Alcohol and diabetes can be a tricky subject. But having diabetes shouldn’t get in the way of being able to drink alcohol, unless this has been advised on medical grounds.
On this page:
- Can I drink alcohol if I have diabetes?
- Does alcohol cause diabetes?
- Alcohol and hypos
- Alcohol and your weight
- Alcohol and carbohydrates
- Managing diabetes and drinking
- The morning after
- Alcohol, fertility and pregnancy
- Alcohol and your emotions
- Healthier drink choices
Can I drink alcohol if I have diabetes?
You can drink alcohol if you have diabetes unless your diabetes team has advised you not to.
But you need to be aware of how it can affect your body and how to manage this. For example, drinking can make you more likely to have a hypo, otherwise known as low blood sugar or hypoglycaemia, because alcohol interferes with your blood sugar levels. It can affect your weight too, as there can be a lot of calories in alcoholic drinks.
It’s sensible to keep within government guidelines on alcohol units (see these below).
Does alcohol cause diabetes?
Alcohol doesn’t cause diabetes but drinking to excess can increase your risk of type 2 diabetes. That’s partly because alcohol has a lot of calories, which can lead to weight gain. And living with overweight or obesity is one of the risk factors for type 2 diabetes.
So the safest way to drink alcohol is to stay within government guidelines.
Take a look at our information about risk factors and find out your risk of developing type 2 diabetes.
Government guidelines on alcohol units
To help keep health risks from alcohol at a low level, it’s safest not to regularly drink more than 14 units a week. These guidelines are the same for men and women. The guidelines also recommend that if you choose to drink up to 14 units a week, spread this over at least three days. Try to have a few alcohol-free days too.
But what does this mean when you’re in the pub or having dinner with a glass of wine at home?
One unit equals 10ml or 8g of pure alcohol, which is roughly a single measure (25ml) of spirits or half a pint of lower-strength beer. This It means you shouldn’t drink more than six pints of lager or six medium glasses of wine a week.
But the size of the glass and type of alcohol affects the number of units, so it’s best to check how many units are in your drink and the guidelines at Alcohol Change UK.
Alcohol labels
ABV means alcohol by volume. The strength of alcoholic drinks has increased over the years, with new wines from South America, South Australia and South Africa containing 14% ABV or higher – this means that a bottle will contain approximately 10.5 units and 750 calories, and a large glass of wine (250ml) can be over 3 units and 200 calories.
Many labels on alcoholic drinks clearly depict the alcohol and calorie content so, just like food labels, it pays to look at them closely.
Alcohol and hypos
If you use insulin or some other diabetes medications like sulphonylureas, you’re more likely to have a hypo. Drinking alcohol can then add to this, because alcohol reduces your body’s ability to recover when blood sugar levels are dropping.
Usually, the liver stores extra glucose which is released back into the blood when needed, such as when blood sugar levels drop. But alcohol stands in the way of the liver’s ability to do this effectively.
If you’re not sure whether your medication can cause hypos or if they're affected by alcohol, it’s best to speak to your healthcare team.
If you drink a lot or on an empty stomach, you’re even more likely to have a hypo.
Your risk of having a hypo doesn't go away after you stop drinking – it increases and can last up to 24 hours.
Some people may use a continuous glucose monitor (CGM) to monitor their sugar levels. With flash glucose monitors and CGMs you can set alarms to alert you if your blood sugar levels go too low or too high. These can help you to act quickly if your levels go too low when you’ve been drinking. This is something you can discuss with your healthcare team.
It’s not uncommon for some people to mistake having a hypo for being drunk. So, carry hypo treatments around with you and always wear some medical ID. You should also make sure that whoever you’re with knows you have diabetes, and knows how to help with a hypo if you need them to.
Alcohol and your weight
Depending on what you like to drink, there can be a lot of calories in alcohol. So if you’re trying to lose weight, you may want to drink less. Alcohol stops your body burning fat as all its attention is turned to burning off the alcohol, which makes weight loss more difficult.
Alcohol also reduces production of the hormone leptin which tells your brain you’re full. This may be the reason why drinking alcohol makes you feel hungrier as leptin levels drop and you might be more likely to tuck into a late-night kebab.
It also reduces your willpower - you are less likely to go for the healthier option when out for a meal, cooking a meal, or raiding the fridge at home and these effects can last the next day.
Alcohol and carbohydrates
If you’re carb counting, drinking can make it a lot more tricky. While a lot of alcoholic drinks contain carbs, you might not need to take your usual mealtime amount of insulin to cover them. That’s because you’re more likely to have hypos.
It all depends on what you drink, how much you drink, and what else you’re doing while you’re drinking – like eating or dancing. So it’s best to talk to your healthcare team and get their advice before thinking about adjusting your insulin for alcohol.
Managing diabetes and drinking
If you have type 1 diabetes, courses like DAFNE can give you advice on how different types of alcoholic drinks can affect your blood glucose levels, and also suggest appropriate insulin adjustment and where this may be necessary.
However, it is stressed on the course that people may respond to alcohol in different ways, and it’s advised that monitoring your blood glucose before and after drinking will help you to discover your own requirements.
The morning after you’ve been drinking
If you end up having one too many, drinking a pint of water before you go to bed will help keep you hydrated. If you’re lucky, it may also help prevent a hangover in the morning. If you do wake up with a hangover, it’ll still help to drink plenty of water.
And always have breakfast – it will help you manage your blood sugar. If you can’t face food or you’ve been sick, drink as many fluids as possible including some sugary (non-diet) drinks if your blood sugar levels are low.
Checking your blood sugar levels regularly the next day may help you prevent a hypo before it happens. The symptoms of having a hypo are similar to feelings of a hangover, so you need to know if you’re having one. No matter how awful you feel, you need to treat a hypo straight away. Don’t ignore it.
If you take insulin, you might need to change your dose depending on what your blood sugar levels are. Talk to your healthcare team about what you should be doing.
Types of alcoholic drinks
There's no 'best' alcoholic drink for people with diabetes. If you're going to drink, it's good to be aware of all the facts so you can choose the types of drinks best for you:
- Avoid low-sugar beers and cider – sometimes called diabetic drinks. They might have less sugar, but there's more alcohol in them.
- Avoid low-alcohol wines – these often have more sugar than normal ones. If you do choose these, just stick to a glass or two. Try to limit drinks with a lot of sugar, such as sweet sherries, sweet wines and liqueurs.
- Choose alcohol-free alternatives. Alcohol-free beers, ciders, wines, and spirits are now widely available. But be aware that these still have some free (added) sugars and carbs which will affect blood sugar levels. Water is the best drink to choose – it is sugar, carb and calorie free.
- Have diet or sugar-free mixers with any spirits – if a friend gets one for you, make it clear what you need.
- Some drinks like beers, ales and ciders contain carbs and will increase your blood sugar levels initially. Spirits, dry wines and Prosecco not so much, so these may be a better bet if you are concerned about the carbs in alcohol.
Other health risks from drinking alcohol
If you have diabetes, you should be aware of the other health risks around drinking. That way, you can help to avoid them by limiting how much you drink. Here are a few things to watch out for:
- Excessive alcohol, or heavy drinking, can lead to raised blood pressure.
- Alcohol can make neuropathy (nerve damage) worse.
- It dehydrates your body and stops you sleeping properly.
- It can also lead to certain cancers and heart disease.
Alcohol, fertility and pregnancy
Alcohol intake can affect fertility in men and women, so if you are trying for a baby it is important to cut back.
For pregnant women the safest option is not to drink alcohol at all during pregnancy. In particular, drinking alcohol during the first three months of pregnancy may increase the risk of a miscarriage.
Excessive alcohol intake during pregnancy is never a good idea, and the more alcohol you drink the greater the risk to your baby. These risks include stillbirth, premature birth and foetal alcohol syndrome.
Alcohol and your emotions
Some people find that alcohol helps them deal with stress or when they're feeling low. It might make you feel more relaxed, but it’s not a healthy way of managing these feelings.
Getting more active can really help if you’re stressed or feeling anxious. Starting a hobby with a friend, or doing something relaxing like having a long bath or reading a book can all help.
You can talk to your healthcare team about how you're feeling, they'll be able to give you more advice and support about what might help. Or you might prefer to talk to someone close to you, like a friend or family member.
Remember, you can get in touch with our helpline. They are there to listen and will be able to give you more advice.
Healthier drink choices
Read on for some useful tips to keep the calories and alcohol down:
- Make a long drink with a shot of spirits such as vodka or rum and use plenty of a mixer such as diet lemonade, diet ginger ale, diet cola or water. Top with plenty of ice.
- Go for lower-strength beers and wines, but avoid low-alcohol drinks like Kaliber, Swan Light and Becks Blue as these drinks contain only carbohydrate and so are similar to drinking ordinary sugary drinks and are not recommended for people with diabetes.
- Just like using smaller plates can help you to eat less food, using smaller wine and beer glasses can help you drink less - try it, it really does work!
- Keep your drinking time to a set time. Having a drink at meal times works for some people.
- Measure drinks out at home as opposed to pouring from the bottle.
- Alternate with soft drinks. Having a glass of water between alcoholic drinks is a good way of pacing yourself and avoiding the dehydrating effects of alcohol. It will also give you more time to see the impact that alcohol is having on your blood sugar levels.
