Alcohol contains sugar. That’s why Éduc’alcool has published this scientific report on the relationship between alcohol and diabetes, a disease that affects a lot of people in Quebec.

In fact, Diabetes Québec estimates that some 900,000 Quebecers suffer from the disease, and about 250,000 of them are not even aware that they have it.

Alcohol and the risk of developing diabetes

Studies show that people who drink alcohol moderately and regularly have a lower risk of developing diabetes, while heavy drinking increases the risk significantly.

Alcohol affects various risk factors related to diabetes.

However, the relationship between drinking and these risk factors varies depending on how much and how frequently a person drinks.

Alcohol and Diabetes looks at the connections between drinking and the risk of developing diabetes, explaining how alcohol can act on various processes that regulate blood sugar. For example, heavy drinking can lead to acute or chronic inflammation of the pancreas, thereby reducing the organ’s capacity to produce insulin.

Generally speaking, the risk of diabetes varies according to drinking habits.

Among western populations, a reduced risk of developing diabetes is associated with regular, moderate drinking, which means about 2 standard drinks a day, 3-4 days a week. However, for women who have more than 3.7 drinks a day, and for men who have more than 4.5 drinks a day, the risk is notably higher than among people who have never drunk alcohol.

However, those amounts should not be seen as upper limits! That quantity of alcohol is associated with a notable increase in the risk of developing diseases other than diabetes, such as certain cancers et cardiovascular diseases.

Drinking when you are diabetic

When someone already has diabetes, heavy drinking can lead to other complications, such as an increased risk of hypoglycemia, as well as cardiovascular, kidney and vision problems.

For that reason, it is recommended that diabetics make sure they meet the following three criteria before drinking alcohol:

  1. Have their diabetes under control, i.e. able to maintain blood sugar at recommended levels;
  2. Have no health problems for which drinking would be contraindicated, such as pancreatic disease or uncontrolled hypertension;
  3. Know how to prevent and treat hypoglycemia (below-normal blood sugar).

Since alcohol can cause blood sugar to rise (hyperglycemia) and drop (hypoglycemia), it is important to monitor blood sugar levels regularly while drinking. It is also important to have handy the things normally used to prevent or treat hypoglycemia, such as sweet snacks or glucose tablets.

In type 1 diabetics, alcohol can cause a short-term drop in blood sugar, up to 24 hours after the last drink, which means it is important to drink while eating a meal containing carbohydrates. A snack may be necessary to prevent or treat hypoglycemia that might occur while drinking.

Similarly, people who take medication that can lead to hypoglycemia should always eat before or while drinking alcohol.

What’s more, both drinking (even moderate drinking) and hypoglycemia can impair cognitive function and reaction time. If both occur at once, the impact is even greater.

Therefore, anyone at risk of hypoglycemia (because they are taking insulin or certain oral medications) who chooses to drink must be aware:

  1. Of the danger of confusing a symptom of hypoglycemia with an effect of alcohol;
  2. That the harmful effects of hypoglycemia can be exacerbated by alcohol, impairing certain functions significantly, even if blood alcohol levels are below the legal limit for driving.

Warning: All alcoholic beverages are not created equal when it comes to carbohydrates

Short-term blood sugar levels can be affected differently, depending on the type of alcohol consumed. For example, a standard serving of regular beer contains three times more carbohydrates than red table wine, and six times more than white table wine. That means hyperglycemia could become a problem before hypoglycemia, and a diabetic must take care to correct the hyperglycemia, which is usually short-lived. It is generally recommended that people not consider the carbohydrates in alcohol when calculating their insulin dose.

While pure spirits have no carbohydrates, spirit-based cocktails may well be full of them because of added ingredients such as sugar, syrups, fruit, etc.

Alcohol also contains a significant number of calories. Given the importance of weight control in treating type 2 diabetes, the calorie content of alcoholic beverages is another factor to consider.

Thus, based on the scientific data available to date, it is better to drink only while eating a meal with enough carbohydrates in it, and to stick to the 2-3-4-0 low-risk drinking guidelines:

  • Women should limit their consumption to 2 standard drinks a day, and no more than 10 a week, while men should limit their consumption to 3 standard drinks a day, no more than 15 a week.
  • On special occasions, women can have 3 drinks and men, 4.
  • Everyone should plan at least one day a week with no alcohol to keep drinking from becoming a habit.

For more information, see Alcohol and Diabetes.