Diabetes and Alcohol: Do the Two Mix? (Part 1)

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Jan 22, 2008

Diabetes and Alcohol: Do the Two Mix? (Part 1)

Amy Campbell

A nice glass of Chianti…a cold beer on a hot summer day…celebrating with a flute of champagne. There are so many ways that alcohol is integrated into both everyday life and special occasions. Granted, not everyone drinks alcohol, but many people do. And when it comes to the question, "Can I drink alcohol if I have diabetes?" the answer is about as clear as that for "Is a low-carb diet good for diabetes?" In other words, the answer really is "It depends!"

It's important to mention right off the bat that there are certainly many reasons why people should not drink alcohol. Some may be related to diabetes and some may be related to other reasons. Therefore, it's important to discuss this issue with your health-care provider if you have any doubts or concerns. And if you're newly diagnosed with diabetes or starting on a new medicine, it's worthwhile bringing up the topic if your provider doesn't.

While you'd be hard-pressed to find any health organization actually recommending that you drink alcohol, you might take some comfort in knowing that the American Diabetes Association, the American Heart Association, and even the American Cancer Society agree that drinking alcohol in moderation is certainly not off-limits to most people.

But back to diabetes and alcohol. What's the concern here? And why should some people with diabetes not drink alcohol? To answer these questions, it's helpful to understand a little bit about how alcohol is processed in the body.

The body treats alcohol as a drug, not as a food product. This means that, when you drink any type of alcoholic beverage, your liver kicks into high gear, preparing itself to "detoxify" the body of this "poison" (I'm using these words for dramatic effect). Essentially, the liver has to metabolize, or break down, alcohol into less harmful substances. This takes, on average, about two hours. While the liver is truly a miracle organ, it can only do so much multitasking at one time. And handling alcohol is its number one priority. So, this means that while your liver is busy reigning in the effects of that green apple martini, it may not pick up on the fact that your blood glucose levels are starting to wind their way down.

In most cases, your liver is able to release glucose when blood glucose levels start to drop in an effort to prevent low blood glucose (hypoglycemia). But with alcohol on board, this may not happen. Now, it's no big deal if you have diabetes and you control your blood glucose with a healthy eating plan and physical activity alone. Hypoglycemia isn't going to occur if you don't take medicine. However, if you take certain types of diabetes pills called sulfonylureas, such as glipizide or glimepiride, or if you take insulin, your chances of developing low blood glucose rise considerably. Your chances are even higher if you've been drinking on an empty stomach (think cocktails before supper); if you grab a beer or wine cooler after a few runs down the ski slopes (exercise is already lowering your blood glucose levels); or if your blood glucose levels are already on their way down (too much medicine and/or not enough food).

Alcohol is a little sneaky, too, because it's not always predictable. When the topic of alcohol and hypoglycemia came up in one of the classes I was teaching a few years ago, an astute gentleman quipped, "Well, why don't I just drink alcohol instead of taking my Glucotrol?"

The question was actually a good one (although we'd never recommend using alcohol in that way). But what he didn't realize, at the time, is that alcohol is not always so predictable. Some people metabolize alcohol more slowly than others. And alcohol metabolism can depend on factors such as the amount of alcohol consumed and over what time period; body size; type and amount of food eaten along with alcohol; and level of physical activity. It's therefore not unusual to hear stories from people (often college students) who, after having had a bit too much to drink, "went low" in the middle of the night or even the next morning after a night of partying.

Well, out of time and space for this week. We'll continue our in-depth look at alcohol and diabetes next week. Cheers!

POST A COMMENT E-MAIL A FRIEND

I was told by the first Dr. that I was involved with my diabetes that I should not drink wine, brandy, rum and most beers. She said that those alcohol drinks have the worst kind of sugar for diabetics. She said the expensive bourbon whiskeys have a different sugar composition which is not as detrimental to the diabetics glucose levels. Is her analysis supported by any research?

Posted by: daonegriz | Jan 24, 2008 09:07 AM

Hi daonegriz,

I'm not aware of research claiming that bourbon has a different sugar composition. In general, however, brandy, rum and other distilled spirits have practically no carbohydrate (the exception would be something like a cherry-flavored brandy, for example). Wine and beer can vary in their carb content; sweeter dessert wines can have up to 15 grams of carb per 4 ounces, and a stout beer can contain 15 grams of carb per 12 ounce bottle. Unless you're drinking these or mixed drinks, such as pina coladas, most alcoholic beverages tend to lower glucose levels. If you drink alcohol, check your glucose levels to find out how it affects you.

Posted by: acampbell | Jan 25, 2008 08:05 AM

And I always thought that alcohol when consumed would turn to sugar therefore increasing your blood glucose. I refuse to drink alcohol in any manner. As a diabetic that tries to control my blood glucose without insulin its important to not consume products you know will effect your glucose levels. I have friends that believe its alright to consume alcohol. One now had no foot and is missing fingers. Not good.

Posted by: wkmmarfa | Jan 26, 2008 09:26 AM

Hi wkmmarfa,
Many people with diabetes don't drink alcohol. And it's wise for people who have difficulty controlling their glucose levels to stay away from alcohol. However, there are people who enjoy having a glass of wine or beer; since alcohol tends to lower glucose levels, it's important for those who choose to drink to learn how alcohol affects them - this means checking more frequently with a meter. Learning how to safely fit alcohol into one's lifestyle is possible and should be done under the guidance of a health-care provider.

Posted by: acampbell | Jan 28, 2008 12:19 PM

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