Alcohol And Diabetes: Full Guide From Someone Who Actually Drinks!

Some of the most common questions I see online include: 

• “Can I drink with type 1 diabetes?”
• “Is it safe to drink with diabetes?”
• “How do I adjust insulin when drinking alcohol?”

The short answer to the first two is a resounding yes! And the third is slightly more complicated. But it is possible to tweak what alcohol you drink to help make it less confusing.

Put it this way ...some diabetics choose not to drink, and others do. 

Both choices are absolutely fine! 

If you’re newly diagnosed with diabetes and are frightened with how alcohol will impact your blood sugars, then don’t fear! 

I’m going to take you through everything I know about drinking with diabetes and take you through what drinks are best for diabetics. 

As well as how to handle hypos and alcohol, and much more. 

Along the way I hope to quash many of the myths and misconceptions I’ve come across over the years.

**Full disclosure: I am NOT a medical professional. Before making any adjustments to your diabetic regime, you should consult your doctor.**

A little background on my history with Alcohol and type 1 diabetes

I thought I’d begin by telling you my personal experience of drinking with diabetes. 

I was diagnosed with type 1 diabetes when I was 16, and I’d tried alcohol a couple of months before my diagnosis (yes, underage, sorry mother!). But I knew that when I was diagnosed, I eventually wanted to be able to drink alcohol with diabetes. 

Without sounding like I drink a lot, but I’ve had experience with all sorts of drinking scenarios and diabetes.

I went to university for 4 years, so I had my fair share of drunken nights, I’ve been on “wild” holidays, and I’ve been travelling around the world with diabetes, sampling all kinds of local alcohols and whatnot. 

I do NOT encourage binge drinking or over-drinking, but I don’t think you should be afraid of drinking with diabetes. And if you do want to enjoy a glass of champagne to celebrate an occasion, or enjoy a cocktail on holiday, then you absolutely can do so without putting your diabetes at risk.

Dangers of drinking alcohol with diabetes

Okay, so let’s start with the negatives: the dangers of excessive alcohol and diabetes. 

Let me begin by stating that excessive drinking for any individual isn’t a great choice, but for diabetics, there are additional risks. 

There are situations that you may find yourself getting excessively drunk, and rather than judge you, I’d rather just give you some tips on how to deal with that below. 

Remember there are recommended daily allowances for the consumption of alcohol for both men and women. In the UK this is 1-2 units a day which looks something like this: 

One unit (approximate measure) :

• 1/2 pint of standard strength beer, lager, or cider
• 1 pub shot/optic/measure (50ml) of sherry or vermouth
• 1 pub shot/optic/measure of spirit (25 ml), eg gin, vodka, or whisky.

There are some important things to note when drinking alcohol with diabetes. 

Alcohol LOWERS your blood sugars.

This means that the more you drink, the more it will increase your risk of having a hypo. 

Alcohol also stays in your system for quite a while and can put you at risk of hypos for up to 24 hours after you’ve been drinking.

I’ve experienced this a few times. 

I could go to bed on a 13-14 (UK measurement) and wake up in hypo, without having taken any insulin, this is due to the effects of the alcohol. 

Different alcohols will have a different impact on your body

All alcohols have varying quantities of sugar in them.

If you’re drinking straight-up spirits (vodka, rum, gin), these are carb-free, which means there is none (or very little) sugar in them. 

So, if you are drinking these with a diet mixer, then there is no sugar intake to balance out the blood sugar, which is why some people choose to drink them with a sugar mixer.

However, if you drink sugary cocktails or cider, these will have quite a high sugar content, so will send your blood sugars running high, and you’ll probably need some form of insulin to counteract that. 

Sugar COULD become less effective

Another risk to be aware of with drinking alcohol and diabetes is the fact that if you do slip into a bad hypo (coma), then the Glucagon injection will be less effective because of the alcohol you’ve taken. 

So by all means, it’s much better that if you choose to drink with diabetes, you stay aware of what you’re drinking and what you’re doing. 

An extreme hypo can look a lot like being drunk. 

You’ve got unsteady movements, slurred speech, drowsiness, and aggressiveness, these are all possible symptoms of a hypo and excessive alcohol consumption. 

Excessive consumption can lead to greater risk of health complications

There are general risks associated with the consumption of alcohol over a long period of time, such as the usual liver and heart disease. 

But there are extra risks to both type 1 and type 2  diabetes when drinking alcohol.

Of course, if you stick to the daily recommended allowance, and you’re not binge drinking, or you’re only drinking on occasion, then it’s highly unlikely you’ll experience these.

But it’s important to be aware of them:

• Neuropathy – worsened nerve problems
• Increased triglycerides – fatty acids that put you at risk for stroke
• Increased blood pressure
• Retinopathy or damage to the eyes
• Liver damage or cirrhosis

Alcohol and other meds don’t mix

It’s also important to remember that if you choose to drink with diabetes, you need to be aware of any other medications you are on that could mix badly. 

This is especially true for type 2 diabetics who may be on a number of medications to help keep their diabetes under control AND you often find that those with type 2 diabetes have additional complications, which could be impacted by alcohol consumption. 

It would be wise to speak with your doctor first! 

10 Tips for drinking alcohol with diabetes

Okay, so I’m going to give you an array of tips for drinking with diabetes based on what I’ve learned over the years. 

1. Spirit-based alcohols can be best

My favourite drink is Vodka and Pepsi Max, I like the taste and it’s carb-free, which means I don’t need any insulin to drink it, which makes my life a little easier. 

So, if you decide to drink a spirit with a sugar mixer, then you do NOT need to give yourself insulin for it. 

If you are drinking these whilst on a night out and dancing, then you might find your blood sugar will drop, so in this instance, it’s best to balance it by using a sugar mixer, so switching Pepsi max for Pepsi full sugar. 

2. Be careful with sugary alcohol

When drinking wine, prosecco, or champagne with diabetes then you need to pay more attention to your levels.

Wine has carbs in it, although you can get lower alcoholic wines, which have less, if you decide to drink wine, the insulin you’ll require will really depend on how much wine you’re planning to drink. 

For me, I find that one glass of wine won't affect my blood sugars, but if I drink a couple of glasses socially, then my blood sugars will start to rise. 

So I would give myself half the dose of insulin required, but I usually find I only drink wine when I’m eating a meal, so I included the carbohydrate count within the meal. 

Avoid drinks like cider.

Cider is a very high sugar content drink. 

You can get low-sugar ones, and I would recommend choosing that option to make your life easier, but if not, then you will find that cider drinks will raise your blood sugars. 

I would personally give half the amount of insulin for the carbs in the drink. 

It’s always important to remember that alcohol will lower your blood sugar eventually, so that’s why we don’t give a full amount. 

3. Be careful of external elements

If you’ve worked out how much insulin you need for the type of alcohol you're drinking, that’s not the only thing you need to consider. 

You need to take into account the situation around you. 

For example, if you are in a club, or at a concert, you’re probably going to be dancing which counts as exercise, which in turn will lower your blood sugar.

So if you know you’re going to be moving around, then make sure you’re taking enough sugar to stop yourself from going low from the exercise and the alcohol. 

Another example is if you’re in the heat.

It’s lovely lying in the sunshine whilst having a couple of drinks, but if it’s very warm and you’re sweating, then this too can lower your blood sugar levels, and mixing that with alcohol, could put you at risk of a hypo. 

I honestly find I’m drinking a couple of drinks in the sun, I can go low, so I usually have a snack too!

4. Use a CGM

Having a CGM (continuous glucose monitor), such as the Dexcom or Freestyle Libre, can be really useful for when you’re drinking alcohol with diabetes. 

This is because you can set alarms before you get low, and monitor your blood sugars more frequently with ease. 

If you have a FreeStyle Libre, then consider upgrading it with a MiaoMiao sensor which will give you alerts when going high or low.

The Freestyle Libre 2 now offers optional alarms.

5. Consider a temporary basal rate

If you’re on an insulin pump, it might be a good idea to take advantage of the temporary basal rate when you’re drinking alcohol with diabetes. 

You can reduce your current insulin rate for a period of time whilst you’ll be drinking. 

This is particularly useful if you are going to be sitting in the sunshine, or dancing! 

I’ve done this before and reduced it by around 20%, but remember the number will be different for everyone and if you’re wondering how to adjust your basal rate while drinking, then it’s a good idea to get in touch with your diabetic doctor for some official advice. 

6. Don’t drink on an empty stomach

Drinking on an empty stomach isn’t good for any individual, and as someone who is guilty of doing this in the past, I can tell you it just makes things worse for you. 

Drinking to blackout isn’t fun, and what’s the point in going out if you can’t remember it the next day? 

Drinking on an empty stomach will increase your risk of getting drunk and increase your risk of going into hypo. 

7. Eat after you’ve had a few drinks

I mentioned before that if I have one or 2 drinks, it doesn’t really impact my blood sugar in any form, but if I’ve been out with friends, or at a BBQ and had more than a couple of drinks, I always make sure to eat something before I go to sleep. 

This is all because of that risk of falling into hypo. 

If your blood sugars are “good” before you go to sleep, you absolutely make sure you eat carbs, or you will fall into hypo while sleeping! 

It’s a good excuse to drunk-eat some foods you don’t normally allow yourself! :P 

8. Carry a medical ID

It’s a good idea to have some form of medical ID on you if you’re drinking with diabetes. 

Even if you’re out with friends, there is always a chance you can be separated, so it’s important that if something happens, people know you’ve got type 1 diabetes. 

You can get nice diabetic ID bracelets or even a card in your purse or phone. 

Check out Laurens Hope for some awesome choice.

9. Have water between drinks

This is a great tip for both diabetics and non-diabetics. 

Drinking water in between drinks helps dilute the sugar in drinks, keep you hydrated (which can lead to higher blood sugars) and help you avoid a hangover! 

Hangovers are mainly caused by the dehydration caused by alcohol, so drinking water in between can help. 

I also recommend drinking plenty of water if flying with diabetes and having a few celebratory drinks. Flying dehydrates you even further, so be aware of this.

10. Keep a record

It’s a good idea to keep a record of how a certain type of alcohol has impacted your blood sugar after you’ve taken it. 

This means you’ll know for future reference and you’ll learn what alcohols you find it easier to manage your diabetes with. 

Best alcoholic drinks for diabetics

This list is simply based on my own experience, but to help make your life easier, I’ve created a little chart that explains the average carbs in most drinks and whether or not they require insulin. 

Spirits (vodka, gin, rum etc)

These typically have no carbs or very little carbs in them but remember they also have a high alcohol content, so you might find it affects you more, but impacts your blood sugarless. 

I generally think these are the easiest drinks to manage with diabetes IF you’re having them in moderation. 

Cocktails

Cocktails are generally full of sugar, but it really depends on the cocktail. 

So, if you’re drinking things like Sex on the beach, or a Pina Colada, then yes, it’s probably not great for your blood sugars and you may find it difficult to find a balance. 

But there are other cocktails that have less sugar, such as a Long Island Iced Tea (with diet coke, not coke), Cosmopolitans, Martinis, and cocktails that are basically just a couple of ingredients with not a lot of juices and other mixers involved. 

Beer and cider

Both beer and cider have sugar in them, and cider can have A LOT of sugar if you’re buying fruity flavoured cider drinks. 

I find these most difficult to calculate carbs with, so I personally try to avoid them, but of course, if you’re only having one, then you might not find it too difficult to manage. 

Especially if you’re eating food whilst drinking it. 

Wines, champagne, and prosecco

All these drinks come from the same family, a grape. They don’t tend to have a terrible impact on your blood sugars, and you should find it easier to manage them. 

Overall Verdict: should I drink alcohol with diabetes or not?

It’s your personal choice! 

Everything in life is okay in moderation, so if you choose to have a drink, that’s absolutely fine, just follow the advice above, and any advice from your doctor and you shouldn’t run into any major problems.

But, if you decide that you don’t want to have a drink, then that’s okay too! 

There are so many alcohol-free alternatives too nowadays, but if you do opt for them, remember there will be carbs in them too! 

Final thoughts

So there you have it, my guide to drinking alcohol and diabetes. 

I hope you’ve found this guide useful, and I’ve tried to be as honest as I can. 

I’m well aware that a lot of guides on diabetes and alcohol on the internet are censored, and not actually written by a diabetic who actually drinks alcohol! 

Lucky for you I’m Irish, so it’s basically a requirement.

Now over to you.

What is your experience with drinking alcohol with diabetes?

What is your biggest concern?

Drop a comment below.