Can diabetics drink beer? Beer and Diabetes

This article talks about alcohol including beer and diabetes in general and mainly about the amount of beer for dabadetics (please exmuse me, mah beer does not lemme type this properlee! :-0)

According to chemistry, alcohol is a solution.

– Chemistry topper

Alcohol, Diabetes and Insulin

Alcohol and diabetes risk reportedly have a U-shaped relationship. What does this U-shaped relationship mean? It simply means that with an increase in alcohol consumption will reduce the risk of developing diabetes initially. However, further increase in consumption of alcoholic beverages such as beer can increase the risk of diabetes.

Moreover, this discussion isn’t useful per se if you are already diagnosed with diabetes mellitus. In such a case, the underlying pathology can be helpful.

Similar to diabetes mellitus itself, the alcohol consumption has a U-shaped relationship with the insulin sensitivity also. This means, the increase in alcohol consumption increases the sensitivity of peripheral tissues to insulin initially. This increase in insulin sensitivity takes sharp down turn and decreases with further increase in alcohol consumption.

Now, you might as at what level of alcohol consumption does the insulin sensitivity starts decreasing? To answer this most of the articles across various media channels say that moderate levels of alcohol are associated with lower/reduced risk of diabetes, well in our case better insulin sensitivity. But, let’s be specific. What is this moderate level of alcohol consumption?

Talking in numbers

If we talk about numbers specifically, the moderate level of alcohol amounts to 6-48 grams per day. But if we need to be more specific, the numbers vary with your body mass index aka BMI. BMI is the relation between your body weight and height. It tells you whether you are underweight, normal, overweight or obese. However, with respect to alcohol, paradoxically it is seen that the permissible amount of alcohol is directly proportional to the individual’s BMI.

In simpler words, if your BMI is higher, the permissible value of alcohol consumption for you is higher than the person with lower BMI as compared to you. This sounds too good to be true, but it is. Whatever be the BMI, the maximum permissible value is 48 grams per day.

Chilled beer has density almost equal to that of water. Therefore, 48 grams of chilled beer will be equivalent to 48 mL. Unfortunately, there hasn’t been any study that shows the effect of binge drinking on diabetes and glucose levels.

However, if we give it a bit more thought, it is apparent that if at all any such study is conducted; the possible outcome would most probably be something unpleasant. This is because; we can’t just talk about alcohol and diabetes. The discussion has to include other potential morbidity that are caused by alcohol consumption.

Also read: Can diabetics eat bacon and eggs?

Effect on habits

Another scientific study tells us that although metabolically moderate alcohol consumption reduces the risk, it is commonly associated with the habits in the diabetic individuals which are not in alignment with good self-control of diabetes mellitus and blood glucose levels per se. This can be explained by the fact that we usually tend to consume alcohol when we are either depressed or just doesn’t want to accept our current situation.

Effect on blood sugar level

Apart from improving insulin sensitivity, alcohol causes a drop in blood glucose also by inhibiting hepatic production of glucose. That is, the liver is unable to produce glucose which it normally does during low levels of glucose in blood. This is important to know because it can lead to hypoglycemic episodes and brain damage. Thus, it is not advised to consume alcohol on empty stomach or with medications.

Although, the maximum limit under moderate consumption is at 48 mL per day, the American Diabetes Association suggests 14 grams of alcohol per day for women and 28 grams for men. For beer, this will be equivalent to 350 mL for women and 700 mL for men. But always check with your doctor before embarking on any such decision and always inform your doctor about your alcohol consumption. And always think about other potential demerits of alcohol while consuming it.

ADA guidelines on beer and diabetes

How much?

ADA suggests that women can have maximum one drink per day amd men can have 2 of those. To be specific, one drink is equal to a 12 oz beer, 5 oz glass of wine or 1 ½ oz distilled spirits (vodka, whiskey, gin, etc.).

What about blood sugar monitoring?

Since, alcohol affects blood sugar levels in a manner that causes hypoglycemia, check your blood sugar levels:

  • Before you drink: avoid drinking if you have low levels of blood sugar, if you have just injected insulin or taken oral antidiabetic drug or if you are on an empty stomach.
  • While you drink: To rule out abrupt reduction in blood sugar level. In such cases keep a sugar candy handy.
  • After you drink: Immediately after and before going to bed
  • All through the night: to avoid hypoglycemic unawareness; which can lead to coma or serious brain damage.
  • Up to 24 hours: alcohol can cause hypoglycemia up to 24 hours after you consume it.

Regular blood sugar monitoring will help you see how the alcohol affects the blood sugar levels in you specifically.

Do not drink if:

  • You are on empty stomach
  • You have injected insulin recently
  • You have taken oral antidiabetic drug recently
  • You have consumed a very low or no carbohydrate meal
  • You are to drive the car later within few hours

Drink it with:

  • Food preferably
  • Low calorie drink mixers like water, club soda, etc.
  • An ID card saying that you are a diabetic and may fall into hypoglycemia

Warning:

  • Almost every individual, diabetic or non-diabetic, has its own bodily mechanism and metabolism. It is always cautioned that food recommendations should be correlated with personal health history and the advice of the doctor.
  • These calculations are based on the daily calorie intake of 2000. Therefore, if your calorie intake exceeds 2000 a day, you can increase the ideal serving size and vice versa. However, the recommended blood glucose level still remains the same.

Also, it is a good practice to have a rough calculation of the nutritional facts of the food items before eating them. This applies to the people belonging to all the spectra of health and fitness and not just diabetics.

Do you want me to analyse any other food item? Comment your request below.

References

  • http://www.endmemo.com/cconvert/gml.php
  • Alcohol | American Diabetes Association (ADA)
  • Koppes, L. L., Dekker, J. M., Hendriks, H. F., Bouter, L. M., & Heine, R. J. (2005). Moderate Alcohol Consumption Lowers the Risk of Type 2 Diabetes: A meta-analysis of prospective observational studies. Diabetes Care, 28(3), 719-725. doi:10.2337/diacare.28.3.719
  • Ahmed AT, Karter AJ, Liu J. Alcohol consumption is inversely associated with adherence to diabetes self-care behaviours. Diabet Med. 2006;23(7):795-802.
  • Howard AA, Arnsten JH, Gourevitch MN. Effect of alcohol consumption on diabetes mellitus: a systematic review. Ann Intern Med. 2004;140(3):211-9.

Hey there, I'm a final year undergrad medical student at Sir Seewoosagur Ramgoolam Medical College (SSRMC), Mauritius.

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