Alcohol and Diabetes: What You Need to Know

Let’s start with the stats

In Australia, around 1.3 million people live with diabetes, and many enjoy the occasional alcoholic drink. According to the Australian Institute of Health and Welfare, more than 1 in 4 Australians over 18 exceed the 2020 alcohol guidelines at least once a month. With diabetes on the rise and alcohol a regular part of social life, it’s important to understand how the two mix.

How alcohol affects blood glucose

Alcohol can have unpredictable effects on blood sugar levels. In the short term, it may cause a drop in glucose - especially if you’re drinking on an empty stomach. This is because alcohol blocks the liver’s ability to release glucose into the bloodstream, which can lead to hypoglycaemia (a hypo), especially in people taking insulin or sulfonylureas.

However, some alcoholic drinks - like sweet cocktails, dessert wines, or full-strength beer - can cause a spike in blood glucose initially due to high sugar content, followed by a potential drop hours later. It's a balancing act.

• Drink in moderation. The Australian guidelines recommend no more than 10 standard drinks a week, and no more than 4 on any one day. Alcohol is not recommended during pregnancy or when trying to become pregnant.
• Watch your carbohydrates and calories. Alcohol can be high in both, which can affect your blood sugar and weight management.
• Be mindful of interactions between alcohol and medications, including insulin, sulfonylureas, and others that increase the risk of hypos. Speak to your GP or pharmacist for further information on medication risks with alcohol.

Tips for type 1 diabetes and alcohol

People with type 1 diabetes need to be especially cautious. Here are some simple strategies to reduce the risk of hypos or hypers:

• Never drink on an empty stomach - always eat carbohydrates before and during drinking.
• Monitor your blood glucose levels more frequently when drinking and for several hours after. Hypos can occur up to 12 hours later.
• Tell your friends you have diabetes, especially if you're drinking. A hypo can look like being drunk, and you want people to recognise if you're in trouble.
• Keep hypo treatments nearby, like jellybeans or glucose tablets.
• Avoid excessive alcohol, as it clouds judgement and can lead to missed insulin doses or mismanaged hypo symptoms.

Best alcohol choices for glucose control

Not all drinks are created equal when it comes to managing blood glucose. Better options include:

• Dry wine (red or white) – lower in carbohydrates and sugar.
• Spirits (vodka, gin, whiskey) with sugar-free mixers like soda water.
• Light beer or low-carb beer – fewer carbohydrates but should still be consumed in moderation.

Try to avoid sugary mixers, sweet wines, creamy cocktails, and cider - all of which can lead to blood glucose spikes.

The bottom line

You don’t have to give up alcohol if you have diabetes, but a bit of planning goes a long way. Whether it’s a glass of wine with dinner or a beer with friends, knowing how alcohol interacts with your diabetes management helps keep you safe while still enjoying life. Always check in with your healthcare team if you’re unsure - and most importantly, drink mindfully.

For further information see the links below:

NDSS booklet - Alcohol and type 1 diabetes

NDSS Alcohol Factsheet

NDSS - hypoglycaemia (low glucose levels)

Australian Alcohol Guidelines