Learn ADA’s alcohol use recommendations
Here is a summary of the Arlington, VA-based American Diabetes Association’s 1999 Clinical Practice Recommendations for alcohol use among diabetics:
- The same precautions regarding the use of alcohol that apply to the general public also apply to people with diabetes. Dietary Guidelines for Americans recommends no more than two drinks per day for men and no more than one drink per day for women. Pregnant women should not use alcohol.
- The effect of alcohol on blood glucose levels is dependent not only on the amount of alcohol ingested but also on the relationship to food intake. Alcohol is not metabolized to glucose and inhibits gluconeogenesis; therefore, if alcohol is consumed without food by people treated with insulin or oral glucose-lowering agents, hypoglycemia can result. (Keep in mind that patient body weight is also a factor when considering insulin dosage, blood-alcohol levels, and dietary requirements.)
- Hypoglycemia can occur at blood alcohol levels that do not exceed mild intoxication. This means a patient may not feel intoxicated and may even have a blood alcohol test lower than the point of intoxication but still experience hypoglycemia with relatively small alcohol consumption.
- If taken in moderation and with food, alcohol use does not affect blood glucose levels when diabetes is well controlled.
- For individuals using insulin, one or two alcoholic beverages (1 alcoholic beverage = 12 oz. beer, 5 oz. wine, or 1½ oz. distilled spirits) can be ingested with the regular meal plan. No food should be omitted because of the possibility of alcohol-induced hypoglycemia. When calories from alcohol need to be calculated as part of the total caloric intake, alcohol is best substituted for fat exchanges (1 alcoholic beverage = 2 fat exchanges) or fat calories.
- Abstaining from alcohol use should be advised for people with a history of alcohol abuse or during pregnancy.
- It is advisable for diabetics to reduce or stop their alcohol intake if they have other medical problems such as pancreatitis, dyslipidemia (especially elevated triglycerides) or neuropathy.
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