What is the effect of alcohol on diabetes?

What is the impact of alcohol on diabetes?

Short-term risks 

Alcohol consumption in both type 1 and type 2 diabetes is associated with two main risks:

• Firstly, alcohol increases the risk of hypoglycemia because it has a powerful effect on blocking the production of sugar by the liver (gluconeogenesis). It is a profound inducer of hypoglycemia, especially in people on insulin or hypoglycemic sulphonamides.
  
• On the other hand, alcohol can raise blood sugar levels, and thus create hyperglycemia, if the drink consumed contains a lot of carbohydrates.
  

In addition, one should be careful, as hypoglycemia can occur up to 24 hours after drinking alcohol and glucagon will not correct alcohol-related hypoglycemia. It should also be noted that the symptoms of hypoglycemia may resemble the symptoms of drunkenness.

Long-term risks 

Since alcohol is very high in calories (about 7 calories per gram), when it reaches the liver via the bloodstream, it is transformed by various enzymes and metabolized into triglycerides. This means that it is converted into fat.

People who drink chronically therefore gradually put on weight. This weight gain is dangerous for diabetics. The fat that accumulates around the waist disrupts the metabolism and promotes insulin resistance. The consequences can be rather serious: in the long term, weight gain increases the risk of developing cardiovascular disease and kidney damage.

The risks related to alcohol consumption are different for people with type 1 and type 2 diabetes.

In type 1 diabetes, patients need daily injections of insulin because the cells in their pancreas no longer produce it. Thus, for this group of people, the major risk of excessive alcohol consumption is hypoglycemic collapse or even coma. It should be noted that tolerance to alcohol varies considerably from one person to another. It is therefore advisable to monitor blood sugar levels more often when drinking alcohol, and also in the hours that follow.

In type 2 diabetes, but also in the pre-diabetes stage, it is really the weight gain that is dangerous. Indeed, alcohol consumption goes against lifestyle recommendations for these patients: weight control, a healthy and balanced diet, regular physical activity, etc. If these measures are well respected, many patients can do without hypoglycemic treatments and avoid insulin injections.

Diabetes and alcohol: what are the recommendations?

The risks associated with alcohol consumption increase according to the quantity consumed. Therefore, to limit these risks, a few recommendations should be followed:

• Do not drink more than 10 glasses per week and no more than 2 glasses per day,
• It is essential not to drink every day and to let your body rest several days a week,
  
• It is better to choose strong alcohols with little or no sugar, such as cognac, gin, vodka or whisky. Be careful though, if spirits in their pure form do not contain carbohydrates, you should not forget that cocktails do, because of the added ingredients (sugar, syrup, juice, soda, etc.),
  
• Avoid beer (even without alcohol), liqueurs and cooked wines, which contain more sugar.
  

Here are the carbohydrate and calorie contents of some alcoholic beverages:

Source: myfitnesspal.com

In addition, to avoid hypoglycemia, it is recommended to:

• Drink slowly,
  
• Never drink without eating first, and always carry extra sugar with you,
  
• Inform those around you about the symptoms of hypoglycemia, as they may resemble those of drunkenness. Inform them about what they should do in case of a problem,
  
• Test blood sugar levels more often and remember to test just before going to bed,
  
• Have an extra snack at bedtime. This will help prevent potential hypoglycemia at night,
  
• Make sure you get up at the usual time the next day for breakfast,
  
• Finally, avoid alcohol before, during and after physical activity.

What are the contraindications regarding alcohol consumption for people with diabetes? 

For diabetic patients, it is strongly recommended to limit the intake of alcoholic beverages in case of :

• High blood pressure,
  
• Proven neuropathy,
  
• Difficulty in controlling blood sugar levels,
  
• High levels of triglycerides (molecules belonging to the lipid category),
  
• Liver problems.
  

Overall, and this is also true for the general population, you should always drink in moderation. Public health authorities recommend that the equivalent of 2 glasses of wine per day for women and 3 glasses of wine per day for men should not be exceeded.

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