Alcohol, in moderation, is fine for most people with diabetes—it may even be good for you—but alcohol can lower blood glucose levels. The American Diabetes Association recommends that men with diabetes limit their alcohol intake to no more than two drinks per day and women to no more than one per day.
The body uses a special process to break down alcohol and it stops the body’s ability to make its own glucose from the liver (gluconeogenesis), so drinking alcohol can lower blood glucose levels afterwards. It is very important to understand how your body and blood glucose levels react to the type of alcohol you drink—beer vs. wine vs. mixed drinks vs. hard liquor. Do some trials at home in a safe environment before drinking in a social setting.
It is usually recommended to avoid giving insulin for your first alcohol beverage and to check your blood glucose levels consistently during a night of alcohol consumption. Some people will need less insulin after drinking alcohol. It is a good rule of thumb to be sure to eat some carbohydrates along with drinking alcohol to help minimize the low blood glucose effect. If having a drink with a lot of sugar in it, such as fruit juice, you may need to take less insulin than anticipated for the juice carbohydrates. Discuss strategies for safe alcohol use with your healthcare team.
Avoid binge drinking. Be sure to drink with friends who are aware that you have type 1 diabetes. Being drunk and being hypoglycemic can sometimes look alike, and it is important not to confuse the two. If you begin to vomit after drinking, your friends should seek care at an emergency department to be sure you aren’t in DKA.