Diabetes is caused by an abnormally low level of a hormone called insulin, which is responsible for transportation of the sugar glucose into cells. Without insulin, glucose accumulates in the blood (hyperglycemia). Left unchecked, hyperglycemia causes significant organ damage and eventually death. The occasional drink or two with dinner does not significantly impact the health of someone with properly managed diabetes, but excessive alcohol consumption leads to major health problems in people with diabetes.
The Link Between Alcohol and Diabetes
Type 1 diabetes is quite uncommon and is caused by an immune disorder or a viral infection during childhood. Type 2 diabetes is more common and its development is significantly associated with lifestyle, including alcohol use. Type 2 diabetes is characterized by a failure to produce sufficient insulin or insulin resistance, which means that cells in your body resist attempts made by insulin to transport glucose out of the blood. Chronic alcohol use impairs glucose metabolism and can contribute to insulin resistance and development of Type 2 diabetes.
Understanding Type 1 and Type 2 Diabetes
For the cells in your body to work properly, they require energy. The best source of energy for cells is a sugar called glucose, which comes from carbohydrates in your diet. Under normal circumstances, glucose can be used in two ways:
- With the help of the hormone insulin, glucose is transported from the blood into cells
- Glucose can be stored in the liver for future use
Type 1 and Type 2 diabetes are characterized by the failure of insulin-assisted transportation of glucose into cells, which means that glucose builds up in the bloodstream. Without medical intervention, the buildup can be fatal.
Type 1 diabetes refers to an immune disorder that is characterized by a total loss of insulin-producing cells. Type 1 diabetes is usually diagnosed in childhood and management requires daily insulin injections. Type 1 diabetes is very uncommon, and although the cause is unknown, genetics likely contribute.
Type 2 diabetes is characterized by insufficient insulin production or insulin resistance, both of which lead to hyperglycemia. The onset of type 2 diabetes is usually in adulthood and 90% to 95% of diabetes cases are Type 2. Type 2 diabetes is generally thought to be caused by a combination of genetic predisposition and lifestyle.
Effects of Type 1 Diabetes and Alcohol
Type 1 diabetes is particularly sensitive to alcohol and different types of alcohol will affect blood sugar differently. However, all types of alcohol impair the liver’s ability to release glucose. As a consequence, people with Type 1 diabetes who administer daily insulin to regulate blood sugar are at risk for blood sugar crashes in the hours after drinking.
For example, if someone with properly managed Type 1 diabetes has several beers (which are loaded with carbs), they will have an immediate spike in blood sugar. The insulin that they administer to keep their blood sugar at a normal level will transport the glucose out of the bloodstream, but because the liver cannot release glucose while it is breaking down alcohol, blood sugar levels drop quickly. This effect is particularly dangerous if someone who has had several drinks goes to sleep before their blood sugar levels can be properly regulated because the brain cannot function in the absence of glucose. If someone is asleep when their blood sugar drops into lethal range, the result can be fatal.
Effects of Type 2 Diabetes and Alcohol
Although some studies have shown that occasional moderate alcohol consumption may be protective against Type 2 diabetes, chronic alcohol consumption causes insulin resistance and impaired glucose metabolism, both of which contribute to Type 2 diabetes. Type 2 diabetes is somewhat less sensitive to the effects of acute alcohol intoxication than Type 1 is, but they face similar consequences — notably a dangerous drop in blood sugar levels.
Excessive Alcohol and Diabetes Don’t Mix
Although studies support that the occasional drink or two with dinner doesn’t negatively impact people with diabetes, binging or moderate alcohol consumption can be dangerous for several reasons.
Alcohol consumption often increases the risk of hypoglycemia and the symptoms of alcohol intoxication are similar to those of hypoglycemia (dizziness, confusion, trembling). Hypoglycemic unawareness is a state where someone fails to recognize symptoms of dangerously low blood sugar, which can be lethal. Alcohol intoxication can prevent someone with diabetes from recognizing the symptoms of low blood sugar.
Diabetes and alcohol damage nerves, which can lead to peripheral neuropathy (PN). PN is associated with impaired sensation perception, especially in the legs and feet, and is among the most common complications of diabetes. PN has been shown to have a faster onset and more severe symptoms in people with diabetes who regularly consume alcohol, even in moderate amounts.
Retinopathy is a leading cause of blindness and is commonly known as “diabetic eye disease” because of its prevalence among people with diabetes. Regular alcohol consumption has been linked to faster onset of retinopathy.
Alcohol and Diabetes Risk
Type 2 diabetes is often treated with medications that either stimulate insulin production or decrease insulin resistance. Adverse, even lethal, alcohol-drug interactions can occur in people taking medications that treat Type 2 diabetes, especially if they also have impaired liver function. If you are on medications to treat diabetes, it is imperative that you discuss the risk of potential interactions with your doctor before you consume alcohol.
If you or a loved one struggle with alcohol use, contact The Recovery Village Palm Beach at Baptist Health to speak with a representative about how professional addiction treatment can help. Take the first step toward a healthier future, call today.
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Emanuele, Nicholas; Swade, Terrence; Emanuele, Mary Ann. “Consequences of Alcohol Use in Diabetics.” Alcohol Health and Research World, 1998. Accessed August 8, 2019.
Baliunas, Dolly; et al. “Alcohol as a Risk Factor for Type 2 Diabetes: A systematic review and meta-analysis.” Diabetes Care, November 2009. Accessed August 8, 2019.
Martín-Timón, Iciar; del Cañizo-Gómez, Francisco. “Mechanisms of hypoglycemia unawareness and implications in diabetic patients.” World Journal of Diabetes, July 2015. Accessed August 8, 2019.
Drugs.com. “Diabetes Medications and Alcohol Interactions.” March 2019. Accessed August 8, 2019.
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