Alcohol and diabetes

Most people enjoy drinking alcohol, whether it is a glass of wine with a meal, a celebratory glass of champagne or a pint with friends at the pub.

The good news is there is no need to give up alcohol just because you have diabetes. Guidelines are the same as those for the rest of the population –  a daily recommendation of two units for women and three units for men.

Over the years the alcohol content of most drinks has gone up.

A drink can now contain more units than you think – a pint of premium lager can contain as much as three units and a small glass of wine (175ml) around two units.

One unit is approximately:

  • 1/2 pint of ordinary strength beer, lager or cider
  • 1 pub measure (50ml) of sherry or vermouth
  • 1 pub measure of spirit (25 ml), eg gin, vodka or whisky.

To work out accurately the number of units in your drink the following equation can be applied:
(Note: ABV = alcohol by volume)
    ABV x volume = number of units
      1000
For example, by using the above equation we can calculate that a pint of lager (568 ml), which has the alcoholic strength of 5.2 % ABV, will contain three units.
    5.2 x 568 = 2.95 (ie 3 units).
      1000

Be aware

  •  Alcohol makes hypoglycaemia (low blood glucose levels) more likely to occur. However, as long as your diabetes is well controlled, moderate amounts of alcohol in line with the above daily guidelines can be drunk shortly before, during or soon after a meal without affecting short-term blood glucose control.
  • Never drink on an empty stomach as the alcohol will be absorbed too quickly into your bloodstream. If you are drinking throughout the evening snack on something starchy like breadsticks or crisps.
  • Do not substitute alcoholic drinks for your usual meal or snacks as this may lead to a hypo (hypoglycaemia).
  • Serious hypoglycaemia can occur with larger quantities of alcohol, particularly if you are treated with insulin and especially if too little carbohydrate is eaten. If this could apply to you, always make sure you take some carbohydrate before going to bed after drinking. Useful snacks include toast, cereal and sandwiches, although chips or pizza on the way home may be an easier, albeit unhealthier, option. 
  • The liver gets rid of alcohol at the rate of about 1 unit per hour but this can vary. If you drink more than a few units in the evening you will have an increased risk of hypos that may occur up to 16 hours after heavy drinking. It is vital you keep your blood glucose levels topped up with carbohydrate and always remember to eat something at breakfast time. Monitor your blood glucose levels closely. 
  • Remember that you, or those with you, may be less aware of your hypo symptoms when you are drinking so always wear some form of diabetes identification. A hypo can be confused with drunkenness when there is the smell of alcohol on your breath.
  • Continuous heavy drinking can lead to raised blood pressure so again try to limit your intake.
  • All types of alcoholic drinks contain calories so if you are watching your weight think about cutting back further.
  • If you have neuropathy (nerve damage), drinking alcohol can make it worse and increase the pain, tingling, numbness and other symptoms associated with nerve damage.
  • Drinking low carbohydrate beers and cider offer no benefit because of their higher alcohol content. 
  • Low alcohol drinks can be useful if you are driving, but few are alcohol-free, so remember if you drink enough of them you may still be over the limit.
  • Low alcohol wines are often higher in sugar than ordinary ones, so if you do choose these, just stick to a glass or two.
  • Drinks with a high sugar content, eg sweet sherries, sweet wines and most liqueurs should be limited.
  • Mixer drinks should be ‘diet’ or ‘sugar-free’ such as diet tonic water and diet cola. 
  • Moderate alcohol consumption, in line with recommended daily guidelines, can be beneficial for your heart. Wine, especially red wine, may offer greater benefit than spirits or beer. However, there is currently insufficient evidence to suggest that you take up drinking if you are currently ‘tee total’.
  •  Never drink and drive.