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Alcohol and Diabetes

A Review of the Professional Literature

By David Mendosa

Your doctors will probably ask you how much you drink. They will warn you about the dangers of drinking too much. But if you tell them that you don’t drink any alcohol, they may not tell you what they know about abstinence.

‘It’s a U-shaped curve.’

That’s because our response to different amounts of alcohol is quite unusual. It’s not something that could be plotted on a straight line. It is “a U-shaped curve.”

We now have solid evidence that abstinence is worse for you than moderate consumption. This is one of the major findings that jump out from a review of the professional, peer-reviewed literature on alcohol and diabetes in the huge Medline database.

The main problem is that a large number of us simply cannot be moderate in our consumption of alcohol. For these people the choice is between heavy use and abstinence. Doctors simply don’t want to take the chance that if you start drinking on their advice, you won’t know when to quit. Others should not consume alcohol because of the medication that they take for diabetes or other conditions.

If anything, heavy consumption of alcohol is worse for you than being a teatotaler. “The short-term risks of heavy or continuous alcohol intake include hypoglycemia, glucose intolerance, and ketone and lactate accumulation,” according to “Alcohol and the NIDDM Patient” in Diabetes Care. “In the long term, heavy alcohol intake is associated with an increased prevalence of cancer, hypertension, cirrhosis of the liver, and symptomatic neuropathy.”

A recent study found that insulin resistance “is minimal in individuals with regular mild to moderate alcohol consumption and increases in both heavy drinkers and subjects without any alcohol consumption.” A comprehensive review of the literature concluded, “Compared with no alcohol use…[m]oderate alcohol consumption is associated with…a decreased incidence of heart disease in persons with diabetes.”

Most if not all of these studies define moderate alcohol consumption as one to three drinks a day. That’s the sweet spot on alcohol’s U-shaped curve. 


  1. Bell DS. “Alcohol and the NIDDM patient.” Diabetes Care. 1996 May;19(5):509-13.

  2. Howard AA, Arnsten JH, Gourevitch MN. “Effect of alcohol consumption on diabetes mellitus: a systematic review.” Ann Intern Med. 2004 Feb 3;140(3):211-9.

  3. Magis DC, Jandrain BJ, Scheen AJ. [“Alcohol, insulin sensitivity and diabetes”] [Article in French] Rev Med Liege. 2003 Jul-Aug;58(7-8):501-7

  4. Tsai CS, Oke TO, Tam CW, Olubadewo JO, Ochillo RF. “The effect of regular alcohol use on the management of non-insulin diabetes mellitus.” Cell Mol Biol (Noisy-le-grand). 2003 Dec;49(8):1327-32.

This article originally appeared on this website April 23, 2004.

Last modified: January 10, 2008

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