The Effects of Alcohol and Tobacco Consumption in Diabetes Patients

If you were recently diagnosed with diabetes, you might be wondering if you can continue drinking alcohol and smoking cigarettes. You can rest assured that you are able to drink alcohol…in moderation, of course! Smoking is discouraged for everyone, and this is especially true for people with diabetes, who are at increased risk of cardiovascular and other complications.

Key takeaways:
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    Patients with diabetes can drink alcohol in moderation.
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    Be prepared and ensure you closely monitor your blood sugar when drinking.
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    Patients with diabetes should not use tobacco.
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    Tobacco use increases the risk of cardiovascular disease and diabetes complications.

The daily recommendation is to limit alcohol consumption to two drinks daily for men and one drink daily for women. This recommendation still applies to people with diabetes.

Smoking increases the risk of cardiovascular disease and cancer, and it causes inflammation in the body, which can lead to joint pain and other issues.,People who smoke cigarettes are 30–40% more likely to develop type 2 diabetes (T2D) than those who do not smoke. In people with diabetes, smoking can increase the risk of developing complications or cause existing complications to progress.

Effects of alcohol on blood sugar

After you are diagnosed with diabetes, drinking alcohol means that, in addition to drinking responsibly, you also need to understand the effects of alcoholic beverages on blood sugar (glucose), be prepared, and keep an eye on your blood sugar while drinking.

Like most aspects of diabetes management, the effect of alcohol on blood sugar is not straightforward.

The effects depend on what and how much you drink. Moderate amounts of alcohol can cause your blood sugar to rise but then drop. Excess amounts of alcohol may decrease your blood sugar. When you have been drinking, your liver is busy filtering alcohol, so your glucagon may not work to bring your blood sugar up.

Beer and wine contain carbohydrates that increase your blood sugar. Hard alcohol, such as vodka or tequila, alone does not tend to have much, if any carbohydrates, but what is mixed with the hard alcohol usually does – such as tonic, juice, etc.

Drinking excess amounts of alcohol can be dangerous because of the risk of low blood sugar, especially for people on insulin or a sulfonylurea, a type of oral diabetes medication.

People with diabetes, especially type 1 diabetes (T1D), should eat before and/or while consuming alcohol so their blood sugar does not drop too low. All people with diabetes should monitor their blood sugar while drinking because overeating when drinking alcohol can also increase your blood sugar!

Tips for drinking alcohol safely with diabetes

  • Talk to the medical provider who manages your diabetes about what changes you need to make in your diabetes regimen when you are drinking (e.g., ask about medications that can affect your blood sugar when alcohol is consumed). Make sure you remember to make those changes. This is especially important if you are dancing or walking, which can cause your blood sugar to drop, even when you are not drinking. You may need to reduce the amount of insulin and/or medication you are taking, monitor your blood sugar frequently, and eat.
  • Wear a medical alert bracelet in case people that you are with do not know about your diabetes or someone finds you alone. This will alert them to call 911 if you are unresponsive.
  • Learn the signs of low and high blood sugar and tell the people that you are with how to recognize them. Explain to people what to do in case of very low blood sugar (hypoglycemia) so they know to call 911 if you are unresponsive or have trouble eating.
  • Eat before you go out or while you are drinking. Before you go to sleep, eat something with protein and/or fat in it. This can help keep your blood sugar up.
  • Set an alarm when you go to sleep to wake yourself up (or have someone check on you) in 2–3 hours to monitor your blood sugar. Having someone else follow your continuous glucose monitor can be helpful too!

Effects of tobacco on diabetes

As previously stated, smoking can increase your risk of developing serious health complications and can make the complications you have from your diabetes worse. Not smoking is key to a healthy future with diabetes – although we know it is very difficult to quit!

When you smoke, nicotine changes cells so they do not respond to insulin that well. Insulin helps the sugar in your bloodstream get into your body’s cells to be used as energy. When your cells do not respond to insulin in the same way, your blood sugar increases.

There are also other chemicals in cigarettes that cause harm to cells in your body and cause inflammation. This inflammation itself can create insulin resistance, which causes your cells to stop responding to insulin the way they should. Usually, people who smoke need more medications or insulin to keep their blood sugar in the target range.

Cigarette smoking can increase the buildup of plaque (a fat, waxy substance that causes atherosclerosis) on the walls of your blood vessels. This, in addition to the damage that high blood sugar causes to the blood vessels and nerves, puts you at increased risk for heart disease and other complications.

Benefits of quitting smoking

There are many benefits to quitting smoking, including:

  • Lowering your blood sugar (and possibly medication/insulin requirements).
  • Decreasing your heart rate.
  • Lowering your blood pressure.
  • Improving your circulation.
  • Improving your lung function (reducing the toxic carbon monoxide).

One year after you stop smoking, you cut your risk of heart disease in half compared to that of someone who still smokes.

Get support to stop smoking

When you decide to stop smoking it can be difficult. It is often not done all at once, but over time. Many people have to quit smoking multiple times until they succeed. This is all normal, so don’t give up on yourself!

Getting support from family, friends, or a support group is also very useful and can help you on your road to success!


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