Approximately two-thirds of the adult population in the United States consume alcohol, according to the National Institute on Alcohol Abuse and Alcoholism. Among patients with diabetes mellitus, alcohol consumption can affect blood sugar levels and complicate short- and long-term glucose management. For diabetic patients who choose to drink alcohol, adhering to recommendations provided by their health care team helps decrease the risk for adverse effects on blood sugar control.
Acute Hyperglycemia
Pure alcohol has no sugar content. Many alcoholic beverages, however, contain sugar. Wine coolers, port wines, frozen fruit cocktails, liqueurs and various sweet mixers typically contain high concentrations of sugar or glucose. Because of their impaired ability to tolerate glucose, diabetic patients who consume carbohydrate-rich alcoholic beverages often experience a short-term increase in their blood sugar levels, or hyperglycemia, reports Ohio State University Medical Center.
Hypoglycemic Reaction
Diabetics who drink alcohol without eating may experience low blood sugar or hypoglycemia. As the blood sugar level decreases, the liver normally responds by manufacturing glucose to prevent a critical deficiency. The metabolism of alcohol, however, interferes with this process. As the liver detoxifies alcohol, the chemical byproduct NADH accumulates in the liver. The excess NADH blocks liver production of glucose, potentially leading to hypoglycemia. Importantly, a hypoglycemic reaction can occur with moderate alcohol consumption, notes the medical reference text "Harrison's Principles of Internal Medicine."
Symptoms
A temporary increase in the blood sugar level in response to carbohydrate-rich alcohol consumption generally causes no symptoms. A hypoglycemic reaction to alcohol, however, often causes dramatic symptoms, including headache, weakness, irritability, clumsiness, trembling, confusion, sweating, moodiness and drowsiness. Given that some of the symptoms of hypoglycemia mimic those of alcohol intoxication, a delay in recognizing a low blood sugar may occur, points out New York-Presbyterian Hospital. This delay may prove dangerous; seizures and coma may occur with untreated hypoglycemia.
Long-Term Control
Overweight and obesity prove important contributing factors to the development and persistence of Type 2 diabetes. Alcohol consumption, which adds to caloric intake, may interfere with weight management goals, reports the Joslin Diabetes Center. Type 2 diabetics with chronic weight management difficulties may experience greater challenges in long-term blood sugar control.
Considerations
The American Diabetes Association recommends that diabetic women consume no more than one alcoholic beverage per day, and men consume no more than two alcoholic drinks daily. Drinking an alcoholic beverage with a meal or snack helps decrease the risk for a hypoglycemic reaction. Opting for sugar-free mixers and distilled spirits, such as whiskey, gin, rum, tequila and vodka, helps minimize the amount of carbohydrates consumed, potentially avoiding an elevation in blood sugar level.
References
- National Institute on Alcohol Abuse and Alcoholism: State of the Science Report on the Effects of Moderate Drinking
- American Diabetes Association: Alcohol
- Ohio State University Medical Center: Alcohol and Diabetes
- "Harrison's Principles of Internal Medicine, 16th Edition"; Dennis L. Kasper, M.D., et al., Editors; 2004
- New York-Presbyterian Hospital: Diabetes and Alcohol Use
