Diabetes Diet

Drinking and Diabetes Don’t Mix

Compared with some other stuff we put in our mouths, the trouble with alcohol might not seem to be a big deal for most of us who have diabetes. We all know, of course, that even a little alcohol can mean big trouble for those of us who can’t handle alcohol in moderation.

More than 30 percent of adult Americans have “experienced alcohol use disorders during their lifetimes,” according to a 2007 study in JAMA Psychiatry. That study also found that 17.8 percent have alcohol abuse problems and that 12.5 are alcohol dependent.

Our genes are responsible for about half of the risk for alcoholism, according to the National Institute on Alcohol Abuse and Alcoholism. The other half is our environment, which includes our friends.

If you were sure from your experience that you can handle a little alcohol and if you were a middle-aged or older man who didn’t have diabetes, a little alcohol might actually be good for you. That’s because the response of some people to different amounts of alcohol seems to be quite unusual. It’s not something that could be plotted on a straight line. Researchers call it a U-shaped or J-shaped curve, where among middle-aged and older men, abstinence seems to be a little worse than moderate consumption, while heavy consumption is much worse.

Many studies seem to indicate that moderate drinkers live longer. They describe this relationship as one between moderate alcohol use and total mortality. But like a lot of medical science, we still don’t know for sure.

One big problem is that “these studies have all been observational and epidemiological in nature,” according to the definitive review article, “To Drink or Not to Drink? That Is the Question,” in Circulation, the journal of the American Heart Association. After all these years, not a single large, prospective, randomized trial — the gold standard of medical research — has ever tested the hypothesis that for alcohol consumption the U-shaped or J-shaped curve is real. Observational and epidemiological studies can show only correlation, which does not imply causation. All scientists and statisticians know that a correlation between two variables does not necessarily imply that one causes the other.

But even these studies of correlation might give pause to young men and to women of all ages.

An epidemiological study of 17,279 men did show a U-shaped or J-shaped curve for men between 35 and 64. But for men between 25 and 34 the relationship was linear — the risk went up in a straight line from 0 to 8 drinks per day.

Another epidemiological study, this one in The New England Journal of Medicine, might concern a woman of any age. It found that, “The rate of death from breast cancer was 30 percent higher among women reporting at least one drink daily than among nondrinkers.”

But even if, like me, you are a middle-aged or older man, you might want to stop drinking alcohol if you have diabetes. Keep in mind that alcohol has a bunch of calories. It’s 6.93 calories per gram, compared to 4 calories per gram for carbohydrates, according to the U.S. Department of Agriculture.

This rule of thumb varies, of course, depending on what it is that you drink, whether it’s hard liquor (distilled spirits), wine, beer, or liqueur. And within these broad categories you can find even greater variation. For example, you can find how many calories and grams of carbohydrates many different domestic and imported beers have in this table.

If you have diabetes, which I can assume you do if you’ve stayed the course of this article so far, you know that it’s the carbs that will raise your blood glucose level. While hard liquor and most table wines don’t contain carbs, they can contribute calories to your diet. Dessert wines and many liqueurs have carbs, and beer has the most of any alcohol.

Why drink then? Just like sugar, alcohol seems to be essentially nothing but a source of empty calories. That’s particularly true for those of us who need to control our blood sugar levels as well as our weight.

This article is based on an earlier version of my article published by HealthCentral.

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  • Reply Betty Flynn February 6, 2014 at 10:02 pm

    I was diagnosed with diabetes type 2 at the end of October 2013. Since then I have been trying to control it with diet and exercise, and think that I have been fairly successful.

    One thing I have noted is that on those days when I had a glass of red wine with dinner, my blood sugar level seemed to be lower when tested appx 2 hours after eating. I’ve concluded that wine was making a positive difference so I now have a glass each night with my meal. Since I’m almost 71 and have never had a problem with alcohol or weight, I am confident that a daily glass of wine is not a problem.

    For those of you who may wonder, diabetes is a family disease; my weight was not a contributing factor…lack of exercise was.

    • Reply David Mendosa February 6, 2014 at 10:08 pm

      Dear Betty,

      I’m glad that a glass of wine works for you. It can reduce blood sugar in some people when they drink it before or with food.



  • Reply Pat December 14, 2013 at 5:28 pm

    For a number of us, one glass of wine with dinner helps to control our blood sugar. My endo even wrote me a prescription for a 4oz glass of wine with dinner every night. My A1C went down and my good cholesterol went up. I agree that it’s not for folks who have a problem with alcohol, but for the rest of us, it might be something to try. I realize that wine can have a number of calories, but you should be able to fit those into your diet. I have been following my doctor’s advice for 3 years now and have not gained weight.

    • Reply David Mendosa December 14, 2013 at 5:49 pm

      Dear Pat,

      Thanks for your comment. I’m glad that a little wine works for you.



  • Reply Ana December 9, 2013 at 5:22 pm

    I was trying to post a link to an .edu link to point to my case. Maybe it did not like a link in the post.
    Many things put a strain on the liver sine it is the “detox” center of our bodies. Granted that does not mean we need to dump more work on the poor organ. Still, for those that enjoy wine, it should not be made to be a bad thing. Just my humble opinion.

    • Reply David Mendosa December 9, 2013 at 6:45 pm

      Dear Ana,

      Posting a link should not have been a problem. I’m sorry that it didn’t work for you, but please try again to post it. We need a dialogue, and that means having input from many sources.



  • Reply Ana December 8, 2013 at 9:31 pm

    Wine with dinner is considered food.
    Alcohol actually lowers blood sugar.
    Women once diagnosed with breast cancer that drink actually have a higher survival.
    I have tried to post this 3 times now and my comment won’t post.

    • Reply David Mendosa December 9, 2013 at 2:11 pm

      Dear Ana,

      Thank you for your comments. I’m sorry that you have trouble posting you comments, but you did succeed. Do you have any idea why you had a problem at first?

      SOMETIMES, alcohol will lower our blood sugar levels. It depends on when you drink it. ALWAYS, alcohol will put a strain on our liver.



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