Alcohol and Diabetes During COVID-19

If you have type 2 diabetes, weight loss, exercise, and healthy eating may be among your most important doctor's orders for managing blood sugar levels. Making healthy lifestyle choices, taking diabetes medications as prescribed, and monitoring blood sugar can keep blood sugar under control, but COVID-19 may put a damper on efforts to make healthy choices.

The pandemic, which has upended so many aspects of pre-pandemic life, has made it difficult for many people to hit health goals, as gyms may be closed or feel unsafe to use, food may be too close for comfort when staying at home so much, and stress may cause anxiety, fatigue, and difficulty following intended healthy behaviors. 

None of those changes are good for diabetes management, and there is another trend that may add fuel to the fire: home alcohol consumption has increased during COVID-19. It is up by 5 to 10%, and drinking while working from home has become far from uncommon [1].

Too much alcohol can be harmful for anyone, and it can be especially dangerous for people with diabetes.

Alcohol and Diabetes

Type 2 diabetes is a condition with higher-than-normal blood sugar levels due to insulin resistance in the body. Diabetes makes it difficult to control blood sugar levels. Abnormally high and low blood sugar levels can both be dangerous.

Drinking and diabetes do not mix, as alcohol consumption makes it tougher to control blood sugar. Alcohol can cause hypoglycemia or hyperglycemia (dangerously low or high blood sugar), interact with diabetes medications, and raise risk factors for heart disease, such as triglycerides and blood pressure, which are already of concern for people with diabetes.

Alcohol and Hypoglycemia

When you drink alcohol, your liver goes to work metabolizing it and removing it from your bloodstream. That means the liver is less able to do another important job: that of releasing stored glucose (sugar) into your bloodstream when you need it. The result can be dangerously low blood sugar, or hypoglycemia. Effects can include dizziness, weakness, shaking, loss of consciousness, nausea, and headaches, among other symptoms. It can be an emergency situation.

Alcohol can also cause hypoglycemia because it interacts with many common diabetes medications, including metformin (Glucophage) and insulin. Hypoglycemia is most common, but interactions with insulin could lead to either hypo or hyperglycemia. Unpredictable blood sugar levels can occur for up to 12 hours after drinking. 

Alcohol and Hyperglycemia

Drinking certain alcoholic beverages could have the opposite effect of hypoglycemia: hyperglycemia. This is due to high carb counts in certain beverages. 

Alcohol itself is not a carbohydrate, but some alcoholic beverages have carbs in them. Non-dessert wines can have under 5 grams of carbs per 5-oz. serving, and beer can have 10 to 20 grams per 12-oz. can or bottle. Spirits are mainly carb-free, but often come in mixed drinks, which can be packed with sugars from soda, fruit juice, and syrups.

Having a few high-carb drinks plus some high-carb foods, if you happen to be going off your diabetes diet while drinking, can lead to way more carbs than usual. The result could be hyperglycemia, which can turn into an emergency situation or cause dangerous hypoglycemia later.

Alcohol, COVID-19, and Weight Gain

Weight loss is often helpful in managing type 2 diabetes because losing extra weight can improve blood sugar control. Effects of the COVID-19 pandemic can make weight loss more difficult if it is harder to get in a workout or stress or boredom eating has increased. 

Alcohol consumption can also lead to weight gain for many reasons. 

• Alcohol has calories, say, 100 to 200 per drink.
• People are likely to eat high-calorie foods while drinking.
• Alcohol can lead to feelings of hunger after drinking although the body does not need those calories.
• Low blood sugar from alcohol may lead to carb and sugar cravings.

Home Alcohol Trends During COVID-19

Why are people drinking more at home? In part, it is likely because there is nowhere else to go. Bars and restaurants may be closed or perceived as risky places for spreading COVID-19, so social drinking may move to the home using video chats to connect. In addition, workplaces are closed, and happy hours may be taking place at home, too.

Stress and anxiety may be leading to home drinking. In addition, people may choose to drink while working from home - but keep in mind that employers may have alcohol use policies and employees can easily get caught.

Bucking the Trend

Why let alcohol and a pandemic get in the way of all that hard work to lose weight and manage diabetes? These are some strategies for reducing alcohol use at home.

• Finding something else to do when the urge to drink happens.
• Building and using a social support system.
• Keeping alcohol out of the home.
• Setting a daily maximum of 1 drink (women) or 2 drinks (men).

Professional help may be necessary if drinking is interfering with daily life, is out of your control, or is otherwise becoming a problem.

Safe(r) Drinking with Diabetes

If you are intent on having the occasional drink, safety precautions are essential if you have diabetes. Aside from not driving while under the influence, these are some additional tips.

• Test blood sugar before, during, and for 12 hours after drinking.
• Never drink on an empty stomach. Having a light snack or meal before having a drink can slow the absorption of alcohol into the bloodstream, as can drinking slowly. 
• Turn to lower-carb, nutritious foods, such as yogurt, chicken, and salads to eat while drinking alcohol, instead of higher-carb foods. This can help limit calorie consumption and keep down carb cravings later. 
• Drinking plenty of water while drinking alcohol can help prevent dehydration and reduce alcohol-induced feelings of hunger.
• Do not drink alone, and tell whomever is with you that you have diabetes and what to do if you need help.

The risks of alcohol are likely to outweigh the benefits of drinking, but there are safer ways to drink if you do choose to drink. Keeping it under control and limiting extra calories can help you stay on track with weight loss and your healthy lifestyle for diabetes.