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Alcohol and Health

Can Alcohol Cause Diabetes?

May 15, 2023
11 min read
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Reframe Content Team
A team of researchers and psychologists who specialize in behavioral health and neuroscience. This group collaborates to produce insightful and evidence-based content.
May 15, 2023
11 min read
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Certified recovery coach specialized in helping everyone redefine their relationship with alcohol. His approach in coaching focuses on habit formation and addressing the stress in our lives.
May 15, 2023
11 min read
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Recognized by Fortune and Fast Company as a top innovator shaping the future of health and known for his pivotal role in helping individuals change their relationship with alcohol.
May 15, 2023
11 min read
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Reframe Content Team
May 15, 2023
11 min read

Diabetes has been around for centuries. At its core, the condition revolves around insulin, which is a hormone produced by our pancreas. Think of insulin as a key. When we eat, our body breaks down food into glucose (a type of sugar) that enters our bloodstream. Insulin, the key, unlocks our body's cells allowing glucose to enter and be used as energy. Without the right amount of keys or if the locks get a tad rusty, glucose gets stuck in our bloodstream.

But how does drinking affect this process? The link between alcohol and diabetes is an important one to understand in order to maintain our health, and there are many questions to ask. Can alcohol cause diabetes? And what can diabetics drink? For example, can a diabetic drink beer? And is there sugar-free alcohol for diabetics to buy? Let's unpack the relationship and learn more about how drinking and diabetes can be a devious pair to our health. 

Historical Understandings of Diabetes

A person checking her sugar levels

Our understanding of diabetes began in Ancient Egypt, around 1500 BCE. The Ebers Papyrus, one of the oldest known medical texts, describes a mysterious malady where patients showed an insatiable thirst and frequent urination. Sound familiar? These are classic symptoms of diabetes.

Fast-forward a few centuries, and the term "diabetes" made its grand entrance courtesy of the Ancient Greeks. Coined by the physician Aretaeus of Cappadocia, "diabetes" translates to "passing through," a nod to the excessive urination associated with the condition.

The plot thickens in the 18th century when doctors started noticing that the urine from people with diabetes had a sweet taste (yes, taste — it was a different time!). This led to the term "diabetes mellitus," with "mellitus" being Latin for "honey-sweet."

Insulin Enters the Scene

The 20th century brought groundbreaking discoveries. In the early 1920s, Canadian scientists Frederick Banting and Charles Best successfully isolated insulin. This was revolutionary! For the first time, people with diabetes had effective treatment for their condition. The duo later sold the patent for insulin for a mere $1, wanting it to be accessible for all.

With the onset of the 21st century, technology started playing a pivotal role. We saw the advent of glucose meters, insulin pumps, and continuous glucose monitors, making diabetes management more efficient than ever. Today, research continues in full swing, with scientists exploring innovative treatments and even potential cures.

Diabetes 101

There are two main types of diabetes, each with its unique origin story:

  • Type 1 diabetes develops when the body goes on strike and doesn’t produce insulin at all. People with Type 1 diabetes rely on external insulin to make up for it. It often starts in childhood, hence its old name, "juvenile diabetes."
  • Type 2 diabetes comes on later in life when the body either doesn’t produce enough insulin or becomes "resistant" to it. Imagine having keys that don't quite fit the locks anymore. It’s the more common type and tends to pop up in adulthood, though increasingly, younger folks are also being diagnosed.

While genes play a role in diabetes (especially Type 1), our modern ways of life have a big part in the rise of Type 2 diabetes, with sedentary lifestyles, processed foods, and increasing stress levels all playing a part. But, as they say, knowledge is power. Being aware of these factors gives us the upper hand in taking proactive measures.

If a patient is showing symptoms of diabetes like excessive thirst, frequent urination, unexplained weight loss, or constant fatigue, a healthcare professional might suspect diabetes. Here's how they confirm it:

  • Fasting blood sugar test. After having the person fast for 8 hours (usually overnight), a blood sample is taken to check your sugar levels. A result of 126 milligrams per deciliter (mg/dL) or higher on two separate tests indicates diabetes.
  • Oral glucose tolerance test (OGTT). This test involves fasting overnight and then drinking a sugary solution. Blood sugar levels are then tested over the next few hours. A reading above 200 mg/dL after 2 hours suggests diabetes.
  • Hemoglobin A1c test. This gives an average of your blood sugar over the past 2-3 months. An A1c level of 6.5% or higher on two separate tests means one has diabetes.
  • Random blood sugar test. A blood sample is taken at a random time, regardless of the time of the last meal. A blood sugar level of 200 mg/dL or higher indicates diabetes.
Types of Diabetes

How Is Diabetes Treated?

The treatment for diabetes depends on the type. Here’s the breakdown:

Type 1 diabetes:

  • Insulin. Since the body doesn't produce insulin in Type 1 diabetes, insulin is a must. It can be administered through injections or insulin pumps.
  • Blood sugar monitoring. Regularly checking blood sugar levels helps in adjusting insulin doses.
  • Healthy lifestyle choices. This includes a balanced diet and regular physical activity.

Type 2 Diabetes:

  • Dietary changes. Eating low-glycemic foods that don't spike blood sugar too rapidly is crucial. Think whole grains, lean proteins, and plenty of veggies.
  • Exercise. Physical activity can help use up the sugar in the blood, acting as a natural insulin.
  • Medications. There are several oral medications that can help manage blood sugar levels. Some people with Type 2 also need insulin.
  • Blood sugar monitoring. Regular checks are vital to see how well treatment is working.

Alcohol can play a role in both types of diabetes, but its relationship with Type 2 is of particular concern.

Alcohol and Blood Sugar 

As soon as there’s booze in our system, our liver springs into action. Normally, the liver releases glucose to maintain blood sugar levels, especially during times when we haven't eaten in a while. However, alcohol prompts the liver to shift gears and process it ASAP, putting glucose release on hold. This can lead to a drop in blood sugar levels, especially if we drink on an empty stomach.

But wait — here's a twist!

Some alcoholic drinks — especially cocktails mixed with sugary beverages — can raise our blood sugar. It's a paradox! On one hand, alcohol pushes the blood sugar down, and on the other, the sugary mixers push it up. Talk about a double whammy! This tug-of-war can result in unpredictable blood sugar fluctuations, which can be especially tricky for those with diabetes.

There are a couple of additional ways in which alcohol affects blood sugar:

  • Alcohol and diabetes medications. Many people with diabetes take medications to help regulate their blood sugar levels. Alcohol can interfere with these meds, either enhancing or diminishing their effects. For instance, some diabetes drugs paired with alcohol can further lower blood sugar, leading to dangerous levels. It's like having two dancers trying to lead: iit throws the rhythm off.
  • The morning after. One might think that once the effects of alcohol wear off, everything goes back to normal, right? Not necessarily. The impact on blood sugar can linger. Some people might experience low blood sugar levels for up to 24 hours after drinking. So, if we feel off-kilter the day after, it might not just be a simple hangover: our blood sugar could be the culprit.
  • Each body is unique. While some might feel the effects of alcohol on their blood sugar immediately, others might not notice much difference. The key takeaway is to be observant. Listen to your body, understand its signals, and make informed decisions!

How Alcohol Wrecks Havoc on Insulin Sensitivity

Over time, consistent and heavy alcohol consumption can lead to reduced insulin sensitivity — our body needs more insulin to do the same job. This is a big red flag for the development of Type 2 diabetes. Think of it as the volume control on a speaker: if the body is very sensitive to insulin, even a low volume (or a small amount of insulin) will be effective. However, if sensitivity goes down, we need more.

Here’s where alcohol comes into play:

  • Immediate after-effects. Just after drinking, alcohol can increase insulin sensitivity. This sounds good on paper, but coupled with alcohol’s ability to decrease blood sugar that results from our liver getting sidetracked by processing alcohol instead of releasing glucose, the result can be a dangerous drop in blood sugar levels.
  • The longer view. Chronic alcohol consumption can decrease insulin sensitivity. Over time, our cells become less receptive to insulin, leading to higher blood sugar levels, which is a cornerstone for Type 2 diabetes.
  • The vicious cycle. Reduced insulin sensitivity means our pancreas has to work overtime, producing more and more insulin to try and get glucose into the cells. This extra insulin in the bloodstream further reduces sensitivity, creating a vicious cycle.

Beyond Glucose

It’s not just about sugar either. Reduced insulin sensitivity can lead to the storage of fat, especially around the abdomen. This belly fat secretes substances that further reduce insulin sensitivity. And guess what can contribute to this fat accumulation? Excessive alcohol consumption.

Excess Calories and Weight Gain: The Alcohol Connection

Alcoholic beverages are also sneaky calorie bombs! Here’s a quick breakdown:

  • Alcohol. 7 calories per gram
  • Proteins and carbs. 4 calories per gram
  • Fats. 9 calories per gram

Yes, alcohol stands tall, second only to fats! While there’s some variety in the calorie content of different types of drinks (more on that later), it’s safe to place it firmly in the “liquid calories” department.

On top of all that, alcohol can be like that friend who always persuades us to order an extra side of fries: it can increase our appetite. Several studies suggest that when alcohol is consumed before or during a meal, people tend to eat more. That’s additional calories on top of the ones from the drink itself. As a result, drinking regularly can lead to weight gain, and increased body weight is a significant risk factor for Type 2 diabetes. 

Moreover, when alcohol enters our system, our body prioritizes metabolizing it, given that it views alcohol as a toxin. This means that the calories from the foods we eat are more likely to be stored as fat since our metabolic machinery is busy dealing with the alcohol.

And it’s not just the alcohol itself. Those fancy cocktails or flavored beers? They often come packed with sugars, mixers, and other ingredients that are calorically dense. A piña colada, for example, isn't just rum. It's a concoction of cream, pineapple juice, and often a good drizzle of syrup.

Not All Drinks Are Created Equal

It's worth noting that the type of alcohol and what you mix it with can affect the risk for diabetes. Sugary mixers, cocktails loaded with syrups, and binge drinking are particularly hazardous. Moderation is key, but when in doubt, cutting back is a surefire way to play it safe.

Which is worse: a pint of beer, a glass of wine, or a mojito? With the array of drinks on offer, it can be confusing to determine which might be the "better" choice, especially when considering alcohol content, mixers, and added sugars. Here’s an overview:

Beer and Diabetes

A favorite at barbecues and sporting events, beer can vary significantly in its caloric content, primarily based on its alcohol content and ingredients. Here are the basics:

  • Light beers. These often contain fewer calories, hovering around 90-110 calories for a standard 12-ounce serving.
  • Regular beers. These pack more punch with roughly 150-200 calories for the same 12 ounces.
  • Craft and specialty beers. These can be the wildcard, as their ingredients and alcohol content differ wildly. Some can even reach up to 300 calories per 12 ounces!

Wine and Diabetes

  • White wine. A 5-ounce glass typically has about 120-130 calories. Dry white wines (think Sauvignon Blanc or Pinot Grigio) generally have fewer calories than sweeter ones.
  • Red wine. A 5-ounce serving has around 120-130 calories, with drier wines like Cabernet Sauvignon or Merlot usually having a bit less than sweeter counterparts.
  • Champagne. A flute of bubbly contains approximately 80-90 calories. But remember, those bubbles can sometimes lead to sipping more than intended!

Cocktails and Mixed Drinks

Here's where things can get a bit, well, mixed up:

  • Simple mixers. Drinks such as vodka tonic or rum and coke usually hover in the 150-200 calorie range per serving. But remember, a lot depends on the quantity of alcohol and type of mixer used.
  • Creamy concoctions. Cream-based drinks like White Russians or Pina Coladas can quickly climb the calorie ladder, sometimes hitting 500 calories or more for a single drink!
  • Mojitos, margaritas, and more. Freshly made cocktails with real fruit and limited sugar can be a decent choice, often lying in the 150-250 calorie range. But beware of pre-made mixes — they can be sugar and calorie bombs!

Best Alcohol for Diabetics

And what about those of us who have been diagnosed — what can diabetics drink? Dry red and white wines are lower in sugar and carbs than sweeter varieties, making them a better choice for those of us with diabetes. Likewise, mixed drinks made with sugar-free mixers are probably a safer bet, since they’re essentially sugar-free. However, keep in mind that sugar alternatives can still cause blood sugar fluctuations — it’s important to know and understand our body and how we react to different foods and drinks.

And what about beer for diabetes? Low-carb varieties are the best way to go. Still, it’s important to keep in mind that moderation is key.

Steps for Nurturing Your Health

Armed with this knowledge, how can we steer clear of alcohol’s potential pitfalls — including ones that have to do with diabetes? Here are some ideas:

  • Personalized drink diary. Start by maintaining a drink diary for a week. Note down each drink, its type, mixers used, how you felt afterward, and any blood sugar fluctuations. This will give you insight into patterns and specific drinks that might be more problematic for you.
  • Mindful drinking. Before you grab that drink, ask yourself why you're reaching for it. Are you genuinely enjoying it, or is it out of habit? By being more present with yourself, you can make more intentional alcohol consumption choices.
  • Swap the sugary mixers. Opt for low-calorie or sugar-free mixers. For instance, if you enjoy cocktails, explore recipes that include fresh ingredients like lemon or lime juice, herbs, and seltzers instead of sugary syrups and sodas.
  • Set clear boundaries. Determine a drink limit for yourself when you go out or attend events. Tell a friend or family member who can help keep you accountable.
  • Monitor blood sugar. If you choose to drink, check your blood sugar before, during, and after drinking to understand the impact on your levels. Always keep glucose tablets or a snack handy in case of sudden lows.
  • Educate and advocate. Inform bartenders or hosts about your needs. More establishments are becoming health-conscious and might offer alternatives or adjustments that better suit your health needs.
  • Smart timing. If you're on insulin or diabetes medications, consult your doctor about the best time to consume alcohol, considering your medication timings. This can prevent sudden dips or spikes in blood sugar.
  • Stay informed with research. The world of diabetes research is dynamic. Every few months, review the latest studies or guidelines on alcohol and diabetes. This will ensure that you're always making decisions based on the most recent and reliable information.
  • Lean on your tribe. Let friends and family know about your choice to cut back or quit. They can be your accountability buddies and might even join you on the journey.
  • Celebrate small wins. Every time you say "no" or make a healthier choice, give yourself credit. It's these small steps that ultimately lead to significant changes.

Summing Up

All in all, it's clear that alcohol has a complex relationship with diabetes. By understanding the risks and making informed choices, we can prioritize our health and well-being. After all, life's celebrations are just as sweet without the added risks. Cheers to informed decisions and a healthier you!

Summary FAQs

1. Can alcohol consumption impact blood sugar levels?

Absolutely! Alcohol can cause blood sugar levels to drop, especially if consumed on an empty stomach, due to the liver prioritizing processing alcohol over releasing glucose. However, sugary mixers in some alcoholic drinks can elevate blood sugar, leading to unpredictable fluctuations.

2. What’s the relationship between alcohol and insulin sensitivity?

Alcohol plays a dual role. Initially, it might increase insulin sensitivity which, paired with its ability to lower blood sugar, can be a risky combo. Chronic alcohol consumption, however, can decrease insulin sensitivity, pushing your body towards conditions like Type 2 diabetes.

3. Are all alcoholic beverages calorically equal?

Nope! Different drinks have varying caloric contents. For example, light beers usually have fewer calories than regular or craft beers. Similarly, the calorie content in wines can differ based on type (red, white, or bubbly) and sweetness. Cocktails can vary widely, especially when factoring in mixers and added sugars.

4. How does alcohol influence appetite and metabolism?

Alcohol can increase appetite, often leading to consuming more food (and thus more calories) during a meal. Additionally, as our body prioritizes metabolizing alcohol, calories from food are more likely to be stored as fat.

5. Are there hidden calories in cocktails?

Yes! While the alcohol itself contains calories, many cocktails also include mixers, syrups, and other ingredients that can significantly increase the drink's overall caloric content. It's always a good idea to check what's being mixed in.

6. Does beer really have the nickname "liquid bread"?

It sure does! This nickname is due to beer's caloric content and its origins from grains, much like bread. However, while some beers can be calorie-dense, there are lighter options available.

7. What's a general takeaway for alcohol and health?

Being aware and informed is crucial. Whether it's understanding how a drink impacts blood sugar, insulin sensitivity, or weight, having this knowledge can guide decisions that align with one’s health and wellness goals.

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