Diabetics often ask whether drinking alcohol is safe, given their condition. Many believe that alcohol consumption causes hyperglycemia (high blood glucose), because beer, wine, and liquor are high in carbohydrates. However, a 12-oz. can of regular beer only has 13 g of carbohydrates, while wine and liquor are generally under 5 g of carbohydrates per glass. With the approval of a doctor and dietitian, diabetics may drink in moderation if they have normal blood glucose levels.
Effects
When you drink alcohol, the alcohol moves into your bloodstream without being metabolized in your stomach. Although alcohol takes less than five minutes to get into the bloodstream, it takes two hours to metabolize one drink in your liver. Diabetes medications such as insulin, sulfonylurea (glipizide, glyburide) or meglitinide (Prandin) stimulate the pancreas to produce more insulin. Consuming alcohol can cause dangerously low blood glucose (hypoglycemia) because your liver is working to remove the alcohol from the blood instead of regulating blood glucose. Alcohol can cause hypoglycemia from minutes after the first drink up until twelve hours after drinking.
Guidelines
If you choose to drink alcohol, limit the amount, and have it with food. Talk with your health care team about whether alcohol is safe for you. If you drink alcohol several times a week, make sure your doctor knows this before she prescribes a diabetes pill.
The American Diabetes Association recommends that you check your blood glucose before you drink and that you eat either before or while you drink. Also, you should also check your blood glucose before you go to bed to make sure it is at a safe level (between 100 and 140 mg/dL). If your blood glucose is low, eat something to raise it.
One drink is defined as a 12-oz. beer, 5-oz. glass of wine or 1 ½ oz. of distilled spirits (vodka, whiskey, gin, rum, etc.). Women should drink one or fewer alcoholic beverages a day. Men should drink two or fewer alcoholic drinks a day.
Tips
The American Diabetes Association suggests the following tips: check your blood glucose to help you decide if you should drink alcohol, and only drink if your blood glucose is under control. Never remove food from your regular meal plan, and try to have a snack or meal while you are drinking, such as pretzels, popcorn, crackers, fat-free or baked chips, raw vegetables or a low-fat yogurt. Sip on your drink slowly to make it last and allow your liver to metabolize the alcohol. If drinking wine, try wine spritzers to decrease the amount of wine you drink. When mixing drinks, use diet soda or diet tonic water, club soda or water. Always have a no-calorie drink with you to avoid dehydration.
Nutrient Content of Alcohol
A 12-oz. can of regular beer contains 153 calories and 13 g of carbohydrates, while a 12-oz. can of light beer contains only 103 calories and 6 g of carbohydrates. A 5-oz. glass of red or white wine contains 125 calories and only 4 g of carbohydrates. In a 1.5 oz. shot of 80 proof liquor (vodka, whiskey, gin, rum) there are 97 calories and 0 g of carbohydrates. The majority of the calories in these beverages come from the alcohol, which contains 7 calories per gram of alcohol.
Warnings
Drinking too much alcohol and having hypoglycemia are very similar symptomatically, evidencing sleepiness, dizziness and disorientation. You never want anyone to confuse hypoglycemia for drunkenness, because he might not give you the proper assistance. The best way to get the help you need if you are hypoglycemic is to wear an I.D. that states, "I have diabetes." Another problem with alcohol is that it may cause your eating habits to change and can affect your diabetic diet. To avoid this, have a friend with you to help you obtain a meal, or bring food with you. Do not drive or plan to drive for several hours after you drink alcohol.
References
- American Diabetes Association: Alcohol
- Mayo Clinic: Alcohol and Diabetes
- "Understanding Nutrition"; Ellie Whitney; 2005
