro about drinking straight alcohol is that the carb count is typically very low. The con is the extremely high alcohol content. Since there is so much alcohol in liquors, it makes you more susceptible to drinking too much and feeling the negative side effects of drinking with diabetes. Furthermore, if you are drinking liquor, make sure that you are also drinking water or other liquids. You don’t want to end up dehydrated, which can mess up your blood sugar levels.
Learn more about drinking with diabetes.
Information from chart from UCSF
Return to Beyond Type 1’s Alcohol and Diabetes Guide.
Type 2 Diabetes and Alcohol: Proceed With Caution
Alcohol can worsen diabetes-related nerve damage. (RON CHAPPLE STOCK/CORBIS)
Alcohol can worsen diabetes-related nerve damage.(RON CHAPPLE STOCK/CORBIS)Hoping for a beer at the ball game, or a glass of wine with dinner?
If you have type 2 diabetes, that’s probably OK as long as your blood sugar is under control, you don’t have any complications that are affected by alcohol (such as high blood pressure), and you know how the drink will affect your blood sugar, according to the American Diabetes Association.
An alcohol-containing drink a day might even help your heart (though if you don’t already drink, most experts say that’s not a reason to start).
In moderation, alcohol may cut heart disease risk
According to a study by researchers at the Harvard School of Public Health, women with type 2 diabetes who drank relatively small amounts of alcohol had a lower heart-disease risk than those who abstained. A second study found that men with diabetes had the same reduction in heart risk with a moderate alcohol intake as non-diabetic men.
In general, the recommendations for alcohol consumption for someone with type 2 diabetes are the same as anyone else: no more than two drinks per day for men and no more than one drink per day for women. (Make sure to measure: A drink serving is 12 ounces of beer, 5 ounces of wine, or 1.5 ounces of hard liquor such as scotch, gin, tequila, or vodka.)
People with diabetes who choose to drink need to take extra care keeping food, medications, alcohol, and blood sugars in balance.
Janis Roszler, RD, a certified diabetes educator in Miami, Fla., recommends:
- Mixing alcoholic drinks with water or calorie-free diet sodas instead of sugary (and calorie- and carbohydrate-laden) sodas and other mixers.
- Once you have had your drink, switch to a non-alcoholic drink, such as sparkling water, for the rest of the evening.
- Make sure you have an eating strategy and plan in place to avoid overeating and overdrinking in social situations. Alcohol can make you more relaxed, and may lead you to make poor food or drinking decisions.
- Don’t drink on an empty stomach because alcohol can have a very rapid blood glucose lowering effect, which is slowed if there is food in your stomach.
- If you’re going to have a drink, wear your diabetes identification bracelet or necklace.
“If you become hypoglycemic and there is alcohol on your breath, police or paramedics may mistake your condition for being drunk and may not get the care you need,” says Roszler.
Next Page: Alcohol could make complications worse Alcohol may also worsen nerve damage
Some people with diabetes, though, should not consume alcoholic beverages.
Drinking can worsen nerve damage from diabetes and increase the pain, burning, tingling, and numbness that people with nerve damage often experience.
If you have complications related to your diabetes, you should be more careful about your alcohol intake. More than three drinks a day can worsen diabetic retinopathy. And even if you have fewer than two drinks per week, you can increase your risk of nerve damage (alcohol abuse can cause nerve damage, even in people without diabetes). Alcohol can also raise levels of fat called triglycerides in the blood.
Here’s something else to consider: Researchers at Kaiser Permanente in California wanted to see whether there is a relationship between drinking and diabetes self-care behaviors. The team examined survey data for 65,996 adults with diabetes to determine their levels of alcohol consumption and adherence to good health habits, such as testing their blood sugar, getting their A1C levels checked, and taking their medicines.
People who drink alcohol, the study found, are less likely to follow recommended practices than those who don’t drink, and the more they imbibe, the less likely they are to stick with recommended health practices.
Although the study doesn’t prove that drinking causes poor health behaviors, it does suggest that drinking is a marker for poor self-care.
You’ll need to test your blood sugar to gauge alcohol’s effect
If you do choose to drink, there are no specific recommendations for one type of alcoholic beverage as better than another. However, the American Diabetes Association notes that light beer and dry wines tend to have less alcohol, carbohydrates, and calories.
It’s important to test before and after having a drink to see the impact on your blood sugar, especially when you’ve first been diagnosed with diabetes or if you’re taking insulin or other medicines that can cause hypoglycemia. Treat abnormal blood sugar levels as directed by your health care team.
Alcohol usually causes blood sugar to drop (while the liver is processing alcohol, it takes a break from its other role of releasing stored glucose as needed). However, alcohol can sometimes raise blood sugar.
“I do drink alcohol in very moderate amounts,” says Donna Kay, 40, of Prairie Village, Kan., who was diagnosed with type 2 diabetes in 2003. She always checks her blood sugar before and after consuming alcohol. “If I’m at a dinner party, I’ll duck into a bathroom,” she says.
“For me,” says Kay, “beer will raise my blood glucose, while a martini will cause it to fall a little. I avoid drinks with fruit juice or a lot of sugar, such as a cosmopolitan or a piña colada. “They are not worth the blood sugar spike or the calories. Also, some alcohol, such as Baileys Irish Cream, has lots and lots of added sugar—I skip the sugary stuff so I can save those carbs for something else,” Kay says.
Red and white wine both have about 100 calories per five-ounce glass; sweeter red wines will have a higher calorie count because of the extra sugar from the grapes. A screwdriver (vodka and orange juice) made up of 1.5 ounces of vodka and eight ounces of orange juice would have 208 calories and 25 carbohydrate grams (all the carbohydrate is from the orange juice.)
You may have to adjust other food choices during the day to accommodate the extra calories and carbohydrates from alcoholic drinks. As a general rule, it is better not to “drink” your calories; healthy food choices should come first.