Is It Safe to Drink Alcohol If You Have Diabetes?

Many people like to enjoy a drink every now and then. But if you have diabetes, you may be wondering if it’s safe for you to drink at all. If your blood glucose (sugar) is within target range, it’s probably fine for you to drink as long as your healthcare provider agrees that it’s OK — and it’s in moderation. Still, drinking with diabetes does come with some unique risks. Read on to learn more about what they are and how to lower them.

What are the risks of drinking if I have diabetes?

Hypoglycemia, or low blood glucose is the biggest risk of drinking alcohol when 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 out toxins — like alcohol and drugs — from the body. Alcohol can cause problems with diabetes because the liver prioritizes filtering alcohol over balancing blood glucose. This can lead to hypoglycemia. Left untreated, this can become a medical emergency. 

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People that take diabetes medications are at high risk for hypoglycemia when drinking alcohol. This is because insulin and other diabetes medications lower blood glucose levels.

Hypoglycemia symptoms can easily be mistaken for “being drunk,” creating safety issues for someone living with diabetes. This means that when you’re drinking, you may assume the way you’re feeling is because of the alcohol. Likewise, other people may assume your symptoms are alcohol-related, when in fact you need emergency help to treat a low blood glucose level.

Symptoms of hypoglycemia include:

• Hunger

• Fast heartbeat

• Shakiness

• Anxiety

• Sweating

• Tingling

• Dizziness

• Weakness

• Drowsiness

• Confusion

You can see how these can easily be mistaken for alcohol intoxication. Unfortunately, while being drunk improves with time, hypoglycemia only gets worse. 

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 can raise your risk for diabetes-related conditions, including:

• Weight gain and high blood pressure

• High triglyceride levels (fat in your blood) 

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

• Diabetic retinopathy (blood vessel damage in the eyes)

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 eat too many foods that aren’t healthy for your condition. 

Can you drink alcohol if you have diabetes?

If you’ve been diagnosed with diabetes, it may be safe for you to drink a moderate amount of alcohol. Heavy drinking should be avoided as it can cause hypoglycemia, high triglyceride levels, and ketoacidosis (very high blood sugar levels).

Alcohol can affect each person differently. While the most common concern may be hypoglycemia, there may be other reasons to avoid alcohol. When it comes to alcohol and diabetes, it’s important to speak with your healthcare provider before drinking.

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

In general, yes. It’s generally safe to drink a moderate amount of alcohol as long as it is a low-carbohydrate (sugar) drink and you are watching your blood glucose levels. Remember, the key concern is hypoglycemia. While drinking alcohol, a person may be less aware of the symptoms of hypoglycemia. As a result, they may be less likely to check their levels or adjust their medications. 

If you’re taking diabetes medications, combining them with alcohol can be dangerous. As mentioned, this is because the liver gives priority to breaking down alcohol and isn’t as focused on blood glucose levels.

If you take:

• Insulin and/or sulfonylureas (glipizide, glyburide, glimepiride), drinking can raise your risk for hypoglycemia.

• Metformin while drinking, you may be at a higher risk of hypoglycemia and lactic acidosis, a serious side effect of metformin. Too much lactic acid in the body can cause abdominal pain, diarrhea, and muscle cramps among other symptoms.

What are the best drinks for people with diabetes?

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

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

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

• Order mixed drinks with carbonated water or diet soda instead of high-carbohydrate options (such as juice, regular sodas, or other sweet mixers).

How much alcohol should you drink if you have diabetes?

Try to stick to the American Diabetes Association guidelines for how much to drink:Women should have no more than one drink a day, while men should have no more than two. 

One drink is: 

• 12 oz. of beer 

• 5 oz. of wine 

• 1.5 oz. of liquor

How can I stay safe when I drink?

In addition to what you drink, how you drink matters, too. Here are some tips to avoid some possible dangers of drinking when you have diabetes:

• Stay hydrated when you drink.

• Eat before drinking alcohol, which helps to lower your risk of hypoglycemia. 

• Avoid high-carbohydrate alcoholic drinks.

• Keep track of your blood glucose before, during, and after drinking. If you have hypoglycemia (blood glucose less than 70 mg/dl), take steps to correct it. 

• Wear medical alert identification, so others will recognize hypoglycemia and can help you in case of an emergency.

• Have a designated driver. 

Why trust our experts?

Written by:

Jewels Doskicz, RN, BA

Jewels Doskicz, RN, BA, is an Arizona-based registered nurse with 22 years of hospital-wide clinical nursing experience and 11 years of medical writing and editing experience. She was a former healthcare content creator for a digital health tool at HealthLoop and director of clinical content operations at GetWellNetwork.

Edited by:

Samvida Patel, MNSP, INHC

Samvida Patel, MNSP, INHC, is a health editor at GoodRx. She is a nutritionist and integrative nutrition health coach with over 8 years of experience in health communications.

Reviewed by:

Sophie Vergnaud, MD

Sophie Vergnaud, MD, is the Senior Medical Director for GoodRx Health. An experienced and dedicated pulmonologist and hospitalist, she spent a decade practicing and teaching clinical medicine at academic hospitals throughout London before transitioning to a career in health education and health technology.

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