Alcohol and diabetes can be a tricky subject. Whether you have type 1 or type 2 diabetes, for some people, having a few drinks at home or in the pub is part of everyday life. And having diabetes shouldn’t get in the way of this unless this has been advised on medical grounds. 

But when you have diabetes, it’s a bit more complicated. You might want to know whether it's safe to drink alcohol with diabetes, and how much is OK.

So yes, you can still drink, 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, 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.

We’ll give you all the facts here.

Does alcohol cause diabetes?

There are several risk factors for type 2 diabetes, these include your family history, age and ethnic background. We also know you’re more likely to develop it if you’re overweight. 

Excess alcohol intake is associated with an increased risk of type 2 diabetes, but the relationship between alcohol and risk of type 2 diabetes can be a little bit complicated and staying within government guidelines is the safest way to drink alcohol. Alcohol can also contain a lot of calories, which can lead to putting on weight.

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.   

But what does this actually mean when you’re in the pub or having dinner with a glass of wine at home? It means you shouldn’t drink more than six medium glasses of wine or six pints of lager a week. 

But the size of the glass and type of alcohol affects the number of units, so it’s best to check the guidelines at Alcohol Change UK.

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.

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 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 get 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.

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 you can, including some sugary (non-diet) drinks if your blood sugar levels are low. 

If you’ve got a blood sugar meter at home, check your levels regularly the next day. 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 levels are. Talk to your healthcare team about what you should be doing.

Types of 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.
• 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

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 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.