What's the link between alcohol and diabetes?

• 28% of men and 14% of women drink above the recommended units per week (NHS data 2019). 
• Alcohol is a causal factor in more than 60 medical conditions including: mouth, throat, stomach, liver and breast cancers, high blood pressure, cirrhosis of the liver and depression. (gov.uk 2018)

What does the research say?

What we know so far regarding any possible health benefits of alcohol is not much help. Moderate alcohol use in healthy adults is often praised, but we still do not have enough clinical evidence to support this. Most research is based on questionnaires that investigate current and past habits of the individuals related to their lifestyle (diet, exercise, caffeine, and alcohol). Achieving high accuracy with these results can be quite challenging, especially when the people participating need to recall details from years ago or they underestimate the true amount. These studies may indicate association, but not necessarily cause and result.

For instance, adults who engage in more social activities and enjoy moderate amounts of alcohol could be healthy, but we cannot be certain that alcohol has anything to do with making them healthier. Moreover, it is widely believed that the potential health benefits of alcohol wouldn’t make a compelling argument that one should begin drinking or increase their alcohol intake, because the risks are far greater. However, if you, or someone you know, drinks responsibly you can probably continue to do so. Moderate alcohol use for healthy adults generally means limiting alcohol intake to 14 or less units a week.

And what could we possibly say about wine? Red wine has been famous for its health benefits against “bad” cholesterol. The polyphenols in wine could relax blood vessel walls and prevent the oxidation of low-density lipoprotein (LDL). As a result, they act against atherosclerosis – the formation of cholesterol-filled plaque on the inside of the arteries. A specific type of polyphenols are flavonoids that can be found in foods like blueberries, strawberries, apples, onions, dark chocolate, and tea. However, some polyphenols are specific to red wine.

White wine also contains polyphenols, but tend to be overlooked, since the amount is 10 times less compared to red. Some scientists are currently attempting to study the effects of dealcoholized wine. Hopefully, in the future we’ll have accurate knowledge of whether the polyphenols alone or the combination of them with alcohol provide the best results.

Reasons to avoid alcohol:

• You’re pregnant or trying to become pregnant
• You have been diagnosed with alcoholism
• You have had a haemorrhagic stroke
• You have liver or pancreatic disease
• You are on a strict diet
• You have had heart failure or you've been told you have a weak heart
• You take prescription or over-the-counter medications that can interact with alcohol
• You have sleep problems – alcohol dehydrates you and could affect your sleep quality if you drink in the evening
• You will be driving or operating heavy machinery
• You are underage (when you are travelling be sure to check the legal drinking age)
• You have recently been diagnosed with diabetes or you have been for a long time, and you are still having hypos
• You are severely depressed. 

You wouldn’t want to tempt someone who should not be drinking for one or more of the above reasons or make them feel uncomfortable.

Alcohol and diabetes key points:

The relationship between alcohol and risk of type 2 diabetes can be complicated and this is one more reason why you should stay within the government guidelines for drinking alcohol.

• Excess alcohol intake is associated with an increased risk of type 2 diabetes.
• Alcohol reduces your body’s ability to recover when blood sugar levels are dropping. If you drink a lot or on an empty stomach, you’re even more likely to have a hypo.
• Alcohol stands in the way of the liver’s ability to store extra glucose which is released back into the blood when needed, such as when blood sugar levels drop.
• Your risk of having a hypo doesn't go away after you stop drinking – it increases and can last up to 24 hours.
• It’s not uncommon for some people to mistake having a hypo for being drunk.
• When drinking always carry hypo treatments around with you, wear some medical ID and make sure that whoever you’re with knows you have diabetes and how to help with a hypo if you need them to.
• If you’re carb counting to estimate the amount of insulin you need, take into consideration not only the carbs in an alcoholic drink, but also the likelihood to get hypos.

Choose your drinks wisely:

• Avoid low-sugar/“diabetic” beers and cider. They have less sugars, but sometimes have more alcohol in them.
• Avoid low-alcohol wines – they often have more sugar in them.
• Try to limit drinks with a lot of sugar, such as sweet sherries, sweet wines and liqueurs.

• Have diet or sugar-free mixers with any spirits.
• Spirits, dry wines and prosecco do not contain as many carbs as beers, ales and ciders; so these may be a better choice if you are concerned about the carbs in alcohol.

There’s little to suggest that drinking alcohol can better our health. Drinking within the current government guidelines of 14 units a week can help prevent alcohol having a negative impact on our health.

References:

1. NHS. Alcohol misuse
2. NHS . Alcohol support
3. WHO. Diet factsheet
4. Diabetes.org. Alcohol and diabetes.
5. https://www.ncbi.nlm.nih.gov/books/NBK482121/
6. Drink Aware
7. Alcohol use: weighing risks and benefits
8. Drinks to consume in moderation
9. Is wine fine or beer better?
10. NHS. Statistics on alcohol
11. Gov.UK. The public health burden of alcohol review