Diabetes & Alcohol

glasses of red and white wine

Drinking alcohol can lead to serious low blood sugar reactions.

Alcohol can also affect diabetic nerve damage, eye disease, and high blood triglycerides.

You may wonder if drinking alcohol is safe for people with diabetes. If you drink alcohol, there are some things you need to know first about alcohol safety.

Is it Safe to Drink Alcohol?

Check with your doctor to make sure alcohol doesn’t interfere with your medications or complicate any of your medical conditions. Drinking alcohol can lead to serious low blood sugar reactions, especially if you take insulin or types of diabetes pills that stimulate the release of insulin from the pancreas. Alcohol can also affect other medical conditions you may have, like diabetic nerve damage, diabetic eye disease, and high blood triglycerides. Get guidelines for alcohol use from your medical provider.

How Much Alcohol Can I Drink?

If you choose to drink alcohol, drink in moderation. Limit your intake of alcohol to no more than one serving per day for women, and no more than two servings per day for men.

One serving size of alcohol equals:

  • 12 ounces of beer
  • 5 ounces of wine
  • 1½ ounces of distilled spirits (such as rum, whiskey, gin, etc.)

Alcohol and Risk of Low Blood Sugar

If you are managing your diabetes with diet and exercise alone, drinking alcohol can stil increase your risk of low blood sugars. And if you take insulin or types of diabetes pills that stimulate insulin production, drinking alcohol can lead to even more serious low blood sugar reactions.

Normally, the liver releases glucose to maintain blood sugar levels. But when you drink alcohol, the liver is busy breaking the alcohol down, so it does a poor job of releasing glucose into the bloodstream. This can lead to a drop in blood sugar levels if you are drinking alcohol on an empty stomach.

Each alcoholic beverage takes about 1-1 ½ hours to finish processing in the liver. For that entire time, the risk of low blood sugar exists. So, if you have 2 drinks, you double that time to 2 to 3 hours that you are at risk for low blood sugar. The more alcohol consumed, the bigger the risk for serious low blood sugar.

The solution? Never drink alcohol on an empty stomach. ALWAYS consume alcohol with a meal or snack that contains carbohydrates. Never skip meals or substitute alcohol for a meal.

Follow these safety tips too:

  • Know the symptoms of a low blood sugar (hypoglycemia) and tell others. If you should pass out, those around you need to know that this is a medical emergency, and not just a sign of intoxication.
  • Wear your medical ID bracelet at all times.
  • Carry a carbohydrate source, like glucose tablets, with you in case of a low blood sugar.
  • Test your blood sugar more often. The effects of alcohol can make it harder for you to detect symptoms of a low blood sugar.
  • In cases of severe low blood sugar, glucagon injections may not work effectively to raise the blood sugar, since the glucagon hormone stimulates the liver to release glucose – and alcohol impairs that process.
  • If you combine exercise with alcohol, your risk of low blood sugar is even higher. Because most exercise lowers blood sugar levels, check your blood sugar more often. You may need a carbohydrate snack to prevent low blood sugar.

Be Good to Your Heart and Waistline

Alcohol is high in calories and low in nutrients. That’s why alcohol is often called “empty calories.” When your liver breaks down alcohol, it turns the alcohol into fat. That means drinking alcohol can make you gain weight. At 7 calories per gram, alcohol is nearly as calorie-dense as fat (9 calories per gram). That’s where that beer belly comes from! Alcohol use can also lead to elevated blood fats, or triglycerides, which raises your heart disease risk.

Are Some Alcoholic Drinks Better Than Others?

To meet your goals of managing your blood sugar, body weight and heart health, keep these tips in mind:

  • If you are striving to lose weight, limit your alcohol intake. Or consider avoiding alcohol to rid your diet of empty calories.
  • Watch out for calorie and carbohydrate-rich mixers like regular sodas, juices and tonic water. Choose diet sodas, diet juices, diet tonic water and club soda instead.
  • Choose light beer instead of regular beer.
  • Choose dry wines instead of sparking wines, dessert wines, sweet wines and wine coolers.

View a list of calories and carbohydrates in popular alcoholic beverages on A Look at your Liquor.


Please remember to drink safely and responsibly! Never drink and drive. Don’t use dangerous equipment, or engage in activities that require coordination, concentration, or alertness. Don’t take a hot bath, hot tub or sauna because the heat combined with the alcohol may cause your blood pressure to drop too much.


How much is considered one drink?

This table lists popular alcoholic beverages and gives the average serving size, carbohydrate content, and number of calories.

BeverageServing SizeCarbohydrate
Regular beer12 oz13150
Light beer12 oz5100
Non-alcoholic beer12 oz1260
Dry White, Red, Rose4 oztrace80
Sweet wine4 oz5105
Wine cooler12 oz30215
Sparkling Wines
Champagne4 oz4100
Sweet kosher wine4 oz12132
Appetizer/Dessert Wines
Sherry2 oz274
Sweet Sherry, Port2 oz790
Cordials, Liqueurs1 ½ oz18160
Distilled Spirits
80-proof Gin, Rum, Vodka, Whiskey, Scotch1 ½ oztrace100
Dry Brandy, Cognac1 oztrace75
Bloody Mary5 oz5116
Daiquiri5 oz10281
Gin and Tonic7 ½ oz16170
Manhattan2 oz2178
Margarita6 oz29205
Martini2 ½ oztrace156
Pina Colada4 ½ oz32245
Tom Collins7 ½ oz3120
Whiskey Sour3 ½ oz14162
Amaretto Sour1 ½ oz19118
Fuzzy Navel1 ½ oz7120
Kamikazi1 ½ oz2150
Mud Slide1 ½ oz17160
Turbo1 ½ oz3110
Non-caloric mixers (mineral water, sugar-free tonic, club soda, diet soda)any00
Tonic water4 oz1141
Tomato juice, Bloody Mary mix4 oz525
Juice (orange, grapefruit, pineapple)4 oz1560

Please remember to drink responsibly, and have a designated driver!


USDA National Nutrient Database UCSF Medical Center 7/05

Self-assessment Quiz

Self assessment quizzes are available for topics covered in this website. To find out how much you have learned about  Diabetes & Alcohol, take our self assessment quiz when you have completed this section.  The quiz is multiple choice. Please choose the single best answer to each question. At the end of the quiz, your score will display. If your score is over 70% correct, you are doing very well. If your score is less than 70%, you can return to this section and review the information.

©2007-2020 Collective work Martha Nolte Kennedy,
The Regents of the University of California.
All rights reserved.