Eating with Diabetes: Alcoholic Beverages

Since you've been diagnosed with diabetes, you have hopefully started learning how various foods and beverages affect your blood sugar. But what about alcohol? How does it affect your blood sugar and how do you account for it when planning meals and celebrations?

First, remember this: Alcoholic beverages do affect your blood sugar. And beyond that, there are other considerations that a person with diabetes has to keep in mind when choosing whether or not—and how much—to drink. We recommend that you discuss your use of alcohol with your diabetes care team. After that, here are a few general recommendations.

Practice Moderation
It's true that diabetes puts you at a greater risk for heart disease, and that you should be taking proactive steps to protect your heart health. Though some published research has suggested that consuming alcohol may be good for your heart, the potential benefits are very small, and are certainly no reason to start drinking alcohol if it is not something you would normally do. Only drink alcohol when your diabetes is controlled (typically defined as an A1C level less than 7%).

Do NOT drink alcohol when you are pregnant or trying to become pregnant.

If you choose to drink alcohol, do so in moderation. Moderation is defined as no more than one drink per day for women or two drinks per day for men. One drink equals 1.5 oz of distilled spirits, 4 oz. dry wine, or 12 oz. beer.

Alcohol Guidelines for People with Diabetes
All foods and beverages affect your blood sugar differently, and alcohol is no exception—even though this particular beverage is classified as a drug. Alcohol is neither calorie-free nor carbohydrate-free, and it impacts your blood sugar and can also interact with the medications you take.

Several medications, including the diabetes drug Metformin, warn against alcohol consumption on their labels. Check your medicine cabinet and new prescriptions for these warnings. If you have questions about whether or not drinking alcohol is safe for you, talk to your doctor or pharmacist.

Alcohol can interfere with weight control. It's high in calories, second only to fat in calories per gram (fat has 9 calories per gram; alcohol has 7). If you drink alcoholic beverages regularly, they can contribute a lot of calories to your diet, which can slow or stop weight loss, and promote weight gain. To limit the effect of alcohol on your weight, drink alcohol in moderation (defined above) or only on occasion.

Alcohol can interfere with your blood glucose control, both raising and lowering blood sugar. Once in your system, alcohol initially lowers blood sugar, which can lead to hypoglycemia (low blood sugar). To minimize your chances of experiencing a hypoglycemic reaction caused by drinking alcohol keep these tips in mind.

  • If you take some certain oral diabetes medications or insulin, drinking alcoholic beverages can increase your risk for having a hypoglycemic reaction.
  • Alcohol consumption makes it harder to recognize symptoms of a low blood sugar reaction. Dizziness, confusion, and blurry vision are a few symptoms of low blood glucose that are also symptoms that you may have had too much to drink.
  • Don’t drink alcohol alone. It is best to drink with someone who is aware you have diabetes, and is able to recognize and treat hypoglycemia.
  • Do not substitute alcohol for food. Always drink alcoholic beverages with a meal or with snacks containing carbohydrates; never imbibe on an empty stomach.
Some alcoholic beverages can raise your blood sugar because of their high carbohydrate content. To prevent your blood sugar from going to high, avoid sweet wines, liqueurs, and sweetened drinks like daiquiris, margaritas, pina coladas, etc. and choose lower-carb drinks. Be sure to account for these carbohydrates when planning your meals and snacks.

Calories and Carbs in Alcoholic Beverages
Makers of alcoholic beverages are not required to post nutrition facts on their labels, so it can be difficult to know how many calories and carbs various drinks really contain. The following provides some general ranges.

Beverage Serving Size Calories Carbohydrates
Beer, regular 12 oz 150 13 g
Beer, light 12 oz 100 5 g
Beer, non-alcoholic 12 oz 75 16 g
Distilled spirits* 1.5 oz 100 trace
Martini 5 oz 310 4 g
Wine, red 4 oz 80 2 g
Wine, white 4 oz 80 1 g

*Does not include mixer

For anyone trying to eat healthier, manage their weight, or control their diabetes, the guidelines for drinking alcohol can be a confusing cocktail to swallow. Use your best judgment when it comes to drinking, and talk with your health care provider for more specific guidelines.

For more specific information or help, talk to your health care provider. The American Diabetes Association's National Call Center also offers live advice from 8:30 a.m. to 8 p.m. EST, Monday through Friday at 1-800-DIABETES or 1-800-342-2383.