Alcohol and Diabetes

Glasses of alcohol next to image of someone with diabetes

Diabetes is caused by an insufficient level of a hormone called insulin. Insulin helps every cell in your body obtain energy in the form of glucose. Without insulin, glucose accumulates in the blood and cannot get into cells. If hyperglycemia is not treated, it can cause organ damage and even death. While the occasional drink with dinner is generally harmless for a diabetic, excessive alcohol consumption can be dangerous.

Before we can understand how alcohol affects diabetes, we need to know what diabetes is and how it affects the body.

Every cell in your body needs energy in order to function properly. The most efficient form of energy is a sugar called glucose, which comes from the metabolic breakdown of carbohydrates in your diet. For about 4 hours after you eat, glucose circulates in your bloodstream, where cells have access to it, before being stored in the liver for future use. In order for cells to be able to take up glucose, they need something that can help them transport the glucose out of the blood. This help comes in the form of a hormone called insulin. When insulin is not present, cells cannot take up glucose.

Consequently, glucose levels build up in your blood (“hyperglycemia”), causing damage to your cardiovascular system and preventing cells from being able to function normally. Diabetes is characterized by a failure of insulin-assisted transportation of glucose cells and, without medical intervention, can be fatal.

There are two types of diabetes:

  • Type 1 diabetes is an immune disorder that is characterized by a total loss of insulin-producing cells. Type 1 diabetes is typically diagnosed in childhood and management requires careful monitoring of blood glucose levels and daily insulin injections. Type 1 diabetes makes up 5-10% of diabetes cases and, although the cause is unknown, genetics likely contribute.
  • Type 2 diabetes is generally a consequence of lifestyle habits (poor diet and lack of exercise are major contributors) and is characterized by insufficient insulin production or cells that become resistant to insulin. Type 2 diabetes is usually diagnosed in adulthood makes up 90% to 95% of diabetes cases.

Can Diabetics Drink Alcohol?

The National Institute of Diabetes and Digestive and Kidney Diseases recommends that women with diabetes have no more than one alcoholic drink per day, and men have no more than two drinks per day. Alcohol increases the risk of low blood sugar (“hypoglycemia”). Hypoglycemia and alcohol intoxication have similar symptoms (dizziness, confusion, trembling), and intoxicated diabetics may attribute symptoms of dangerously low blood sugar to alcohol. This is called hypoglycemic unawareness and can be dangerous, even fatal.

Different types of alcohol will affect blood sugar differently (for example, beer and sugary cocktails are carb-heavy so temporarily increase blood glucose), but all types of alcohol lead to potentially dangerous drops in blood pressure. In order to prevent alcohol-induced hypoglycemia, it is important that diabetics eat food whenever they drink.

Type 1 Diabetes and Alcohol

Type 1 diabetics are particularly sensitive to alcohol because they are unable to make insulin.

  • Effects: Alcohol causes a rapid drop in blood sugar. Because type 1 diabetics cannot produce insulin, they rely on insulin that they’ve administered themselves. Determining the correct insulin dose to account for alcohol consumption is challenging.
  • Risks: Unless they carefully monitor their insulin levels, type 1 diabetics risk hypoglycemic unawareness and potentially fatal hypoglycemic shock when they drink alcohol. Going to sleep while drunk is very dangerous for type 1 diabetics.

Type 2 Diabetes and Alcohol

Type 2 diabetes is less sensitive to alcohol-induced hypoglycemia than type 1.

  • Effects: Alcohol reduces levels of blood sugar, but because type 2 diabetics produce some insulin, their cells have less risk of being completely unable to access glucose compared to someone with type 1 diabetes.
  • Risks: As with type 1, type 2 diabetics could have hypoglycemic unawareness when they drink alcohol. Fatalities are less common than in type 1.

Both types of diabetes are associated with similar risk for other alcohol-related problems, including:

  • Peripheral neuropathy (PN): PN, especially in the feet and legs, is one of the most common complications of diabetes and can be very painful. PN has been shown to occur more quickly and be more severe in diabetics who regularly drink alcohol, even in moderate amounts.
  • Retinopathy: Retinopathy is often called “diabetic eye disease” because it is so common in people with diabetes. Frequent alcohol consumption has been linked to more rapid development of retinopathy.

Can Alcohol Cause Diabetes?

Although alcohol cannot directly cause type 2 diabetes, it can increase the risk of developing it:

If you or a loved one is struggling with alcohol use, contact Orlando Recovery Center to speak with a representative about how professional addiction treatment can help. Take the first step toward a healthier future, call today.


National Institute of Diabetes and Digestive and Kidney Diseases. “What is Diabetes?” December 2016. Accessed August 8, 2019.

Kim, Soo-Jeong; Kim, Dai-Jin. “Alcoholism and Diabetes Mellitus.” Diabetes & Metabolism Journal, April 2012. Accessed August 24, 2019.

Emanuele, Nicholas; Swade, Terrence; Emanuele, Mary Ann. “Consequences of Alcohol Use in Diabetics.” Alcohol Health and Research World, 1998. Accessed August 8, 2019.

National Institute of Diabetes and Digestive and Kidney Diseases. “Diabetes Diet, Eating, & Physical Activity.” December 2016. Accessed August 24, 2019.

Martín-Timón, Iciar; del Cañizo-Gómez, Francisco. “Mechanisms of hypoglycemia unawareness and implications in diabetic patients.” World Journal of Diabetes, July 2015. Accessed August 8, 2019.

Lindtner, Claudia et al. “Binge drinking induces whole-body insulin resistance by impairing hypothalamic insulin action.” Science Translational Medicine, 2013. Accessed August 24, 2019.

Schrieks, Ilse C; Heil, Annelijn L; Hendriks, Henk F; Mukamal, Kenneth J; Beulens, Joline W. “The effect of alcohol consumption on insulin sensitivity and glycemic status: a systematic review and meta-analysis of intervention studies.” Diabetes Care, April 2015. Accessed August 24, 2019.

Twig, Gilad; Afek, Arnon; Derazne, Estela; Tzur, Dorit; Cukierman-Yaffe, Tali ; Gerstein, Hertzel C; Tirosh, Amir. “Diabetes Risk Among Overweight and Obese Metabolically Healthy Young Adults.” Diabetes Care, November, 2014. Accessed August 24, 2019. “The Connection Between Diabetes and Your Pancreas.” June 2017. Accessed August 24, 2019.</p>

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