Prediabetes and Alcohol: The Impact on Blood Sugar and Reversing Prediabetes

You discovered you have prediabetes.

You probably have a lot of questions running through your mind. Some of them may be related to prediabetes and alcohol.

Can people with prediabetes drink alcohol?  How will alcohol impact my blood sugar? What kind of alcoholic beverage is best? How much alcohol is ok? Can you still enjoy some alcoholic beverages AND reverse prediabetes?

Don’t worry. I’ve got you covered.

April is National Alcohol Awareness Month and the perfect time to shed some light on prediabetes and alcohol consumption.

So let’s dive in. Here are three things you need to know about drinking alcohol with prediabetes.

Is it safe to drink alcohol with prediabetes?  

Yes, in general, people with prediabetes can drink alcohol and follow the same health and safety guidelines as people without prediabetes (1,2). 

Low blood sugar is a major safety issue, but pertains more to people with diabetes who take insulin or medications that stimulate insulin secretion. 

People with prediabetes who take Metformin should avoid excessive alcohol intake due to a rare but serious condition called lactic acidosis. Be sure to discuss medication interactions with your healthcare provider and/or pharmacist!

Can I drink alcohol and still reverse my prediabetes?

You may have even heard that drinking wine can decrease your risk of developing type 2 diabetes and wondered, is that really true?

The short answer is MAYBE. The current consensus is that moderate alcohol intake may lower the risk of developing type 2 diabetes by improving insulin sensitivity (how well our body responds to insulin) (2,3).

But….please keep reading because the devil is in the details!

First, what is considered moderate intake?

For women, moderate intake equals 1 drink per day. For men, moderate intake equals 2 drinks per day.

The size of the drink is key and depends on the type of alcohol.

One drink = 5 oz wine or 12 oz beer or 1.5 oz spirits.

Pay attention the next time you have a glass of wine. Is it really 5 ounces? For reference, five ounces is just slightly more than a ½ cup. 

Drinking patterns matter too. The protective benefit of moderate alcohol intake is lost when all alcoholic drinks are consumed in one sitting versus spread throughout the week. We can’t save up all seven drinks for a Saturday night! (3).

The specific type of alcoholic beverage is also important when it comes to type 2 diabetes prevention. Moderate wine consumption is associated with lower type 2 diabetes risk compared to beer and spirits (2,3).

It is important to note that any increase in alcohol consumption beyond the recommended “moderate” amount is associated with a reduction in healthy lifestyle behaviors and potential weight gain (1).

What are the best alcoholic beverages for prediabetes?

Like other liquid calories (regular soda, juice drinks, etc), alcohol intake is associated with higher long-term weight gain. Alcohol contains 7 calories per gram compared to 4 calories per gram of protein and carbohydrate and 9 calories per gram of fat.

A challenge for people with prediabetes is when their favorite alcoholic beverages are actually cocktails that include sugar-sweetened beverages such as mixers, regular soda, and juice. 

For example, a 12 ounce frozen margarita can easily pack a punch of 310 calories, 35 grams of carbohydrate, and 25+ grams of sugar!

One way to lighten up your favorite mixed drink is to customize your order. Think of it like ordering your coffee beverage at Starbucks… “Can I get a ½ caf, oatmilk, 2 pumps sugar-free vanilla syrup Frappuccino?” Instead now you are ordering a cocktail at your local bar… “Can I get a margarita, but can you skip the mixer and add extra fresh lime juice and a splash of simple syrup or agave?”

Ariana, at the “Cup of OJ”, lives with diabetes and offers some great suggestions for ordering low carb cocktails. You can find them here:  low carb cocktails to order at the bar.

When you are whipping up some mixed drinks at home, be sure to check out the Kitchen Community for Cassie’s lightened up recommendations. You can find them here: 18 delicious low calorie alcoholic drinks.

Key takeaways: what you should consider when drinking alcohol with prediabetes

  • If you currently drink alcohol (especially wine) in moderation, cheers!
  • If you don’t drink alcohol, it isn’t worth starting just for the possible health benefits. If you decide to start, be sure to keep an eye on any changes to your hemoglobin A1C.
  • Please keep in mind that more is not better! Excessive alcohol intake on a consistent basis can actually increase the risk of developing type 2 diabetes.
  • If you prefer mixed drinks, be sure to keep an eye on the calories and added sugar. Experiment with new ways to lighten up your drinks whether you are enjoying them out on the town or right in the comfort of your own home
  • Remember, your personal history of alcohol use, medical conditions, medications, etc should always be discussed with your healthcare provider.

What is your favorite alcoholic beverage? Comment below.

P.S. If you know someone who needs this information, share it!

bottle of champagne with glass of champagne
bottle of champagne with glass of champagne