People with diabetes should be extra cautious when it comes to alcohol consumption. It can suddenly trigger both high and low blood sugar fluctuations, but hypoglycemic episodes could have more serious health consequences. Experts point out that alcohol ends up disrupting the liver’s ability to break down glucose as it prioritises the metabolisation of alcohol. This leads to a sudden blood sugar dip after consuming alcohol in people with diabetes.
Dr Subrata Das, senior consultant, internal medicine and diabetology, Sakra World Hospital, Bengaluru, says that alcohol can significantly impact the blood sugar levels in people with diabetes. Depending on the alcohol content and the person’s response, it can lead to hypoglycemia (low blood sugar) or hyperglycemia (high blood sugar).
“Some people who consume alcohol skip their diabetes medication,” continues Dr Das. It may alter the effects or reduce the efficacy of the medicine, leading to uncontrolled sugar levels. In extreme cases of high blood sugar, diabetic ketoacidosis (DKA) can occur, causing an excess of acids in the body.
According to a study published in Alcohol Health and Research World, prolonged alcohol consumption in people with diabetes following a consistently healthy diet may lead to high blood sugar levels. However, in those who don’t consume a healthy and balanced diet, drinking may lead to hypoglycemia. Also, alcohol consumption can worsen diabetes-related medical complications, such as disturbances in fat metabolism, nerve damage and eye disease.
1. Control your quantity
While it is generally advised not to start drinking, those already consuming alcohol should limit their intake, says Dr Das. For example, one to two pegs of whiskey or up to two beers per week is considered a moderate amount for someone who doesn’t have any liver complications, adds Dr Das. The idea is to restrict drinks like beer that are high in calories, according to experts.
2. Don’t drink on an empty stomach
“People with diabetes should avoid drinking alcohol on an empty stomach”, emphasises Dr Das. Alcohol consumption without food can lead to controlled blood sugar levels, hypoglycemia and even pancreatitis. Calorie-rich alcohol such as beer which has a high glycemic index may raise sugar levels. However, other alcoholic beverages cause hypoglycemia.
Dr Eileen Canday, head of the nutrition and dietetics department, Sir HN Reliance Foundation Hospital, Mumbai, suggests consuming alcohol with a meal or a carbohydrate-rich snack such as toast or oats to maintain blood sugar levels.
3. Drink water and stay hydrated
Drinking alcohol causes dehydration that increases the risk of diabetic ketoacidosis, informs Dr Das. He advises having at least two to three litres of water daily to stay properly hydrated.
4. Avoid carbonated sugary drinks to dilute alcohol
If you consume liquor, you could mix it with water or calorie-free mixers like club soda, diet tonic water or diet soda. Dr Canday also recommends carrying a source of sugar, such as glucose tablets, in case of hypoglycemia.
Dr Das suggests that while mixing drinks, people should avoid using sugary beverages like cola.
5. Check your blood glucose level
Dr Das recommends that people with diabetes should monitor their blood sugar levels after consuming alcohol, especially before going to bed.
He adds, as the risk of hypoglycemia increases about four or five hours after drinking, checking your sugar level can help identify any fluctuations and allows for timely intervention to prevent serious complications. If the sugar levels are lower than the recommended limit, one should have a snack before sleeping.
6. Inform your drinking partners that you have diabetes
If someone with diabetes is planning to drink socially, it’s important to inform those around them about their condition, highlights Dr Das. He explains this will allow others to take appropriate action in an emergency, such as severe abdominal pain or vomiting, which can be a sign of diabetic ketoacidosis or pancreatitis. Check the blood sugar level, if it goes below 70 mg/dl, consume glucose tablets or some sugar candy.
Dr Canday suggests carrying a visible medical ID stating that you have diabetes. This is important because the symptoms of excess alcohol and low blood sugar are similar. He adds that people with diabetes should also avoid drinking alone.
7. Arrange for a designated driver
If you are consuming alcohol outside your home, Dr Das strongly advises against driving under the influence of alcohol, no matter how little has been consumed. He says, “Alcohol’s effects can peak hours later, making it unsafe to drive even if someone feels okay”. Always opt for a sober driver or alternative transportation, he recommends.
