Diabetes: Drinking alcohol safely

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One of the most frequently asked questions about living with diabetes concerns the consumption ofalcohol and how to do it safely.

Specific questions range from whether certain drinks are "blood sugar friendly" to counting carbs for the alcohol, and the effect on blood sugar a few hours later. The type of alcohol consumed – wine, beer, mixed drinks or hard liquor – certainly plays a role in the answers.

Not surprisingly, curiosity seems to pique during the winter holidays, around St. Patrick's Day in March and every year. And with the global pandemic significantly increasing, it seems many have “alcohol and diabetes” on their minds more than ever.

It’s a universal subject that remains worthy of sharing at any time. Here is a “flight” of resources compiled for DiabetesMine readers.

Drinking with Diabetes website

A helpful starting point is a resource created by fellow diabetes advocate, Bennet Dunlap, who lives with type 2 diabetes and has two children who live with type 1 diabetes (T1D). Its website is a hub full of practical information and stories from the D community about personal experiences with alcohol.

This online guide isn't exactly a "how-to" for drinking safely with diabetes, but it does offer real-life stories of people with diabetes (PWD) who have faced various challenges and gets visitors started. conversations about responsible consumption behavior. Whether it’s choosing not to drink, limiting your drinking, or learning from what others say they “should have done,” the voices of the community are open and honest.

Consumer advice from a T1D endocrinologist

For more practical information, DiabetesMine turned to , a practicing endocrinologist at the University of California, San Diego who has lived with T1D himself since the age of 15. He regularly speaks about diabetes and alcohol use at virtual and in-person events across the country.

His message: Yes, people with disabilities can drink alcohol safely, as long as they do so mindfully and in moderation.

Pettus points to experts who say women should drink no more than one drink per day and men no more than two drinks per day. To be clear, a drink is: 12 oz of beer, a 5 oz glass of wine, or 1 ½ oz of distilled spirits.

He also shared his own tips for safe drinking, based on his personal experiences (as there is a severe lack of clinical data on mixing alcohol consumption and T1D).

• Always eat something before drinking.
• Avoid sugary mixed drinks.
• Bolus for alcohol, but half of what you normally would for carbs.
• Check blood sugar often (before drinking, while drinking, before bed).
• If you don't use an insulin pump, always take your basal insulin (maybe even before you go out).
• Lower the basal temperature overnight or reduce your basal dose of Lantus/Levemir by approximately 20%.
• Take smaller boluses the next day.
• Set an alarm in the middle of the night (3 a.m.) to check glucose levels.
• Do not bolus just before bedtime.
• If you don't already have one, get one that helps assess the impacts of alcohol on your diabetes over time.
• Allow yourself to run a little high while drinking to avoid the lows: target range 160-200 mg/dL.
• In case you're wondering (and in an emergency), glucagon can still work while drinking, although .

Pettus says the key is to avoid excessive consumption alcohol.

Beer and blood sugar

According to Pettus, the general rule is that the darker the beer, the more calories and carbohydrates it contains.

Mike Hoskins/DiabetesMine

How many carbs and calories are in beer? Some examples:

• Amstel Lite contains 95 calories and 5 grams of carbohydrates.
• Dark beer like Guinness has 126 calories and 10 carbs.
• Budweiser has 145 calories and 10,6 carbs.
• A really “good beer” from a popular microbrewery probably has around 219 calories and 20 carbs.

Microbreweries are a little harder to pin down on an exact carb and calorie count, as each varies slightly – no India Pale Ale (IPA) or stout is an exact duplicate of another, and craft brewers are renowned to add different ingredients to specialize their products.

Mike Hoskins of DiabetesMine conducted his own personal study of . He tested a handful of local Michigan craft beers and found that each raised his blood sugar (BG) by an average of 75 to 115 points per glass, with no insulin or carbs on board.

What he learned is that planning ahead helps you enjoy a few brews without experiencing extremely high or low blood sugars. As an insulin user, you need to think carefully about the food and physical activity that will likely accompany your alcohol consumption.

If you're celebrating St. Patrick's Day in March, it's helpful to know that the brand doesn't necessarily have a different number of carbs or calories, as it's usually the food coloring that makes the drink a different color.

Diabetic Gourmet Magazine has a great round-up of the different carb counts to remember for St. Patrick's Day consumption, as well as those that often accompany those who choose to drink on this celebratory occasion.

Does drinking a beer after a workout have any benefits?

Low Carb Herbal Teas

Thanks to Kerri Sparling, diabetes advocate and author, who recently shared her findings on:

• The lowest carb beer on the market appears to be , at 85 calories and 1,65 grams of carbs per bottle. According to surveys, “it has a refreshing taste and the double fermentation process makes its carbohydrate load almost undetectable.” Although this British beer is difficult to find in the United States, it can be purchased online and shipped to the United States for an additional fee.

• Michelob Ultra, at 95 calories and 2,6 grams of carbohydrates per bottle, is regularly found in American bars. “It doesn't have much flavor, just like its Natural Light counterpart (95 calories, 3,2 carbs). But if you're looking for options without the high carb load, this will do the trick.

• One bottle of Amstel Light contains 95 calories, 5 carbs.

• Heineken Premium Light contains 99 calories, 7 carbs. These are popular beers and common in American bars.

• “Lighter” options include Corona Light (109 calories, 5 carbs); Bud Light (110 calories, 6,6 carbs); or Sam Adams Light (119 calories, 9,7 carbs). “All three are readily available in most markets and are gentler on your blood sugar than your average high-carb beer. »

• And if you live with it, there are a few gluten-free beers on the market that might suit you: Omission Lager has 140 calories and 11 carbs and is a beer that'll satisfy all palates, including those of average beer drinkers and beer connoisseurs. 'craftsmanship. A pint of gluten-free is another option, with 125 calories and 9 carbs. This import is now available for purchase at Beverages & More and through Instacart in the United States

Can you drink wine with diabetes?

We're glad you asked. DiabetesMine recently published which includes a ton of details.

Here are some of the most important things to know:

• On average, wine contains 120 calories and 5g of carbohydrates per glass.

• Dry white has the least sugar, reds are a bit higher, and dessert wines are sweet, "just like they look," according to , a registered dietitian nutritionist who lives with T1D herself.

• Low-alcohol wines often have more sugar for taste reasons, and you're better off looking for a varietal with 12,5 to 16 percent alcohol to avoid added sugars, according to Keith Wallace, winemaker, sommelier and founder of the.

• Location matters: Italian and French wines traditionally have less residual sugar, while Oregon wines, for example, have more added sugar, Wallace said.

• Don't drink wine on an empty stomach, have fast-acting glucose on hand, and tell at least one person in your group about your diabetes and how to help yourself if you experience hypoglycemia.

“Wine is good, in many ways,” Wallace told DiabetesMine. “People with disabilities have so much stress and wine is a great stress reducer. This should not be a worrying thing. Well done, it’s excellent.

Cocktails and strong alcohols

Drinking cocktails and hard liquor with diabetes can be especially tricky. That's because festive cocktails often include fruit juice and flavored syrup that pack a BG punch. Mixers and liquors can be sweet and have a higher carbohydrate content which also increases blood sugar. On the other hand, straight-up hard alcohol hits the liver hard, which can lower blood sugar levels.

If you prefer mixed drinks, this recommends the best options for people with disabilities: a Bloody Mary, Dry Martini, Vodka & Soda, or even an Old Fashioned or Mojito cocktail made with Stevia instead of real sugar.

If you're opting for straight hard liquor, experts recommend whiskey, bourbon, scotch and rye, all carb-free distilled spirits. Be careful, however, with flavored whiskeys, which may contain sugar syrup.

When , it is important to prepare for potential hypoglycemia.

Remember that your liver's main function is to store glycogen, which is the stored form of glucose, so you will have a source of glucose when you haven't eaten. Especially when you drink "pure" alcohol without additional ingredients, your liver has to work to remove it from your blood instead of working to regulate blood sugar. For this reason, you should never drink alcohol when your blood sugar is already low. And again, never drink on an empty stomach.

Well done, friends!