High Blood Sugar and Alcohol: What You Need to Know

Drinking alcohol can be especially dangerous for people with high blood sugar. Here’s why.

Managing high blood sugar is complex, and adding alcohol into the mix makes it even more so. Alcohol can cause both spikes and drops in blood sugar levels, necessitating careful planning and caution.

The Immediate Effect of Alcohol in People With High Blood Sugar

The most critical fact to know is that alcohol consumption can significantly lower blood sugar (hypoglycemia). This risk is particularly high for anyone with type 1 diabetes or type 2 diabetes using insulin or sulfonylureas, which can cause low blood sugar.

Alcohol disrupts the liver’s ability to release stored glucose into the bloodstream, as it prioritizes processing the alcohol instead. This interruption can lead to lower blood sugar levels. Additionally, alcohol may increase insulin sensitivity, further complicating blood sugar management.

The hypoglycemic effect of alcohol can be delayed, occurring after you’ve stopped drinking, falling asleep, or even the next day. Complicating matters, the symptoms of drunkenness and hypoglycemia overlap significantly, making it difficult to recognize and respond to low blood sugar.

Heavy drinking, particularly binge drinking, can be extremely dangerous, especially for young adults like college students who may engage in risky drinking behaviors. Many already struggle with glucose control, which heavy alcohol consumption exacerbates. Going to sleep drunk is particularly risky because hypoglycemia symptoms, which would normally wake you up, may go unnoticed.

The Morning After

The blood sugar-lowering effects of alcohol can peak hours after consumption. A study involving men with high blood sugar showed that symptomatic hypoglycemia often occurred 12 hours after drinking. This delayed effect means you’re at risk for blood sugar issues the morning after drinking. Handling a hangover may require extra care and preparation.

Alcohol and Carbohydrate Content

Alcohol itself contains few or no carbohydrates. Spirits like vodka and tequila have minimal carbs, while a glass of wine or light beer contains only a few grams. However, sweet wines, beers, and sugary cocktails can be high in carbs, causing a rapid blood sugar spike and necessitating insulin use. Combining this with alcohol’s delayed blood sugar-lowering effect can be dangerous, making it safer to avoid sugary alcoholic beverages.

Mitigating the Risks of Drinking Alcohol for People With High Blood Sugar

Many people with high blood sugar don’t receive adequate education about alcohol. For those using glucose-lowering drugs, it’s crucial to monitor blood glucose levels closely while drinking and for up to 24 hours afterward. Here are some tips to drink more safely:

• Practice moderation.
• Check your blood sugar frequently, both while drinking and the day after.
• Consider having a snack to prevent hypoglycemia.
• Be mindful of the carbohydrate content in your drinks.
• Avoid exercising during or after drinking, as it can lower blood sugar.
• Have a sober friend who understands your condition and can help in an emergency.
• Wear a medical alert bracelet.
• Remember that drinking can cause delayed hypoglycemia.
• Discuss with your doctor how to adjust your medication when drinking.

High Blood Sugar, Alcohol, and Ozempic

Some drugs used to manage high blood sugar, like semaglutide (Ozempic) and tirzepatide (Mounjaro), might reduce alcohol cravings and consumption. However, these drugs can also provoke vomiting, similar to excessive drinking, so caution is still advised.

The Long-Term Effect of Moderate Drinking With High Blood Sugar

Moderate drinking has been linked to increased insulin sensitivity and a reduced risk of type 2 diabetes, though more recent research disputes these benefits. In 2023, the World Health Organization stated that no amount of alcohol consumption is safe for health.

The Long-Term Effect of Heavy Drinking With High Blood Sugar

Heavy drinking is harmful to everyone, but it poses specific risks for people with high blood sugar, including accelerating complications like neuropathy and retinopathy. It also significantly increases the risk of dementia and Alzheimer’s disease. Binge drinking can be toxic to pancreatic beta cells, raising the risk of type 2 diabetes.

The Takeaway

Drinking alcohol carries significant immediate risks, particularly hypoglycemia, for people with high blood sugar. Those taking insulin or sulfonylureas should be especially cautious. Frequent heavy drinking has many harmful effects and should be avoided. If you’re concerned about your drinking habits, please seek professional help.