Alcohol and Diabetes: What You Need to Know

A bottle and a glass of red wine — Photo: congerdesign via Wikimedia Commons (CC0). Image credits

Last reviewed: October 9, 2026 · Sources: CDC, NIH/NIDDK, American Diabetes Association

Many people with diabetes can drink alcohol in moderation if their diabetes is well managed and their health care provider agrees. But alcohol affects blood glucose in ways that can be surprising, and it can increase the risk of dangerous low blood glucose, especially for people who take insulin or certain diabetes medicines. This guide explains how alcohol affects the body, the risks, safer drinking tips, and when to avoid alcohol entirely. It is not a recommendation to drink; if you do not drink, there is no health reason to start.

How alcohol affects blood glucose

Your liver helps keep blood glucose steady by releasing stored glucose between meals and overnight. When you drink alcohol, the liver prioritizes breaking down the alcohol, and it releases less glucose. This can cause blood glucose to drop, sometimes for many hours after drinking, including overnight. The American Diabetes Association notes that alcohol can cause low blood glucose shortly after drinking and for up to 24 hours after.

At the same time, many alcoholic drinks contain carbohydrates. Beer, sweet wines, hard ciders, and cocktails made with juice, regular soda, syrups, or mixers can raise blood glucose. So alcohol can cause highs at first and lows later, which makes glucose harder to predict.

Who is at higher risk of lows?

The risk of alcohol-related hypoglycemia is highest for people who take:

Insulin
Sulfonylureas or meglitinides, which increase insulin release

People who manage diabetes with eating and activity alone, or with medicines that do not usually cause lows, have a lower risk, but alcohol can still affect glucose and judgment.

Why lows from alcohol are especially dangerous

Symptoms can be confused with being drunk. Dizziness, confusion, slurred speech, and sleepiness can be signs of either low blood glucose or intoxication. Others may not realize you need help.
Glucagon may work less well. Glucagon works by signaling the liver to release stored glucose. If the liver is busy processing alcohol, glucagon may be less effective.
Lows can happen during sleep. Drinking in the evening raises the risk of overnight lows.
Judgment is impaired. You may forget to check glucose, eat, or take medicine correctly.

See our hypoglycemia guide for symptoms and treatment.

What is moderate drinking?

The Dietary Guidelines for Americans define moderate drinking as up to 1 drink a day for women and up to 2 drinks a day for men, on days when alcohol is consumed. The ADA uses similar limits for adults with diabetes who choose to drink. Drinking less is better for health than drinking more. A standard drink in the United States contains about 14 grams of pure alcohol, which is roughly:

12 ounces of regular beer (about 5% alcohol)
5 ounces of wine (about 12% alcohol)
1.5 ounces of distilled spirits (about 40% alcohol)

Many drinks served in bars and restaurants contain more than one standard drink. MedlinePlus has more information about alcohol and health.

Tips for safer drinking with diabetes

If you and your provider agree that drinking is OK for you:

Never drink on an empty stomach. Drink with a meal or snack that contains carbohydrate.
Check your blood glucose before drinking, while drinking, before bed, and if you wake during the night. Use your CGM alarms if you have one.
Have a bedtime snack if your glucose is on the lower side or your care team advises it.
Choose lower-carbohydrate options, such as light beer, dry wine, or spirits with zero-calorie mixers like club soda or diet soda, and avoid sugary mixers.
Pace yourself. Alternate alcoholic drinks with water or other zero-calorie drinks.
Wear a medical ID that says you have diabetes.
Drink with people who know you have diabetes and know how to recognize and treat a low.
Carry fast-acting carbohydrate and your meter or CGM.
Don't drive after drinking.
Ask about insulin adjustments. Do not skip insulin to "make room" for alcohol, and do not change doses unless your care team has taught you how.
Watch the next morning. The risk of lows continues for many hours, especially after evening drinking or exercise.

Alcohol and exercise

Alcohol and physical activity both lower blood glucose. Drinking after a long workout, sporting event, or a night of dancing increases the risk of delayed lows. Check your glucose more often and consider a snack. See exercise and diabetes.

Alcohol, weight, and calories

Alcohol contains calories without nutrients, and mixed drinks can be very high in calories. Regular drinking can make weight management harder and may increase appetite. See weight and diabetes.

Long-term effects

Heavy drinking can raise blood pressure and triglycerides, damage the liver and pancreas, and worsen nerve damage. It can make diabetes complications worse and diabetes harder to manage. See diabetic neuropathy and heart health.

When to avoid alcohol

Talk with your provider, and avoid alcohol, if you:

Are pregnant or trying to become pregnant. See diabetes and pregnancy planning.
Have frequent lows or hypoglycemia unawareness
Have pancreatitis, liver disease, high triglycerides, or certain kinds of nerve damage
Take medicines that interact with alcohol
Have a history of alcohol use disorder
Are under the legal drinking age

Alcohol and diabetes medicines

Some medicines interact with alcohol. Heavy drinking while taking metformin can increase the risk of lactic acidosis, a rare but serious condition. Ask your pharmacist about alcohol and each of your medicines. See metformin and common diabetes medications.

Teens and young adults

Young people with diabetes may face pressure to drink. Honest, practical conversations about the risks, especially delayed lows, are important. See diabetes in children and teens.

Getting help

If you are concerned about your drinking, talk with your provider. The SAMHSA National Helpline (1-800-662-4357) provides free, confidential treatment referral and information, 24 hours a day.

Frequently asked questions

Is beer or wine better for people with diabetes?

Neither is "better" in general. Regular beer usually contains more carbohydrate than dry wine, while sweet wines, dessert wines, and many cocktails contain a lot of sugar. Light beer, dry wine, and spirits with zero-calorie mixers are lower in carbohydrate, but all alcohol carries the same risk of delayed lows. Portion size matters too; a large glass of wine can hold well over one standard drink.

Should I take my usual insulin if I plan to drink?

Do not skip or change insulin doses unless your care team has given you specific instructions. Skipping insulin, especially with type 1 diabetes, can lead to high glucose and ketones. Your team can teach you how to adjust mealtime doses around drinks that contain carbohydrate and whether to lower doses after an evening of drinking or dancing.

How long should I watch my glucose after drinking?

The risk of low glucose can last many hours, including overnight and into the next day. Check before bed, set CGM alerts, and check again on waking. If you live alone, consider letting someone know your plans.

Can I drink if I have type 2 diabetes and don't take insulin?

Many people can, in moderation and with food, if their provider agrees. Pay attention to the calories and carbohydrates in drinks and to how alcohol affects your eating choices.

Key takeaways

Alcohol can lower blood glucose for many hours after drinking because the liver focuses on processing alcohol.
The risk of lows is highest for people taking insulin or sulfonylureas.
If you drink, do so in moderation, with food, and check your glucose, including before bed.
Symptoms of a low can look like being drunk; wear a medical ID and drink with people who know how to help.
Some people should avoid alcohol entirely; ask your provider what is safe for you.

Sources

Links to the sources cited above appear in the text. We rely on the Centers for Disease Control and Prevention (CDC), the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), and the American Diabetes Association (ADA).

Related guides: Food, fitness, and weight

Browse all diabetes guides →