To Drink or Not to Drink

One of the first questions I get from new clients is “can I (or really should I) drink alcohol?”  I can typically feel the fear surrounding the question as they await my answer.  After all, drinking is a way we humans celebrate those little or big things in life like birthdays and graduations and when our team wins the Super Bowl (congratulations to all you Denver Broncos fans).

People are usually surprised and delighted when I tell them that drinking in moderation, even with diabetes, is okay, provided they stick to the more diabetes-friendly libations. In fact, research has shown that drinking certain alcohol in moderation, such as red wine, has health benefits, like reducing the risk of heart disease. [1]

Of course the phrase “in moderation” is always open to speculation and debate. In “doctor speak,” moderation means one drink per day for women and no more than two drinks per day for men. And, to be even more specific, one drink should equal 12 ounces of beer (I’ll talk about which kinds are okay and which you should avoid in a minute), 5 ounces of wine, or 1 ½ ounces of distilled spirits (like whiskey and gin).

Now let’s take a look at alcohol that’s okay for people with diabetes and some that should definitely be off limits.

Wine

“Wine is sunlight held together by water.”

– Galileo Gallilei

As I mentioned earlier, studies have long shown the heart benefits of drinking a glass of red wine every day.  Wine contains polyphenols, which include anthocyanin, resveratrol, and flavonoids, which are potent antioxidants shown to prevent and help a variety of health problems.

In fact, new research suggests red wine can help improve blood sugar control. [2] Dry red wine is a great choice for people with diabetes for another reason.  Of the 120 calories in a 5 ounce serving, nearly all come from the alcohol, not additional carbohydrates. That being said, be sure to avoid dessert wines and ports.

A dry white wine is also a safe choice.

Distilled Spirits

Interesting that many hard liquors are safer for diabetics than soft drinks. One ounce of liquor, such as whiskey and gin (depending on the proof), has about the same amount of alcohol as five ounces of wine. And, most liquors, with the exception of something like a coconut rum, are carb-free.

Whiskey, in particular, is high in antioxidants and has been shown to reduce the risk of developing type 2 diabetes by 30-40%. [3]

Where people get into trouble with hard liquors is mixing them with sweetened soda or juices, which immediately raise the carb content and send your blood sugar levels soaring. To prevent these spikes, best to mix your liquor with either water, seltzer, or tonic.

“Too much of anything is bad, but too much of a good whiskey is barely enough.”

– Mark Twain

Beer

Beers are tricky as there are so many varieties on the market. Generally speaking, stouts, amber ales and craft beers contain more carbs than a light beer. In fact, “light” and “low carb” pretty much mean the same thing in beer lingo.

The other factor to consider is the wheat and gluten in beer.  In fact, most beer contains gluten which can trigger inflammation, gut irritation, and carbohydrate cravings.  There are beers produced today that are gluten-free for those with Celiac disease and known gluten-intolerance, but they are not typically a first choice for many beer drinkers.  If you’re craving a cold brewski on a hot summer day, and you don’t react to wheat and gluten, then it’s probably best to reach for a light beer.

Cocktails

Obviously the sweeter the drink the more sugar and carbs it’s going to have. Cocktails like margaritas, daiquiris, and mojitos should be avoided when at a restaurant or bar. However, if making them at home and substituting stevia-sweetened drops, or a small amount of fresh fruit, these drinks don’t have to be off limits.

Sangria

Here’s where red wine can get you into trouble.  I know how delicious this beverage can be, and recipes can vary, but generally juices are involved, which can elevate your blood sugar levels. Some sangria actually has as much sugar as a regular soda.

Best to stick to a glass of dry red (or white) wine instead.

Beware of Hypoglycemia

The effects of alcohol consumption on your glucose levels can last up to 12 hours, so it’s important to test your blood before going to bed or before taking medications like insulin or sulphonylurea drugs.  To prevent levels from dropping, it’s best to eat a meal or snack, such as nuts with your drink.

It’s also important to note here that hypoglycemia can mimic the effects of alcohol. Early warning signs of low blood glucose are also dizziness, sluggishness and disorientation. To the untrained eye, you will simply appear drunk, not like a diabetic in need of help. For this reason, it’s a good idea to let friends and family know the signs of hypoglycemia and to also wear an ID bracelet that identifies you as a diabetic.

Other Tips to Drink By

• Consuming alcohol can make anyone dehydrated, so be sure to have a no calorie drink next to you such as water, seltzer, or iced tea.
• Alcohol can cause even people with the best of intentions to overindulge with food. While it’s important to eat with your drink, that doesn’t mean you should throw diabetic caution to the wind and order five fried appetizers before your burger and fries arrive. Make sure to stay on track with your healthy eating while still allowing for a celebratory libation every now and then.
• Make sure those empty calories are worth it. Even if you decide to drink in moderation, remember that each drink you have will add calories to your day, and if you’re trying to lose weight in an effort to manage your diabetes (or get rid of it completely) may be best to just say no… for now.
• Be aware that certain medications and alcohol simply don’t mix. Oral hypoglycemic agents, for example, can have a reaction with alcohol, so be sure to speak with your prescribing doctor.

If there is one key takeaway here it has to be the word MODERATION. Hopefully my bold all caps will help you remember. Diabetes does not have to take all the fun out of your life, but the disease needs to be respected and certain rules need to be followed for your health and safety.

So…

Bottoms up – but easy does it.

Resources

[1] Goldberg IJ, Mosca L, Piano MR, Fisher EA. AHA Science Advisory: Wine and your heart: a science advisory for healthcare professionals from the Nutrition Committee, Council on Epidemiology and Prevention, and Council on Cardiovascular Nursing of the American Heart Association. Circulation. 2001; 103:472–5.

[2] “Effects of Initiating Moderate Alcohol Intake on Cardiometabolic Risk in Adults With Type 2 Diabetes”, Ben-Gurion University of the Negev

[3] A. Pietraszek, S. Gregersen, K. Hermansen.  “Alcohol and type 2 diabetes: A review”, Nutrion, Metabolism, and Cardiovascular Diseases.  June 2010, Vol 20(5): 366-375.