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Management of type 2 diabetes: A handbook for general practice

Lifestyle interventions for management of type 2 diabetes

Alcohol consumption

Management of type 2 diabetes: A handbook for general practice
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Last revised: 17 Sep 2020

Grade: B

People with diabetes can take alcohol in moderation as part of a healthy lifestyle, but should aim to keep within the target consumption recommended for people without diabetes

  1. Scottish Intercollegiate Guidelines Network. Management of diabetes: A national clinical guideline (updated 2017). Edinburgh: SIGN, 2017.
These recommendations are drawn from the most recent recommendations from organisations including the National Health and Medical Research Council (NHMRC), the Scottish Intercollegiate Guidelines Network (SIGN), Diabetes Canada, the American Diabetes Association (ADA) and other relevant sources. Refer to ‘Explanation and source of recommendations’ for explanations of the levels and grades of evidence.

Alcohol affects the management of type 2 diabetes through its effects on diet and control of BGLs:

  • Alcohol interferes with the action of insulin, insulin secretagogues and glucagon, thereby increasing the risk of hypoglycaemia in people with type 2 diabetes who take these medications.5
  • Alcohol can lower BGLs and reduce awareness of hypoglycaemia.

Alcohol and hypoglycaemia have independent but additive adverse effects on cognitive function.9

Reduction in energy intake, which should involve assessing alcohol intake, may be important for managing people who are overweight or obese as part of diabetes management.

Patients should be educated about safe levels of alcohol intake, according to Australian guidelines, and should be told that there is increased risk of hypoglycaemia if alcohol is consumed while using medications such as sulfonylureas.41

Current Australian guidelines to reduce health risks from drinking alcohol recommend no more than 10 standard drinks (a standard drink contains 10 g of alcohol) per week, and no more than four standard drinks on any one day.42 Low-alcohol beers are an alternative to ordinary or diet beers. The carbohydrate content of low-carbohydrate beer is not significantly less than full-carbohydrate beers, and the alcohol content is often full strength.

It is recommended that people with diabetes abstain from alcohol if they plan to drive.43

Australian alcohol guidelines can be found on the National Health and Medical Research Council (NHMRC) website.

  1. National Institute for Clinical Excellence. Guidance for the use of patient-education models for diabetes. Technology appraisal guidance TA60. London: NICE, 2003.
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  6. Diabetes Canada Clinical Practice Guidelines Expert Committee. Diabetes Canada 2018 clinical practice guidelines for the prevention and management of diabetes in Canada. Can J Diabetes 2018;42:S1–325.
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  9. Scottish Intercollegiate Guidelines Network. Management of diabetes: A national clinical guideline (updated 2017). Edinburgh: SIGN, 2017.
  10. Colberg SR, Sigal RJ, Yardley JE, et al. Physical activity/exercise and diabetes: A position statement of the American Diabetes Association. Diabetes Care 2016;39(11):2065–79.
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  40. Targher G, Alberiche M, Zenere MB, Bonadonna RC, Juggeo M, Bonara E. Cigarette smoking and insulin resistance in patients with noninsulin-dependent diabetes mellitus. J Clin Endocrinol Metab 1997;82(11):3619–24.
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  42. National Health and Medical Research Council. Australian guidelines to reduce health risks from alcohol [in publication]. Canberra: NHMRC, 2020.
  43. Cheyne EH, Sherwin RS, Lunt MJ, Cavan DA, Thomas PW, Kerr D. Influence of alcohol on cognitive performance during mild hypoglycaemia; implications for Type 1 diabetes. Diabet Med 2004;21(3):230–37.
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