Drinking with Dr. E and Dr. P: How Alcohol Affects Blood Sugars

Does drinking alcohol raise your blood sugars or lower them? The answer can be both, depending on your beverage of choice. Dr. E and Dr. P discuss which types of alcohol are “the best” for people with diabetes, which types have the most calories and carbs, what you can do to prep for a night of drinking and when you might want to keep your blood sugars running a little high.


Additional Resources:

Podcast #22: Alcohol and Diabetes

  1. Amy

    What’s about glucagon? Does it work if you have been drinking?

    • Yes if you can find it!

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        We have been told that glucagon does not work when drinking. That the liver is a pretty simple organ and can only process the alcohol.
        Just want to get to the facts on this…or could it be that it depends on amount of alcohol consumed?

        • In general, the dose of glucagon in the emergency kits are high enough to overcome any effects alcohol may have on suppressing the liver. No one has ever studied this in a scientific way, so it is a theoretical concern.

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      this wouldnt work well because-Glucagon is a peptide hormone, produced by alpha cells of the pancreas. It works to raise the concentration of glucose and fatty acids in the bloodstream, and is considered to be the main catabolic hormone of the body. It is also used as a medication to treat a number of health conditions. Its effect is opposite to that of insulin, you’re 100% better off when you see your sugar rising to add insulin

      • Amy Wolk

        I think the question was will glucagon work if a person has ingested alcohol and experiences a severe low blood sugar while intoxicated. (Or has had a drink or two.).
        It is my understanding, like John Whiteheads, that the liver can only do one job at a time.

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        The point of glucagon is to raise the blood glucose level in an extreme low. We all know insulin is to lower blood glucose levels. We have also been told that it doesn’t work while drinking…this is why I asked again after Dr E says it will work…just need to clarify the answer.

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      No, it does not.

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    THANK YOU, THANK YOU, THANK YOU for the video about alcohol and diabetes. I have been a T1 diabetic for over 50 years and never really understood the affects of alcohol. I hardly ever have any alcohol, mostly because of some severe lows during the night when I did! (Like call 911!) Now I get it! THANK YOU!

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    Found this very interesting. Do you have any different recommendations for a T2 diabetic?

    • Not really…test a lot while drinking to know where you are at, and of course avoid high caloric drinks.

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        what are you saying?? i really dont know, BUT the NUMBERS dont lie-ALCOHOL WILL normally LOWER your sugar, BUT the fruity drinks, like a wine cooler or an alcoholic punch, might raise your sugar with the added sugar content. So drinking beer or wine can be a benefit- and of-course, using a blood glucose meter or CGM will be the most helpful-obviously never let the levels get too low or too high. This doesnt mean have a glass of wine or a beer before bed.

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    T1D for 57 years. My experience with drinking alcohol, its effects, and how I manage them is in agreement with your demonstration and recommendations. Never really got much confirmation from doctors on how to manage – until now. Well done.

  5. You 2 are the ultimate T1D docs. Thanks for sharing your real-time, interactive, self-experimentation. As a T1D for nearly 61 years, I always benefit from your trove of knowledge, insight and sound advice; even when you are a bit tipsy. Thank you, as always.

    • David…thanks so much for your kind comments. Next time join us! Thanks for all that you do as well with the Diabetes Research Connection.

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    Glad that you guys did this. Proves the point that we can learn from the mistakes of others!

    Seriously, no way that we (my son is T1D) would learn as much about what alcohol does
    without having the risk of suffering some mistake along the way.

    Here, you two guys walked us through the mistakes so we didn’t have to.

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    You guys are my heroes! I enjoy watching your videos and love how it touches patient’s lives. Kudos and keep up the great work!

  8. As a Type 1 diabetic for 30 years (in Feb 2021), and as a diabetes educator, I was about to flip out on you guys when I first saw this, but I’m glad I watched it all the way to the end. I do NOT recommend drinking alcohol at all, but I understand harm reduction, and I appreciate you both doing this for that reason.

    I’m sure you both know many stories of T1Ds dying from lows as a result of overnight lows after drinking, but here are some stories you can add. #1-We have a close T1D family friend who was mistaken for being drunk (doesn’t drink at all) and someone at a restaurant called the cops on him. He was handcuffed, tasered, shackled, dragged out to a police car, and thrown in to be taken to jail. Thankfully, someone recognized him and called his mom, who met them and BEGGED them to take him to the hospital instead, where he was treated for low blood sugar and released. I would bet 100% if he smelled of alcohol, they would not have believed he was having a low blood sugar, and he would be dead right now. That freaks the HECK out of me. #2-A lady in one of my Diabetes Self-Management Program classes had a T1D friend die at her house after a party. They all thought he was drunk when he asked to lay down. They found him dead the next morning from a low blood sugar. #3-Lastly, when I was in college, a T1D classmate would have 911 called after almost every party he attended from lows. I thought, at the time, it was highs from not bolusing, but it was actually overnight lows.

    I disapprove of drinking alcohol so much because of those reasons, but you both did an awesome job of drawing people in and explaining the dangers and precautions so well. I wish I could share this on every online support group page where there are people talking about how much they can drink or how to bolus for drinks. I find most people are ONLY concerned about the carbohydrate content/calories; the carbs or calories would be my LAST concerns. My concerns would be how low the alcohol would drop me, when it would drop me, and if I did drop, would someone be around to help me that were coherent enough to know what was happening. This is very needed information, presented in an interesting way. Thank again for sharing!!!

    • Thanks so much for your thoughts. You are right in that one needs to be careful when drinking. It is a big part of life for many, so why not teach people to drink safely and in moderation! You are welcome to send our video to anyone or any group you feel appropriate. It is on our website.

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    Brilliant video. Hope your heads were ok the next day!
    I always understood that glucagon will not work if you have alcohol in your system because alcohol counteracts gluconeogenesis.
    You guys are great! Stay safe!

    • Decades ago, I was revived from insulin shock twice by glucagon.
      I’m not why it worked for me but not others.
      Thank you so much for providing clarity. We can always learn more about Type 1 diabetes.

    • In general, the dose of glucagon in the emergency kits are high enough to overcome any effects alcohol may have on suppressing the liver. No one has ever studied this in a scientific way, so it is a theoretical concern.

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    I wonder what would happen with Fre wine. It is alcohol removed wine. It probably has more carbs, so I wonder if it should be treated more like juice.

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    Loved the video, you two are a hoot!
    Any recommendations for counseling T2DM clients on metformin re: risk of lactic acidosis with ETOH?

    • Lactic acidosis is extremely rare and I would not worry about it at all. Seriously! Never heard of it actually happening and never seen it. Cheers!

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    Wish someone would have told me this in my heavier drinking days. Probably change my drink preference now. Thank you so much.

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    Brilliant! How about drinking water between drinks to keep hydrated? Usually makes me get up to go to the bathroom mid-night and then check my blood sugar.
    Thank you, I enjoyed your scientific experiment!

    • Good idea Sean – we’ll have to add that in to the next “experiment”!

    • Great idea…make yourself get up to pee to test! You need a CGM with alerts and alarms! Always good to sleep with someone..even if you just met him/her!:)

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    This was awesome!!! THABK YOU!!! Right or wrong drinking is part of social interactions for business or personal life! This made me feel as if I’m not the only “diabetic drinker” and also just simply made sense and gave great tips for ensuring our well-being when we indulge. Well done! THANK YOU BOTH!!!

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    Thank you–very informative, and hysterical

  16. Robert Lewis

    This is great info, so much confusing information out there.

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    I feel so much better about my choices I use,a shot of vodka with a can of sparkling water or red wine.im a T 2 and found this info to be so educational. I do still have the thing about not wanting to snack b4 bed because I’m usually still full from dinner. Thanks again!

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    Thank you, thank you, thank you! Loved this video.

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    Excellent. Just excellent.

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    I am a seemingly disdained Mich Ultra drinker, to some volume. Ultra has 2.6 G Carbs per 12 oz. As I normally drink 10 of them in an evening, that would be 26 G carbs, but it is also 950 calories, besides the carbs and the .6 G protein per can, what creates the rest of the calories?

    • Fat. Alcohol is fat. If you look at the calories for 1 shot of any type of hard alcohol, it’s all fat. On a side note, do you need the number for AA? 🙂

  21. What were Steve’s blood sugars over night? Did they go down like Jeremy said or stay the same like Steve predicted?

    If you don’t want to tell the world, please tell me.

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    Fantastic, sensible advice. Well presented, intelligent – and it confirms exactly with my own experience: spirits lower my BG – but only a little, wine equals it out. Low carb beer is the same (Lagunitas summer time IPA is a little watery but the best one I’ve found).
    Delicious, hoppy ipa though…. I can take insulin for it, but I’ll need to back it up with a carb snack later on.

    When they finally let the pub open – Guinness for me.

    Ty both muchly!!

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    Steve, when you had dinner after drinking did you bolus for the carbs?

    And if you are going out to dinner and drinking at the same time do you do a full Bolus for the carbs for the food?

    • Hi Katy,

      1) Yes, I bloused for the carbs that night. Absolutely.

      2) It’s like adult diapers…it depends. It depends on how much you’re going to be drinking, what your blood sugar is, what type of alcohol you’re drinking, your trend arrows…but in general, I do bolus. But I keep a close eye on my CGM.

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