Is It Safe to Drink Alcohol If You Have Diabetes?

Many people enjoy having a drink every now and then. But with more news recently about the health effects of alcohol, more people are questioning their relationship with their drinking habits. If you have diabetes, you may be wondering if it’s safe to drink at all. 

Drinking alcohol with diabetes comes with some unique risks. Keep reading to learn more about what they are and how to lower your risk.

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.

Hypoglycemia symptoms

Hypoglycemia symptoms can easily be mistaken for “being drunk.” This can create safety issues for someone living with diabetes. If you’re drinking, you may assume the way you’re feeling is because of the alcohol. Other people might also think your symptoms are alcohol-related, when you actually need emergency help to treat a low blood glucose level.

Symptoms of hypoglycemia include:

• Hunger

• Fast heartbeat

• Shakiness

• Sweating

• Irritability 

• Tingling

• Dizziness

• Feeling lightheaded

• Headache 

• Weakness

• Drowsiness

• Confusion

As you can see, these can easily be mistaken for alcohol intoxication. However, being drunk improves with time. Hypoglycemia only gets worse if it’s not treated. 

EXPERT PICKS: WHAT TO READ NEXT

• Alcohol affects more than just your blood sugar. Learn more about how alcohol affects your body and overall health.

• What are the best drinks for people with diabetes? Water is an obvious choice, but there are a handful of other drink options that are safe for your blood sugar.

• Hyperglycemia vs. hypoglycemia: Learn more about blood sugar and what it means if you have high or low blood sugar.

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.

Can people with diabetes drink beer or wine?

Yes, in moderation. It may be helpful to learn how much alcohol and sugar are in each type of drink. The contents can vary a lot by drink. For example, a regular beer may have 13 g of carbohydrates or more. But a light beet only has 6 g.

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:

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

• Avoid alcoholic drinks that are high in carbohydrates.

• Stay hydrated when you drink.

• Keep track of your blood glucose before, during, and after drinking. 

• Carry fast-acting carbohydrates with you for treating low blood sugar. 

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

• Have a designated driver.

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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