Recommendations regarding alcohol consumption and diabetes currently relate to a number of different sources but focus on two main issues, hypoglycaemia for Type 1 diabetes and the increased cardiovascular risks with Type 2 diabetes, see Nutritional Management of Cardiac Risk Factors in Type 2 Diabetes & “Effect of Variations in Amount and Kind of Dietary Fat and Carbohydrate in the Dietary Management of Type 2 Diabetes” sections. The Nutrition Subcommittee of Diabetes UK produced a paper in 1985 which refers to a maximum safe intake of 30 g (3 units) per day for men and 20 g (2 units) per day for women. The government’s report, Sensible Drinking, published in 1997, refers to a maximum intake of 3 units per day for women and 4 for men. Precautions which apply to the general population also apply to people with diabetes.
However, for people on insulin therapy and sulphonylureas, alcohol should always be consumed with carbohydrate-containing foods. This is because of the increased risk of hypoglycaemia as alcohol suppresses gluconeogenesis.
Alcohol can also interfere with the action of glucagon in insulin-induced hypoglycaemia. People taking sulphonylureas can experience facial flushing with alcohol.
Daily alcohol intake has been associated with cataract development which is independent of the effects of diabetes itself.
Alcohol contributes 7 kcal/g and so may contribute to calorie intake and impact on weight control in people with Type 2 diabetes as well as aggravate hypertriglyceridaemia.
More recent studies on people with Type 2 diabetes suggest that people with well-controlled diabetes can safely consume 21 – 28 g/d alcohol with no change in glycaemic control. There are possible beneficial effects of alcohol on blood lipids and coagulability. Moderate intake of wine (one or two glasses per day) which contains flavonoids and phenolic compounds may confer benefits by virtue of antioxidant properties.
