Alcohol and diabetes
Although many people may have heard of diabetes, being diagnosed with it, or being close to someone who is diagnosed, can still present lots of questions. How it affects your diet or daily routine might be one of them.
In the UK, diabetes affects around 2.3 million people, and it’s thought there are at least half a million more people who have the condition but are not aware of it.(1)
Insulin is the hormone that controls the amount of sugar in the blood. Diabetes occurs when the pancreas doesn’t produce enough insulin, or the insulin it does produce doesn’t work properly.
Types of diabetes
Type 1 diabetes develops if the body is unable to produce enough insulin. It occurs when the insulin-producing cells in the pancreas are destroyed. This can be triggered by an autoimmune response – the body attacking itself – which can be due to a viral or other infection. It can also be down to genetic factors. This type of diabetes usually appears before the age of 40. At present there is nothing that can be done to prevent type 1 diabetes.(2)Type 1 diabetes accounts for between five and 15% of all cases of diabetes.(3)
Type 2 diabetes develops when the body can still make some insulin, but not enough, or when the body becomes resistant to insulin.
Type 2 diabetes is linked with being overweight and inactive. In particular, people who are an ‘apple-shape’ – with lots of fat around the abdomen – have been found to be at a greater risk of developing type 2 diabetes. This type of diabetes also runs in families.
Type 2 diabetes usually appears in people over the age of 40, and is more common in men. However, it is becoming more common among overweight children and young people in the UK. It is also particularly common among people of African-Caribbean, Asian and Hispanic origin.(4)
Between 85 and 95% of all people with diabetes have type 2 diabetes.(5)
Facts and figures
Drinking alcohol can contribute to the conditions that cause diabetes. There is evidence to suggest that heavy drinking can reduce the body’s sensitivity to insulin, which can trigger type 2 diabetes.(6) Diabetes is a common side effect of chronic pancreatitis, which is overwhelmingly caused by heavy drinking. One in three people who have chronic pancreatitis will develop diabetes.(7)
Drinking can also increase your chance of becoming overweight and therefore your risk of developing type 2 diabetes. Alcohol contains a huge amount of calories – one pint of beer can be equivalent to a chocolate bar.
However, several studies have shown that light to moderate drinking actually may reduce your chance of getting type 2 diabetes.(8) (9) (10) (11)
A 2005 review of 15 previous studies into the link between diabetes and alcohol concluded that ‘moderate drinkers’ (those who drank between one and six units per day) were a third less likely to develop type 2 diabetes than abstainers or heavy drinkers. Teetotallers and heavy drinkers have an equally high risk of developing diabetes.(12) This is thought to be because low to moderate levels of alcohol make the body more sensitive to insulin.(13)
Progression
Symptoms
The main indications that you might have diabetes are feeling very thirsty, producing excessive amounts of urine, tiredness, weight loss and loss of muscle bulk. Other symptoms include blurred vision, cramps, constipation, itchiness around the vagina or penis or getting thrush and other skin infections regularly.(14)
- People with diabetes by and large live normal lives. However, if you’re diagnosed with diabetes, you will need to make changes to your lifestyle to control the condition. For both type 1 and type 2 diabetes your doctor will advise you to eat a healthy diet and take exercise to control your blood sugar levels. All type 1 diabetics and some type 2 diabetics will have to inject insulin and/or take other medications on a daily basis.(15)
- Diabetics will generally be advised by their doctor that they can safely drink alcohol in moderation. However, it is recommended that they stay within the Government guidelines for the rest of the population – no more than two to three units per day for women and three to four units per day for men.(16)
- However, there are a number of issues diabetics should be aware of if they choose to drink. Alcohol lowers blood sugar levels, and diabetics must take this into account and eat plenty of food, preferably carbohydrates, to make sure their blood sugar levels stay steady.(17) Otherwise, hypoglycaemia can occur. Symptoms of hypoglycaemia include slurring words, a headache, confusion, double vision, abnormal behaviour and eventually unconciousness. Hypoglycaemia can be particularly dangerous when you’re drinking because others can mistake it for drunkenness and may not realise you need urgent medical help.(18)
- If you have nerve damage as a result of diabetes, drinking alcohol can make it worse and increase the pain, tingling, numbness and other symptoms.(19)
Advice and getting help
If you’re concerned that you might have diabetes, contact your GP. For more information on the condition, visit Diabetes UK’s website www.diabetes.org.uk.
If you’re concerned about your own alcohol consumption, or that of someone else, you can
call Drinkline on 0800 917 8282.
Contents approved by Drinkaware Chief Medical Adviser, Prof. Paul Wallace BSc (Hons), MSc, MBBS, FRCGP, FFPHM
References
1 NHS Choices, Diabetes type 1, http://www.nhs.uk/conditions/diabetes/Pages/Introduction.aspx
2 Ibid.
3 Ibid.
4 NHS Choices, Diabetes type 2,http://www.nhs.uk/conditions/Diabetes-type2/Pages/Introduction.aspx?url=Pages/what-is-it.aspx
5 Ibid.
6 Shah, J 1987, ‘Alcohol decreases insulin sensitivity in healthy subjects’, Alcohol and Alcoholism, vol. 23, no. 2, pp. 103-109.
7 NHS, patient information leaflet on pancreatitis
http://cks.library.nhs.uk/patient_information_leaflet/pancreatitis
8 Carlsson, S et al, ‘Alcohol consumption and the incidence of type 2 diabetes: A 20-year follow-up of the Finnish Twin Cohort Study’, Diabetes Care, vol. 26, no. 10, pp. 2785-2786.
9 Kopper, L et al 2005, ‘Moderate alcohol consumption lowers the risk of type 2 diabetes: A meta-analysis of prospective observational studies’, Diabetes Care, vol. 28, no. 3, pp. 719-725.
10 Avogaro, A et al 2004, ‘Acute alcohol consumption improves insulin action without affecting insulin secretion in type 2 diabetic subjects’, Diabetes Care, vol. 27, no. 6, pp. 1369-1374.
11 Umed, A et al 2000, ‘Alcohol consumption and risk of type 2 diabetes mellitus among US male physicians’, Archives of Internal Medicine, vol. 160, no.7, pp.1025-1050.
12 Kopper, L et al 2005, ‘Moderate alcohol consumption lowers the risk of type 2 diabetes: A meta-analysis of prospective observational studies’, Diabetes Care, vol. 28, no. 3, pp. 719-725.
13 Kiechl, S et al 1996, ‘Insulin sensitivity and regular alcohol consumption: Large, prospective, cross-sectional population study (Bruneck study)’, British Medical Journal, vol. 313, no. 7064, p.1040.
14 Diabetes UK, Treating Diabetes.http://www.diabetes.org.uk/Guide-to-diabetes/Introduction-to-diabetes/Treating_diabetes/
15 Diabetes UK, Alcohol and Diabetes,http://www.diabetes.org.uk/Guide-to-diabetes/Food_and_recipes/Alcohol_and_diabetes/
16 Ibid.
17 Ibid.
18 NHS Choices, Hypoglycaemia,http://www.nhs.uk/Conditions/Hypoglycaemia/Pages/Symptoms.aspx
19 Diabetes UK, Alcohol and Diabetes,http://www.diabetes.org.uk/Guide-to-diabetes/Food_and_recipes/Alcohol_and_diabetes/
- Page last updated by
- Matthew Bateman, 10 Sep 2009.
- Page checked on
- 01 Sep 2009
