Drinking Alcohol and Diabetes

These instructions are for Children's Hospital of Philadelphia (CHOP) patients with diabetes about drinking alcohol.

Important information about diabetes and alcohol:

As a teen, you are probably going to be faced with the decision about drinking alcohol. As a teen with diabetes, you need to know how this can affect your blood sugars. There are risks in drinking alcohol. We are not recommending that you drink. If you decide to drink, you need to know the facts about diabetes and alcohol.

• Alcohol can cause initial high blood sugars, also called hyperglycemia or highs.

• Alcohol can cause delayed low blood sugars, also called hypoglycemia or lows.

• When intoxicated, there is a higher chance of making poor decisions that could affect your health and safety.

What is happening in your body?

• Throughout the day your liver releases stored glucose. This steady stream of glucose, along with your basal, or long-acting insulin, keeps your blood sugars stable throughout the day.

• Another job of the liver is to keep your blood clean. When drinking alcohol, the liver gets distracted as it cleans out the alcohol, and it stops producing glucose. This is extremely important to know since you still have basal insulin working and your blood sugar may go too low.

Instructions for what to look for and what to do about drinking alcohol with diabetes:

High blood sugars

• Food helps absorb alcohol. Food can also "take up space" in the stomach so that alcohol doesn't absorb as quickly. Make sure you eat carbs throughout the night and before bed. Eat more carbs if you are active, like dancing, playing basketball or heading out to a pool party. You will need extra carbs for every 30 minutes of activity.

• Some alcohols and mixers used with alcohol may contain carbs. Consider the different types of liquids you mix with your drink (soda, juice, sugary syrup) as you may need to take insulin.

• It is not recommended to dose fast-acting insulin for all the carbs you eat and drink when you are drinking alcohol. Try dosing for half the carbs to start. Speak with your diabetes team to get suggestions on recommended insulin dosing for your situation.

• If you are going to bed with a high blood sugar, it is not recommended to give a correction dose. Your blood sugar will come down later.

• Stay hydrated with non-sugared, non-alcoholic beverages before, during and after drinking alcohol.

Watch out for lows!

• Alcohol puts you at risk for low blood sugars up to 12 hours later.

• Have a snack before going to bed. This may be without fast-acting insulin coverage. It is dangerous to have a low blood sugar while sleeping or intoxicated since it is more challenging to recognize and treat the low.

• Decrease your basal insulin injection or basal rate on your insulin pump.

• Carry fast-acting carbs to treat low blood sugars.

• Glucagon does not work well when you drink alcohol. Make sure you have a plan for emergencies. Share this plan with your friends and family. Your plan may include glucose gel, sugared drink, or calling 911.

Safety tips for drinking alcohol responsibly:

• Tell your friends and family what to look for and how to treat a low blood sugar. If you have a college roommate or friend on campus, it is important to train them to recognize low blood sugar symptoms. You should instruct them to give glucagon and call 9-1-1 if they are unsure if your symptoms are due to low blood sugar or alcohol intoxication.

• Know your drinks. Check the alcohol content of beer, wine, and spirits. Know the carb counts of sodas, mixers, and juices.

• Don't overdo it! Diabetes or not, it is dangerous to consume too much alcohol.

• Don't drink on an empty stomach. Eat something before going out like a full meal with carbs and protein.

• The signs of intoxication can look like a low blood sugar. Make sure the people you are with know the difference.

• Wear a medic alert ID. Symptoms of a low blood sugar can look like you had too much to drink. Medic alert IDs keep emergency personnel aware.

• Be sure to carry your diabetes supplies with you.

  • Have a way to check your blood sugar.

  • Carry oral glucose gel or tablets and glucagon.

Remember to use and consume alcohol in a responsible manner.

Alcohol should be used and consumed only by persons of legal drinking age. The Diabetes Center does not support underage drinking.

Contact the Diabetes Centerwith questions or concerns.

Reviewed on March 1, 2023, by Kelli O’Connell, MS, RD, LDN, CDCES, CPT