Alcohol and diabetes: consequences, advice

Having a drink with friends is always nice. But alcohol has an impact on health, even if it is consumed in small quantities. In addition to the risk of drunkenness, with its share of road accidents and violent behavior, alcohol consumption increases the long-term risk of addiction, cancer, cardiovascular disease, anxiety, depression and memory problems. In this context, the French health authorities recommend limiting oneself to “maximum two glasses a day and not every day. »

For a diabetic, “the problem is the same as for the general population”, observes Dr. Pierre Nys, endocrinologist. Alcohol is not prohibited, the moderation advice remains the same with, however, a few nuances. Diabetes is, in fact, linked to metabolic disorders which can be aggravated by alcohol. What encourage patients to be cautious.

An alcohol overload (for example: several drinks in the same evening) can block the production of sugar in the liverwith a risk of hypoglycemic illness.

And the specialist to specify: « This risk is particularly significant in type 2 diabetics who are taking medications such as sulfonylureas and, more generally, in type 1 or 2 diabetics who are on insulin. »

With 7 calories per gramwe can consider that alcohol is high in calories. When it arrives in the liver via the bloodstream, it is transformed under the action of various enzymes. “Alcohol is metabolized into triglycerides, in other words: it turns into fat”, explains the endocrinologist.

People who drink too much gradually start to put on weight, but this weight gain is particularly dangerous in diabetics. The fat that accumulates around the waist disrupts the metabolism and promotes the insulin resistance characteristic of the disease. The consequences can be serious. « This weight gain increases the long-term risk of cardiovascular disease and kidney damage in diabetics who are particularly fragile in these areas », emphasizes Dr. Nys.

Excessive alcohol consumption can, in the long run, cause inflammation of the pancreas, with the risk of severely disrupting its functioning. “This chronic calcifying pancreatitis alters the production of insulin in the pancreas, which can unbalance diabetes. This situation is difficult to recover because there are few therapeutic solutions. For a type 2 diabetic, this may mean a switch to insulin,” says Dr. Nys.

In type 1 diabetes, patients require daily injections of insulin since their pancreatic cells no longer produce it. For them, the major risk of excessive alcohol consumption is hypoglycaemic discomfort or even coma, knowing that alcohol tolerance varies considerably from one person to another. During an alcoholic evening and in the hours that follow, Dr. Nys advises these patients to monitor  » more than usual «  their blood sugar. A precautionary measure.

In type 2 diabetes and in the prediabetes stage, it is the weight gain that is potentially dangerous. The consumption of alcohol goes against the lifestyle recommendations recommended for these patients: controlling their weight, adopting a healthy and balanced diet, practicing regular physical activity. Well respected, these simple lifestyle measures allow many patients to do without hypoglycemic drugs and to avoid insulin injections.

Aperitifs, cooked wines, digestives and cocktails contain large amounts of sugar. They are therefore particularly not recommended for diabetics.

Even if it means drinking alcohol, you might as well turn to wine, beer or champagne (less sweet and less strong in alcohol), provided you stay within a reasonable consumption.

Non-alcoholic beer is not a good alternative, in the eyes of Dr. Nys: “It contains maltose, a sugar that is very hyperglycemic”. Better to skip it.