Can I Drink Alcohol if I Have Type 2 Diabetes?

A Guide to Safe Alcohol Consumption with Type 2 Diabetes

Drinking with Type 2 Diabetes
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Studies have shown that moderate alcohol consumption may have favorable effects such as, raising good cholesterol (HDL) and lowering the risk of cardiovascular disease. Some studies suggest that moderate alcohol consumption may even reduce the risk of developing Type 2 diabetes. The most important rule is to keep consumption moderate. The American Heart Association defines moderate alcohol consumption as 1 drink per day for women and 2 drinks per day for men.

One alcoholic beverage is measured as a 12 oz beer, 5 oz glass of wine or 1 ½ oz distilled spirits (vodka, whiskey, gin, etc.).

On the other hand, excessive alcohol consumption or binge drinking, defined as more than five alcoholic beverages in a two-hour time span for men and four for women, can increase the risk of heart disease, Type 2 diabetes, and metabolic syndrome. Excessive consumption can also make glucose control a challenge by increasing weight and insulin resistance

If you do decide to drink alcohol, some options are better than others. In addition, if you have diabetes there are certain considerations you must take in order to stay safe. Alcohol consumption can result in increased insulin production which can lower blood sugars.The American Diabetes Association recommends that persons with diabetes be educated on the recognition and management of delayed hypoglycemia (low blood sugar) when drinking alcohol, especially if those persons are using insulin or other medications that can cause blood sugars to drop.


What types of alcohol should I avoid and what should I choose instead: It’s wise to avoid sugary drinks made with juice mixers, added sugar and syrups, because they can add excess calories and sugar. These types of beverages can spike blood glucose levels and can cause weight gain. Instead, choose beverages like wine, champagne or distilled alcohol with sugar-free mixers like club soda.


For example:

  • Vodka with cranberry (make with 1/2 oz vodka and 6oz juice): 200 calories and 23 g sugar
  • Vodka with club soda and a twist of lime (made with 1/2oz vodka and 6oz seltzer): 100 calories, 0 g sugar

You save 100 calories and 23 g sugar

What Considerations Should I Take to Keep Me Safe?

Drink with food:  If you are going to drink alcohol, do not drink on an empty stomach. Aim to drink with your meal or eat something before you drink to reduce your risk of hypoglycemia. When you are eating, be sure to choose something that has some carbohydrates so that you have some glucose in your system and therefore are at lower risk of having a low blood sugar. If you are following a fixed carbohydrate meal plan you may need to eat a little extra when drinking. Do not replace food with alcohol and do not count alcohol as part of your carbohydrate choices.The only way to really gauge what works for you is to monitor your blood sugar more often when you are drinking alcohol. 

Test: Alcohol can cause your blood sugar to drop even 24 hours after you have consumed it.

Check your blood sugar before heading to bed. Make sure it's in a safe range 100-140mg/dL. If your blood sugar is below 100mg/dL, but not too low (<70mg/dL), you should eat a small 15 carbohydrate snack. An example would be 1 slice of whole grain bread with a teaspoon of peanut butter. Taking in extra calories before bed is not ideal, but safety comes first.

Carry snacks: If you have diabetes and are taking insulin or other oral agents that may cause hypoglycemia, you should always carry snacks. Meals can sometimes be delayed and you need to be prepared. Carry snacks that contain some carbohydrate - a piece of fruit, whole grain crackers, or a meal replacement bar . In the event that your sugar does drop to <70mg/dL you must treat with 15g of fast acting carbohydrate, such as, 3-4 glucose tablets, 4oz of juice (1 small juice box), 5 pieces of hard candy (not chocolate). 

Wear your medical id: Ideally you want to wear a medical id stating you have diabetes at all times. In the case of a medical emergency health professionals should know that you have diabetes. 

Hydrate: For each alcoholic beverage you drink, drink 1 glass of water or seltzer - this will help you stay well hydrated and consume less alcohol. Alcohol can increase your appetite too, and drink water between beverages can distract you from overeating. 


Lindtner, C, et. al. Binge drinking induces whole-body insulin resistance by impairing hypothalamic insulin action. Sci. Transl. Med. 5 (2013); 170ra14.

Huang, Z & Sjoholm A. Ethanol acutely stimulates islet blood flow, amplifies insulin secretion, and induces hypoglycemia via NO and vagally mediated mechanisms.
Endocrinology (2008); 149: 232-236

Lui, C, et. al.Associations of alcohol consumption with diabetes mellitus and impaired fasting glycemia among middle-aged and elderly Chinese. BMC Public Health (2010); 10:714.

Koppes LL, et. al. Moderate alcohol consumption lowers the risk of type 2 diabetes: a meta-analysis or prospective observational studies. Diabetes Care. (2005).; 3: 719-725

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