General practice management of type 2 diabetes

Alcohol consumption
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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


SIGN, 2014


*Refer to Summary, explanation and source of recommendations for an explanation of the level of evidence and grade of evidence

Clinical context

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.71 Alcohol can lower BGLs and reduce awareness of hypoglycaemia. Alcohol and hypoglycaemia have independent but additive adverse effects on cognitive function.65

Reduction in energy intake, which may involve reducing alcohol intake, may be important for managing weight in the overweight or obese person as part of diabetes management.89

In practice

Patients should be educated on how to avoid hypoglycaemia when drinking alcohol.

The current Australian guidelines to reduce health risks from drinking alcohol recommends ≤2 standard drinks (20 g) per day for men and women. Low-alcohol beers are a better choice than ordinary or diet beers.89 The carbohydrate content of low-carbohydrate beer is not significantly less than full-carbohydrate beers and the alcohol content is often full strength.

For healthy men and women, drinking no more than two standard drinks on any day reduces the lifetime risk of harm from alcohol-related disease or injury. Drinking no more than four standard drinks on a single occasion reduces the risk of alcoholrelated injury arising from that occasion.89 It is recommended that people with diabetes abstain from alcohol if they plan to drive.90

Diabetes Australian and RACGP logo's
  1. Scottish Intercollegiate Guidelines Network. Management of diabetes. A national clinical guideline. (SIGN publication no. 116.) [Updated May 2014]. Edinburgh: SIGN, 2014.  [Accessed 17 February 2016].
  2. National Health and Medical Research Council. Australian Dietary Guidelines. Canberra: NHMRC, 2013.
  3. National Health and Medical Research Council. Australian Guidelines to reduce health risks from drinking alcohol. Canberra: NHMRC, 2009.
  4. 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.