‘Tis the Season for Imbibing

By Amy Campbell, M.S., R.D., C.D.E.


The holiday season is a joyous time of year, but for many people, that joy comes with a lot of stress. Having diabetes or any kind of chronic condition can add to that stress, too. Managing blood sugar levels, limiting those tempting goodies, and trying to stick with an exercise program can make this time of year challenging, to say the least.

Another issue that people with diabetes face at the holidays and frankly, any time of year, is the use of alcohol. I bring up alcohol use because the term “holiday spirit” can mean enjoying a glass of wine or champagne, a cup of spiked eggnog or a hot chocolate laced with peppermint schnapps. If you have diabetes, you might be wondering if you can partake in a “holiday spirit” or two.

Is it okay to drink alcohol if you have diabetes?
There isn’t one right answer to this question. The best answer is “Probably.” Most people can safely enjoy an alcoholic beverage or two, but you should always first check with your healthcare provider. You might have other health issues or be taking medicines that could interact with alcohol, causing more harm than good. However, you can take some comfort in knowing that the American Diabetes Association, the American Heart Association and the American Cancer Society agree that drinking alcohol in moderation is not off limits to most people.

How does alcohol affect diabetes?
Alcohol is metabolized, or processed, by the liver. It takes the average person two hours to metabolize one drink. If you drink more than one drink in this time frame, alcohol can affect other parts of the body, such as your brain, giving you that “buzz” feeling. In terms of blood glucose, alcohol may lead to low blood glucose if you take insulin or certain types of diabetes pills, like glipizide, glyburide or glimepiride, for example. The liver has to deal with the alcohol you’ve just consumed and therefore can’t really pay attention to what’s happening with your blood glucose. As a result, your blood glucose may drop too low, especially if you haven’t eaten anything that contains carbohydrate. Drinking alcohol (especially more than what’s recommended) may lead to low blood glucose hours later, as well.

What’s considered “drinking in moderation”?

Here are the standard guidelines for using alcohol: men should have no more than two drinks per day, and women should have no more than one drink per day. A “drink” counts as 5 ounces of wine, 12 ounces of beer or 1 ½ ounces of hard liquor (gin, rum, vodka).

What about mixed drinks?

If you choose to drink alcohol, it’s best to stick with wine, champagne, light beer or hard liquor. If you like “mixers”, choose water, seltzer, diet tonic water or diet soda. A splash of cranberry or orange juice is okay. Try to limit cocktails like rum and Coke, screwdrivers, margaritas or mudslides. Besides packing calories, these drinks may contain quite a bit of carbohydrate that can affect your blood glucose. A cup of spiked eggnog sure goes down smoothly, but it weighs in at about 400 calories and 37 grams of carb!

Are there any health benefits to drinking alcohol?

Surprisingly, alcohol may be good for your health. When consumed in moderation, alcohol can lower the risk of heart disease and stroke, lower the risk of getting diabetes, decrease the risk of dementia, add a few years to your lifespan, and possibly even fight against the common cold. Of course, if you don’t drink alcohol, you probably shouldn’t start drinking. But it’s nice to know that a bit of holiday cheer may be good for your health.

How can you drink safely with diabetes?

First, make sure that your diabetes is under reasonable control. Drinking alcohol on top of swings in your blood glucose can make it harder to get things regulated. Second, if you are at risk for low blood glucose because you take insulin or certain types of diabetes pills, make sure you’re checking your blood glucose regularly (including before and after you drink) and that you always eat a carbohydrate food when you drink. Third, alcohol and exercise don’t mix. Don’t grab a cold beer after a workout session at the gym. You can greatly increase your chances of low blood glucose by doing so. Finally, if you have questions or concerns, or if you have certain complications from your diabetes like heart, eye or kidney disease, check with your healthcare provider before you drink alcohol to make sure it’s safe for you.

Q & A from Janis Roszler, MSFT, RD, CDE, LD/N

Q.   Can the weather affect a person’s blood sugar control?

A.   Yes, it can. Some people find that they need an insulin increase in the winter and a decrease in the summer.  We don’t know why this happens, but it may be related to the fact that some blood vessels dilate in warmer weather, which increases the delivery of glucose in the body.  If your diabetes control seems to be related to changes in the weather, check your blood more frequently and work with your health care team to adjust your diabetes care plan to better meet your changing needs.

Q.   I wear an insulin pump and recently started having an embarrassing problem. Right after I participate in sexual activity, my blood sugar level shoots up to the 300's.  Why does this happen and what can I do about it?

A.   Any form of physical activity, including sex, needs an adequate amount of insulin or your blood sugar level may go high. Your pump infusion set may be moving out of place during your activity. If it is doing this, you won't get the insulin that you need and your blood sugar level will go high. Try moving your infusion set to another area or secure it with special tape. Tape samples should have come with the pump supplies. If it didn’t,  you can contact your pump company and order some.

Q.   School is starting again.  Are there any special scholarships for students with diabetes?

A.   The childrenwithdiabetes.com website lists scholarships and financial aid information on its website. There aren’t a great number of options, but you may find an opportunity that fits you. Bayer Healthcare offers an annual college scholarship to incoming freshman who seek a higher education at an accredited four year university, college, technical or trade school. Check childrenwithdiabetes.com for additional information. 

Q.   What is the carbohydrate content of whiskey?

A.   Whiskey, vodka, bourbon, gin, scotch and rum do not contain carbohydrates.  But that doesn’t mean they should be consumed without care.  Alcohol can cause a rapid drop in blood sugar levels.  Studies showed that people with diabetes who ate food with a moderate amount of alcohol were able to limit the effect the alcohol had on their blood sugar level.  Here are some ways to safely include alcohol in your life:

• Eat something while consuming alcohol.  The additional food helps blunt the hypoglycemic (low blood sugar) effect of the alcohol.
• Don’t imbibe if your blood sugar level is low or you have a history of alcohol problems.
• Limit your intake to a safe amount. The American Diabetes Association suggests that men with diabetes drink no more than 2 alcoholic drinks per day and women with diabetes consume no more than one drink per day.  A serving of alcohol is approximately 12 oz of beer, 5 oz of wine or 1.5 oz of distilled spirits like whiskey and vodka. 
• Wear medical identification.  Symptoms of low blood sugar often resemble drunkenness.  If your blood sugar drops and you have alcohol on your breath, those around you may assume that you are intoxicated and won’t get you the medical assistance you require.
• Discuss your use of alcohol with your health care team to see if it is an appropriate choice.

*This article originally appeared in 2008

**please consult with your healthcare provider before making any changes to your diabetes regimen.

- For more great articles by Janis Roszler, visit the e-version of our magazine at walgreensdiabetes.com