Medically reviewed by Dr. Jordan Pinsker, Vice President & Medical Director, Tandem Diabetes Care.
Alcohol can affect every individual differently. However, alcohol consumption can pose concerns for people living with type 1 diabetes or type 2 diabetes because of the ways it can impact the body. It’s extremely important for someone living with diabetes to consult with their healthcare provider about the risks associated with alcohol and diabetes.
How Does Alcohol Impact Diabetes?
Alcohol can cause people to be more sensitive to insulin for a period of time.1 If someone living with diabetes consumes alcohol, they may need less insulin for carbohydrates and they should keep a fast-acting carbohydrate with them.
With type 1 diabetes, the body does not create (or creates too little) insulin, which requires insulin intake through injections or a pump. Someone living with type 2 diabetes has a resistance to insulin and can’t use insulin efficiently.
Read more here about the difference between type 1 and type 2 diabetes.
For people new to the intersection of alcohol and diabetes, it's advisable to have a friend or family member who knows diabetes to check in with. This person should also know the signs of hypoglycemia and what to do if their friend or loved one needs assistance.
How Does Alcohol Impact Type 1 Diabetes?
People living with type 1 diabetes require insulin. The combination of alcohol and diabetes can change the way the body processes glucose and can make someone more sensitive to their insulin. This can increase the risk of hypoglycemia (low glucose levels). Depending on the amount and type of sugar in the drink, hyperglycemia (high glucose levels) can also occur as well.
Learn more about hypoglycemia versus hyperglycemia.
If someone with diabetes has consumed a lot of alcohol, it’s also possible that they can miss the signs of hypoglycemia. Not only can the signs of too much alcohol intake be similar to that of hypoglycemia, but the level of alertness can diminish, which can further affect a person's ability to be aware of and treat a hypoglycemic episode.
Symptoms of hypoglycemia may include:
- Sweating
- Confusion
- Slurred speech
- Drowsiness
- Difficulty walking
Note: The symptoms listed above may not be an indication of hypoglycemia for all individuals. Consult a healthcare professional for further information.
Type 1 Diabetes and Alcohol Abuse
Seizures, or even death, can occur with rapid and severe drops in blood sugar. When glucose levels drop dangerously low, the body will shut down other functions to redirect the remaining stores of blood sugar to the brain. This can lead to comas, seizures, or, in very severe cases, death.
Diabetes and alcohol abuse (such as binge drinking) can have long-lasting effects in some cases. For reference, the Centers for Disease Control and Prevention (CDC) defines moderate drinking as two drinks or fewer per day for men, or one drink or fewer per day for women. The U.S. Dietary Guidelines Advisory Committee recommends one drink or fewer per day for people of either gender.
“Alcohol can cause rapid changes in blood sugar in people with diabetes,” said Dr. Jordan Pinsker, Vice Present and Medical Director at Tandem Diabetes Care. “While some drinks can raise blood sugar, the major concern is a rapid decline in blood sugar with alcohol use, causing a severe hypoglycemic reaction, even a seizure.” There are many resources available to help people cope with alcohol and substance abuse.
How Does Alcohol Impact Type 2 Diabetes?
Unlike type 1 diabetes, which involves an insufficient production of insulin in the body, type 2 diabetes refers to having insulin resistance. While there are differences in treatment for type 1 and type 2 diabetes, the advice for alcohol use and diabetes management is similar.
Patients with type 2 diabetes using insulin will need to be mindful of hypoglycemia, have fast-acting carbohydrates available, and should have someone who understands the signs and symptoms of hypoglycemia to help.
Can I Drink Alcohol If I Have Diabetes?
The short answer is yes, but anyone living with diabetes should be mindful if they are going to drink.
Always consult with a healthcare provider about any changes to diet or lifestyle so they can help monitor the body’s response. People with diabetes should be honest and realistic with their healthcare provider about what they enjoy drinking and how much alcohol they typically consume. Information from a healthcare provider will provide the best advice on how to drink alcohol safely.
Diabetes and Alcohol Precautions
For those with diabetes, it is advisable to have a support network in place that knows where supplies are kept, such as a blood glucose meter, continuous glucose monitor (CGM), glucose tabs, or a fast-acting carbohydrate. Have someone in the support group who knows how to give emergency glucagon by injection or nasal inhalation.
Find a friend who can check in regarding potential hypoglycemia. The symptoms of intoxication and low blood sugar can be similar (slurred speech, dizziness, lack of coordination, or even a loss of consciousness), so it’s helpful to have someone in the group who understands the difference.
Drink in moderation and always have a plan with a doctor and a support network about what to expect. Know that alcohol may impair the responses in the brain and body, so take precautions to be as safe as possible.
Alcohol and Diabetes: Additional Steps
The liver not only metabolizes alcohol, but it also stores glucose, which can be released when hypoglycemia occurs. However, alcohol may impair the release of stored glucose, thereby potentially creating lows for an extended period of time. That is why it’s important to monitor blood sugar for longer periods of time after consuming alcohol, such as overnight or into the next morning.
Be sure to plan ahead. Monitor glucose frequently, have fast-acting carbohydrate available, and always have glucagon available for an emergency.
“Every person, whether they have diabetes or not, responds to alcohol differently,” said Dr. Pinsker. “For people living with diabetes, it is especially important to be aware of the impact of alcohol and plan accordingly.”
Consuming snacks while drinking alcohol can help mitigate episodes of hypoglycemia. Check glucose throughout consumption to understand whether more fast-acting carbohydrates or more insulin may be needed to balance the equation. It may be wise to set an alarm on a phone to wake up and check glucose for several hours after going to bed.
All of this should be discussed with a healthcare provider.
Unless otherwise noted, all medical information was provided by Jordan Pinsker, MD, and Molly McElwee Malloy, RN, CDCES of Tandem Diabetes Care, Inc.
References
1. Steiner JL, Crowell KT, Lang CH. Impact of Alcohol on Glycemic Control and Insulin Action. Biomolecules. 2015;5(4):2223-2246. doi:10.3390/biom5042223.
2. Tenderich A. Jeremy’s Tips for Safe Drinking with Diabetes. Healthline. Updated March 11, 2019. Accessed May 26, 2022.
