Nutrition for People with Diabetes: Use of Alcohol

Is it OK for people with diabetes to drink alcohol?

People with diabetes should be cautious about drinking alcohol. Too much alcohol can make blood sugar levels fall too low. Drinking even a small amount of alcohol on an empty stomach can lead to a very low blood sugar. If you take insulin or diabetes pills, you have an even greater risk for low blood sugar because alcohol increases the effects of the medicine. Also, some medicines, including those for diabetes, can interact with alcohol and cause serious and potentially life-threatening problems. Always ask your healthcare provider about possible drug interactions before you drink alcohol.

What are the other effects of drinking alcohol when you have diabetes?

Alcohol can make some diabetic health problems worse. If you have nerve damage in the arms or legs (neuropathy), eye disease, high blood pressure, or liver disease, drinking any amount of alcohol can make these problems worse. Drinking heavily over time can cause nerve damage.

People with diabetes are at risk for high blood pressure. Drinking too much alcohol increases blood pressure. High blood pressure can worsen diabetic complications, such as kidney failure, retinopathy, and heart disease.

Diabetics who have high levels of triglycerides in their blood should not drink alcohol. Drinking even small amounts of alcohol can cause the liver to make even more triglycerides if you already have high levels.

What are the guidelines for drinking alcohol if I have diabetes?

If you have trouble controlling your blood sugar level or you have complications from diabetes, you should never drink alcohol.

If you do drink alcohol, your blood sugar is in good control, and you do not have any complications, follow these tips:

• Never drink alcohol on an empty stomach. Always eat a meal or a snack that contains carbohydrate (starch, fruit, or milk) before or with your drink. If you are involved in a social physical activity, such as dancing, eating enough carbohydrate food is especially important because exercise also lowers the blood sugar level.
• The general guidelines for how much alcohol is safe to drink are the same as for people who don't have diabetes. Research shows that drinking alcohol in moderation has been associated with some health benefits. Drinking alcohol is a personal choice that should be based on your current health, other risk factors, and your healthcare provider's advice. One drink a day if you are a woman and 2 drinks a day if you are a man are considered to be moderate levels of drinking. One drink equals one 12-ounce beer, one 5-ounce glass of wine, or a shot of one and one half ounces of spirits.
• If you cook with alcohol, use regular drinking wine, not cooking wine. There is less sodium in the drinking wine. Cook the food slowly so that the alcohol has time to burn off.
• Always wear a diabetes alert bracelet or necklace because the signs and symptoms of low blood glucose and intoxication are similar. Make sure your companions know that you have diabetes and know that if you are acting drunk, you may actually be having a low blood sugar reaction that needs to be treated. Tell them how to help you when you are having low blood sugar.
• Monitor your blood sugar often. Keep a high-carbohydrate snack or glucose tablets on hand to treat low blood sugar.
• Combining alcohol with exercise can cause blood sugar to go dangerously low, even hours after the physical activity. It is better to quench your thirst with water rather than alcohol before, during, and after exercise.

How do I fit alcoholic beverages into my meal plan?

Drinking alcohol can make it harder to lose weight. On its own, alcohol is high in calories. Factor in the extra calories that you may get from eating snacks, meals, or mixers to avoid low blood sugar and you can easily go over your calorie limit for weight loss. Either avoid alcohol altogether or use the following tips to fit the added calories better into your meal plan.

• If you do not take insulin, the calories from alcohol can be substituted for some of the fat portions in your diabetic meal plan. (Most meal plans allow for 3 to 6 fat portions per day.) Your body breaks down alcohol in a way similar to how it breaks down fat. Each drink is equal to 2 fat portions, or about 100 calories.
• If you take insulin, you can occasionally add up to 1 or 2 drinks to your daily meal plan. No food should be omitted from your usual eating plan because of the greater risk for hypoglycemia with insulin use.
• Make your drink last longer by combining wine with no-calorie mixers such as club soda, sparkling water, or diet soda for a spritzer. Try to drink slowly.
• As a rule, choose alcoholic beverages and mixers that are lower in alcohol, carbohydrates (sugars), and calories. Examples are dry or light wines; light beers; and sugar-free mixers such as diet soda, water, seltzer, club soda, and low-salt vegetable juice. Avoid sweet wines, wine coolers, and sweet liqueurs, such as Irish Cream. They are high in calories, sugar, and carbohydrate.
• A good alternative is to drink nonalcoholic beer or wine. Check labels. Count every 15 grams of total carbohydrate in a beverage as 1 carbohydrate choice in your food plan.

Listed below are the calories, carbs, and meal plan equivalents for different alcoholic drinks.

 
Serving            Calories       Carbohydrates       Meal Plan
                                      (grams)         Equivalent
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Distilled spirits (vodka, whiskey, rum, etc.) 
 1.5 ounce (oz)    105             negligible           2 fats

Wine - Dry White or Red 
 4 ounces           80 to 90       0.5 to 1 g           2 fats 

Light Wine 
 4 ounces           50 to 60       1.5 g                1 fat

Sweet Wine 
 2 ounces           90             7 g                  0.5 carb choices
                                                        1.5 fats

Wine Coolers 
12 ounces          190            23 g                  1.5 carb choices 
                                                        3 fats

Beer, Regular 
12 ounces          150            15 g                  1 carb choice
                                                        1.5 fats

Beer, Light 
12 ounces           70 to 100      3 to 7 g             1 to 2 fats

Nonalcoholic Beer 
12 ounces           50            15 g                  1 carb choice
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For more information, visit the American Diabetes Association Web site at http://www.diabetes.org or call 800-342-2383.