Diabetes and Alcohol

When most of us think of alcohol, we think of calories and carbohydrates. It’s easy to assume that drinking alcohol increases blood glucose levels. You might think this because:

• There’s carbohydrates in the alcoholic drinks
• We often eat foods that are high in carbohydrates and calories when we drink alcohol
• Alcohol can stimulate our appetite, and cause us to overeat

But it's also important to be aware that alcohol can cause delayed hypos.

Hypoglycaemia is when a blood glucose level is below 4.0 mmol/L. People with diabetes are at risk of hypos when they inject insulin or take a class of medication called sulphonylureas. Talk to your doctor or diabetes educator to check your risk.

Drinking excess amounts of alcohol can cause delayed hypos in people with diabetes who are at risk of hypoglycaemia.

Why do hypos occur when we drink alcohol?

Alcohol is toxic, so the liver tries to clear it out of our blood stream as soon as it can. While our liver is busy getting rid of the alcohol, it’s unable to do one of its other functions. This important function is to release glucose back into the blood when blood glucose levels start to drop.

Another point is that many of us are more active while we’re drinking. Activities such as dancing, playing sport or having sex increase the hypo risk if you haven’t adjusted your management.

Alcohol can also stop you from recognising hypo symptoms, and make it more difficult to treat.

How can we prevent delayed hypos when drinking alcohol?

Check your BGLs before, during and after alcohol. This can help detect blood glucose levels that are reducing or if you’re hypo. You can then plan for the next time you drink.

Always carry hypo treatment with you.

Make sure someone knows you have diabetes and can treat your hypo if needed.

If you’re likely to exercise when you’re out drinking, you may need to take less insulin before you go out and before you go to bed. You may also need a carbohydrate snack.

If you take sulphonylurea medication, you may be able to reduce your dose or have more carbohydrates. Talk to your diabetes team for specific advice.

Carry identification in case you need emergency help. A hypo can sometimes be mistaken for drunkenness when you’ve been drinking.

When should you drink less or have no alcohol?

You may need to consider consuming less alcohol than outlined in the Australian guidelines. This could be due to your age, medication or if you’re trying to lose weight.
Your doctor might also advise you to drink less alcohol or avoid alcohol if:

• You’re overweight
• Have high blood pressure
• Have high triglyceride (type of blood fat) levels
• Have diabetes complications
• Have liver disease

The Australian alcohol guidelines are currently being reviewed and a revised draft should be ready within the next few months. There could be some changes, including changes to the ‘safe drinking limits’ for beverages such as red wine.

For more information:

Read the NDSS Fact Sheet on Alcohol, or call the NDSS to talk to an accredited practising dietitian or diabetes nurse educator.

Getting help

If alcohol is affecting your health, family, relationships, work or school life, financial or other life situations, you can find help and support at the Alcohol and Drug Foundation website here.