Is It Safe to Drink Alcohol If You Have Diabetes?

What are the risks of drinking alcohol if I have diabetes?

Hypoglycemia, or low blood glucose, is the biggest risk when drinking alcohol if you have diabetes. Let’s look at how this can happen.

The liver makes, stores, and releases glucose to help balance blood sugar levels. It also filters toxins from your body, like alcohol and drugs. Alcohol can cause problems with diabetes because the liver prioritizes filtering alcohol over balancing blood glucose. This can lead to hypoglycemia. If this isn’t treated, it can become a medical emergency.

People who take diabetes medications are at high risk for hypoglycemia when drinking alcohol. That’s because insulin and other diabetes medications lower blood glucose levels.

Other health concerns related to diabetes and alcohol

While hypoglycemia is one of the biggest risks of drinking alcohol when you have diabetes, it’s not the only one. Drinking too much alcohol can be damaging and raise your risk for diabetes-related conditions, including:

• Weight gain 

• High blood pressure

• High triglyceride levels (fat in your blood) 

• Peripheral neuropathy (a type of nerve damage that causes tingling, burning, and pain in your legs and feet)

• Diabetic retinopathy (blood vessel damage in your eyes)

• Euglycemic diabetic ketoacidosis (acidic blood levels due to ketones)

• Sleep disturbances, which can make it harder to manage your blood sugar

Drinking can also cloud your judgment and affect how you normally manage your diabetes. For example, you may forget to take your diabetes medications or watch your glucose when you’re drinking. Or you may be more likely to eat the kinds of foods that can make your condition worse. 

Can you drink alcohol if you have diabetes?

Most people with diabetes can safely drink a moderate amount of alcohol if their blood sugar is well controlled. But alcohol affects everyone differently. While hypoglycemia is the most common concern, there may be other reasons to avoid alcohol. For example, other medical conditions can worsen with alcohol.

It’s always a good idea to talk with your diabetes care team before drinking alcohol. They can help you understand if it’s safe for you, or if you need to get better control of your diabetes first. If you do drink, keep a close eye on your blood sugar to see how alcohol affects it.

It’s best to avoid heavy drinking. It has serious negative effects for anyone, but for people with diabetes, it can lead to dangerous complications like severe hypoglycemia and diabetic ketoacidosis.

How much alcohol should you drink if you have diabetes?

Try to stick to the American Diabetes Association’s guidelines for how much to drink. These guidelines state that women should have no more than one drink per day and men should have no more than two. 

One drink is: 

• 12 oz of beer 

• 5 oz of wine 

• 1.5 oz of liquor

Can I drink alcohol while I’m taking insulin or diabetes medications?

In general, yes. But it may depend on the medication. Remember, the key concern is hypoglycemia. Alcohol can make you less aware of the symptoms of hypoglycemia. Some diabetes medications may also affect the risk of hypoglycemia or other unwanted effects:

• If you take insulin or sulfonylureas (like glipizide, glyburide, or glimepiride), then drinking can raise your risk of hypoglycemia.

• If you drink while taking metformin, you may be at a higher risk of hypoglycemia and lactic acidosis, a serious side effect of metformin. Too much lactic acid in your body can cause symptoms like abdominal pain, diarrhea, and muscle cramps.

What are the best drinks for people with diabetes?

If your healthcare team says it’s OK for you to have alcohol, here are some general suggestions for choosing the safest alcoholic drinks:

• Choose light beers and dry wines with less alcohol and fewer calories.

• Avoid sweet wines and mixed drinks that have a lot of sugar, like piña coladas. 

• When ordering mixed drinks, use carbonated water or diet soda instead of high-sugar options like juice, tonic, regular soda, or other sweet mixers.

• Most spirits (like vodka, gin, and whisky) have fewer carbohydrates than beer or wine, but they often contain more alcohol.

Why trust our experts?

Written by:

Jewels Doskicz, RN, BA

Jewels Doskicz, RN, is an Arizona-based registered nurse with more than 20 years of hospital-wide clinical nursing experience. She has spent over a decade in medical writing and editing, with a focus on diabetes and autoimmune disease.

Edited by:

Sophie Vergnaud, MD

Sophie Vergnaud, MD, is the Senior Medical Director for GoodRx Health. A pulmonologist and hospitalist, she practiced and taught clinical medicine at hospitals in London for a decade before entering a career in health education and technology.

Reviewed by:

Mandy Armitage, MD

Mandy Armitage, MD, has combined clinical medicine with her passion for education and content development for many years. She served as medical director for the health technology companies HealthLoop (now Get Well) and Doximity.

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