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Who Answers?If you have type 1 or type 2 diabetes and take regular insulin injections, drinking alcohol can negatively affect your insulin levels and cause many unpleasant side effects. Mixing alcohol and insulin injections is a risky practice, and it’s important to know the potential consequences, such as worsening diabetes-related medical issues.
In this article:
- What is Insulin?
- Does Alcohol Affect Insulin?
- What Are the Risks of Mixing Alcohol and Insulin?
- What To Do if You Mix Alcohol and Insulin
- Alcohol Use Disorder and Diabetes
What is Insulin?
Insulin is a hormone produced by your pancreas. This hormone helps your body use and store glucose in your body. Here is an overview of how it works:1
- Food and drinks break down into glucose or sugar.
- The glucose then signals the pancreas to release the hormone insulin.
- Insulin tells the body to either use the glucose for energy or store it in the liver.
- As the glucose is used for energy, blood sugar levels drop, signaling the pancreas to decrease insulin production.
- When blood sugar levels drop low enough, the liver will release the stored glucose for more energy.
That is how insulin is supposed to work in your body, but if you have been diagnosed with type 1 or type 2 diabetes, your body is either not producing enough insulin or is not using it properly. If this is the case, your doctor will most likely prescribe injections of insulin that you can use to replace or supplement the natural release of insulin.
Does Alcohol Affect Insulin?
Alcohol influences both the natural insulin produced in our bodies and insulin medications used to treat diabetes. Alcohol causes inflammation in a part of your brain called the hypothalamus, which disrupts your brain’s ability to receive signals related to insulin needs in the body.2
Most of the interaction between alcohol and insulin is not a direct relationship but rather, how alcohol impacts the blood sugar levels in the body that insulin attempts to control.
Some ways alcohol can affect insulin and blood sugar levels include:
- Alcohol causes an initial spike in your blood sugar levels, which causes a release of insulin to bring the level down, so a sharp drop usually follows the spike up in blood sugar.
- Alcohol gets processed by your liver, which means while alcohol is still in your system, your liver will not be able to focus on releasing the stored glucose to raise blood sugar levels.
- Heavy alcohol use over a long time impairs liver function and blood sugar level regulation.
How Long Does the Effect Last?
Alcohol affects your blood sugar for as long as it is in your body. The effects of alcohol on your blood sugar will peak in about 1-2 hours as your blood absorbs the sugar from the alcohol.
Once all of the sugar is in your blood, your body will use it for energy, but your liver will not be able to release more blood sugar just yet. It can take up to 12 hours for the alcohol to be fully processed from your liver so that your body can begin to raise your blood sugar level again.
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Help is standing by 24 hours a day, 7 days a week.Who Answers?What Are the Risks of Mixing Alcohol and Insulin?
As with mixing other substances, there are a few risks involved in drinking alcohol if you have diabetes and are taking insulin medications, including:3
- Long-term alcohol use in those with diabetes can result in excessive blood sugar levels.
- Heavy drinking can cause a build-up of acids in the blood that may end in severe health problems.
- Alcohol use can worsen diabetes-related medical issues, such as problems metabolizing fat, nerve damage, and eye disease.
- Both diabetes and alcohol use are associated with high blood pressure and cardiovascular disease.
- Alcohol use in diabetics can lead to dangerously low blood sugar levels, also called hypoglycemia.
Hypoglycemia
The greatest risk in mixing alcohol and insulin is hypoglycemia. One of the dangers here is that the signs of hypoglycemia mimic the signs of inebriation, which could prevent you from recognizing that your blood sugar is dangerously low. Signs of hypoglycemia include:4
- Feeling shaky or jittery
- Hunger
- Being tired, dizzy, or lightheaded
- Experiencing confusion, trouble seeing or speaking
- Irritability
- Heart palpitations or racing heart
- Headaches
- Loss of consciousness
- Seizures
If you do experience hypoglycemia after drinking alcohol, your glucose levels will return to normal at a much slower rate than they usually would if you had not been drinking alcohol. A study showed that patients who were recovering from an alcohol-induced hypoglycemic episode experienced incontinence, disorientation, memory, and other neurological problems. In some cases, these negative effects lasted for months or years.3
Who is at Risk?
There are a few groups that have a higher risk of experiencing the negative effects of mixing alcohol and insulin.
- If you have type 1 or type 2 diabetes or are taking insulin medication, you are at a greater risk of experiencing any of the dangerous effects.
- If you have alcohol use disorder (AUD), you are at greater risk since you cannot reduce your alcohol consumption.
- If you don’t have diabetes, you may still be at risk since regular alcohol use can increase your risk of developing type 2 diabetes due to insulin resistance.
You may have heard of alcohol and insulin resistance. Insulin resistance refers to an impaired response of the body to insulin, resulting in elevated levels of glucose in the blood. A study showed that heavy alcohol use causes insulin resistance, which increases your risk of developing type 2 diabetes.2
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Help is standing by 24 hours a day, 7 days a week.Who Answers?What To Do if You Mix Alcohol and Insulin
If you lose count of your drinks or don’t pay attention to your blood sugar levels, you may end up with some of the negative effects of mixing alcohol and insulin. If you drink alcohol slowly, you should be able to differentiate between the signs of inebriation and hypoglycemia. If you notice the signs of hypoglycemia, you should go to your nearest emergency room or call 911.
The American Diabetes Association shares some helpful recommendations for your alcohol use if you are also taking insulin:5
- The recommended amount of alcohol is no more than one drink per day for women and two drinks per day for men.
- Check your blood sugar levels before drinking, and avoid drinking if your levels are low.
- Avoid drinking when you have an empty stomach.
- People with diabetes who are tracking carbohydrates in their diets shouldn’t count the calories in an alcoholic drink towards this number.
- Heavy craft beers and those with high sugar contents could be more dangerous than other types of drinks.
If you are having trouble adhering to these recommendations and frequently wind up drinking more or for longer than intended, you may have alcohol use disorder, the clinical term for an alcohol addiction.
Alcohol Use Disorder and Diabetes
If you have alcohol use disorder and diabetes, you are at risk of experiencing serious side effects, including hypoglycemia. AUD makes it extremely difficult to control the amount of alcohol you drink and often requires medical and therapeutic intervention. You will need alcohol addiction treatment for both your diabetes and alcohol use simultaneously.
Some of the treatment tools that will help you include:
- Medical detox
- Medication management (including insulin management)
- Nutrition and meal planning
- Support groups
- Therapy
- Relapse prevention and aftercare services
Those who seek treatment for alcoholism often achieve meaningful recovery and change. If you or someone you know has AUD, please call
800-948-8417
Who Answers?
to discuss your treatment options.
Resources
- Centers for Disease Control and Prevention. (2021). Insulin Resistance and Diabetes.
- Lindtner, C., Scherer, T., Zielinski, E., Filatova, N. Fasshauer, M. Tonks, N.K., Puchowicz, M., Buettner, C. (2013). Binge Drinking Induces Whole-Body Insulin Resistance by Impairing Hypothalamic Insulin Action. Science Translational Medicine, 5(170), 170.
- Emanuele, N.V., Swade, T.F., and Emanuele, M.A. (1998). Consequences of Alcohol Use in Diabetics. Alcohol Health and Research World, 22(3): 211–219.
- National Institute of Diabetes and Digestive and Kidney Diseases. Low Blood Glucose (Hypoglycemia). National Institute of Health.
- American Diabetes Association. What can I eat?.