Overview
Diabetes type 2 is an alarming global health concern. It affects millions of people worldwide, and the number of diabetes patients is increasing at an alarming rate. The relationship between alcohol consumption and diabetes is tenuous. Studies show that moderate alcohol consumption can reduce the risk of type 2 diabetes. But binge drinking can increase the risk of diabetes. In the following article, we will examine this relationship.
What is diabetes type 2?
Diabetes has two types, Diabetes type 1 and type 2. Diabetes type 1 occurs when special cells in the pancreas die and can no longer produce insulin. Diabetes type 2 occurs when your body does not produce enough insulin OR the insulin does not work as it is supposed to (called insulin resistance). Under normal conditions, insulin acts by reducing high blood glucose levels after food intake. This drop in sugar level occurs because of insulin's action on individual sugar molecules. Insulin binds to the molecules and takes them inside the cell. Inside the cell, they undergo various mechanisms to break down the sugar and convert it into energy. All these processes take place in the body cells' mitochondria. A total of 422 million people in the world have diabetes. 90-95% of these diabetes patients belong to type 2 diabetes.
Immediate effects of alcohol on blood sugar levels
The immediate effects of alcohol on blood sugar levels can come in two ways. Either it lowers the blood glucose level or increases the blood glucose level.1 Alcoholic beverages, such as beers, are high in carbohydrates and can raise blood sugar levels. As the liver begins breaking down the alcohol, it stops producing glucose, leading to a sharp decrease in blood sugar levels.
Drinking on an empty stomach can lead to hypoglycemia
When you have an empty stomach or have not eaten anything in the past few hours, it is evident that your blood glucose level is low. It's important to note that the effect of alcohol metabolism on glucose metabolism is complicated and should be fully understood. But the least is that alcohol metabolism inhibits gluconeogenesis, the process of making new glucose in the cells. So already having low blood glucose levels and inhibition of gluconeogenesis by uptake of alcohol will consequently result in hypoglycemia.
Moderate drinking with a meal raises blood sugar
When you eat something, your body breaks down food into sugars and other substances. This sugar then gets released into your bloodstream. This sudden abundance of sugar in the bloodstream will cause an increase in blood sugar levels. Alcoholic beverages are rich in carbohydrates and cause an increase in blood sugar levels. So, when you eat, your blood sugar goes up, too. This means that drinking moderately with a meal can also raise your blood sugar.
Is it safe to drink when you have type 2 diabetes?
Only moderate drinking, with caution, is recommended in cases of type 2 diabetes, as it may lead to an increase or a decrease in blood sugar levels, and the precise effect is hard to predict. Heavy or binge drinking can make your type 2 diabetes worse, and alcohol can interact with your antidiabetes medicines.
Frequent heavy drinking has been linked to increased insulin resistance.
Studies have indicated that binge drinking can cause increased resistance.2 It comes after the inhibition of gluconeogenesis, by alcohol metabolism, causes a decreased level of insulin, resulting in an increase in lipolysis.3 Lipolysis is a process in which triacylglycerols (aka triglycerides or fats) are broken down into glycerol and fatty acids via hydrolysis. The primary biological function of insulin is to inhibit fat breakdown (lipolysis) and promote triglyceride storage. An increased flow of fat breakdown products to the liver, to allow gluconeogenesis to take place, causes insulin resistance. Increased lipolysis is a significant factor in causing insulin resistance.
Be especially careful if drinking alcoholic drinks which may contain extra sugar, such as many beers and most cocktails. You should be mindful that they are very rich in carbohydrates and may therefore cause an increase in the level of sugar. Already having hyperglycemic conditions in your body, plus these rich sources of carbohydrates, can increase blood sugar levels and cause trouble for people with diabetes.4
If you're worried about your or your loved one's alcohol intake
If you are worried about your alcohol intake or your loved ones, then you should clarify specific points. If you or they are diabetes patients, then alcohol intake should be monitored regularly. It is because moderate alcohol intake can cause a drop in blood glucose levels and help you maintain your blood glucose levels in diabetes. Decreased or normal blood sugar levels will help you tackle the ailment and prevent you from further complications of diabetes.
The complications of diabetes include diabetic nephropathy, amputation, neuropathy, etc. They can be controlled and prevented by restricting drinking to a moderate level. This means two glasses of alcohol for men and one glass of alcohol for women.
If there is an excessive intake of alcohol, then a decreased sugar level will be seen, which can lead to fatigue and other health-related issues. Secondly, it can cause insulin resistance due to an increase in lipolysis. Patients can also report interactions of alcohol with drugs and resulting adverse effects.
Summary
Diabetes is a chronic condition where your body does not produce enough insulin; in some cases, the insulin produced does work according to its desired action. Diabetes has two types, type 1 and type 2. In type 1, there are inadequate insulin levels; in type 2, there are inadequate insulin levels OR the insulin does not work as it is supposed to. Alcohol consumption can increase or decrease your blood sugar levels. Drinking on an empty stomach can cause a drop in blood sugar levels as alcohol metabolism inhibits hepatic gluconeogenesis. While if you drink with a meal, there are chances that the blood glucose level will increase. Extensive alcohol consumption can cause insulin resistance in your body. One should be careful of drinking beer, cocktails, etc., as they are rich in sugars and can further aggravate your diabetes and blood glucose levels. In the end, you should have proper monitoring of alcohol intake of you and your loved ones who are also diabetes patients. Only a moderate amount of alcohol can reduce your sugar levels, but binge alcohol can negatively affect the patient.
- De La Monte S, Derdak Z, Wands JR. Alcohol, insulin resistance and the liver-brain axis: Alcohol and insulin resistance. Journal of Gastroenterology and Hepatology [Internet]. 2012 [cited 2023 Mar 1]; 27:33–41.
- Lindtner C, Scherer T, Zielinski E, Filatova N, Fasshauer M, Tonks NK, et al. Binge Drinking Induces Whole-Body Insulin Resistance by Impairing Hypothalamic Insulin Action. Sci Transl Med [Internet]. 2013 [cited 2023 Mar 1]; 5(170).
- Pietraszek A, Gregersen S, Hermansen K. Alcohol and type 2 diabetes. A review. Nutrition, Metabolism and Cardiovascular Diseases [Internet]. 2010 [cited 2023 Mar 1]; 20(5):366–75.
- Van De Wiel A. Diabetes mellitus and alcohol. Diabetes Metab Res Rev [Internet]. 2004 [cited 2023 Mar 1]; 20(4):263–7.