Diabetes 2 and alcohol

Lots of people like to enjoy a drink every now and then. But if you have diabetes, you may be wondering if it’s safe for you to drink at all. If your blood sugar is under control, it’s probably fine for you to drink as long as your doctor agrees that it’s OK—and as long as it’s in moderation. Still, drinking if you have diabetes does come with some unique risks. We’ll discuss these risks and how to take care of yourself below.

What are the risks of drinking if I have diabetes?

Low blood sugar is the most likely risk of drinking if you have diabetes. Let’s look at how this can happen.

Your liver produces glucose, or sugar, to help your body bring up blood sugar levels when they get too low. The liver is also responsible for breaking down alcohol when you drink. During this process, substances are formed that can make it harder for your liver to make new sugar. When this happens, your blood sugar levels can become too low—a condition known as hypoglycemia. Left untreated, hypoglycemia can become a medical emergency and lead to confusion, seizures, and coma.

People with diabetes are at a particular risk for hypoglycemia when they drink because they are usually on insulin or other medications that lower their blood sugar already. The more you drink, the longer it will take your liver to process the alcohol and the longer the risk for low blood sugar exists.

What makes this situation even more dangerous is that you can easily mistake hypoglycemia for intoxication. If you’ve ever had a few too many, the symptoms of low blood sugar may sound familiar:

  • Dizziness
  • Nausea
  • Drowsiness
  • Blurred vision
  • Irritability
  • Headache
  • Poor coordination
  • Hunger
  • Racing heartbeat

If you’re drinking, you may assume these symptoms are from the alcohol or be less aware of them. People around you may also assume your symptoms are from alcohol and not realize that you need help.

Other health concerns

While low blood sugar is the biggest risk of drinking if you have diabetes, it’s not the only one. Drinking (especially heavy drinking) can contribute to or increase your risk for conditions related to diabetes, including:

  • Weight gain and high blood pressure, which can make diabetes and its complications worse
  • High triglyceride (fat) levels in your blood, which can cause a condition called pancreatitis that may interfere with insulin production and mess with your blood sugar levels
  • Peripheral neuropathy, a condition in which nerves are damaged, causing tingling, numbness, burning, and pain, often in the legs and feet
  • Diabetic retinopathy, a condition in which blood vessels in the eye are damaged from too much sugar in the blood

Finally, drinking can impair your judgment and lead to lapses in how you manage your diabetes. For example, you may forget to take your insulin or check your blood sugar levels if you’re intoxicated.

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Can I drink while I’m taking insulin or diabetes medications?

Talk to your doctor about drinking while taking diabetes medications. Combining them can cause side effects, and the risk is higher if you are a heavy or chronic drinker.

For example, if you take insulin and/or sulfonylureas (e.g., glipizide, glyburide, glimepiride), drinking can increase your risk for hypoglycemia.

And if you take metformin while drinking, you may be at an increased risk of both hypoglycemia and lactic acidosis, a buildup of too much lactic acid in the body that causes abdominal pain, diarrhea, muscle cramps, and tiredness.

What kind of alcohol can I drink, and how much?

If you and your doctor decide that it’s OK for you to drink, here are a few guidelines you should follow when deciding what to drink and how much to consume:

  • Stick to light beers and dry wines, which have less alcohol and fewer calories.
  • Avoid sweet wines and mixed drinks with a lot of sugar, like piña coladas.
  • If you order a mixed drink, use water and diet soda instead of regular soda or other sweet mixers.
  • Try to stick to the American Diabetes Association guidelines for how much to drink: no more than 1 drink a day for women and 2 drinks a day for men (these are the same recommendations for people without diabetes). One drink is defined as 12 oz. of beer, 5 oz. of wine, and 1.5 oz. of liquor.

How can I stay safe when I drink?

In addition to paying attention to what you drink, you can pay attention to how you drink. Here are some tips for how to avoid some of the potential dangers of drinking:

  • Stay hydrated when you drink.
  • Eat beforehand. It reduces your risk of hypoglycemia. Never drink on an empty stomach.
  • Avoid sugary drinks.
  • Check your blood sugar before you drink and before you go to bed. If it’s low, eat a snack such as half a sandwich, yogurt, cheese with crackers, or an apple with peanut butter.
  • Carry some form of ID that says you have diabetes, so if you do experience hypoglycemia, others will be able to recognize it and help you in case of an emergency.
  • Have a designated driver (to avoid a DUI and in case of hypoglycemia).

Does alcohol increase your risk of developing diabetes?

It can. But it may depend on how much you drink, and possibly what you drink.

Studies have found that binge drinking and heavy drinking may increase the risk of type 2 diabetes in both men and women. Binge drinking is defined as 5 or more drinks for men or 4 or more drinks for women on a single occasion. Heavy drinking is defined as binge drinking on 5 or more days in the past month.

But it’s a bit more complicated than that. These studies also found that moderate amounts of alcohol was actually linked to a lower risk of diabetes. Other studies have reached similar findings. What’s more, a study found that wine may be more likely to decrease your risk of type 2 diabetes compared to beer or spirits.

There are a few things to keep in mind about these studies, though. First, alcohol consumption is not the only risk factor for diabetes. Your risk will also depend on other factors, such as your age, weight, and race, and whether you have a family history of diabetes.

Second, even though studies have found that moderate alcohol consumption may have health benefits, new research is beginning to question whether the risks of drinking might outweigh the benefits.

In other words, if you don’t already drink, it may not be wise to run out and buy a bottle of pinot noir just to reduce your risk of diabetes.

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  • What to Know About Alcohol and Diabetes

    Can I drink alcohol? This is one of the top questions people with diabetes (PWDs) ask their health care providers after being diagnosed with diabetes. Understandable if you want to continue to enjoy alcohol as part of your lifestyle. The answer varies based on you, your health status, and the blood glucose-lowering medications you take to manage your diabetes.

    Eating with Diabetes: 30 Healthy Low-Carb Foods to Eat

    In general, diabetes experts recommend that most PWDs can drink alcohol in moderation without compromising their health, blood glucose control, or safety. In fact, there may be a few health benefits of regular moderate alcohol intake.

    Here is expert advice on drinking alcohol with diabetes, plus up-to-date advice about how to fit alcohol into your healthy eating plan. Plus find out how many calories a margarita has? Does a glass of wine spike blood sugar? Will a beer derail your diabetes meal plan? From wine and spirits to beer and cocktails, our diabetes drink guide tells you all you need to know about mixing diabetes and alcohol.

    How Much Alcohol Is Too Much?

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    Adults with diabetes can drink alcohol and should follow the same guidelines as the general public: an average of up to one drink per day for women and up to two drinks per day for men (see serving sizes below). Adults, with or without diabetes, should not drink more than three or four drinks in any single day. Health care providers do not advise you start drinking if you typically abstain.

    When it comes to blood sugar control, research shows a moderate amount of alcohol has minimal short- or long-term effects on blood sugar levels in people with type 1 or type 2 diabetes. However, drinking more than three drinks per day over time has been shown to make glucose control a challenge.

    A serving size for one drink is:

    • 12 ounces of regular or light beer
    • 5 ounces of wine (any type other than sweet dessert wine)
    • 1-1/2 ounces of 80-proof distilled spirits (such as scotch, gin, rum, or whiskey) (consumed alone or within a mixed drink)
    • 1-1/2 ounces of liqueur

    Alcoholic beverages are made from grains or fruits (starches or sugars) through the processes of fermentation and distillation, so alcohol cannot be changed into glucose. Also, alcohol is the only nutrient that doesn’t require insulin to be broken down for energy-carbohydrate, protein, and fat do.

    Heart-Healthy Benefits of Alcohol

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    Moderate consumption of alcohol has been shown to have a few health benefits: It’s associated with a 30-50 percent decrease in the risk of heart disease and a 50-80 percent decrease in the risk of death from heart disease.

    Improves HDL (good) cholesterol.
    “The majority of alcohol’s beneficial effect is on improving HDL (good) cholesterol,” says Alan Graber, M.D., Ph.D., FACE, a past president of the American Association of Clinical Endocrinologists (AACE). Studies suggest that one to two alcoholic drinks a day (beer, wine, or spirits) increases HDL an average of 12 percent. “However, the benefit of improving HDL is lost if a person gains weight,” Graber says.

    Improves insulin sensitivity.
    A couple of recent research studies have shown that adults with diabetes might see a slight improvement in their insulin sensitivity with moderate alcohol consumption. This means the body may make more efficient use of the insulin the pancreas continues to make.

    Alcohol and Blood Glucose-Lowering Medications

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    The biggest concern surrounding alcohol consumption is for people who take insulin and/or glucose-lowering medication, which can cause the increased risk of hypoglycemia. These include all of the insulins and pills in the sulfonylurea category and in the glinide category. The most commonly used glucose-lowering medications for type 2 diabetes today generally don’t cause hypoglycemia.

    The effects of insulin and other blood glucose-lowering medications that work by increasing your body’s release of insulin, such as sulfonylureas and glinides, can also increase the risk of late-onset hypoglycemia, says endocrinologist Alan Graber. Talk to your healthcare team about the type of medicine you’re taking and how it may react with alcohol.

    When to Say ‘Yes’ or ‘No’ to Alcohol

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    When to say ‘yes’ to alcohol: “If a person with diabetes chooses to drink alcohol, they should also know what effect alcohol may have on their blood glucose control and the management of their diabetes, and how to drink safely,” Graber says.

    • When to say ‘no’ to alcohol: Drinking alcohol isn’t recommended for PWDs who:
    • are not yet of legal age to consume alcohol.
    • take prescription or over-the-counter medications that can interact with alcohol.
    • have uncontrolled blood sugar.
    • have a history of alcohol abuse or dependence.
    • take metformin (Glucophage) and have difficulty restricting alcohol intake to more than a moderate amount, including a history of binge drinking. If so, talk to your provider about not using metformin.
    • have a condition that prohibits consuming alcohol: liver disease, pancreatitis, advanced neuropathy (nerve problems from diabetes), or severe hypertriglyceridemia (elevated triglycerides).
    • plan to drive or operate machinery, which could cause injury to one’s self and others.
    • are pregnant (due to the general recommendations and warnings about alcohol consumption and pregnancy).
    • are breastfeeding.

    Trying to lose weight?
    Most PWDs can enjoy moderate alcohol consumption. However, the amount of alcohol should be considered additional calories within a healthy eating plan. Healthful foods should not be omitted to compensate for the calories from alcohol. Each serving of alcohol contains about 100-150 calories, and they can add up quickly. Consider keeping alcohol consumption to a couple times a week or less if weight loss is in your diabetes management game plan.

    Top Tips for Drinking Alcohol

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    Here are the top tips for drinking alcohol for people with diabetes:

    • Don’t drink on an empty stomach. Don’t skip meals when you drink alcohol, particularly if you take a blood glucose-lowering medication that could cause hypoglycemia. As a guideline, plan to eat when having a drink, and know what your blood sugar level is before you start drinking.

    • Limit extra calories and carbohydrate with alcohol. Avoid high-calorie and high-carbohydrate mixed drinks, such as margaritas and daiquiris. Keep the calorie and carb count of your alcohol drinks low by drinking light beer, a glass of wine, or a shot of distilled spirits on the rocks or mixed with a noncaloric beverage like water, club soda, diet tonic water, or diet soda.

    • Practice moderation. One way to stick to your drink limit is to not use your alcoholic beverage to quench your thirst. Have a no-calorie drink with a meal, or alternate an alcoholic drink with a nonalcoholic drink (within your alcoholic drink limit).

    • Test, test, test. Your blood sugar should be at a safe level (90-150 mg/dl) before you drink alcohol. If your blood sugar is less than 70 mg/dl and you take a glucose-lowering medication that can cause hypoglycemia, treat your low before you drink. The best way to learn how your body responds to alcohol is with frequent glucose checks.

    • Carry emergency glucose. If you’re at risk of hypoglycemia, make sure you carry glucose tablets, gel, or liquid. Hypoglycemia treatments such as juice or regular soda might be available where you are consuming alcohol, but it’s best to have treatments on hand.

    • Hypoglycemia may strike later. The potential for late-onset hypoglycemia in PWDs who take insulin happens a number of hours after consuming alcohol. Therefore, regular blood sugar checks are important, including overnight if necessary.

    • Educate companions to provide an assist if needed. Alert friends and family about the signs and symptoms of hypoglycemia and how these signs could differ from overconsumption of alcohol. Let them know how to check your blood sugar if you can’t and where you have your hypoglycemia treatments. If you are unconscious and experiencing severe hypoglycemia, encourage them to call 911 and to stay with you until emergency personnel arrive.

    • Wear diabetes ID. Signs and symptoms of hypoglycemia can be similar to the effects of excess alcohol consumption. People who don’t know you, such as law enforcement personnel, might attribute these signs and symptoms to intoxication and not realize you have diabetes. This can prevent you from getting the rapid care you need. Wear a diabetes ID to help people quickly identify that your blood sugar is low and provide you with the proper care.

    Carb & Calorie Drink Guide

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    Note: All drinks on the following slides were prepared using standard recipes from The New American Bartender’s Guide (NAL Trade, 2002) and with nutrition information primarily from calorieking.com. The amount of ice can vary, so ice was excluded from the serving size unless otherwise specified.

    Nutrition values vary by brand (the manufacturer may be able to provide precise nutrition information), serving size, and how they’re prepared. Cocktails made from packaged mixes will have higher carb and calorie values than listed.

    Light Beer

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    Serving Size: 12 ounces Calories: 103 Carbs: 6 grams

    Tip: The difference between light beer and low-carb beer is insignificant. If you are watching calories, choose a light beer that satisfies you. If you have calories to spare, enjoy a regular beer of your choice.

    Margarita

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    Serving Size: 3.5 ounces Calories: 153 Carbs: 7 grams

    Tip: Measure the serving of your favorite drinks at home so you’ll be able to better estimate the servings when you’re at a restaurant. Many restaurants serve super-sized margaritas made with very sweet mixers. Make a skinny margarita at home and you’ll know exactly what you’re getting.

    Wine

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    Serving Size: 5 ounces Calories: 125 Carbs: 4 grams

    Examples of Red Wine: Burgundy and Merlot

    Examples of White Wine: Chardonnay and Pinot Gris

    Tip: No studies have found that red wine is a healthier choice than any other form of alcohol. However, it does have a unique profile of antioxidants that can be beneficial to your health if consumed in moderation.

    Scotch

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    Serving Size: 3 ounces Calories: 221 Carbs: 0 grams

    Tip: Healthy mixers for scotch, bourbon, and other spirits include water, club soda, diet soda, and diet tonic. Fruit juice is an option but adds carbs and calories.

    Sparkling Wine

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    Serving Size: 4 ounces Calories: 78 Carbs: 1 gram

    Tip: Different types of sparkling wine contain different amounts of sugar: Extra Brut contains less than 0.6 percent sugar per liter, while the sweetest type, Doux, can have up to 8 percent sugar per liter. Create your own wine spritzer with a 5-ounce serving of wine along with the sparkle from club soda or diet lemon-lime soda.

    Regular Beer

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    Serving Size: 12 ounces Calories: 150 Carbs: 13 grams

    Tip: If you’re trying to lose weight, choose a light beer to save calories and carbs.

    Martini

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    Serving Size: 2.25 ounces Calories: 135 Carbs: 0 grams

    Tip: Whether it’s a sweet or savory martini, go light on the garnish. Some olives are packed in sugar-water and can add unwanted carbs. So can oranges, strawberries, grapes, and sugary rims.

    Mojito

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    Serving Size: 7 ounces Calories: 298 Carbs: 12 grams

    Tip: Make your mojito with a low-calorie sweetener to help save calories and carbs.

    Bloody Mary

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    Serving Size: 10 ounces (with ice) Calories: 125 Carbs: 7 grams

    Tip: Use low-sodium tomato juice when making your bloody mary.

    Kahlua and Cream

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    Serving Size: 3 ounces Calories: 230 Carbs: 10 grams

    Tip: Cut the fat in this drink by choosing 2 percent milk, low-fat milk, or almond milk instead of high-fat cream.

    Strawberry Daiquiri

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    Serving Size: 8 ounces (with fruit and ice) Calories: 145 Carbs: 11 grams

    Tip: Have fun making your own sweet cocktail. Sugar-filled drink mixes, such as daiquiris and pina coladas, may pack 25-50 grams of carb in just 4 ounces, whereas cocktails made from scratch can have significantly less carbohydrate. If you’re making drinks at home, shop for low-sugar or sugar-free mixers or use fresh fruit, such as strawberries.

    Irish Coffee

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    Serving Size: 5 ounces Calories: 210 Carbs: 8 grams

    Tip: Save calories by sweetening with a sugar substitute.

    Egg Nog

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    Serving Size: 4 ounces Calories: 201 Carbs: 13 grams

    Tip: Choose light egg nog to save calories, carbs, and fat.

    Sherry

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    Serving Size: 2 ounces Calories: 91 Carbs: 8 grams

    Tip: Sherry is a great drink to sip slowly and enjoy.

    • Related:
    • Meal Plans for Diabetes
    • Best Diabetes-Friendly Desserts and Sweets

    The Effect of Evening Alcohol Consumption on Next-Morning Glucose Control in Type 1 Diabetes

    CONCLUSIONS

    We found that the consumption of a moderate amount of alcohol 2–3 h after an evening meal greatly increased the likelihood of hypoglycemia after breakfast the following morning. This was associated with reduced secretion of growth hormone in the 4 h after midnight.

    Both lower fasting blood glucose level and a reduced increase in postprandial glucose preceded late-morning hypoglycemia. Lange et al. (12) reported a similar pattern, but their study was less detailed in its control of diet, exercise, and insulin injections. They also reported several episodes of symptomatic nocturnal hypoglycemia in the control studies but did not specify how these were treated. Furthermore, to eliminate potentially confounding variability in insulin absorption between alcohol and control nights, we used an insulin infusion in place of the bedtime injection of NPH insulin. In light of similar morning insulin levels, the average reduction in glucose of 5–6 mmol/l is striking, and the depth of hypoglycemia was sufficient to prompt treatment in all cases.

    Ethanol is known to affect various aspects of glucose metabolism, raising several possible explanations for our findings. Without glucose turnover data, however, we can only make inferences about glucose production and utilization. Inhibition of gluconeogenesis by ethanol is well recognized, and in nondiabetic subjects, one would expect ∼45% inhibition at the peak ethanol concentration in our study (17). In type 1 diabetes, gluconeogenesis is responsible for a significant proportion of increased basal hepatic glucose output, and patients may therefore be more sensitive to ethanol. However, in a study of fasted type 1 diabetes controlled by hypoinsulinemic clamp, there was no difference in glucose response to a 1-h infusion of ethanol (peak level 26.2 mmol/l) or saline (11). In nondiabetic subjects, reduced glucose production seems to be matched by inhibition of glucose utilization (probably by acetate) at low and moderate ethanol concentrations (4–14 mmol/l) (18). Alcohol hypoglycemia has been reproduced by sustained (8-h) administration of ethanol, with blood levels up to 97 mmol/l (19). The effect is more potent after 2–3 days of fasting and potentially lethal in patients with chronic alcoholism who are treated with insulin (20). However, in circumstances in which gluconeogenesis is not critical to maintaining blood glucose, its suppression by ethanol seems less likely to cause hypoglycemia. In the patients in our study, there was certainly no immediate decrease in glucose after consumption of wine, and we would have to postulate reduced basal glucose output persisting 2–4 h beyond elimination of ethanol if this were the sole mechanism.

    In rats and humans, there is evidence that both basal and stimulated release of growth hormone is impaired by ethanol. In rats, there are also data to support a dose-response effect both in vivo (21) and in vitro (22). Rat pituitary exposed to ethanol showed a 60% reduction in 4-h secretion of growth hormone at the lowest concentration (10.9 mmol/l) and maximal suppression (∼92%) at a concentration of 43.6 mmol/l (22). In humans, no dose-ranging studies have been reported, but in nondiabetic subjects after evening ethanol intake of 0.8−1.5 g/kg, a more than two-thirds reduction in integrated response of growth hormone (15) or fewer peaks of growth hormone between 2:00 and 6:00 a.m. (14) have been observed. In nondiabetic subjects, the physiological nocturnal increase in growth hormone does not seem to influence carbohydrate metabolism the next morning (23). By contrast, administration of pulsed growth hormone to type 1 diabetic subjects has a marked effect on hepatic glucose output, and even moderate elevations in growth hormone can lead to poor metabolic control within 8–10 h (24). Moreover, complete abolition of nocturnal secretion of growth hormone has been shown to ameliorate the dawn phenomenon in type 1 diabetic subjects, associated with a sustained reduction in glucose production (25). Using an identical basal insulin infusion rate, we found a similar blunting of the dawn glucose increase after consumption of wine, with a two-thirds reduction in integrated response of growth hormone (and reduced peak amplitude) between midnight and 4:00 a.m. We do not believe the latter has been demonstrated previously in diabetes. The growth hormone levels in the control study were lower than expected, which may have been due to poor sleep quality or because most of our subjects had reasonable glucose control. If the subsequent postprandial hypoglycemia were attributable to lower nocturnal secretion of growth hormone, it might be mediated by a relative increase in peripheral insulin sensitivity.

    Ethanol seemed to have no effect on subsequent cortisol or glucagon secretion, although there was no increase in either hormone after hypoglycemia. An absent glucagon response is common in type 1 diabetes, and although impaired cortisol secretion might delay recovery from hypoglycemia, more prolonged sampling would be necessary to confirm this finding. We did not measure catecholamine or free fatty acid (FFA) levels. Ethanol causes a dose-dependent increase in norepinephrine (with reduced clearance) and of epinephrine during acute intoxication (26). These effects might lead to reduced peripheral uptake of glucose, perhaps ameliorating any acute glucose-lowering effect of suppressed gluconeogenesis. Acutely, moderate alcohol doses inhibit release of FFA from adipose tissue, probably through the action of acetate (27). Prolonged infusion leads to a progressive increase in FFA levels (19), potentially via increases in catecholamine levels. The suppression of FFA by ethanol may be responsible for the impaired recovery from hypoglycemia seen in type 1 diabetes, via increased glucose utilization (7). In our study, the acute increase in blood ethanol occurred as insulin was decreasing. This would have yielded competing influences on FFA levels, and we can only speculate about the net short-term effect. FFA levels might have increased as ethanol waned overnight, but it seems unlikely that any acute effect on FFA turnover could explain the much later occurrence of hypoglycemia.

    One further mechanism to be considered is the ability of ethanol to induce acute inflammatory changes in the upper gastrointestinal tract, which are associated with carbohydrate malabsorption (28,29). The duration of this malabsorption is unknown, as studies have focused on acute effects. If persistent for 10–12 h, it could certainly limit the postbreakfast glucose increase and predispose subjects to hypoglycemia. Further research is required in this area.

    We chose the quantity of alcohol in our study to represent an average evening’s drinking in young adults and an amount that would generate a peak blood level just above the legal limit for driving in the U.K. (17.4 mmol/l). We used wine to keep the total volume of beverage to a reasonable level and separated drinking from eating to ensure consistent gastric absorption of ethanol. Although the subjects did not experience a “hangover” as such, they had increased scores on several associated symptoms. Several possible mechanisms, perhaps acting in concert, might account for our findings. Smaller ethanol doses, as recommended by the British and American Diabetes Associations, would be expected to have less effect on secretion of growth hormone and gluconeogenesis and be less toxic to the gastrointestinal tract. However, it is unknown whether there is a risk of delayed hypoglycemia at these doses. Although recognizing the small sample size in our study, we would warn anyone with type 1 diabetes to be alert to the possibility of late-morning hypoglycemia after an evening consumption of alcohol and to be sure that some rapid-acting carbohydrate is available. Reduction in the breakfast insulin dose might also be advisable. Additional glucose testing should be recommended in circumstances in which hypoglycemia could be dangerous, such as driving or operating machinery.

    In summary, we have shown that in patients with type 1 diabetes, evening consumption of alcohol causes lowering of blood glucose the next morning and increases the risk of hypoglycemia after breakfast. This is associated with but not necessarily due to a reduction in nocturnal secretion of growth hormone. Patients should be alerted to this possibility and advised regarding appropriate preventative measures.

    The art of juicing

    What exactly is juicing? For those who are new to or are totally unaware of the trend, juicing involves the turning of raw produce (whether it is vegetable or fruits) into liquid. Recipes can include only fruits as ingredients, or only vegetables. Many also blend the two together to help them get the most of both food groups. It is of common believe that juicing can be healthy especially if you don’t consume a lot of fruits or vegetables as part of your regular diet.
    The juiced liquid contains vitamins, minerals, antioxidants and other chemicals that are found as part of the fruit or the vegetable.

    However, the healthy fibers which are found in such produces are lost during the process. Proponents claim that it helps the body absorbs the nutrients better than it would if one was consuming whole fruit or vegetable.

    Is it a good idea to juice if you have diabetes?

    Drinking any liquid other than water can have its ups and downs. Most drinks today, besides water, contain a tremendous amount of sugar and carbohydrate in them. The two together can equally affect your blood sugar levels, increasing the risk of hyperglycemia. Depending on how your blood sugar levels are affected, it can either be good or bad. It is important, as a person with diabetes who is effectively managing their diabetes, to be careful of the amount of sugary drinks you consume.

    Depending on which fruit or vegetable you are juicing, you can experience spiked blood sugar. People with diabetes must focus on incorporating fruits that are low in sugar content and vegetables which are non-starchy and low in carbohydrates. While it is easy to consume the recommended servings of produce with juice, it is equally possible that you may consume more carbs because you are unable to determine the amount of carbs that the drink may contain. This can potentially put you at a higher carb count than your doctor’s recommendation and hinder your diabetes management.

    Juicing as part of a diabetes management plan can be successful. Some fruits have phytonutrients and antioxidants which can help in decreasing sugar levels. Experts recommend this bevearage for people with diabetes, but only as part of a healthy, steady and nutritious diet. If done in moderation, it is fine and should only be avoided to be done in excessive volumes.

    Joni Jimenez-Tan Cardoso, who runs the thegoodboxph.com, had uncontrollable diabetes for the longest time. Her daughter, Crissy, the chef for thegoodboxph.com, put her on a juicing diet for 3 months. She claims that her results were staggeringly good. Her blood sugar levels went down to borderline 90-100 from a high of 250-270, her eyesight surprisingly improved, and her weight went down from 135lbs to 120lbs.

    She is certain that this was a result of regularly eating every 3 hours to keep her blood sugar levels constant, controlling her intake of carbohydrates, and avoiding foods that contained a high glycemic index (complex sugars). Joni states that drinking juices could play a huge part in diabetes management if one wants to concurrently lose weight, manage their diabetes, and detoxify.

    A study conducted in 2013 demonstrated that fruits which are high in fiber, phytonutrients and antioxidants have many health benefits to them. Consumption of whole fruits like berries, grapes and apples are shown to be greatly associated with decreasing the risks of type 2 diabetes. The same study states that consumption of fruit juice is associated with a high risk of type 2 diabetes.

    Experts mostly agree that they would recommend juicing for people with diabetes not as a meal replacement, but only as part of a healthy, steady (eating lightly every 3 hours during the day), and nutritious diet.

    Benefits of juicing

    • You can enjoy the recommended amount of daily serving for fruits and vegetables
    • It is easier for your body to absorb the nutrients
    • Reduces produce waste
    • Feeds the gut with good bacteria
    • Reduces the risk of cancer
    • Boosts immune system
    • Removes toxins and detoxifies the body
    • Aids digestion

    Incorporating this lifestyle is an incredible way to flood cells with nutrients, lose weight and detox but can be potentially problematic for people with diabetes. Those with diabetes must focus on lowering their insulin resistance. High fiber menu plans are a diabetics best bet. Fiber is a key player in slowing down the absorption of sugar, says Mercedes Kay Gold, who is a Certified Nutritional Practioner and a Certified Mobile Personal Trainer and a huge proponent of juicing.

    While fruits and vegetables may be a plethora of health, natural sugar is still an issue. She suggests blending raw produce as an alternative to drinking juices if one is afraid of losing fiber. For the process to be a success, it’s imperative to make choices that contain the highest amount of micronutrients while taking into account the glycemic index and load value of each food.

    She recommends going overboard on greens. Kale, parsley, spinach, dandelion, celery, cucumber and a touch of green apple or kiwi are a great go-to base. Carrot and beet add a touch of sweetness without flooding the pancreas in sugar. Berries are one more option but try stick to one serving of fruit per glass. Load up on vegetables and go for ginger and garlic, which are both pancreas protectors.

    That the benefits of juicing for diabetes lay in that green juices allow for efficient nutrient assimilation and for a means to stay hydrated. Annick Lewis, a Nutritionist (BSc) & Qualified Personal Trainer and CEO & Founder of the Green Balance at www.GreenBalance.co, recommends the lowest sugar options with the least amount of fruits and highest amount of vegetables.

    She further recommends green juices because they are great for people with diabetes to use as a strategy to keep vitamins in the diet and especially on days that are rushed and without room for cooking vegetables. It helps to keep live fresh nutrients entering the body and improving oxygen flow.

    This helps to nourish their bodies and improve immune function by which they may be somewhat deficient on a cellular level. Adding in spices that encourage efficient blood sugar control such as cinnamon helps to nourish the cells in the body. This could be a great strategy to improve insulin resistance.

    For more informative diabetes related articles read the following:

    • MyGlucoHealth Wireless Review
    • Can I Still Donate Blood if I Have Diabetes?
    • Diabetes And Turmeric: Is It Good Or Bad?
    • How Much Should I Eat Daily To Control My Blood Sugar Levels With Diabetes?

    Drawbacks

    • Losing weight is not easily achievable.
    • Clients have been known to experience weight gain
    • You lose out on fiber
    • The fruit juices may have too much sugar in them
    • This lifestyle can get expensive – the blender cost a lot and some people may not have the money to buy new fruits and vegetables on a regular basis
    • Requires time to prep and clean to avoid bacteria contamination
    • It could also increase your craving for real food after your juice regimen

    Fia Batua, who is a Registered Nutritionist Dietitian and a Certified Sports Nutritionist, reminds us to take note of the juicing process removing most soluble iber, which is proven to help reduce bad cholesterol levels and improve blood glucose control, found in fruits and vegetables. This leaves one with a concentrated number of carbohydrates: about 30-40g carbohydrates per 8-ounce. Most juice recipe available has glycemic index of about 60-75 out of 100, and that can be quite high. It may also lead to muscle loss because it is low in calorie content and not a good source of protein.

    She urges that people with diabetes should consider juicing in moderation especially if they have problem controlling their blood sugar. They can incorporate it in their lifesytle, about 4-6ounce, once daily. In line with other experts, she also strictly advises the incorporation of fruits with low glycemic index. She recommends the following ratio for juices: 80% vegetables-20% Low GI fruits. Such fruits can be berries, apple, orange and pear for fruits.

    Best vegetables/fruits to juice with

    The best fruits to juice are those with low glycemic index such as (not limited to the list below):

    • Avocado
    • Apples
    • Pears
    • Papaya
    • Berries
    • Cranberries
    • All citrus fruits
    • Peaches cherries

    Greeny leaf vegetables will give you the best results for juicing. These could include:

    • Celery
    • Zucchini
    • Cucumber
    • Broccoli
    • Swiss chard
    • Mint
    • Lettuce

    Tips for juicing

    • Consider making the amount you will be drinking
    • Select pasteurized products for fresh juice
    • Always be careful of the sugar present in fruits so you don’t overdo it
    • Go for as many vegetables as possible
    • Use fruits which are low in glycemic index
    • If you are worried about fiber, blend your produce instead of making it in a juice
    • If making a huge batch, store remaining in airtight containers in the fridge
    • Avoid canned or dried fruits as they are processed with added sugar

    Dalia Maori, R.D. is lead dietitian for Cambridgeshire’s overweight and obesity lifestyle service run by Everyone Health and Cambridgeshire County Council. She also runs her own website, www.daliamaorinutrition.com. For her, juicing can be a helpful way to consume fruits and vegetables for people with diabetes if done the correct way. In diabetes, it is recommended to understand which carbohydrates raise the blood sugar too high.

    Keeping an eye of such foods can help in decreasing the chances of high sugar levels. She recommends non- starchy vegetables as a great choice for people with diabetes because they are low in carbohydrate and don’t raise the blood sugar significantly. It is a different story with fruits. Once the fibre in the fruit is broken down, the sugary part of the fruit is absorbed much faster. Fiber is known to help slow down carbohydrate release in the digestive system.

    She warns that it is important for people with diabetes to watch which fruits they use to juice. Her rule is to avoid high carbohydrate fruits in juices and to concentrate on using those which are lower in carbs such as berries. Remember that making juice which is at least 80% vegetable based will help to ensure that blood sugar levels are kept under control.

    Maria Mekhael, a Nutritional therapist who runs https://www.thediettherapist.com/, warns of the same issues with juicing as Dalia. While she agrees that it is a great way to boost your vitamin and mineral levels, it can have its own negative side-effects. If done carefully with a focus on low carbohydrate, non-starchy vegetables and fruits lower in natural sugars, juices can be safe for people with diabetes. It is important to still consider the levels of carbohydrates in your drink.

    She is also concerned about the fibers being stripped during the juicing process. We know that fiber (and particularly soluble fiber) is especially helpful for those with diabetes; it tends to increase the viscosity (or “thickness”) of the intestinal contents after a meal, which slows carbohydrate digestion and glucose absorption. She explains that the fibre in whole fruits and vegetables lowers their glycemic index, so when you take this out, you concentrate the sugars – resulting in a much larger and more rapid hit on your blood glucose levels. In addition, juices are not very filling, so it’s far easier to drink many more carbohydrates than you would normally eat via the whole fruit.

    Some people find that even while using only vegetables (lower in carbs and sugar than fruit), they still experience blood sugar spikes because vegetables have a much lower yield of liquid, so that have to use more to get a full glass. Though many are relatively low in carbohydrates (excluding the starchier ones like carrots and beets), these begin to add up fast when you are using more produce.

    Having a vegetable-based juice with a meal that contains protein, fiber, and healthy fats is one thing; but the concept of “juicing” often correlates with a juice “fast” – drinking juice and consuming little else (if anything) for a set period of time.

    If you are considering including juicing as part of your lifestyle, it’s better to do incorporate these within a sustainable healthy eating program focusing on small amounts of juice at any one time, alongside a meal. Also remember to base your juice recipes around non-starchy vegetables, for example leafy greens like kale and spinach, and others such as broccoli, celery and cucumber, aiming to keep fruit to one serving per juice.

    Don’t forget to consult your doctor first, especially if you are on medication, and monitor your blood sugar carefully. Remember that if you experience dizziness, or feel tired, weak and unwell, that these are signs you should stop.

    FAQs

    Is it a good idea to juice if you have diabetes?
    Juicing as a diet is not recommended for people with diabetes. Studies show that eating whole fruits along with a balanced healthy diet is more effective at helping them keep control of their blood sugar levels.

    How can you ensure you are getting the best of everything when making a juice?

    Keep in mind that the fibers will be stripped out of your fruits. If you want the fiber to remain as part of your drink, experts recommend blending instead. If you are unconvinced about blending and would still like to juice, try adding more vegetables than fruits to keep the carb and sugar count low.

    What is the difference between the juice diet and juicing?

    The Juice Diet involves of only consuming liquid and no solid foods for however amount of time that you have set for yourself. Some people will juice for days, some will for weeks and in some extreme cases, people will juice for months. Juicing is when you are making liquids as part of your diet and are also consuming some solid food. In the Juice Diet, just like juicing, fresh produce is turned into liquid which help detoxify the body.

    How long should you juice for?

    If you are planning to on a juice diet, please speak to your doctor before you do so. Only drinking liquid and consuming no solid food can prove to be more harmful than beneficial if you have diabetes. It is imperative that you bring your concerns to your doctor and seek their recommendation on how long you should juice for.

    Over to you

    What are your thoughts on juicing and diabetes? Have you tried following or incorporating it in your lifestyle? If so, did you try the juice diet as a meal replacement or did you only incorporate juicing as part of your overall diabetes management plan? We would love to hear from you. Please leave your comments in the box below.

    TheDiabetesCouncil Article | Reviewed by Dr. Sergii Vasyliuk MD on September 03, 2018

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    Last Updated: Thursday, September 13, 2018 Last Reviewed: Thursday, September 13, 2018

    Alcoholic Drinks That Are Safe and (Unsafe) for Diabetics

    When you’re diabetic, you have to maintain a careful balance in your diet to ensure your blood sugar levels are stable. And when it comes to alcohol, you probably assume it’s totally off limits. The American Diabetes Association reports alcohol can drop your blood glucose significantly. And if your liver’s stores of glucose are totally used up, this can lead to dangerously low levels or death in severe cases.

    The good news is you can actually enjoy a drink if you do so in moderation (and of course, always ask your doctor about any restrictions you should follow). Here are the least offensive drinks for diabetics, followed by the worst ones.

    Safer drinks for diabetics

    Sommelier fills glasses of wine at a tasting | Berezko/Getty Images

    No matter what you’re drinking, there are certain guidelines diabetics should follow. The ADA suggests women have only one drink per day, and men have two. Eating something fatty can also help keep your blood sugar levels stable while you’re drinking, so consider this. Also, make sure you’re staying hydrated by sipping on plenty of water, and let someone you’re out with know you’re diabetic.

    Light beers:

    This recommendation shouldn’t come as much of a surprise. These beers have a fraction of the sugar that a normal beer has, making them safer for diabetics to consume. And it turns out Bud Select 55 might be the best choice overall, Shape notes. Not only does one beer contain just 55 calories, but it also only has 1.8 grams of carbs. Compare this to a normal beer that can have up to 15 grams of carbs for one pint.

    Dry wines:

    If your drink of choice is wine, you’ll want to go with a dry red or white variety. WebMD notes there’s some research to suggest these wine types may actually help your body use insulin with more efficiency. And Shape notes there’s also good news for those who like Champagne, as it typically has the lowest number of carbs out of any wine.

    Liquor on the rocks:

    Stay away from those sugary mixers when you’re diabetic. If you prefer liquor, then order something that’s high-quality so you can enjoy it on the rocks. Alternatively, you can skip the rocks and have it neat — or add in a splash of water or sparkling water to cut the taste.

    Classic cocktails with sugar-free ingredients:

    As stated before, sugary mixers are a definite no-no for diabetics. But that doesn’t mean all cocktails have to be off limits. If you want something simple like a vodka-cranberry, ask your bartender if diet cranberry juice is available to make it basically carb-less. For cocktails you know involve many different sweetened elements (like a margarita), see if you can simplify it with good tequila, lime juice, a pinch of Stevia, a small splash of Triple Sec, and ice.

    Drinks to skip

    Fall cocktails | Rimma Bondarenko/iStock/Getty Images Plus

    Sangria: This drink may be delicious, but it’s also jam-packed with sugar. Red wine aside, sangria typically involves brandy or orange liqueur, fruit juice, and fruit, which loads the drink with carbs. You’re much better off picking out a nice dry wine and putting a few pieces of fresh fruit in with a flavored sparkling water. Skip the excess juice and liqueur.

    Dessert wines:

    Some wines are perfect for sugar-lovers — and these are the ones you should be staying away from. One glass of dessert wine contains around 14 grams of carbs. You’re much better off with the low-carb sangria idea if a touch of sweetness if what you’re after.

    Cocktails made with fruit juice:

    As mentioned, certain cocktails are generally off limits for diabetics — and this includes margaritas, mudslides, mojitos, and daiquiris. Consider creating your own low-carb cocktails at home if you’re looking to go this route (and sugar-free sparkling waters come in plenty of flavors as a delicious and safe mixer to try).

    Bloody Marys:

    While not the “sweetest” tasting item on the list, you may be surprised to know that a Bloody Mary contains loads of carbs unfitting for a diabetic. WebMD suggests if you really want this cocktail, take out the alcohol and go for the virgin drink. Without the vodka, there are still 15 grams of carbs. Consume at your own risk.

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