What Alcohol Really Does to Your Blood Sugar

Alcohol and diabetes: blood sugar crashes, myths, and safer drinking strategies
Diabetes Digital Podcast by Food Heaven
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Welcome back to another episode of the Diabetes Digital Podcast.
Today we are talking about alcohol.
I love me some alcohol.
You do.
Love me a cocktail.
But if you do drink alcohol and you have pre diabetes or diabetes, this episode is definitely for you.
0:20
This conversation is going to be filled with tips to help you navigate drinking alcohol more safely while managing your blood sugar.
And just a quick reminder that everything we share is for educational purposes.
It’s not a substitute for personalized medical advice.
Welcome to the diabetes digital podcast.
0:37
I’m Wendy.
And I’m Jess, and we’re best friends, registered dietitians and diabetes educators.
Through our telehealth platform, Diabetes digital.co, we offer accessible and personalized virtual nutrition counseling for people with diabetes and pre diabetes.
Visit diabetesdigital.co.co to book your first appointment.
0:57
We accept insurance and offer affordable self pay options.
Now let’s get into today’s episode.
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Now on to the episode.
All right, let’s just jump right in to alcohol and its impact on blood sugar.
And why does it impact blood sugar differently?
Because I feel like a lot of people don’t know that alcohol can either raise or lower your blood sugar.
3:19
And we’ll talk about how that works.
So alcohol is metabolized in the liver, which is also responsible for releasing glucose into the bloodstream.
OK.
So just a quick reminder.
When you eat foods that have carbohydrates, so things like bread, cakes, pasta, those breakdown into glucose and the liver is responsible for releasing that glucose into the blood.
3:44
So when you drink, your liver prioritizes breaking down the alcohol in May ’cause glucose release, which can increase the risk of low blood sugar, also known as hypoglycemia, especially several hours after drinking.
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Why is that?
Because the liver looks at alcohol is a toxin that it has to get out of the body, so it prioritizes breaking that down 1st and may not put enough sugar into your blood.
And why do we need sugar slash glucose in our blood for energy?
4:16
So if you are on medications like insulin or sulfonarias, then these medications already lower blood sugar.
So when you combine them with alcohol, they can double down on the risk of hypoglycemia or low blood sugar.
4:31
Let me give you an example of one of my patients.
So they drank wine with dinner and they took their usual insulin.
They felt fine, but then at 3:00 AM, they woke up.
And what happened?
They were shaky.
They were confused, and that’s because their blood sugar dropped hours later.
4:49
And that’s because they drank that alcohol and they were also on insulin.
So why is this tricky?
Because low blood sugar symptoms can mimic being intoxicated.
So what does it feel like when you’re driving?
Well, Wendy, let me ask you, what are your symptoms of when you’re feeling the alcohol?
5:12
Uninhibited for sure, which needs to me drinking more alcohol because I’m like free and wild, getting hungry, wanting to eat food.
And the tricky thing with that is that because you’re uninhibited and you’re hungry and let’s say you are eating food, your body’s not fully registering what is happening in the body with digestion.
5:34
And you’re probably at capacity, but you just keep eating because your, your brain is not fully like registering things.
And that can go the other way as well.
Yeah, and also for many of us, including me who doesn’t drink and so like 1 drink, I’m over the edge.
Like you can have confusion, slurred speech, dizziness, and those are the symptoms of someone who might be intoxicated, but also the same symptoms of low blood sugar.
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So that really makes it harder for the person or other people around them to recognize this is a blood sugar emergency.
So it’s really important to remember, especially if you are somebody who is taking medications like insulin or medications that lower your blood sugar, to not drink on an empty stomach.
6:19
Honestly, this is good for everybody, but those people, it’s critical.
Don’t drink on an empty stomach.
Always eat a meal with carbohydrates, protein, fiber and healthy fat before or with your alcohol and know your medications.
So you definitely want to talk to your doctor or diabetes educator about how alcohol might interact with them.
6:39
And also like, if you don’t have access to a balanced meal, because oftentimes when you’re out drinking, a lot of these establishments might have just like bar food or like things that are very convenient, it’s better to eat that than not eat anything at all.
So if it’s like, you know, a pretzel stick or, I don’t know, wings, like whatever bar food is available, have that instead of like completely skipping that meal.
7:06
And now I’m going to go into like just some myths and misunderstandings.
One of the biggest ones is that alcohol always raises your blood sugar.
And that is not necessarily true.
It can spike your blood sugar if it’s a sugary drink, like if you’re having a daiquiri or something like that.
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But if you’re having more of like a straight drink with none of those like additives, like let’s just say like a whiskey knee or something like that, then that can actually cause a drop in your blood sugar, especially if you’re on those medications that just was talking about.
And if you’re on insulin, then you definitely need to be eating something when you’re drinking alcohol.
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Another myth that we come across a lot is that light beer or low carb drinks are always safer.
And again, not necessarily.
While they might have fewer carbohydrates, they can still lower your blood sugar and interact with certain medications.
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So low carb doesn’t necessarily mean low risk.
Another myth I’m misunderstanding, if my blood sugar is high, alcohol is going to help bring it down.
You know, alcohol is is not a treatment option for hyperglycemia.
OK?
Like you don’t want to use alcohol to try to get your blood sugar down, especially if you notice that you have like a very heavy meal followed by dessert and you’re like, OK, well, let me throw down a drink so I can get the glucose down.
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It’s not the most safe or effective way to do that, and it can backfire, especially if you’re taking insulin.
And then the last myth that I see a lot is this idea that it’s OK to skip meals when drinking to avoid blood sugar spikes.
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And that ties into what I was saying earlier.
Skipping meals while drinking can increase the risk of hypoglycemia, which is when your blood sugar is dropping too low.
And so like, having a drink is not a replacement for having a meal.
You always want to pair those things together, even if it’s like a hearty snack, you know, just so that your stomach has something to hold on to and hopefully your blood sugars are a little more stable.
9:11
Now, I don’t want people to feel like we’re telling you, especially if you have diabetes and you’re on these meds, that you can’t drink alcohol because it definitely has an impact in our life.
And you know, there’s people who really enjoy alcohol.
Or it might be part of the holidays, birthdays, weddings, workplace happy hours.
9:30
Also, in some cultures, not drinking can feel like going against the grain or even disrespectful.
It’s so funny because my husband doesn’t drink, but my dad drinks beers and like he only every single time he asked him like, hey, do you want a beer to drink with me?
9:46
My husband always says yes and I’m like, why are you drinking beer?
He’s like, I’m not gonna decline.
It’s rude.
You don’t drink.
You know, such as like, drunk off of.
Yeah, yeah.
Sitting there with this beer, I’m like, I get it.
10:01
Like certain cultural situations or you know, the in laws, whatever it is.
And people with diabetes may feel left out judge or pressure just to have one, even if they’re unsure how it will affect your blood sugar.
So This is why I really want people to work with their doctor, their dietitian, their diabetes educator to figure out a plan and strategy that works well for you individually.
10:23
It might involve some testing here and there just to see what’s going to keep your blood sugar from, you know, spiking way up and also dropping too low.
Now, a couple of just general tips cause again, this is not to be substituted with medical advice.
10:39
And some of these we have said, but we’re just like hammering down on them because they’re so important.
And #1 is never drink on an empty stomach ever, ever, ever.
If you only take one thing from this podcast episode, take that you don’t want to drink on an empty stomach.
Always pair your alcohol with different macro nutrients.
10:57
Again, it may be bar food, it may be a full meal.
Ideally, you know, carbs, fat, protein, fiber.
This will slow the absorption and lead to more stable blood sugar.
Also, choosing drinks with fewer added sugar.
So options like dry wine, spirits with soda water and lime, or a light beer tend to have a less immediate impact on blood sugar than let’s say, cocktails sweetened with mixers or liqueurs.
11:21
I Remember Me, I didn’t really drink in college.
Probably I can count on two hands the amount of times I drank, which is wild.
But one of those drinks that we would have here and there, me and my friends would be going to Cheesecake Factory and getting either like a Midori sour or what was the other one, a Peach Bellini.
11:41
And then when you look, because you know, cheesecake has like the nutrition labels, it’s a lot of sugar and those drinks are soup.
They taste amazing, but they’re like super sweet.
And so, you know, if you’re concerned about blood sugar, like maybe spacing those out with water or you know, going for the options that I mentioned.
11:59
And of course, it’s really important if you do have diabetes, pre diabetes PCOS, like monitoring your blood sugar closely.
So definitely check throughout your night of cocktails drinking and also check before bed because as as we mentioned, those lows can happen hours after drinking, which catches a lot of people by surprise, especially if you’re taking insulin or glucose lowering.
12:23
Meds.
Yeah.
And that reminds me with The Cheesecake Factory, the volume of some of these drinks is like crazy.
It’s like it serves 5 people and they’re so, so sweet.
And I don’t have diabetes, but personally I prefer less volume.
12:42
And so something that you can do that I always do is getting drinks served up.
Yes.
Even if they’re typically served like on the rocks, like a Margarita, you can ask to see if they can serve it up, which means that they’ll put it in like a coupe or something.
12:58
It won’t have any ice.
It’s way less volume, more alcohol, more spirit forward.
You save money because you don’t need as many drinks to get a little buzz, you know.
So that’s something that you can do as well.
And I love bars where like they have.
13:15
I’m seeing that more and more now when I go to bars.
So I don’t know if it’s like something that’s that’s becoming more popular, but they’ll have pictures of the glasses that they serve the drinks in next to like, yeah.
And I’m like, Oh my God, every bar needs to do that because I hate when I get a huge glass and it’s like all this ice and I’m like, OK, no, I this is not what I signed up for.
13:38
Yeah.
So that’s something that you can do as well.
But if you’re going to be out and about and you have diabetes, just make sure that someone, someone knows.
If you’re by yourself, then you’re by yourself.
But if you’re with friends or family and they don’t know, especially if you’re on medication, just let someone know in case you go a little bit low and, you know, maybe they’re like, oh, she’s, she’s having a great time.
14:00
She’s, you know, so drunk.
And it’s actually like you have hypoglycemia.
So they might be able to catch something that maybe you’re missing.
And medical IDs is something that you can wear as well.
This could be a lifesaver if you’re on insulin and you lose consciousness and especially if you’re by yourself.
14:18
There are medical IDs for people that have diabetes.
So that’s something that you can get at the pharmacy or you could talk to your doctor about.
And it’s important to keep supplies with you.
So if you are on glucose lowering medications, you could get glucose tablets at the pharmacy.
14:34
I think you might also be able to get them prescribed to you.
You could just, you know, put them in your wallet, put them in your bag.
It’s very discreet.
And if you’re finding that you’re going too low, you could just pop a few of those tablets to bring your blood sugar back up.
So those are some things that might be helpful too.
14:51
And.
Now my specialty, the mocktails, I also wish they would have those pictures next to mocktails because I just don’t like a lot of volume unless it’s water in general, because I’m just like, this is a lot.
So if you’re someone who’s like, I prefer to skip alcohol, mocktails can still feel fun and festive for whatever reason you’re choosing not to drink.
15:12
It can be, you know, you just start trying a dry life and seeing how it goes, or it could be a health reason.
Whatever it is.
Yeah, it could be a personal preference like it is for me.
I just don’t like, I feel sick when I drink and I, I honestly wish I could drink, but I literally my body’s like, no.
15:29
So let’s talk about mocktails.
Nowadays.
There are so many mocktails.
Even when I was out with Wendy and her husband, like they had like beers that were mocktails that were really good.
It’s everywhere.
There’s like these CBD ones that I love.
15:44
Me and my friend Rawa, we go to this bar in Sacramento and they’re so good because you have, it gives you a little bit of a relaxing feeling, but it’s they’re.
Yeah, they’re really good.
There’s it’s just CBD and and like water, there’s like no sugar.
Because the thing with me too is like the sugar that is like the number one thing if I think about what makes me feel tired and crash is if I have a sugary drink.
16:07
So even with the mocktails, sometimes they like overcompensate.
It’s a little too much sugar and I feel kind of like, so I like stuff that’s like very limited on the sugar.
Another thing is soda water with lime and herbs.
That one is great because it’s more water based.
Or even my favorite signature mocktail to ask for when they don’t have any or if I just want something refreshing is a soda water with a splash of pineapple juice.
16:32
Tastes delicious.
And the nice thing is when you’re drinking like a water based drink, you still feel great.
Like when I was out with Wendy and Gabe and my husband in another event, like I had water and I was like, I feel drunk.
16:51
I’m hydrated, y’all.
So I.
Think it’s mental like yeah just you’re high off the vibes.
I’m high off the vibes and I’m high off hydration and electrolytes.
OK so yeah, definitely don’t underestimate how great you can feel just drinking water.
17:08
You can also infuse sparkling water with cucumbers, berries, or ginger for another refreshing option.
Or let the bartender just go at it.
I feel like they love getting a chance to just get creative.
So say hey can you just make me a really good no proof drink?
17:26
Like whatever you think.
I mean these days most restaurants have a whole mocktail menu.
It’s it’s become a whole industry at this point.
And we even have like a bar here called Tea Totalis, which is a non alcoholic bar and there’s so many great wines and it’s just a new, it’s a new day for the non drinkers.
17:45
It’d be annoying me though, because with these mocktails I’m like, okay, $15.
Right, the fish is juice.
Like it’s juice and seltzer water.
Yeah.
So yeah, you need to stop overpricing and slapping mocktail on it.
18:00
Yeah, it’s.
Ridiculous.
So that I really don’t like cuz yeah, some of my friends were on the mocktail cake.
I’m like, girl, you’re getting ripped off like.
Yeah, and that’s why I stay with my seltzer and my pineapple juice, honey and it’s like what 2-4 dollars call it a day cuz it’s also just like I don’t want all that over sugar thing either.
18:22
Yeah, they’re ripping us off, that’s for sure.
It’s not it’s not good.
Or get the can like the CBD 1 is in a can, like anything that’s kind of pre in a can.
Typically those will be like $5, a little bit cheaper.
Things to keep in mind.
Yeah, well, in wrapping, just remember that everyone is different.
18:40
Alcohol effects different people in different ways.
So you kind of just have to look at your blood sugar trends, see what your body does best on, keeping in mind that movement is also going to affect your blood sugar levels, stress, sleep.
18:55
And so you kind of have to keep track of all of that when coming up with a routine that works best for you when you are drinking, especially if you’re drinking regularly, if it’s like here and there, then you know, you don’t have to track it as much.
But if if you go out every weekend and go drinking and having a good time, then it’s definitely something to keep a close eye on.
19:13
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19:28
We are a team of at this point 11 dietitians and certified diabetes educators and we offer an evidence based approach that ensures you receive reliable guidance and accurate information.
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20:03
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20:18
So definitely take advantage of that.
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All right, until next time.
Bye.
20:36
Thanks for joining us for today’s episode.
If you’re interested in nutrition counseling with one of our expert dietitians to help improve your pre diabetes or diabetes, visit us at diabetesdigital.co.
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20:57