Diabetes and alcohol

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Alcohol use can become an addiction. Its use can also impair judgment. When used well it has salutary effects on the body. Despite this, those who choose to drink it should only do so occasionally.

Individuals without diabetes should know whether their intake of alcohol increases the risk of developing diabetes or not while those with diabetes ought to know the various effects that alcohol can have on their blood sugar levels. Beers and wines contain calories. Many alcoholic beverages contain a lot of sugar that has been used in the fermentation process. A bottle of regular beer contains about 26g of carbohydrate which translates to more than 100 calories. People with or without diabetes that are overweight or obese and consume alcohol will most likely not be able to shed the excess weight due to the calorie content of the alcohol consumed.

Alcohol goes straight from the stomach into the blood! Very high blood levels of alcohol are achieved about one hour after onset of alcohol consumption. The liver is the organ that breaks down the alcohol consumed, hence, intake of three or more bottles of beer or its equivalent can ultimately lead to liver disease and other health problems.

Those who consume alcohol moderately are known to have less heart disease than those who do not drink alcohol at all. However, those who drink heavily have the risk of becoming alcoholics, may develop hypertension, cancers, have accidents and may commit suicide. Excessive alcohol use is a well recognized cause of chronic pancreatitis which can eventually cause some problems with ability to digest food properly and may also lead to development of diabetes.

The liver plays a prominent role in keeping the blood sugar level from going too low by releasing sugar into the blood from time to time. This process is however hampered by alcohol intake during which time the liver will be busy with breaking down of the alcohol consumed. On the other hand, the various types of sugars contained in the drink can lead to high blood sugar levels. Alcohol consumption can thus cause either low or high blood sugar levels.

Alcohol consumption only becomes safe for the person with diabetes if the blood sugar level has been well controlled and the alcohol is taken with some food, not on an empty stomach. Spirits are best drunk mixed with water.

For the person with or without diabetes who must take alcohol what then is the recommended dose? For regular beer, a maximum daily dose of two drinks for men and one drink for women is recommended. A drink is 12 ounces (360 ml). A bottle of beer in Nigeria is about 600ml. This thus translates into a bottle of beer for males and half a bottle for females. For spirits, 1.5 ounces (one and half a “shot” or 45ml) is the maximum daily recommended dose. For alcoholic wine (red or white), 5 ounces (150ml) a day is the maximum daily dose.

Drinks like sweet wines, Sherries, ports, dark sweetened beers like stout (which has high content of sugar of about 30g in the big bottle) should be consumed with great caution. Spirits also should be consumed with great caution due to the very high alcohol content.

People with diabetes should clarify from their doctors if they can safely consume alcohol. Alcohol intake is not recommended for those whose nerves are already damaged by diabetes, ditto for those with concomitant diabetes and hypertension. People with diabetes should monitor their blood sugar level closely during periods of alcohol consumption and should avoid exercise at such periods so as not to precipitate dangerously low blood sugar levels.
The advice then for those who have not started drinking is that they need not start, while those who are already drinking will do themselves a whole world of good if they comply with the aforementioned doses.

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By Dr Olubiyi Adesina
Consultant Diabetologist

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