From the Guidelines
People with diabetes who use insulin should limit their alcohol consumption to no more than one drink per day for women and two drinks per day for men, as excessive alcohol intake can increase the risk of hypoglycemia and other complications. According to the most recent guidelines 1, moderate alcohol intake does not have major detrimental effects on long-term blood glucose management in people with diabetes. However, risks associated with alcohol consumption include hypoglycemia and/or delayed hypoglycemia, particularly for those using insulin or insulin secretagogue therapies.
To minimize these risks, individuals with diabetes who choose to drink should be educated about the importance of monitoring blood glucose frequently after drinking alcohol 1. They should also be advised to consume alcohol with food containing carbohydrates, check their blood sugar before, during, and after drinking, and wear medical identification. It is also crucial to avoid drinking on an empty stomach or when blood sugar is already low and to have someone nearby who knows how to recognize and treat hypoglycemia.
The guidelines also recommend avoiding sugary mixed drinks and sweet wines, opting instead for dry wines, light beers, or spirits with sugar-free mixers 1. Additionally, individuals with diabetes should be aware that alcohol can mask hypoglycemia symptoms, making them harder to recognize, and can interact with diabetes medications besides insulin, potentially causing adverse effects. By following these guidelines and taking necessary precautions, individuals with diabetes who use insulin can minimize the risks associated with alcohol consumption and maintain good blood glucose control.
From the FDA Drug Label
Alcohol, including beer and wine, may affect your blood sugar when you take Levemir. The FDA drug label advises that alcohol may affect blood sugar levels when taking insulin, such as Levemir.
- Key points:
- Alcohol may impact blood sugar control
- Patients taking Levemir should be aware of this potential interaction
- It is essential to follow the healthcare provider's instructions for managing diabetes while consuming alcohol 2
From the Research
Alcohol Consumption and Diabetes
- Moderate alcohol consumption is associated with a reduced risk of type 2 diabetes, possibly due to improved insulin sensitivity or glycemic status 3.
- Alcohol consumption did not influence estimated insulin sensitivity or fasting glucose, but reduced HbA1c and fasting insulin concentrations compared to the control condition 3.
- The relationship between alcohol consumption and insulin resistance shows a U-shaped curve, with insulin resistance being minimal in individuals with regular mild to moderate alcohol consumption 4.
Insulin Therapy and Diabetes Management
- Metformin is a commonly used antidiabetic medication that reduces glucose production in the liver, decreases insulin resistance, and increases insulin sensitivity 5, 6.
- Metformin can be used as the first-line agent in the management of diabetes, but newer agents such as sodium-glucose cotransporter-2 inhibitors and glucagon-like peptide-1 receptor agonists are favored for individuals with type 2 diabetes who would benefit from cardio-renal protection 5.
- Insulin therapy may be necessary for patients with type 2 diabetes who do not achieve glycemic control with metformin and other antidiabetic agents 7, 6.
Interactions between Alcohol and Insulin
- Alcohol consumption can increase the risk of hypoglycemia in both diabetic and non-diabetic subjects, possibly due to a direct inhibition of gluconeogenesis or reduced secretion of counterregulatory hormones 4.
- There is limited research on the specific interactions between alcohol consumption and insulin therapy, but it is recommended that individuals with diabetes consult with their healthcare provider before consuming alcohol 3, 4.