Most people with diabetes can safely enjoy small amounts of alcohol, however depending on the amount consumed, alcohol consumption can lead to both high and low blood glucose levels (BGLs). It’s important to be aware of these risks and how to manage them, particularly if you take insulin or Sulphonylureas (e.g. Gliclazide, Glipizide).

Risks of Consuming Alcohol for People with Diabetes

Hypoglycaemia (hypo) After Drinking

Alcohol can interfere with the liver’s ability to release glucose, which is the body’s primary source of energy, potentially causing BGLs to drop too low. The liver, which usually maintains BGLs, will prioritise processing alcohol as a toxin, temporarily halting glucose release.

It takes about one hour for your liver to process one standard alcoholic drink – five drinks would take five hours!

The effects of alcohol on BGLs can be delayed, meaning a hypo can occur hours after drinking, even after you have gone to bed.

Eating food, especially carbohydrates (carbs) while drinking can slow down the rate alcohol is absorbed and help prevent drops in BGLs.

Masking Symptoms

Hypo symptoms (dizziness, confusion, slurred speech) can be similar to those of intoxication, making it harder to recognise and handle low BGLs.

Interactions with Medications

Alcohol can interfere with the effects of some diabetes medications, potentially leading to either low or high BGLs. 

Carbohydrates in Drinks

Many alcoholic beverages, especially those with sugary mixers, contain carbs that can raise BGLs. 

Recommendations

• Consult with your healthcare team. Discuss your alcohol consumption habits and any concerns with your Doctor, Diabetes Educator, or Registered Dietitian. 
• Don’t drink on an empty stomach. Always eat a meal or snack before and while drinking alcohol.
• Before bed. Have a snack with long acting carb, and/or consider reducing your basal insulin by 10-20% if you’ve consumed more alcohol than the daily recommendations.
• Monitor your BGLs. Check your BGLs before, during, and after drinking, and be aware of your low BGL symptoms.
• Carry a source of fast-acting carbohydrate. HYPO DUO Step 1 or other fast-acting carbohydrate options may be used if low blood glucose occurs.
• Choose low-sugar drinks. Opt for low-sugar or diet mixers when making mixed drinks. 
• Drink slowly. Pace yourself and avoid drinking too quickly. 
• Be aware of the effects of alcohol. Understand how alcohol can affect your BGLs and how to manage it. 
• Consider being the designated driver. If you’re going out with friends, consider being the designated driver to ensure everyone gets home safely.
• Be aware of your hypo symptoms (e.g. shakiness, sweating and confusion etc.), and know how to handle your hypo. 
• Drink in moderation. If you choose to drink alcohol, do so in moderation, following the guidelines below. 

Why Glucagon Might Not Work After Drinking Alcohol Consumption

If you’ve been drinking alcohol and experience a hypo, Glucagon injections might not work as well, or at all.

This is because alcohol affects your liver’s ability to release stored glucose into your bloodstream. Glucagon works by telling your liver to release that stored glucose, but if your liver is busy processing alcohol, it may not respond properly. As a result, your blood glucose may not rise as expected after using Glucagon.

Important Tip:

If you’re planning to drink alcohol, it’s important to eat food and monitor your blood glucose closely, especially before going to bed. Let someone know you have diabetes and carry hypo treatment with you. In case of a severe hypo, calling emergency services may be necessary.

Guidelines for Alcohol Consumption

The Australian guidelines for alcohol consumption is no more than two standard drinks per day and one standard drink for women, with both men and women having at least two alcohol-free days each week.

What is a standard drink?

A standard drink is a unit of measurement for alcohol consumption, always containing 10 grams of pure alcohol. 

Examples:

• Light beer (2.7% alc/vol) 425 mL
• Mid strength beer (3.5% alc/vol) 375 mL
• Full strength beer (4.9% alc/vol) 285 mL
• Regular cider (4.9% alc/vol) 285 mL 
• Sparkling wine (13% alc/vol) 100 mL
• Wine (13% alc/vol) 100 mL
• Fortified wine e.g. sherry, port (20% alc/vol) 60 mL
• Spirits e.g. vodka, gin, rum, whiskey (40% alc/vol) 30 mL