Alcohol and diabetes type 2 is a controversial topic in the modern world. Taking one perspective, we can see that moderate intake of red wine, for instance, can raise good cholesterol and keep our vessels healthier. This is proven by the research that observed women with type 2 diabetes who, while drinking small amounts of alcohol, lowered risks of heart disease.

From another view, many alcoholic beverages don’t have a positive effect on our organs and systems, such as liver, leading to increased risks of sudden spikes in blood glucose. But if healthy people handle these spikes okay, for those with type 2 diabetes alcohol drinking still remains a question of life and death.

Can You Drink Alcohol with Type 2 Diabetes

While following doctor’s recommendations and trying to stick to a healthy lifestyle, many people admit they allow themselves some fast food, physically passive days, or alcohol, all of which is not advised in cases with type 2 diabetes. Doing it once in a while will not ruin all your efforts to become healthier, but there is one condition. And it is moderation.

When it comes to drinking alcohol, many people can’t stop at one sip. This is known as alcohol abuse, when a person can’t control their cravings because of some kind of emotional tension or making this habitual. Excessive drinking makes, if not the biggest, then a serious problem when we talk about alcohol and type 2 diabetes. Still, what can we call moderate? Are there precise amounts?

American federal dietary guidelines for 2020-2025 give the following definitions of moderate alcohol intake: ‘Not more than 2 drinks a day for men and 1 drink or less for women.’ Besides, they warn that it’s better not to start drinking if you didn’t drink before. Excessive drinking is, meanwhile, described as ‘more than 5 alcoholic beverages in 2 hours for men and four for women;’ still, it does not apply to cases when a person drinks almost every day, so the guidelines have to be viewed only in the context.

Effects of Alcohol on Diabetes Type 2

The given guidelines might still be very vague. To find out what changes seldom alcohol intake will make in your body, we need to understand how alcohol use impacts nerves, heart, blood glucose, etc., in people with type 2 diabetes.

People with type 2 diabetes are, as a rule, not recommended to drink, especially when it takes place over a short time period. The point is that even a single drink during the meal might have both positive and negative effects. At first, it might increase your natural insulin production, which seems to be good.

Together with this process, your blood sugar drops, and if you take insulin or other medical supplements, this can cause hypoglycemia that is hard to spot due to lower blood sugar. This example is only one possible effect of alcohol on diabetes type 2 patients. Now, let us look at other outcomes.

Appetite Stimulation

Drinking can encourage overeating thanks to stimulating your appetite. Once it is consumed, it is rapidly absorbed by the stomach and just as quickly gets to the bloodstream. Besides, alcohol contains its own calories. To make it more convincing, 3 portions of rum will count as a good meal containing at least 540 calories, so it will be too much even if you don’t overeat.

Appetite stimulation might not be so vivid if you drink occasionally, but it is especially true for chronic alcohol intake.

Increased Insulin Production

Another effect of alcohol on a diabetic is connected to the impact on glycemic control and the behavior of insulin. Ethanol makes the body produce more insulin without engaging beta cells in this process, which also results in the inhibition of lipolysis – the process of breaking down fats. In case alcohol consumption is frequent, this might lead to higher risks of myocardial infarction.

Interaction with Diabetes Medications

Depending on how much sugar a drink contains, alcoholic beverages can make blood glucose levels drop or rise almost instantly (also depending on the amounts). Logically, if you take anti-diabetic tablets that lower blood sugar levels and stimulate your pancreas to produce more insulin, this can cause the blood sugar to drop too low.

Such a condition often goes out of control and needs a medical emergency to deal with it. To prevent this insulin shock, always mention to your healthcare team not just what you eat but what you drink (or plan to drink) as well.

Impact On Liver

Our liver has got ‘stored glucose,’ and doses of alcohol are proven to slow down the release of glycogen. What is more, it’s difficult for the liver to process alcohol – it actually spends nearly 2 hours to break down a single drink. The energy for doing this could be otherwise used to release the stored glucose in the bloodstream for the benefit of body cells.

Increased Blood Pressure

Frequent drinking episodes with more than one drink at a time significantly raise high blood pressure risks, as experts at the Journal of the American Heart Association claim. In fact, a 2020 study of a group of adults with type 2 diabetes has shown that this risk grows by 60% even when a patient is a moderate drinker (around 8 alcoholic beverages per week). Light drinking, however, is not associated with hypertension or any stage of its development. Hence, the more often and the bigger the dose of consumed alcohol, the higher risks and severity of high blood pressure appear.

Among other serious changes that alcohol brings, we would like to underline:

  • Nerve damage.
    Our nerves are very sensitive to alcohol, and regular drinking can make their condition even worse. If you already experience pain, numbness in any parts of the body, or tingling, this is a serious reason to give up drinking as soon as possible. Talk to the doctor if you have any of the diabetic neuropathy symptoms and discuss your alcohol intake.
  • Ketosis.
    This is, perhaps, not the most popular effect of frequent drinking, but it’s a part of a hazardous condition known as DKA, also including electrolyte imbalance, lower blood pH (acidosis), hyperglycemia, and constant dehydration. Poor control of your blood sugar in the background of regular intake of high starch alcohol does not directly cause the condition but contributes to developing ketosis.

Alcohol in diabetes

How Can It Affect Medications or Insulin

In combination with many medications, alcoholic beverages can cause both hypoglycemia (too low blood sugar) and hyperglycemia (too high blood sugar). Many medical supplements can result in serious complications – dangerously low blood glucose, taking away the liver’s ability to regulate blood glucose (the condition called hepatic glyconeogenesis), or lactic acidosis.

That is why it is forbidden for patients who are treated with metformin to take any kind of alcohol during the therapy. Even though lactic acidosis is a rare consequence of mixing alcohol with metformin, its symptoms are tricky and are not always recognized by patients.

Chlorpropamide, otherwise known as diabinese, is also dangerous to mix with any alcohol since it can cause the undesirable state of heavy nausea, headaches, and weakness.

What’s the Best Alcohol for Diabetics Type 2

There is no such thing as the best alcohol for diabetes type 2 patients. Still, if we apply the same logic of high-sugar and low-sugar drinks to define what beverages are safer to have sparingly or on special occasions, we will see that these are less harmful:

  1. Dry wines.
  2. Champagne.
  3. Red wine.
  4. Light beer.
  5. Distilled spirits.

What is wise to do for anyone fighting type 2 diabetes and desiring to prevent all the harmful effects of alcohol is to avoid drinks such as sweet liqueurs, sherries, as well as low-alcohol wines. The latter can have even more sugars than average wines. Choose sugar-free mixers to keep the good effects.

The Dos and Don’ts of Drinking Alcohol With Type 2 Diabetes

Even if you rarely drink alcohol, there is a set of expert pieces of advice that you will definitely need someday.

Dos Don’ts
1. Know what your limit is. 1. Don’t drink on an empty stomach.
2. Take time to drink one portion. 2. Don’t drink sugary alcohol.
3. Always test blood sugar before you drink anything. 3. Don’t choose energy drinks or drinks containing caffeine after you’ve had alcohol.
4. Wear your diabetes identification bracelet if you are going to have a drink.  
5. Drink plain water or other non-sugary and non-alcoholic drinks during the evening.  

Now, let us see the most important Dos and Don’ts in a close loop.

Diabetes and drinking

Know Your Limit

What you should ask your doctor before even planning to drink is what your safe dose is. You might be upset to hear that it is zero alcohol at all or be allowed to drink something once a week. Make sure you remember the recommended safe dosage for you and stick to the doctor’s words.

Drink Slowly

Again, having a drink is not about the amount. Being slow will let you enjoy your glass of wine without crossing the border of what is allowed. Drinking fast can lead to dizziness, loss of orientation and won’t add up to the great atmosphere.

Test Blood Sugar Before Having a Drink

To see how alcohol affects your body in particular, make sure you measure blood sugar before. This makes sense the most for the people who have been freshly diagnosed with type 2 diabetes. Hence, you will see what specific drinks make your blood sugar drop or rise and whether these changes are massive or not.

Don’t Drink Alcohol on an Empty Stomach

Just like when interacting with medical supplements, food makes the processing of alcohol slower and milder. Taking some carbohydrates with your meal will be the best choice if you are going to drink.

Don’t Drink Sugary Drinks Beverages

The problem is that many drinks contain both carbohydrates and sugars. Sugary drinks are also higher in calories, which won’t make your body respond well. They will make it harder for you to lose weight and control blood pressure. Better eliminate liqueurs and replace them with adequate amounts of red wine.

To check how much carbs or sugar a drink has, see the chart below.

Comparing Carbs and Sugar in Alcoholic Beverages
Alcohol Sugar Carbs
2 ounces port wine 20 g 7 g
12 ounces spiked seltzer 5 g 5 g
5 ounces white wine 1.4 g 4 g
5 ounces red wine 0.9 g 4 g
12 ounces light beer 0.3 g 6 g
12 ounces beer 0 g 13 g
1.5 ounces distilled spirits 0 g 0 g

When to Avoid Drinking

It is proven that alcohol consumption in as much as 19-20 drinks monthly increases chances for metabolic syndrome. If you have already spotted these signs described below, these are good reasons to avoid drinking.

Diabetic Retinopathy

This condition is characterized by eyesight problems or even total blindness. Since blood vessels in our retina are delicate, alcohol makes them even more fragile. Moderate consumption does not lead to this condition; yet, if it is already present, it can make the disease develop faster.

Blood Pressure That Is not Controlled

If well-controlled forms of diabetes can allow patients to have a drink sometimes, those with difficulties controlling it should abstain from alcohol.

High Triglycerides

Drinkers more often have lower serum HDL cholesterol, elevated triglycerides, and higher waist circumference. High triglycerides together with type 2 diabetes boost the risks of having heart disease, so for better heart health, doctors recommend cutting down on drinking.

Can Alcohol Cause Type 2 Diabetes

To wrap it up, drinking alcohol can cause the development of type 2 diabetes, mostly due to increasing the sensitivity to insulin, slowing down the liver’s work, and triggering blood sugar jumps. Still, rare drinks of non-sugary wines or beers will show their benefits for those who don’t have medical restrictions. Anyway, remember to see or call your doctor if you are unsure if you’re allowed to drink anything or want to know the safe dose.

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