Can I drink alcohol if I have type 2 diabetes?

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Living with type 2 diabetes often means avoiding foods and drinks that can affect your blood sugar (glucose) levels. Alcohol doesn't have to be one of them.

In fact, there is evidence that many people with type 2 diabetes can safely drink alcohol and may even benefit from moderate alcohol consumption.

Of course, your healthcare provider can best determine which one is right for you. But if you do drink, keep in mind that not all alcoholic beverages are the same when it comes to diabetes.

This article explains how alcohol affects blood sugar and what benefits it can bring. It also provides guidelines for including alcohol in your type 2 diabetes diet, if you wish.

Brianna Gilmartin / Get Medication Information

How the body processes alcohol

The body processes alcohol differently from most other foods. This can have several consequences for people with type 2 diabetes.

To understand why, it helps to have a general idea of what happens to alcohol, for example, in a glass of wine after it has been drunk:

1) The wine goes straight to the stomach. What happens here depends on whether there is food there or not.

2) If there is food in the stomach, the pyloric valve that separates the stomach from the small intestine will close so that the nutrients in the food can be digested before moving into the small intestine. This keeps the alcohol in the stomach.

If there is no food in the stomach, the pyloric valve is open and alcohol can flow directly into the small intestine.

3) Wherever alcohol is found, it is not digested like other foods. Instead, it goes directly into the bloodstream. This is possible because alcohol is made up of molecules so small that they can be absorbed by thousands of tiny blood vessels that line the stomach and small intestine.

4) Once in the bloodstream, alcohol enters cells throughout the body. It eventually travels to the veins that carry blood to the liver, the only organ that metabolizes alcohol.

It is at this point that alcohol can affect blood sugar levels in ways that are especially important for people with type 2 diabetes. This is because the liver is where excess glucose is stored in a form called glycogen.

When the blood sugar level drops too low, the liver converts glycogen to glucose, which can then be delivered into the bloodstream and return to normal levels.

However, the liver cannot do this and simultaneously metabolize alcohol, so it will focus primarily on fighting alcohol rather than converting glycogen to glucose. As a result, blood glucose levels remain low.

Summary

Alcohol is absorbed directly into the bloodstream from the stomach or small intestine, carried through the body, and carried to the liver. The liver will focus on working with alcohol rather than converting stored glycogen into glucose, which is necessary to maintain normal blood sugar levels.

Risks of drinking alcohol in type 2 diabetes

Insulin is a hormone produced by the pancreas that helps cells metabolize the sugar (glucose) they need for energy.

Type 2 diabetes is associated with elevated blood glucose levels. This happens when the body does not produce enough insulin or does not respond properly to insulin, which is called insulin resistance .

Due to the effects of alcohol on blood sugar control and other aspects of the disease, drinking alcohol carries certain risks if you have type 2 diabetes, which healthy people cannot.

It is also important to know that much is unknown about alcohol and diabetes.

Ignorance of hypoglycemia

Ignorance of hypoglycemia occurs when a person with diabetes has low blood sugar but does not recognize the symptoms.

It is more common among people with type 1 diabetes who take medications such as insulin to control their blood glucose levels. Medications keep blood sugar levels in such tight control that they rarely fail.

But even people with type 2 diabetes and taking medications can be vulnerable to not knowing hypoglycemia, even if their blood sugar levels are likely high rather than low.

Glucagon kits commonly used for hypoglycemia from type 1 diabetes do not work if there is alcohol in the body. Eating food will help solve this problem.

The American Diabetes Association and the National Institute of Diabetes, Digestive and Kidney Diseases advise people with diabetes to learn to recognize and manage late hypoglycemia (low blood sugar) when they drink alcohol, especially if they are taking insulin or other medications that can cause low blood levels. blood sugar release.

Hyperglycemia

While alcohol can lower blood sugar levels, it can also increase them.

Long-term regular alcohol consumption has been shown to increase insulin resistance .

An increase in blood sugar levels is followed by hyperglycemia or excessively high blood sugar levels. This can cause a variety of symptoms, from thirst and frequent urination to slowly healing wounds, disorientation, and more.

This means that drinking alcohol can make blood sugar control even more difficult for people with type 2 diabetes, which is defined by high glucose levels.

Weight gain

All alcohol contains about 7 calories per gram, which is just a little less than 9 calories per gram of fat.

Also, when the liver breaks down alcohol, it turns it into fat, which can contribute to weight gain.

Being overweight can cause or worsen type 2 diabetes.

Benefits of alcohol for type 2 diabetes

Alcohol lowers blood sugar levels. And people with diabetes need to lower their elevated glucose levels. So it makes sense that alcohol use may play a role in the prevention and treatment of type 2 diabetes. There is some evidence that this may be the case.

For example, studies have shown that in people with type 2 diabetes, drinking alcohol can sometimes slightly lower glucose levels.

Moderate alcohol consumption has also been linked to a number of other health benefits, such as an increase in the amount of good cholesterol (HDL) in the blood. It can help lower your risk of heart disease , which is at higher risk if you have type 2 diabetes.

People who drink red wine can get another benefit. According to the American Heart Association, red wine contains antioxidants, compounds in certain foods that help prevent cell damage.

They do this by counteracting free radicals, unstable molecules that can cause disease. People with type 2 diabetes tend to have particularly high levels of free radicals.

However, it is important to understand that this advantage is just theory. There are no studies showing a definitive link between drinking red wine and improving diabetes.

With all of this in mind, the risks of drinking type 2 diabetes may still outweigh any benefits. If you are considering incorporating alcohol into your lifestyle, it is important to consider your personal health, as well as the advice of your doctor.

Plus, you can make healthier lifestyle changes for similar health benefits. For example, exercise is good for both insulin and heart health.

Drink safe

If you don't drink, there is no reason to start. If you do and want to find a way to keep alcohol in your diet, the potential risks shouldn't stop you, unless your doctor tells you to.

However, you should be aware of these risks when drinking. These strategies can help you drink alcohol safely.

identify yourself

Before heading to a bar or restaurant where you plan to have a drink, wear a medical identification bracelet. This way, in an emergency, medical staff will know you have diabetes.

Eat first

Remember that if you have food in your stomach while drinking alcohol, it will take longer for it to be absorbed into your bloodstream.

Snack while taking a sip or just before to reduce the risk of hypoglycemia . Choose foods that contain carbohydrates so that you have a little glucose in your body and therefore have a lower risk of hypoglycemia.

Bringing a snack to a bar or cocktail party can be helpful as there is no guarantee that the right food will be available there to help normalize your blood sugar level if it drops. A piece of whole fruit, whole grain crackers, or a meal replacement bar are good options.

If your glucose drops below 70 mg / dl, you should reduce your fast-acting carbohydrates by 15 g. This could be three or four glucose tablets, 4 ounces of juice (small juice box), or five hard candies (not chocolate).

Choose wisely

Certain types of alcohol are especially high in carbohydrates and sugar, even if you drink them alone.

The same goes for cocktails made with regular soda or other mixes, simple syrup and other types of added sugar, or even fruit juice.

Dessert wines also contain significantly more sugar than other wines.

Comparison of carbohydrates and sugar in alcoholic beverages.
Alcohol Sugar Carbohydrates
2 ounces of port 20 g 7 g
12 ounces mineral water added 5 g 5 g
5 ounces of white wine 1.4 g 4 g
5 ounces of red wine 0.9 g 4 g
12 ounces light beer 0.3 g 6 g
12 ounces of beer 0 g 13 g
1.5 ounces of distilled alcohol 0 g 0 g

You can easily minimize the carbs and sugar in your shake by drinking it on its own or with ice, or mixing it with soda, sparkling water, diet soda, and some fresh lemon or lime.

For example, compare a typical frozen margarita (2 ounces of tequila, one ounce of a triple second, one ounce of lemon juice, and 3 cups of fruit) to tequila on ice (1.5 ounces of tequila) with added lemon. Margarita contains approximately 17 calories and 42 grams of sugar, while tequila contains only 100 calories and is sugar-free.

Do not overdo it

Even for people without diabetes, drinking too much alcohol can be dangerous.

Here's how the Centers for Disease Control and other federal agencies define restraint:

  • One drink a day or less for women and two drinks a day or less for men.
  • A drink is defined as containing 14 grams (0.6 fluid ounces) of pure alcohol: 12 fluid ounces of regular beer (5% alcohol), 5 fluid ounces of wine (12% alcohol), or 1.5 fluid ounces 80 strong spirits (40% alcohol) such as vodka, whiskey, gin, etc.
  • Binge drinking or binge drinking is defined as consuming more than five alcoholic beverages in two hours for men and four hours for women.

These guidelines represent the maximum amount of alcohol to drink. But of course, less is better.

Check your blood sugar level

After drinking alcohol, blood sugar levels may drop after 24 hours. Check your blood sugar before and during drinking, and then again before bed.

According to the American Diabetes Association, it should be between 80 mg / dL and 130 mg / dL at bedtime. If it is low, follow your doctor's advice, such as consuming extra calories to counteract the decrease.

Summary

Is it safe to drink alcohol? It is a common problem for people with type 2 diabetes. Because it is processed differently than most foods and other beverages, it may have some benefits, such as lower blood glucose levels, and some real risks, including too low a drop in glucose levels.

The safest method of drinking alcohol if you have type 2 diabetes is to drink in moderation, choose drinks that are low in sugar and carbohydrates, never drink on an empty stomach, and closely monitor your blood sugar before, during, and after. . Drinking.

Of course, check with your doctor first to make sure it's okay to drink.

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