December 17, 2019 Diabetes and drinking

From Ontario’s “Buck-a-Beer” plan to B.C.’s recent move to allow the sale of wine in grocery stores, alcohol is becoming more available across Canada.

If you live with diabetes, you might think you should not or cannot drink—but as a general rule, you can. However, there are some things to keep in mind.

If you take insulin or certain oral medications that can cause hypoglycemia (low blood sugar), alcohol can increase your risk of having a low. “Alcohol can keep the liver busy breaking down the alcohol, and that prevents the liver from releasing blood sugar when it’s needed to prevent a low,” explains Erin Krusky, a registered dietitian and the manager of education and outreach at Diabetes Canada.

Alcohol can also have other effects on your blood sugar. “Some alcoholic drinks, such as wine coolers, liqueurs, or mixed drinks that contain regular pop or juice, may have added sugar. Beer can also contain some carbohydrates because it is made from barley and/or other grains,” says Krusky. This makes it even more important to monitor your blood sugar when drinking, and to have something on hand (such as glucose tablets or regular pop) to treat lows if they occur. It also helps to have alcohol with a meal or snack that includes a carbohydrate, and to alternate between water and alcohol to reduce your risk of becoming dehydrated (meaning the body has lost a large amount of water).

Another concern is that if you have been drinking—especially if you drink more than recommended limits—you may not think clearly, making you less likely to recognize and respond to a low, says Krusky.

Low blood sugar is not the only health concern when it comes to alcohol. “In all people, alcohol can increase blood pressure and certain cholesterol levels,” says Krusky.

“People with diabetes [already] have an increased risk of cardiovascular diseases like heart attacks and strokes. Drinking more than the recommended amount of alcohol can push that risk up even further.”

For women, the recommended limit is no more than two standard drinks per day (see “Did You Know?” for the definition of a “standard drink”), to a maximum of 10 per week; for men, no more than three standard drinks per day, or less than 15 total drinks per week. (These recommendations apply to everyone, whether or not you live with diabetes.) “For those with high blood pressure [whether or not they have diabetes], the recommended daily intakes are lower: one standard drink per day for women, and two or less standard drinks per day for men,” says Krusky.

Balance is key, and so is enjoyment. “There aren’t any foods or drinks that you need to avoid completely,” says Krusky. “It’s important that you feel you can join in a toast for a friend or family member at a special celebration if you want to.”

Did you know?

Differences in alcohol concentration mean the size of a drink will depend on the type of booze being poured, even though one standard drink will always contain 10 grams of alcohol. One standard drink is:

• 341 mL/12 fluid ounces of beer

• 43 mL/1.5 fluid ounces of spirits

• 142 mL/5 fluid ounces of wine

Learn more by visiting Alcohol and Diabetes.

This article appeared in Diabetes Dialogue, Autumn 2019)