Diabetes and Alcohol

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What is this information about?

This information is about drinking alcohol when you have diabetes.  

It includes safe drinking advice and a guide to show you how much alcohol and energy are in standard alcoholic drinks.

Why have I been given this information?

If you have diabetes, you are at greater risk of harm when drinking alcohol than someone who does not have diabetes.  

Alcohol lowers blood sugar which may put you at greater risk of hypoglycaemia. This is because alcohol stops your liver from being able to correct your blood sugar levels, if they start to fall.  

Drinking alcohol regularly raises your blood pressure, triglycerides and cholesterol. This increases your risk of heart disease and heart attacks, stroke, pancreatitis and liver disease. 

Alcohol is also high in energy which can affect your weight. This could be a problem if you are overweight or trying to lose weight.

Who is most at risk?

If you take insulin or sulphonylureas (Gliclazide, Glipizide, Glimepiride, tolbutamide) you are at increased risk of having a hypo when drinking alcohol and should take extra care to follow the advice in this leaflet.

Do I need to take extra insulin if I drink alcohol, and I am carbohydrate counting?

No. Some alcoholic drinks contain carbohydrates. However, you do not need to give yourself extra insulin to manage these because the overall effect of the alcohol will lower your blood sugar levels. Extra insulin would increase the risk of having a hypo.

How much alcohol can I drink safely?

The recommendation for people living with diabetes is the same as the general population, for both men and women:

• Drink no more than 14 units per week. 
• Spread alcohol intake evenly over three or more days. 
• Have several alcohol-free days per week.

What things can I do to stay safe while drinking alcohol?

Stick to the recommended safe drinking amounts

• Be mindful of home measures. These are often larger than those served in a pub, bar or restaurant.

Never drink alcohol on an empty stomach

• When you drink alcohol, you are at higher risk of having a hypo. It is important to eat starchy food before drinking to maintain blood sugar levels.  
• Alcohol also causes irritation to the stomach lining. Drinking on an empty stomach can increase your risk of being sick. This can interfere with your diabetes medications and affect blood sugar (glucose) levels. 
• Alcohol enters the body quickly if there is no food to slow it down. This affects the areas of your brain involved in decision making and judgment. This could reduce your ability to act sensibly. Take precautions and prevent risk.

Check Labels

• The alcohol content of spirits, lager and wine can vary. Choose low strength where possible. 
• Avoid sweet wine, sherries, ciders, and liqueurs. These all have higher sugar content. 
• Avoid high sugar mixers (fruit and vegetable juices, sodas, and cordials). 
• Pre-mixed spirits and cocktails (ready-to-drink) are often high in sugar and have little nutritional information in their packaging. Choose sugar-free, diet or slim-line varieties or avoid if in doubt. 
• The sugar content of alcohol-free drinks varies from very low to very high. Always check the label.

What should I do if I drink, or think I am going to drink, more than is recommended?

If you are taking insulin or sulphonureas (Gliclazide, Glipizide, Glimepiride, tolbutamide), your risk of hypos is increased. This effect can last well into the next day. Please follow the guidance below.

• Snack on starchy foods while drinking and eat a starchy snack before bed.
• Try to eat something starchy when you first wake up, for example, toast or cereal. 
• Keep hydrated by drinking water or low sugar soft drinks between alcoholic drinks and before bed. Consider adding ice to drinks or adding diet soda or soda water to wine or lager. 
• Be aware that heavy drinking can raise blood pressure. This could lead to worsening of diabetes-related complications. 
• It can be difficult to tell the difference between a hypo and the effects of alcohol. Other people may not notice either. Always carry ID and let other people know that you have diabetes. Wear a medical tag if you have one.  
• If you wear a blood glucose sensor, make sure you have the alarm set and give yourself enough time to be able to find appropriate food or drink items. If you are in a loud environment, set your alarm to sound and vibrate and check it regularly. Do not turn off your alarm if it wakes you and make sure you have something sugary close to your bed in case you need it. 
• Never drink and drive.

Guide to alcohol units

Who can I contact for further information and advice?