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A diabetes expert shares some advice.

I feel awful after more than a drink or two. Is my diabetes to blame?

Let’s take a look at how alcohol is metabolized, or processed, in the body. After you have an alcoholic drink, alcohol moves from the stomach to the liver, where it is metabolized (broken down). In most people, it takes about 5 minutes for alcohol to be detected in the bloodstream. The liver, on the other hand, takes about 2 hours to process one drink (defined as 5 ounces of wine, 12 ounces of beer or 1½ ounces of distilled alcohol: rum, vodka, whisky, etc.). Drinking alcohol can cause hypoglycemia (low blood sugar) because, while the liver is metabolizing alcohol, it becomes less efficient at releasing glucose into the bloodstream. And, of course, this is a big deal for people with diabetes.

The American Diabetes Association recommends women have no more than one drink a day, and that men have no more than two. The effects of alcohol vary depending on your height and weight, the amount of food and alcohol you consumed, and at what rate, as well as your own personal metabolism. If you drink more alcohol than your body can process, you’re going to experience the effects. Drinking on an empty stomach and taking oral, blood glucose–lowering medications (such as glipizide or glyburide) or using insulin may cause dangerously low blood sugar levels.

Since you’ve had a strong reaction to alcohol, consult with your diabetes health care team to find out if drinking alcohol is healthy for you. If you choose to drink, safety is your priority. Keep in mind the following tips:

• Monitor your blood sugar before, during and after drinking alcoholic beverages.
• If you’re going to drink, have something to eat to reduce your chances of a hypoglycemic episode.
• Carry blood glucose tablets to raise blood sugar in case it dips dangerously low.
• Consider wearing a medical ID, as symptoms of hypoglycemia (dizziness, swaying, disorientation and confusion) may be mistaken for drunkenness, and if your blood sugar is low, you’ll need immediate help.

Published on March 18, 2015.

—Advice by Lorena Drago, MS, RD, CDN, CDE. Lorena is a registered dietitian, certified diabetes educator and consultant. She is the author of Beyond Rice and Beans: The Caribbean Guide to Eating Well with Diabetes.