7 Facts about Diabetes and Alcohol Use

As we’ve described in this article, alcohol can lead to unexpected fluctuations in your blood sugar. Carry diabetes identification when you go out drinking and make sure signs & symptoms of dying from alcoholism you have friends who know about the risks of drinking with diabetes. Show them the hypoglycemia handout on this page before going out so that they know how to help you.

Those who do present in a hypoglycemic coma usually are an exception to this ‚rule‘ and fit into a few clinical stereotypes. Most have had a prolonged calorie fast in the setting of an extended alcoholic binge or have a fasting state of several days with a more moderate amount of alcohol ingestion [2–4]. Additionally, these patients are usually abstaining from alcohol by the time of presentation .

Comparison of changes in the plasma glucose and IRI concentrations during glucose loading in the presence/absence of alcohol

If it cannot fulfill its role in maintaining blood sugar levels at the time, a person may experience hypoglycemia. As demonstrated in this case series, it seems that socioeconomic factors may also play a large role in affecting the clinical presentations of patients because of their effect on basic science pathophysiology. Alcohol-induced hypoglycemia may be only one example of this phenomenon; further research should be done to elucidate how these factors can affect other basic pathophysiologic processes.

• Ethanol has been found to significantly lower overnight secretion of growth hormone in nondiabetic subjects , and reduced response of growth hormone to hypoglycemia in the presence of ethanol has also been reported .
• Ultimately, insulin secretion declines even further, to levels below those seen in nondiabetics .
• Also included are suggestions about how to detect hypoglycemia and how to manage patients who are convinced they are suffering from hypoglycemia.
• It acts by inducing an unpleasant physical response (e.g., nausea and vomiting) after alcohol consumption.

Hypoglycemia can have serious, even life-threatening, consequences, because adequate blood sugar levels are needed to ensure brain functioning. C-peptide levels, and thus insulin production, were significantly lower in both groups of diabetics than in non-diabetics. No difference in C-peptide levels existed, however, between drinking and nondrinking diabetics, indicating that chronic alcohol consumption did not alter the diabetics’ insulin production. Consequently, the elevated glucose levels observed in the drinking diabetics likely were not caused by alcohol’s effects on insulin levels, but may have resulted from an alcohol-induced increase in insulin resistance in those diabetics. Accordingly, more studies are needed to determine whether the beneficial effects of daily moderate alcohol consumption outweigh the deleterious effects.

Alcoholic Hypoglycemia & Ketosis

The effect is more potent after 2–3 days of fasting and potentially lethal in patients with chronic alcoholism who are treated with insulin . However, in circumstances in which gluconeogenesis is not critical to maintaining blood glucose, its suppression by ethanol seems less likely to cause hypoglycemia. On the basis of previous findings made not only in healthy individuals3, 15, but also in patients with type 1 or type 2 diabetes, several mechanisms for alcohol‐induced hypoglycemia have been proposed. Therefore, changes in insulin secretion or peripheral insulin resistance during the first 30 min do not represent a likely mechanism for the hypoglycemic events identified in the present study. Studies of diabetic patients have failed to show any short-term effect of moderate alcohol intake with a meal or alcohol administered intravenously after an overnight fast . However, some authors report an increased risk of hypoglycemia in the morning, 12–16 h after consumption of an alcoholic beverage in the evening .

Remember, hard alcohol by itself has zero carbs and will not raise your blood sugar but still can put you at risk for low blood sugar that can occur hours after hard liquor ingestion. When you’re drinking, your risk of experiencing a low blood sugar is higher based on the combination of your liver pressing pause of releasing stored glucose and your food not being digested as quickly. This paper presents a case report of a man whose alcoholism was originally diagnosed as hypoglycemia, although subsequent clinical history and laboratory findings did not confirm the diagnosis.

Alcoholism and hypoglycemia

Hypoglycemia can cause strong cravings for alcohol, since alcohol contains large amounts of sugar. An alcoholic may experience the symptoms of low blood sugar and reach for another drink in an effort to ease them. Consuming large amounts of sugar, caffeine and alcohol are common signs of someone with undiagnosed hypoglycemia. Alcohol consumption takes a toll on liver function because the liver has to process the alcohol instead of releasing glucose on time. If left untreated, blood sugar imbalances can become a major health concern.

In most patients, the disease develops before age 40, primarily during childhood or adolescence. In those patients, the immune system attacks certain cells of the pancreas, called beta cells. (For more information on the structure and function of the pancreas, see textbox, p. 213.) Beta cells produce insulin, one of the two major hormones involved in regulating the body’s blood sugar levels and other metabolic functions. Most importantly, insulin leads to the uptake of the sugar glucose into muscle and fat tissue and prevents glucose release from the liver, thereby lowering blood sugar levels (e.g., after a meal) . As a result of the immune system’s attack, the beta cells can no longer produce insulin. Consequently, the patient essentially experiences total insulin lack.

Table S2 | Changes in measured values during the 20‐g alcohol tolerance test in the subgroup of the participants with both active alcohol dehydrogenase 1B and aldehyde dehydrogenase 2 genotypes. Ben G, Gnudi L, Maran A, Gigante A, Duner E, Lori E, Tiengo A, Avogaro A. Effects of chronic alcohol intake on carbohydrate and lipid metabolism in subjects with type II (non-insulin-dependent) diabetes. Chlorpropamide is a medication used to treat type 2 diabetes by increasing pancreatic insulin secretion. Some people treated with chlorpropamide experience an unpleasant, disulfiram-like reaction5 after drinking alcohol. Despite the high prevalence of impotence in male diabetics and the fact that many of these men consume alcohol, few studies have evaluated the relationship between alcohol intake and impotence in diabetics.

Comparison of changes in serum ethanol concentration during alcohol loading in the presence/absence of glucose

Two additional medications—metformin and troglitazone—are now being used to treat people with type 2 diabetes. These agents act to lower the patient’s blood sugar levels by alcoholic lung disease decreasing insulin resistance rather than by increasing insulin secretion. Accordingly, these medications help control blood sugar levels without causing hypoglycemia.

Plasma glucose, insulin, triglyceride and ethanol concentrations during each test were compared. LDL cholesterol is strongly related to cardiovascular disease and stroke and has been called “bad” cholesterol. Reduction of LDL cholesterol decreases a person’s likelihood of suffering a heart attack or stroke. LDL cholesterol levels tend to be lower in alcoholics than in nondrinkers (Castelli et al. 1977), suggesting that chronic alcohol consumption may have a beneficial effect on cardiovascular risk.

You can learn more about how we ensure our content is accurate and current by reading our editorial policy. Alcohol and hypoglycemia are an unsafe combination, especially in people with diabetes and in those who drink frequently. If someone passes out or collapses, this may signify severely low blood sugar, requiring urgent medical attention.

People with type 2 continue to produce insulin in early disease stages; however, their bodies do not respond adequately to the hormone (i.e., the patients are resistant to insulin’s effects). Thus, insulin does not lower blood sugar levels to the extent that it does in people without diabetes. For example, obesity, inactivity, and cigarette smoking may worsen genetically determined insulin resistance. Insulin primarily serves to lower blood sugar levels by promoting the uptake of sugar (i.e., glucose) in the muscles and fat (i.e., adipose) tissue as well as the conversion of glucose into its storage form, glycogen.

Diabetics clearly should avoid heavy drinking (i.e., more than 10 to 12 drinks per day), because it can cause ketoacidosis and hypertriglyceridemia. Moreover, heavy drinking in a fasting state can cause hypoglycemia and ultimately increase diabetics’ risk of death from noncardiovascular causes. The glucose-lowering action of alcohol augments that of other hypoglycemic agents and may induce severe hypoglycemia with irreversible neurological changes. Five insulin-dependent diabetics were hospitalized with severe hypoglycemia after an alcohol debauch.

Ethanol is known to affect various aspects of glucose metabolism, raising several possible explanations for our findings. Without glucose turnover data, however, we can only make inferences about glucose production and utilization. Inhibition of gluconeogenesis by ethanol is well recognized, and in nondiabetic subjects, one would expect ∼45% inhibition at the peak ethanol concentration in our study .

Scientists explain how alcohol causes hypoglycemia (too low blood sugar)

Drugs such as opioids and alcohol work by disrupting your body’s normal processes, creating feelings that make you want to do it again and abuse the substance. Hypoglycemia occurred more frequently following the simultaneous ingestion of alcohol plus glucose than following the ingestion of glucose alone, suggesting that alcohol in the combination of glucose induces reactive hypoglycemia. Taskinen MR, Valimaki M, Nikkila EA, Kuusi T, Ehnholm C, Ylikahri R. High density lipoprotein subfractions and prostheparin plasma lipases in alcoholic men before and after ethanol withdrawal.

Thus, ethanol consumption rapidly increases the blood lactate concentration, while decreasing the level of glucose. Ethanol also can redistribute pancreatic microcirculation to enhance late-phase insulin secretion. This can cause hypoglycemia directly and inhibit the release and activation of counter-regulatory corticotropin, cortisol, and growth hormone that normally counteract hypoglycemia, which increases the risk for reactive hypoglycemia . That effect has been observed in both type 1 and type 2 diabetics as well as in nondiabetics .

Those researchers also reported that diabetics who consumed more than eight standard drinks per week developed peripheral neuropathy faster than did diabetics who consumed eight or fewer drinks per week. Gluconeogenesis, which also occurs primarily in the liver, involves the formation of new glucose molecules from alanine and glycerol. Alanine is generated during the breakdown of proteins in the muscles, whereas overcoming alcohol addiction glycerol is formed during the metabolism of certain fat molecules (i.e., triglycerides). Alcohol metabolism in the liver, however, actually shuts down the process of gluconeogenesis and thus the second line of defense against hypoglycemia. Consequently, both of the body’s mechanisms to sustain blood sugar levels are inactivated in people who consume alcohol but do not eat, resulting in profound hypoglycemia.

Afterwards she reported feeling shaky/tremulous and nauseated; when her BG was then checked, it was found to be 59 mg/dL. Her symptoms resolved when she was given dextrose and her BG increased to 105 mg/dL. The patient was then evaluated by the Endocrine team, and a 72-hour fast was started. If you have type 1 or type 2 diabetes, you can drink wine, but you should be aware of the particulars of this alcohol and how it might affect your blo…