From the Guidelines
Alcohol consumption in moderation, defined as no more than one drink per day for women and no more than two drinks per day for men, 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, weight gain, and hyperglycemia for those consuming excessive amounts 1.
Key Considerations
- People with diabetes should be educated about these risks and encouraged to monitor blood glucose frequently after drinking alcohol to minimize such risks.
- For those using insulin or insulin secretagogue therapies, alcohol should be consumed with food to reduce the risk of nocturnal hypoglycemia 1.
- Some alcoholic beverages, especially sweet mixed drinks, can cause blood sugar spikes before the delayed drop occurs.
- Patients with poorly controlled diabetes, hypoglycemia unawareness, or advanced complications should consider avoiding alcohol altogether.
Recommendations for Safe Alcohol Consumption
- Limit consumption to 1-2 drinks per day for men and 1 drink per day for women.
- Never drink alcohol on an empty stomach; always consume it with food containing carbohydrates to help stabilize blood sugar levels.
- Check blood glucose before drinking, while drinking, before bed, and more frequently the next day.
- Wear medical identification indicating you have diabetes, and ensure friends know how to recognize and respond to hypoglycemia. It is crucial to weigh the potential benefits of moderate alcohol consumption, such as a decreased risk of cardiovascular disease, against the potential risks, particularly for individuals with specific diabetes-related complications or those using certain medications 1.
From the Research
Effect of Alcohol on Blood Sugar in Patients with Diabetes
- The relationship between alcohol consumption and blood sugar levels in diabetic patients is complex, and excessive alcohol consumption can lead to lactic acidosis, a rare but serious complication 2.
- Lactic acidosis is characterized by elevated lactate levels, and in diabetic patients, it can be caused by various factors, including metformin use, renal impairment, and alcohol abuse 3, 4, 5.
- Studies have shown that alcohol misuse can reduce lactate clearance, increasing the risk of lactic acidosis in patients with diabetes, even in those with normal renal function 2.
- A study of 29 diabetic patients with lactic acidosis found that alcohol abuse was reported in 12 subjects, suggesting that alcohol consumption is a significant contributor to the development of lactic acidosis in this population 5.
- The use of metformin, a common antidiabetic medication, can also increase the risk of lactic acidosis, particularly in patients with renal impairment or those who consume excessive amounts of alcohol 3, 4, 6.
- Overall, the evidence suggests that excessive alcohol consumption can have a significant impact on blood sugar control and increase the risk of lactic acidosis in patients with diabetes, highlighting the importance of moderate alcohol consumption and close monitoring of blood sugar levels in this population.