When it comes to alcohol and diabetes, there is some confusion as to whether it can be included or not. There is a large body of information that states that moderate drinking has cardio (heart) protective effects but it can also cause havoc with your blood sugar levels. Can you answer the following questions?
- Is your blood sugar controlled?
- Do you know how alcohol can affect you?
- Are you sticking to the recommended amount?
If not, this article will give you insights and tips on how to make sure you are managing your blood sugar levels while drinking alcohol.
HOW DOES ALCOHOL AFFECT YOUR BODY?
When we drink alcohol, it moves into our bloodstream without first being metabolized in your stomach. Within five minutes of your first drink, your bloodstream contains enough alcohol to measure. Alcohol is metabolized by the liver, and for the average person it takes about two hours to metabolize one drink. If you drink faster than your body can metabolize it, it moves through your bloodstream to other parts of the body especially your brain, causing the ‘buzz sensation’.
Alcohol can have different effects on your blood sugar levels. This is often determined by how much as well as what we drink. Drinking moderate amounts of alcohol may cause blood sugar to rise while excessive alcohol can cause hypoglycaemia (low blood sugar levels). This hypoglycaemia can occur shortly after and for up to 24 hours after drinking. As your liver is processing alcohol it cannot make new glucose, preventing your body’s normal protective mechanism from kicking in if your blood glucose level falls too low during or after drinking. For those who are taking insulin or oral medications such sulfonylureas (Glipizide, Glyburide) and meglitinides (Prandin), extra care needs to be taken as these drugs lower blood glucose even more and can also stimulate the pancreas to make more insulin. This combined effect of alcohol and medication could cause hypoglycaemia and caution needs to be taken.
Other effects of alcohol on your body include:
- Stimulating your appetite, which may cause you to overeat, thereby affecting your blood sugar control.
- Alcohol does not contain any useful nutrients and is the second most calorie-rich nutrient after fat. One gram of alcohol is equal to about 7 kCal / calories. Therefore if weight loss is your goal it might make it more difficult to achieve.
- It can also affect your judgment or willpower, resulting in poor food and treatment decisions.
- It may increase triglycerides as well as blood pressure.
- It can also cause slurred speech, flushing, nausea and increased heart rate.
Symptoms of hypoglycaemia are similar to those of drinking too much alcohol. These include sleepiness, dizziness and disorientation. Therefore care needs to be taken not to confuse hypoglycaemia for drunkenness.
HOW MUCH CAN I DRINK, AS A DIABETIC?
When it comes to alcohol, the South Africa Food based Dietary Guidelines recommend that “If you drink alcohol, drink sensibly”. They also state that if you drink make sure it is in moderation. This is by no means saying you need to start drinking but what do we mean by moderation? This is 1 drink per day for women and 2 drinks per day for men. It is important to remember that the alcohol guideline is the same for those with diabetes and for those without.
Now when we talk about “drinks” in the guideline, one alcoholic drink is equivalent to:
- 1 can or bottle (330 m)l of beer
- 120ml of wine
- 25 ml / 1 shot of spirits.
Now this might seem like a lot if you count the total number of drinks per week but it is better to drink moderate amounts daily than binge drink once or twice a week. Alcohol is often used as a way to relax at the end of the day and forms part of many celebrations and traditions. Make sure that you are drinking for the correct reason, rather use healthier stress-relieving techniques like exercising, reading a book, gardening or meditating.
USEFUL TIPS IF YOU ARE GOING TO DRINK ALCOHOL
- Check your blood sugar before you drink and for up to 24 hours afterwards. Make sure you check your blood sugar levels before you go to bed to ensure it is at a safe level to prevent a hypo during your sleep. If it is low then a carbohydrate-containing snack before bed might be necessary.
- Do not drink on an empty stomach or when your blood glucose is low. Make sure you eat beforehand or while you drink as food slows down the absorption of alcohol into the blood stream.
- Don’t skip a meal in order to drink.
- Make sure you drink slowly.
- Keep yourself hydrated by drinking water or sugar free drinks in between.
- Don’t mix alcohol and exercise, both increase your risk of getting a low blood sugar level.
- If you drink alcohol several times a week, tell your doctor or diabetic nurse so that he or she knows this before prescribing certain diabetic medications.
WHAT ALCOHOLIC DRINK SHOULD I CHOOSE?
As diabetics and those following a healthy balanced diet we are taught there are better options when it comes to certain foods. What about alcohol, is it the same as the guidelines for food? The answer is yes… there are definitely better options when choosing alcohol.
Choose low-carbohydrate alcoholic beverages where possible such as light beer, whiskey or dry wine as they have less alcohol and fewer calories. Usually one or two units can be had without effecting your blood sugar too much.
Try to avoid sugar-rich alcoholic drinks such as ciders, alcoholic fruit drinks or coolers, liqueurs, cocktails containing fruit juices or spirits with sugar-rich drinks (coke, lemonade etc.). These are high in sugar and therefore carbohydrates.
Rather mix your alcohol with water, soda water or sugar free soft drinks to reduce the sugar content e.g. Replace the coke for diet coke or tab, mix sparking water or soda water into your wine to make spritzers.
ARE THERE BENEFITS OF DRINKING ALCOHOL?
Light to moderate drinking has been linked to reduced risk of cardiovascular disease, while heavy drinking appears to increase the risk. Ronksley et al. (2011) found that when participants consumed 2.5–14.9 g of alcohol per day (about 1 drink a day), there was a 14–25% reduction in the risk of all cardiovascular outcomes compared with those who don’t drink at all but larger amounts of alcohol was associated with higher risks for stroke incidence and mortality.
Red wine is one of the alcoholic drinks that are said to be cardio-protective. Red wine or grapes contain antioxidants and polyphenols such as resveratrol, catechins, epicatechin and proanthocyanidins. These substances, particularly resveratrol are said to reduce oxidative damage in the body, as well as prevent heart disease by protecting the lining of blood vessels in your heart and increasing your HDL (good) cholesterol. According to the Mayoclinic, most of the studies done on resveratrol are done on animals with great results, but to get the heart-protective effects from wine you would need to drink several bottles which far exceeds the recommended daily amount. This being said, people who drink about 150 ml of red wine a day have been shown to have a 32% lower risk of developing heart disease than non-drinkers. According to the Copenhagen Heart Study, researchers found that in middle-aged men, weekly and daily consumption of wine was associated with lower risk of stroke over beer or spirits. They also noted this effect could be due to the cardio-protective ingredients in wine as well as the timing of consumption. e.g. wine was most often drank with meals while beer and spirits at random. They concluded that the compounds in the wine in addition to ethanol were responsible for the protective effect on risk of stroke.
There you have it… the low down on your what, how much and how you can ensure that you are drinking alcohol safely as a diabetic. Remember, if you have any other questions about alcohol chat to your diabetic nurse, doctor or dietician.
This content was provided by FUTURELIFE®
- Jacobs L, Steyn NP. Food-Based Dietary Guidelines for South Africa: If you drink alcohol, drink sensibly. Is this guideline still appropriate? S Afr J Clin Nutr. 2013;26(3)(Supplement)
- Carbohydrate Counting. Can’t tell your carbs from your protein? Accu-check booklet