Management of type 2 diabetes: A handbook for general practice

Lifestyle interventions for the management of type 2 diabetes

Alcohol consumption

Lifestyle interventions for the management of type 2 diabetes | Alcohol consumption 


Recommendation 

Grade 

References 

Recommended as of:

People with diabetes drink no more than 10 standard drinks per week 

1, 2 

14/11/2024

Alcohol has complex metabolic effects that affect the management of type 2 diabetes through its effects on diet and the management of blood glucose levels: 

  • 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.3 
  • Alcohol reduces awareness of hypoglycaemia. 
  • The effects of alcohol may depend upon the quantity consumed and the length of exposure to alcohol (eg single one-off episodes versus the effects of chronic consumption). 

Alcohol and hypoglycaemia have independent but additive adverse effects on cognitive function.4 Additional potential negative effects from alcohol consumption can impact diabetes-associated disease and neuropathies.5 

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

People with diabetes should be educated about safe levels of alcohol intake, according to Australian guidelines, and should be told that there is an increased risk of hypoglycaemia if alcohol is consumed while using medications such as sulfonylureas and insulin.6 

Current Australian guidelines to reduce health risks from drinking alcohol recommend no more than 10 standard drinks (a standard drink contains 10 g alcohol) per week, and no more than four standard drinks on any one day.3 Low-alcohol beers are an alternative to ordinary or diet beers. The carbohydrate content of low-carbohydrate beer is not significantly less than that of full-carbohydrate beers, and the alcohol content is often full strength. Light (low alcohol) beer has about 2.7% alcohol (compared with around 4.6% in a standard beer), but it has the same number of kilojoules as a low-carb beer, and a similar amount of carbohydrates to a standard beer. Any benefit will be negated unless the person is consuming the same number or fewer of standard drinks. 

It is recommended that people with diabetes abstain from alcohol if they plan to drive.7 

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

  1. Conigrave KM, Ali RL, Armstrong R, Chikritzhs TN, et al. Revision of the Australian guidelines to reduce health risks from drinking alcohol. Med J Aust 2021;215(11):518–24. doi: 10.5694/mja2.51336.
  2. National Health and Medical Research Council (NHMRC). Evaluating the evidence on the health effects of alcohol consumption: Evidence evaluation report. In: Australian guidelines to reduce health risks from drinking alcohol. NHMRC, 2020 [Accessed 6 September 2024].
  3. National Health and Medical Research Council (NHMRC). Australian dietary guidelines. NHMRC, 2013 [Accessed 6 September 2024].
  4. Scottish Intercollegiate Guidelines Network (SIGN). Management of diabetes: A national clinical guideline. SIGN, 2017. Available at: [Accessed 17 September 2024].
  5. National Health and Medical Research Council (NHMRC). Australian guidelines to reduce health risks from drinking alcohol. NHMRC, 2020. Available at: [Accessed 6 September 2024].
  6. Pietraszek A, Gregersen S, Hermansen K. Alcohol and type 2 diabetes: A review. Nutr Metab Cardiovasc Dis 2010;20:366–75. doi: 10.1016/j.numecd.2010.05.001.
  7. 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. doi: 10.1111/j.1464-5491.2004.01154.x.
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