by Scheinberg D

IMAGE People with diabetes already know what foods to eat and which to avoid. But they may not know the effect that alcohol has on the body.

How Alcohol Affects Blood Sugar

First, let's look at the liver. The liver makes and stores glucose (sugar). The glucose is released when the body needs to raise blood sugar levels. The liver also breaks down alcohol, but it does not make glucose as well when it does.

Now let's look at the medicines a person may be taking. Insulin and type 2 diabetes medicines lower blood sugar levels. Combining low blood sugar levels with an alcohol-impaired liver may put a person at risk for dangerously low blood sugar levels. This is known as hypoglycemia. It can happen shortly after drinking and last up to 24 hours. The symptoms are like being drunk—confusion, anxiety, and feeling faint. It can be hard to tell them apart. This may mean a person may not get medical help if their blood sugar levels drop too low.

Drinking Responsibly

People with diabetes should talk with their doctor to make sure alcohol is safe for them. If it is, they will need to drink responsibly. For example, it is important not to drink on an empty stomach. It can lower blood sugar to dangerous levels. Eating food, especially carbohydrates (carbs), with alcohol can keep blood sugar levels from dropping too low.

People with diabetes should also use their glucose meter to check blood sugar levels before drinking. If blood sugar is very low (below 70 mg/dL [milligrams per deciliter]), they should eat something to raise it before drinking alcohol. Also, people drinking before bedtime should check their blood sugar before they go to bed to make sure it is at a safe level (between 100-140 mg/dL).

Alcohol and Weight Gain

Keep in mind that alcohol may lead to weight gain because it adds extra calories to a person's diet. These calories are stored as fat in the body. Not drinking, limiting drinks, or choosing low-calorie drinks can help a person achieve their weight-loss goals. This may be very important for someone with type 2 diabetes who is trying to maintain a healthy weight to control their diabetes.

Guidelines When Drinking Alcohol

A person who decides to drink should keep these tips in mind:

  • Limit drinking. Women should drink no more than 1 alcoholic beverage a day. Men should drink no more than 2 drinks a day. One drink is equal to a:
    • 12-ounce beer OR
    • 5-ounce glass of wine OR
    • 1½-ounce of distilled spirits, like vodka, whiskey, or gin
  • Do not drink on an empty stomach. Alcohol should be consumed with food, either at a meal or with a snack. Some healthy snack options are pretzels and popcorn.
  • A person who drinks several times a week should tell their doctor. Medicine changes may need to be made.

Other Helpful Tips

  • A person should not drink unless their blood glucose is under control.
  • Test blood sugar levels:
    • Before drinking
    • Before going to bed
  • Sip drinks slowly.
  • Keep a no-calorie beverage nearby to stay hydrated.
  • Try wine spritzers—wine with club soda. They have less alcohol.
  • Avoid drinks with a lot of sugar. These are usually mixed drinks that have high-carb mixers. Instead, use calorie-free drink mixers like diet soda, club soda, diet tonic water, or water.
  • Carry glucose tablets or another sugar source. Glucagon shots may not work in people who have hypoglycemia due to alcohol.
  • Do not mix alcohol and exercise. This will increase the chances of having low blood sugar.
  • Never drink and drive. Designate a safe driver or call a cab or car service.
  • Wear a medical alert bracelet. It will let others know to get medical help if there is a problem.

Drinking alcohol is a part of many social situations. A person with diabetes should talk to their doctor about the effects of alcohol on their health problem, especially if they are taking medicines. With guidance and careful planning, diabetes can be controlled in any situation.


American Diabetes Association 

National Institute of Diabetes and Digestive and Kidney Diseases 


Dietitians of Canada 

Health Canada 


American Diabetes Association. Standards of medical care in diabetes - 2020. Diabetes Care. 2020 Jan; 43 (Suppl 1):S1-S212.

The big picture: Checking your blood glucuse. American Diabetes Association website. Available at: Accessed August 25, 2020.

Dietary considerations for patients with type 2 diabetes. EBSCO DynaMed website. Available at: . Accessed August 25, 2020.

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