Alcohol and Type 2 Diabetes - What You Need to Know

While plenty of information about the health effects of alcohol may be found with a few simple clicks, good information about its effects on individuals with Type 2 Diabetes is often much more difficult to come by. So, what are the effects? How much carbohydrate and sugar do alcoholic beverages typically contain? What is a moderate amount? And is it safe to consume?

This is what you need to know about alcohol and Type 2 Diabetes.

What are the health effects of drinking alcohol?

Most of the alcohol that we consume is absorbed in the upper part of the small intestine, where it enters the bloodstream. It then travels in the blood to the liver where it is broken down (metabolized). This process causes an increase in triglycerides, which leads to excess fat in the liver and bloodstream. The continued accumulation of triglycerides in the liver may result in a condition known as “fatty liver disease.” In the bloodstream, excess triglycerides can cause blood vessels to become “clogged” and increase one’s risk for cardiovascular disease.

Carbohydrate and sugar content of alcoholic beverages

Most alcoholic beverages contain carbohydrates or added sugars. This is particularly important for individuals with Type 2 Diabetes who are trying to manage their blood sugar. For example, mixed drinks like margaritas, piña coladas, and daiquiris often have a high sugar content with more than 30 grams per serving!

Wine and beer, on the other hand, contain a moderate amount of carbohydrates, with wine typically having between 4 to 8 grams per serving, and beer consisting of between 6 to 12 grams on average. Those containing no carbohydrates or sugar are distilled liquors such as gin, rum, or vodka, whose sugar is lost during the distillation process.

How does alcohol affect my blood sugar?

Alcohol can impact blood sugar in two ways: by the carbohydrate and sugars that are often found in alcoholic beverages, as mentioned above, and by the way the alcohol itself is broken down in the liver.  Mixed drinks, beer, and wine often contain carbohydrates and sugar. The carbs and sugar in these beverages are quickly converted to blood sugar in the body, which can cause a high blood sugar if consumed in excess, or on an empty stomach.

Interestingly, the alcohol itself can have an inappropriate lowering effect on blood sugar. As alcohol enters the liver, the liver must shift its focus from balancing blood sugar to breaking down this toxic substance. As a result, this can cause blood sugar lows that can be dangerous for individuals with diabetes. In fact, in susceptible individuals, drinking beverages high in both sugar and alcohol may cause an initial blood sugar spike, followed by a steep dip, resulting in low blood sugar.

What is a moderate amount?

The Dietary Guidelines for Americans suggests that moderate alcohol consumption for healthy adults may be characterized as up to one drink per day for women, and up to two drinks per day for men. One drink is defined as a 12 oz beer, 5 oz wine, or 1.5 oz spirits.

Is it safe to drink?

Keep in mind that the above recommendations are for healthy adults, and do not necessarily apply to individuals with diabetes, high cholesterol, or those with a compromised liver or kidneys. Such individuals should consult their healthcare provider about whether or not they can safely consume alcohol. Those on medications such as sulfonylureas, meglitinides, and insulin should be particularly careful due to alcohol’s ability to cause low blood sugar.

What are some tips to consider when consuming alcohol?

  • Exercise discretion when drinking, particularly if you have diabetes.

  • Use the moderate consumption guidelines above as an upper limit.

  • Drink with food, avoiding alcohol on an empty stomach.

  • Don’t replace food with alcohol in your meal plan.

  • Savor every sip, drinking slowly to enjoy it fully.

  • Stay well hydrated – match every alcoholic drink with a glass of water.  If you choose a mixed drink, opt for a sugar-free or reduced sugar mixer like club soda, diet tonic water, or diet soda.

Want more info? Chat with us in your Brook app for additional tips & tricks or to get your questions answered any day of the week.

Reviewed by Heather King, MS, RDN​, CDE

on July 2nd, 2020. Heather is a Certified Diabetes Educator, has been a Registered Dietitian for over 12 years, and is Brook's Health Director.