Does alcohol consumption cause hypoglycemia (low blood sugar)?

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Last updated: April 20, 2025View editorial policy

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From the Guidelines

Alcohol can cause hypoglycemia, particularly in individuals with diabetes who take insulin or certain diabetes medications, and it is essential to consume alcohol with food to minimize this risk. According to the most recent and highest quality study, 1, advising adults with diabetes who consume alcohol to not exceed the recommended daily limits (one drink per day for adult women and two drinks per day for adult men) is crucial. Additionally, educating people with diabetes about the signs, symptoms, and self-management of delayed hypoglycemia after drinking alcohol, especially when using insulin or insulin secretagogues, is recommended 1.

Some key points to consider:

  • Alcohol interferes with the liver's ability to produce glucose through gluconeogenesis, which is especially dangerous when someone hasn't eaten recently.
  • The risk of hypoglycemia is particularly high for people with diabetes who take insulin or certain diabetes medications, as alcohol can enhance their blood-sugar-lowering effects.
  • The hypoglycemic effect typically occurs several hours after drinking as the liver continues processing alcohol.
  • To reduce this risk, always eat carbohydrate-containing food when consuming alcohol, avoid drinking on an empty stomach, monitor blood glucose levels if you have diabetes, and be aware that symptoms of hypoglycemia (confusion, dizziness) can be mistaken for intoxication.
  • The risk is greatest with excessive alcohol consumption but can occur even with moderate intake in susceptible individuals, as noted in 1 and 1.

It is essential to prioritize the management of blood glucose levels and be aware of the potential risks associated with alcohol consumption, especially for individuals with diabetes. By following the recommended guidelines and taking necessary precautions, individuals can minimize the risk of hypoglycemia and maintain optimal blood glucose control.

From the Research

Alcohol and Hypoglycemia

  • Alcohol consumption can increase the risk of hypoglycemia in patients with type 1 diabetes, as it inhibits gluconeogenesis, decreases growth hormone levels, and impairs hypoglycemia awareness 2, 3.
  • Studies have shown that moderate alcohol consumption can lead to hypoglycemia in patients with type 1 diabetes, particularly when consumed without food 2, 4.
  • However, the evidence for the effect of alcohol on glycaemic control in people with type 2 diabetes is less clear, with some studies suggesting that light to moderate alcohol consumption does not affect glycaemic control 5.
  • The combination of alcohol and glucose consumption can increase the risk of reactive hypoglycemia, as alcohol can enhance the peak insulin response to glucose and increase the risk of hypoglycemia 6.
  • To reduce the risk of hypoglycemia when consuming alcohol, it is recommended to eat food (saccharides) at the same time, and some guidelines suggest adjusting insulin doses 2, 3.

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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