Alcohol and Diabetes
Diabetes mellitus is a disorder of the endocrine system. It is a disorder in the blood levels of insulin, which is a hormone in the pancreas that helps convert blood sugar into energy.
Type 2 diabetes (which is also called adult-onset diabetes) results from the body’s inability to process this hormone effectively. Almost 90 percent of all people with diabetes have Type 2. Being overweight and having a family history of diabetes are the strongest predictors of Type 2 diabetes. Lifestyle patterns (being inactive), including alcohol consumption, may also play a role in the development of the disease. Seventy-eight per cent of people who have Type 2 diabetes will experience some degree of vision loss.
Diabetes affects approximately 1.8 million
adults in the Canada. Ten
Canadians aged 65+ have the disease, compared to 3% of those aged 35 to 64. With the aging of the Canadian population, the number of
cases of type 2 diabetes are projected to increase. The
rate of Type 2 diabetes is
3 to 5 times higher in native communities than
in the general population. (1) Does Alcohol Affect the Development
Diabetes affects approximately 1.8 million adults in the Canada. Ten percent of Canadians aged 65+ have the disease, compared to 3% of those aged 35 to 64. With the aging of the Canadian population, the number of cases of type 2 diabetes are projected to increase. The rate of Type 2 diabetes is 3 to 5 times higher in native communities than in the general population. (1)
Does Alcohol Affect the Development of Diabetes?
There is some evidence to suggest that moderate consumption of alcohol leads to a reduced risk of developing diabetes. In 1995 Harvard University researchers reported in the British Medical Journal that men who consumed two drinks per day had a 40% reduced risk of developing diabetes compared to non-drinkers. (2)
A 1999 research article in the July 21 Issue of the Journal of the American Medical Association suggests that light to moderate alcohol consumption by people with type 2 diabetes is associated with a reduced risk of death due to coronary heart disease. In the study, researchers compared people who never drank alcohol with people who reported drinking light to moderate amounts of alcohol (up to two drinks per day). When the data were analyzed, the results suggest that such alcohol consumption might lower risk of death from coronary heart disease by as much as 80 percent. (3) As with all research of this nature, it is important to consider whether there are other social, economic, health, or lifestyle differences that distinguish drinkers from never-drinkers.
Other research suggests that the ties between alcohol and diabetes may be more complex. A Japanese study looking alcohol and the risk of diabetes, compared men with different body masses, and discovered a bit of a paradox. Those lean men had a higher risk of developing Type 2 diabetes if they were heavy drinkers. Heavier men, in contrast, had a greater risk of developing Type 2 diabetes if they were moderate drinkers. (4)
The American Diabetes Association (ADA) stresses the importance of individuals and physicians working together to make decisions regarding consumption, whether or not the patient has diabetes.
People who have difficulty limiting themselves to light to moderate drinking should not be encouraged to drink.
What Are the Concerns About Alcohol for Older People Who Have Diabetes?
There are several concerns:
1. Older people can have a harder time telling when their blood glucose is low. Like all people who have diabetes, the aim is to have the best blood glucose control possible.(5)
2. Any person who has diabetes and is drinking more than moderate amounts
may be neglecting his or her diet. The person may not be eating or not getting proper nutrition. The person may not be drinking enough non-alcoholic fluids to avoid becoming dehydrated. (6)
may be or can become overweight because of a sedentary lifestyle. Often the person in this situation is consuming a lot of empty calories from the alcohol, and not eating well planned meals. (6) Either way, lack of proper nutrition can throw the blood glucose levels out of control.
may not be taking the oral medications properly or taking advantage of other monitoring supports, such as outpatient follow up visits. (6)
3. A person who is drinking may be experiencing low blood glucose. Other people may mistake this as intoxication, and they may not act in time to help the person.
4. Diabetes that is not being well controlled often leads to peripheral neuropathy, which in turn impairs the person's mobility.
"Peripheral neuropathy begins with painful burning, tingling and aching in the toes and/or fingers that can, when advanced, change to numbness of the feet or hands occasionally associated with sudden sharp pain. Usually the pain is worse at rest, and it frequently interferes with sleep. There is no satisfactory treatment for painful diabetic neuropathy." (7)
5. There are several health problems related to diabetes, including potential vision loss and impaired mobility. These health problems can make it significantly more difficult for an older person to access many of the available resources if she or he develops an alcohol problem.
Guidelines for People Who Have Diabetes
McKinley Health Services in the United States has an interesting handout on its website called "Alcohol, Diabetes and You" which describes how alcohol affects a person who has diabetes, and how alcohol affects blood glucose. It gives "safe sipping tips", carbohydrate grams and exchanges. The information is reprinted from the American Diabetes Association and the American Diabetics Association.
The Canadian Diabetes Association (CDA) http://www.diabetes.ca/Section_About/nutrition2000.asp notes that
|"moderate alcohol consumption is acceptable for people with diabetes whose blood glucose and blood fats are well controlled. All people with diabetes should discuss alcohol consumption with their dietician. Such individuals could consume up to five percent of total daily calories (or two drinks per day), whichever is less."|
The Canadian Diabetes Association also notes that people using insulin should be aware of delayed hypoglycemia that can occur up to 14 hours after alcohol consumption.
WebMaster's Note: Please note both of these sources provide the guidelines to adults generally (which means the guidelines have not been adjusted for age). That information may need to be carefully considered and modified in light of the fact that an older person's body metabolizes alcohol more slowly, as well as in light of other health problems an older person may be experiencing in addition to the diabetes.
How Many Calories Are There in Alcohol
The Canadian Diabetes Association gives some caloric breakdowns of common alcoholic beverages based on Canadian beverage standards:
|1 regular beer||
|1 light beer||
|45 mL (1.5 oz) whisky, rum, scotch
|100 mL (3.5 oz) red/ dry white wine||
Alcoholic beverages can make your blood sugar drop. Avoid the risk of a low blood sugar by having your drink at meal time, or having snack along with the drink.
The carbohydrate content of alcoholic drinks will vary. Limit those with sugar as they will have a higher amount of carbohydrates and may therefore contribute to a high blood sugar. Avoid sweet mixers and use sugar-free products.
Signs and symptoms of low blood sugar and intoxication are similar! If you take insulin, don't get into a situation where you may be drinking on an empty stomach and getting hypoglycemic - and your friends just think you are a little "tipsy". Make sure your companions know you have diabetes and know how to treat an insulin reaction. Always wear identification that you have diabetes.
It is not advised to drink if you are taking certain medications. People taking oral hypoglycemic agents may have a reaction to the alcohol. Discuss this with your doctor.
(1) Canadian Diabetes Association, www.diabetes.ca/Section_about/index.asp
(2) Rimm, Chan, Meir, Stampfer, et al. (4 March, 1995). Prospective study of cigarette smoking, alcohol use, and the risk of diabetes in men, British Medical Journal, 310, 555-559.
(3) Criqui, M. &, Golomb, B. (July 21, 1999). Should Patients With Diabetes Drink to Their Health? Journal of the American Medical Association, 282, No. 3. 279-280 Extract at :
(4) Tsumura, K., Hayashi, T., Suematsu, C. et al. (1999) Daily alcohol consumption and the risk of type 2 diabetes in Japanese men. Diabetes Care, 22(9),1432-1437.
(5) Guidelines for the Nutritional Management of Diabetes Mellitus in the New Millennium, A Position Statement by the Canadian Diabetes Association, Reprinted from the Canadian Journal of Diabetes Care, 23 (3), 56-69 www.diabetes.ca/prof/nutritional_guide_eng.pdf, p. 8.
See also, Clinical Guidelines, www.diabetes.ca/cpg2003/chapters.aspx
(6) See for example: Johnson, K.H., Bazargan, M., & Bing, E.G. (2000). Alcohol a consumption and compliance among inner city minority patients with type 2 Diabetes Mellitus. Archives of Family Medicine, 9 (10), 964-70.
(7) Ask the Podiatrist,... www.diabetes.ca/membership/dialogue/fall00-askprof.html
Last update: 02/01/2005
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