1. Can people with diabetes drink alcohol?

Yes, there is no evidence that an occasional drink is harmful. However, you should avoid alcohol if you are pregnant, you have stomach or liver problems or if your blood fats (triglycerides or cholesterol) are elevated. Alcohol also can have a dramatic effect on your calorie intake. You should consider limiting your alcohol intake if you are concerned about your weight.

2. Does alcohol change the blood sugar levels ?

The intake of alcohol can make the blood sugar go down, up or not change at all. The specific effect, however, depends on what you drink, what you mix it with, how much you drink and whether or not you eat. It also depends on what diabetes medications you are taking.

3. Why would the blood sugar get lower after drinking?

Alcohol can have an effect on the liver. The liver is responsible for converting the alcohol into a less harmful substance. As a result, the liver is temporarily unable to perform some of its other activities. The liver is constantly responsible for sending small packages of stored sugar (glycogen) to the blood stream. This accommodates the body's constant demand for energy. However, this supply is disrupted when the liver is exposed to alcohol. As the liver slows or stops its delivery of glucose to the blood stream, an unplanned lowering of blood sugar can result.

4. How can alcohol also raise the blood sugar?

An increase in your blood sugar levels results from the amount and type of carbohydrate either remaining in the alcohol or mixed with the drink. Some alcoholic beverages are so distilled that the carbohydrate content has been eliminated. These will not raise your blood sugar unless they are mixed with a carbohydrate mixer. Other alcoholic beverages are less distilled so they are lower in alcohol content. These will usually still contain substantial amounts of carbohydrate (CHO), which have the potential to raise your blood sugar levels.

5. What are some examples?

High Alcohol
(no CHO)
Low Alcohol
(low CHO)
Low Alcohol
(high CHO)
rum, whiskey, rye.tequila, burbon ,scotch, martini, liquers, dessert wines lite beers, dry vermouth, dry white & red wines, champagne beer, ale, malt, sweet vermouth, sweet ciders
No CHO Mixers
Low CHO mixers
High CHO Mixers
seltzer water, perrier, mineral waters, club soda, water, sugar free soda V-8 juice, tomato juices juices, eggnog, pina colada, daiquiri soue mixers, tonic water, collins mix, soda, punch

6. Can drinking affect my weight?

Yes, alcohol provides the body with energy in the form of calories. Each gram of alcohol provides seven (7) calories. These calories are handled as if they were fat. For example, twelve ounces of beer has as much calories as two slices of bread and a jigger of scotch has the calories of 1 1/2 slices of bread.

7. What precautions, if any, are necessary before drinking?

  • 1. Never drink on an empty stomach. It's a good idea to drink in combination with a meal. If this is not possible, eat some protein snacks.

  • 2. Alert your friends to the possibility of a low blood sugar. If you seem to have gotten drunk with only a little alcohol, it may not be due to the alcohol but to a low blood sugar.

  • 3. Consider altering your insulin dose if you are going to be drinking. Frequently, alcohol will lower your blood sugar several hours later. This effect coupled with your usual insulin dose is liable to cause an insulin reaction. You should reduce the insulin dose if you have drunk more than 3oz of distilled liquor, 6 oz of wine or more than 16oz of beer. Consider altering the insulin that will be effective 3 to 6 hours after the intake of the alcohol. Check with your health care team more specific instructions on the timing and dosing of the insulin reduction

  • 4. You should also consider adding a snack at bedtime if you have had alcohol during the evening. Again, speak with your health care team for specific instructions.

Carolyn Robertson, RN, MSN, CS, CDE

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