Does Wine Help Or Harm People With Diabetes
Amy Hess-Fischl MS, RD, LDN, BC-ADM, CDE
With commentary from study author Meir Stampfer, MD, DrPH, professor of epidemiology and nutrition, Harvard T.H. Chan School of Public Health
Doctors have long faced a paradox when advising their patients with type 2 diabetes on drinking alcohol. Moderate drinking has been shown to reduce the risk of heart disease, which would benefit people with diabetes who are at increased risk of the disease. Yet, people with diabetes have traditionally been advised to reduce their alcohol consumption to help better control their glucose levels.
Now preliminary results of a new study presented at the European Congress on Obesity in Prague, found that adults with diabetes may be able to safely drink in moderation and reap the heart benefits.
The study randomly assigned 224 patients with controlled type 2 diabetes to have either mineral water, white wine or red wine with dinner every night for two years. All patients were following a healthy Mediterranean diet with no calorie restrictions.
Researchers found that red-wine drinkers had a modest improvement in high-density lipoproteins , the good cholesterol, and also had improved apolipoprotein A1, a component of HDL. Those who drank red or white wine also saw modest improvements in glucose metabolism.
Drinking one 5-ounce serving of red or white wine wasn’t associated with any negative effect on medication use, blood pressure or liver function tests.
How to Drink Responsibly
Grams Of Carbohydrate In Common Alcoholic Beverages
“It’s not that people with diabetes can’t drink at all,” says Harris. “I’d certainly rather my patients have a glass of dry wine or low-carb beer than a soda.”
And when it comes to guessing the carb-content in an alcoholic beverage, Harris says people too often make false assumptions.
“Wine, for example, whether it’s red or white doesn’t matter. It’s not the color that impacts the carb-content, but the level of fermentation because fermentation turns the sugar into alcohol. So that’s why the carbs in wine won’t impact your blood sugar as much that same carbohydrate amount from a glass of actual grape juice.”
Let’s take a look at the carbohydrate content of common alcoholic beverages, according to the Calorie King.
Red wines, per 5 fl oz/147 ml glass
- Merlot 3.7 grams
Spirits, per 1 fl oz/37 ml
Most spirits actually contain 0 grams of carbohydrates. Some flavored varieties, like Smirnoff Strawberry, still only contain fewer than 3 or 4 grams of carbohydrates, which is generally not a quantity you’d actually want to cover with insulin.
Mixers: Remember, the only mixers that don’t contain carbohydrates are club soda and diet soda. Most other mixers, including and sour mix, contain at least 20 to over 40 grams carbohydrates per 8 ounces.
Drink Cows Milk Which Also Provides Protein And Calcium
“Skim or low-fat milk is also a good beverage option, but it must be counted toward your carb total for a particular meal or snack,” Basbaum says.
According to the U.S. Department of Agriculture , a cup of 1 percent milk also provides 305 milligrams of calcium, which accounts for about 23 percent of the daily value.
Be aware that nondairy milk options, such as almond milk, may have added sweeteners and flavorings. They also often lack the blood-sugar-stabilizing protein of cow’s milk.
RELATED: A Detailed Guide to Soy Milk
A Glass Of Wine A Day May Help Control Type 2 Diabetes
- EmbedEmbed
A new study published in the Annals of Internal Medicine adds to the evidence that drinking a moderate amount of wine can be good for your health. iStockphotohide caption
toggle caption
A new study published in the Annals of Internal Medicine adds to the evidence that drinking a moderate amount of wine can be good for your health.
If you’re in the habit of drinking wine with dinner, there may be a bonus beyond the enjoyment of sipping a glass at night.
A new study in the Annals of Internal Medicine adds to the evidence that drinking a moderate amount of wine can be good for your health.
The evidence comes from a new two-year-long study on people with diabetes.
Researcher Iris Shai of Ben Gurion University says in Israel and elsewhere, lots of people with diabetes get the message that alcohol — even in moderation — can be harmful.
“There is a myth that alcohol is not so safe for them,” Shai says.
In order to test the influence of wine on people with diabetes, Shai recruited about 225 people who already had elevated blood sugar, and they agreed to follow a Mediterranean style diet for two years.
Patients Share: This Is How I Manage Diabetes And Alcohol
We asked people with type 1 diabetes on Twitter how they personally manage diabetes and alcohol. Their experience and approach to alcohol is not medical advice for your own diabetes management. Here’s what they had to say:
“Winner answer: check your blood sugar. Repeat. Repeat. Repeat.” Notas Sobre T1D?
“As much as I love red wine, I’ve discovered through experience that it tends to make my blood sugars plummet overnight or the next day. I stick to low-carb beer and I have smooth sailing…no highs, no lows.” Chris Miller?
“After 13 years of living in Madrid, Spain, wine is just like water at dinner. And I have several glasses every night. It doesn’t affect my sugar level at all. I guess I’m lucky and a wino!” Richard Nazarewicz
“I drink IPA beers and usually see a blood sugar spike after the first one, so I bolus for 15 to 20 grams, and keep taking a look at my blood sugar as I have a second or maybe third.”
“Always cheesy chips before bed, and don’t put in any insulin for the whole evening. Would always rather be very high for one night than very low the next morning.” Christie Roberts
“One time, I was in one of those inexplicable chronic low blood sugar situations while on vacation . I finally made the best of it and treated the lows with Mai Tais! Others drank with me in “sympathetic support of my chronic hypos.” Donna Hill?
“I try to limit myself to no more than two drinks, or else I tend to go low during the night.”
Check Your Blood Sugar Before During And After Drinking
The more alcohol you drink, the more you should check your blood sugar during the 10 to 12 hours after drinking. “If you drink one alcoholic beverage,” explains Harris, “it’ll take your liver about 1.5 hours to process it. But if you drink two alcoholic beverages, the time it takes to process doubles to 3 hours.”
The more you drink, the more hours it takes for your body to deal with all of that alcohol.
You Might Be Interested In:
ADA Guidelines on Alcohol & Blood Sugar
The American Diabetes Association does have guidelines regarding alcohol and blood sugar and how alcohol affects blood sugar. Some of their recommendations include:
- The advice when it comes to alcohol and blood sugar is no more than one drink per day for women and two drinks per day for men.
- If you have diabetes, you shouldn’t drink when your blood sugar levels are low or you have an empty stomach.
- People with diabetes shouldn’t count the calories in an alcoholic drink as a carbohydrate choice in their meal plan.
- Certain types of alcoholic beverages may be more detrimental for people with diabetes, including heavy craft beers.
The amount of carbs and sugar varies in every alcohol, so it’s important to pay attention to labels and serving sizes when considering safe alcohol and blood sugar practices.
Whats The Relationship Between Alcohol And Diabetes
There is debate on whether light to moderate amounts of alcohol use can increase the risk of diabetes. Alcohol use, however, is known to increase the risk of type 2 diabetes. There are several ways that alcohol may do this, including:
- Damaging your pancreas where insulin is made
- Increasing your weight, a known risk factor for diabetes
- Decreasing the body’s sensitivity to insulin
- Impairing the liver, which helps to regulate blood sugar levels
The safest way to avoid any of the potential risks of alcohol and diabetes is to avoid using alcohol altogether.
If you want to start living an alcohol-free life but can’t seem to stop, help is available. Contact The Recovery Village to discuss treatment options that can fit your needs.
Effects Of Alcohol On Type 2 Diabetes
For people with type 2 diabetes, isolated episodes of drinking alcohol over the short term may slightly increase insulin production, which in turn lowers blood sugar. This is why some studies have found that one drink with a meal may have temporary benefits for a person who has their diabetes solidly under control.???
That being said, the American Diabetes Association and the National Institute of Diabetes and Digestive and Kidney Diseases recommend people with diabetes know how to recognize and manage delayed when drinking alcohol, especially if they use insulin or other that can cause blood sugars to drop.??????
Because drinking can lower blood sugar, a phenomenon called hypoglycemia unawareness can easily occur. This typically happens when people who tightly control their blood sugar levels with insulin fail to notice the symptoms of hypoglycemia or may not recognize that the symptoms they’re experiencing are due to low blood sugar.??????
Glucagon kits, widely used for hypoglycemia in type 1 diabetes, do not work if someone has alcohol in their system. Eating food will help to correct this problem.
Long-term alcohol use may be more dangerous for people with diabetes, as it may result in increased blood sugar levels . Regular consumption has been shown to lead to increased insulin resistance, which may further destroy glycemic control in those with the disease, as well as poor adherence to general treatment guidelines.??????
If You Are Vomiting From Alcohol
If you begin to vomit because of excessive alcohol consumption, it’s critical to first test your blood sugar and test your ketone level. Whether you have ketones or not, next it’s important to try drinking water to replenish the fluids you lost and prevent dehydration.
If you did have large ketones, and you’re unable to keep fluids down, you should call 911 or ask a friend to drive you to the emergency room. The only way to safely rebalance your hydration, blood sugar, and ketone levels is an intravenous bag of saline, electrolytes and possibly glucose and insulin.
Even if you don’t have ketones, repeated puking and the inability to keep water down means you need to get to the emergency room quickly. Don’t be embarrassed, don’t hesitate. Just get the help you need. It’s not a fun part of life with diabetes, but it’ll keep you alive.
So If I Have Diabetes I Can Drink As Usual
Not quite. People with diabetes need to be extra careful with alcohol.
Alcohol intake significantly increases the risk of . If your diabetes is already well under control, a moderate amount of alcohol may be fine either before, during or soon after a meal.
Even if you have a drink, this may not influence short-term blood glucose levels. However, there are some precautions to be taken care of.
Understanding Red Wine’s Nutrition
Evaluating the nutritional value of red wine is about more than checking its glycemic index and calories. A 5-ounce serving of red table wine has 3.8 grams of carbohydrates and 0.9 gram of sugar, according to the U.S. Department of Agriculture National Nutrient Database. The drink has trace amounts of minerals and vitamins, but is not a significant source of any of them.
Diabetes And Alcohol: How Does Alcohol Affect Blood Sugar
Balancing diabetes and alcohol can be a tricky endeavor. Even in a non-diabetic, not only does alcohol affect certain people differently, different types of alcohol have very different effects on the very same person!
When you add diabetes to a night of drinking, things can get complicated, and even potentially dangerous.
For people with type 1 and type 2 diabetes who take insulin or other diabetes medications that lower blood sugar levels, drinking alcohol needs to be done thoughtfully.
In this article, we’re going to look at how alcohol affects blood sugar levels, when it can become especially dangerous, and how to drink alcohol safely as a person with diabetes.
Table of Contents
It Wears On Your Entire Body
Regular drinking is not only going to make your blood sugars more difficult to control, it’s going to wear on your liver and your kidneys, both of which are already under greater stress if your blood sugars are higher than ideal.
If you already have diagnosed retinopathy in your eyes, regular drinking can worsen the health of the nerves and blood vessels in your eyes.
The long-term effects of regular alcohol consumption are well documented, but for people with diabetes, anything wears on us more noticeably because our body is already experiencing higher levels of inflammation along with blood vessel and nerve damage due to non-diabetic blood sugar levels.
The American Diabetes Association recommends that people living with diabetes follow the general guidelines for alcohol consumption:
- Men: No more than 2 drinks per day on average
- Women: No more than 1 drink per day on average
Drink Tomato Juice Instead Of Sugary Fruit Juice
If you enjoy drinking juice — or you’re tired of drinking water all the time — avoid sugary fruit options and instead opt for a small portion of vegetable juice, like tomato juice, Zanini says. And as long as you stick to 100 percent tomato juice with no added salt or sugar, it might provide you with some good overall health benefits.
For instance, drinking 1½ cups of tomato juice a day for a month cut down on some measures of inflammation in obese women, according to research published in the British Journal of Nutrition. Tomato juice has about 10 grams of carbs per cup, so you’ll need to factor that in.
As always, it’s better to eat whole fruits and vegetables than drink them, Zanini says. Eating one whole tomato per day may help reduce blood pressure and, by extension, the cardiovascular risk associated with type 2 diabetes, according to a study published in the International Journal of Food Sciences and Nutrition.
If You Have Kidney Disease Or Liver Issues
If you’ve already been diagnosed with conditions relating to your kidney or liver function, Harris says alcohol truly is something you should avoid entirely.
The National Kidney Foundation says that while one drink on rare occasion for a person with existing kidney disease isn’t necessarily life-threatening, it isn’t going to help either. And they are very clear that “excessive drinking”–defined by more than four drinks daily–can absolutely worsen your kidney disease and be a life-threatening habit.
Can You Recommend A Few Low
Q: Can you recommend a few low-sugar wines for a diabetic? —Patti
A: According to Thomas Donner, associate professor of medicine at Johns Hopkins University School of Medicine and acting director of the Diabetes Center, most table wines have little to no residual sugars, and therefore no immediate effect on blood sugar levels. Dessert wines, however, do have residual sugars, and should be avoided by sugar-sensitive patients.
But as a diabetic, it’s not enough to know how much sugar is in wine, you also have to be aware of how alcohol affects your sugar levels. In diabetics, the liver produces extra sugars. Alcohol reduces the amount of sugar a liver produces, so consumption of alcohol can actually bring these sugar levels down temporarily. As such, according to Donner, “alcohol may be paradoxically beneficial for people with diabetes.”
Patients taking insulin need to be especially cautious when drinking alcohol, since insulin also lowers blood sugar levels. Donner explains: “the amount of alcohol in one glass of wine is enough to prevent the liver from making sugar, thus increasing the risk of a more severe low blood sugar reaction from insulin therapy.” Too much alcohol can also impair someone’s ability to recognize the symptoms of low blood sugar. Insulin patients, therefore, must be vigilant and test their blood sugar levels when consuming alcohol.
Have a question about wine and healthy living? E-mail us.
Will I Have A Hypo Whilst Drunk
The symptoms of drunkenness can be very similar to a hypo, which can lead to very dangerous confusion.
Furthermore, if you have been drinking heavily, there may be a risk of hypos for up to 16 hours after you have stopped drinking.
Monitoring blood glucose levels closely is an essential part of managing your diabetes in this situation.
How Red Wine Affects Blood Sugar
According to the , drinking red wine — or any alcoholic beverage — can lower blood sugar for up to 24 hours. Because of this, they recommend checking your blood sugar before you drink, while you drink, and monitoring it for up to 24 hours after drinking.
Intoxication and low blood sugar can share many of the same symptoms, so failing to check your blood glucose could cause others to assume you’re feeling the effects of an alcoholic beverage when in reality your blood sugar may be reaching dangerously low levels.
There’s another reason to be mindful of your blood sugar levels while drinking: Some alcoholic beverages, including drinks that use juice or a mixer high in sugar, can increase blood sugar.
Does Quitting Alcohol Lower Blood Sugar Levels
Quitting alcohol will help your blood sugar levels stabilize and reduce spikes in your blood sugar. The body often eliminates these spikes in blood sugar by turning the sugar into fat, creating obesity, sometimes known as a “beer belly.” By stopping alcohol use, you will reduce your risk of obesity which, in turn, will improve your blood sugar levels.
Can Diabetics Drink Wine Despite The Sugar In It
Besides alcohol, sugar in wine brings up the most questions about whether you should drink wine if you have diabetes. Wine does contain sugar which is residual, and it’s just a mandatory part of the wine. Sugars in grapes are naturally occurring and during fermentation, they are eaten by the yeast and turned into ethanol – the alcohol, as a by-product during the fermentation process.
During the production of dry red wines, the yeast eats all the sugars in grapes. That’s why dry wines have lower residual sugar levels, ranging from 1 to 3 grams per litre of wine which makes it safe for drinking if you are fighting with sugar in blood.
There are also wines where yeast hasn’t eaten all the sugar such as dessert and fortified wines, making them significantly loaded with sweetness. They are the ones you should definitely avoid.
But the good news is that you don’t have to quit on fine wine, as you can choose wine low in sugar such as dry or sparkling wines.
On Pull The Cork, we have a wide selection of low sugar wine and you should try natural wine which is perfect for anybody but especially for those who struggle with sugar in the blood.
Things You Should Know About Wine And Diabetes
People with type 2 diabetes have been found to be 2-4 times more likely to suffer from heart disease when compared to people who do not have diabetes, according to the American Heart Disease, an organization that studies diabetes and its complications.
There is some evidence that, when a person with diabetes drinks a moderate amount of red wine per day, they could decrease their chances of heart disease. Other evidence indicates that no amount of alcohol should be taken in by diabetics.
What Is Blood Sugar
Blood sugar, also called blood glucose, is sugar that’s carried to the cells through the bloodstream. Blood sugar generally refers to the concentration of sugar in your blood at a specific time.
We get sugar from the foods we eat, which is normal, and it’s the body’s job to regulate blood sugar levels, so they don’t go too high or low. When a person has balanced blood sugar, it’s called homeostasis.
Throughout the day, it’s not uncommon for blood sugar levels to go up and down based on when you eat and how your body releases a hormone called insulin. If you’ve just eaten, your blood sugar levels will go up, and then they’ll settle back down. If you have diabetes, however, your blood sugar levels may have to be specially managed.
If your blood sugar is always high, you have hyperglycemia, which can happen in people who don’t have a good handle on their diabetes. If your blood sugar is below normal, it’s called hypoglycemia, and this can happen in diabetics if they accidentally use too much of their medication.
So, what role does alcohol play in all of this and how does alcohol affect blood sugar?
Alcohol And Blood Sugar When You Dont Have Diabetes
So, what should you know about how alcohol affects blood sugar if you don’t have diabetes? Some of the ways alcohol affects blood sugar include:
- Alcohol is high in sugar and calories, which can raise the risk of type 2 diabetes. Drinking moderately isn’t likely to lead to type 2 diabetes, but excessive drinking over time can be a trigger for its development.
- If you drink alcohol, it’s important to factor in those sugars and calories when you’re looking at your overall diet.
- Even if you don’t have diabetes and drink excessively, it can cause low blood sugar because drinking increases insulin secretion, although it is unlikely these levels will get dangerously low.
How To Drink Safely
When you’re planning to imbibe alcohol, take steps to keep your blood sugar under control, such as:
- Identify yourself. Before heading out to a bar or restaurant where you plan to have a drink, put on your medical ID bracelet so if an emergency arises medical personnel will know you have diabetes.
- Hydrate. For each alcoholic beverage you drink, down one glass of water or seltzer—this will help you stay well hydrated and consume less alcohol.
- Drink with food. Do not drink on an empty stomach. Have a snack or meal as you sip or immediately beforehand to reduce your risk of . Choose foods that have some carbohydrates, so that you have some glucose in your system and therefore are at lower risk of having low blood sugar.??
- Test your blood sugar. Consuming alcohol can cause blood sugar levels to drop as many as 24 hours afterwards. Check your blood sugar before heading to bed. According to the American Diabetes Association, you should be in a healthy range of between 80 mg/dL and 130 mg/dL before bed.?? If it’s low, follow your physician’s recommendations, such as taking in extra calories to counteract the drop.
If you are following a fixed carbohydrate meal plan you may need to eat a little extra when drinking. Because drinking alcohol can stimulate your appetite, be mindful that you do not replace food with alcohol and do not count alcohol as part of your carbohydrate choices.
How Sugar Affects Your Body
Too much sugar is bad for your heath in a number of ways. Firstly, it’s very high in calories, and excessive consumption can lead to unhealthy weight gain. Being overweight can make you more susceptible to long term health problems, including life threatening illnesses such as heart disease. A high-sugar diet can also lead to type 2 diabetes, which occurs when a person’s blood sugar levels are too high.
Quite apart from the damage it can do to your body, sugar is also the main cause of tooth decay, which can lead to cavities if left untreated.
Things To Remember About Alcohol & Diabetes
Alcohol and diabetes can be a tricky combination, but it’s absolutely possible to enjoy drinking responsibly if you remember these guidelines:
If you found this guide to diabetes and alcohol useful, please sign up for our newsletter in the form below. We send out a weekly newsletter with the latest posts and recipes from Diabetes Strong.