Should people with diabetes be drinking alcohol? Quantity is a key, as we discuss below.

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If you have diabetes, you’ve probably been advised to watch your consumption of sugary soft drinks, coffees laden with flavored syrups, and sweet teas. All the sugar in those beverages can send your blood sugar skyrocketing. But can diabetics drink alcohol? After all, many alcoholic beverages contain carbohydrates, which your body breaks down into sugar.

When it comes to enjoying your favorite brew, wine, or cocktail, remember one key word: “moderation.” It also helps to understand how alcohol affects your blood sugar and how it may interact with the diabetes medications you take.

Can Diabetics Drink Alcohol? And How Much?

Just as diabetes patients can include moderate amounts of carbohydrates in their diet, most can safely consume moderate amounts of alcohol. Moderate alcohol consumption means no more than two standard drinks a day for men and no more than one standard drink a day for women. A standard drink equates to 12 ounces of beer, 8 to 9 ounces of malt liquor, 5 ounces of wine, or 1.5 ounces of 80-proof distilled spirits.

As you follow a diabetes diet, chances are you’re counting carbohydrates and distributing them evenly throughout the day. For the most part, drinking an alcoholic beverage won’t add considerably to your carbohydrate total. (The American Diabetes Association advises that if you count carbs in planning your meals, do not count alcohol as a carbohydrate choice.)

Still, just as the alcohol content varies from beer to wine to distilled spirits, so does the carbohydrate count. For instance, a 12-ounce regular beer contains about 12 to 13 grams of carbohydrates, but distilled spirits, such as gin, rum, vodka, and whiskey, contain virtually no carbs. And, sweet wines tend to be higher in carbohydrates than their dry counterparts.

Also, be smart about any mixers you use. The carb (and calorie) count rises when you combine alcohol with fruit juices or sweetened sodas. Instead, choose mixers like water, club soda, diet soda, or calorie-free tonic water.

Alcohol and Diabetes: Some Words of Caution

One of your liver’s primary functions is to regulate your body’s blood sugar, or glucose. But when you drink alcohol, your liver also must go to work to remove the alcohol from your blood. As a result, alcohol may cause drops in blood sugar for up to about 24 hours after you imbibe.

Drinking excessively may raise your risk of dangerous low blood-sugar levels, or hypoglycemia. The risk is even greater if you take insulin or certain oral medications that are more likely to cause hypoglycemia, such as:

• Meglitinides: nateglinide (Starlix) and repaglinide (Prandin)
• Sulfonylureas: glimepiride (Amaryl), glipizide (Glucotrol), and glyburide (DiaBeta, Glynase, Micronase).

So, consume alcohol only if your blood sugar is under control, and only with a meal or a snack containing carbohydrates. Alcohol can affect everyone differently, so check your blood sugar before and up to 24 hours after you consume your favorite beverage (including before you go to bed) to see how it affects your glucose. If your blood sugar is low, eat something to bring it back up to an acceptable level.

The Importance of Moderation

Realize that certain signs of hypoglycemia, such as dizziness and confusion, resemble those of intoxication, so it’s even more important that you limit your alcohol intake and to wear some form of medical identification that indicates you have diabetes.

Also, ask your health-care professional whether it’s safe for you to drink alcohol, and tell your physician about your alcohol consumption before he or she prescribes a diabetes medication.

Keep in mind that alcohol is high in calories, so if you’re trying to lose weight—as many people with type 2 diabetes are—the practice of limiting or avoiding alcohol consumption may help you in your efforts to shed pounds.

Finally, recognize that alcohol may increase blood pressure and triglycerides (two cardiovascular risk factors that often accompany diabetes) and can worsen diabetic nerve damage, or neuropathy.

So, can diabetics drink alcohol? The answer is yes, but sip smartly, in moderation, and with your doctor’s approval.

Originally published in 2016, this post is regularly updated.