Does Alcohol Increase Your Risk of Type 2 Diabetes?

Alcohol gets a bad rap for a lot of reasons, but does it really raise your risk of diabetes? Nearly 1 in every 10 Americans develops diabetes, most of which is type 2 diabetes. Risk factors for type 2 diabetes include having a more sedentary lifestyle, being over age 45 and having a first-degree relative with the condition, among others.

But if you drink wine, beer or liquor regularly, are you at risk for type 2 diabetes? After speaking to dietitians and diabetes educators, there is not a clear, direct connection between drinking alcohol and developing type 2 diabetes. However, that's not to say that alcohol doesn't have negative consequences when it comes to blood sugar management. Read on to explore the complex relationship between alcohol and blood sugar, and what you can do to prevent type 2 diabetes.

How the Body Metabolizes Alcohol

When we consume alcohol, our body mostly breaks it down through the liver. This allows us to eliminate alcohol and other toxic substances from our body. However, this process takes some time. Too much alcohol consumption can overwhelm our liver and lead to feeling intoxicated.

The liver also helps regulate blood sugar levels. One of its many jobs is to store glucose and send it back to your bloodstream to stabilize your blood sugar levels as needed, particularly overnight. However, your liver prioritizes metabolizing alcohol. So when you drink, your liver won’t send glucose back into your bloodstream when you need it—and the result can be low blood sugar.

The Link Between Alcohol and Diabetes

Some research shows a correlation between alcohol consumption and developing diabetes—but it may depend on how much you’re drinking. In one study from China, heavy drinkers had a 29% higher risk of type 2 diabetes compared to people who never drank. The authors concluded that reducing alcohol intake would be beneficial in terms of avoiding developing diabetes. One limitation of this research is that it relied on self-reports from people, and people may not be fully transparent about how much alcohol they drink. This study also did not have a wide population of women, and so more research needs to be done in females.

Still, an umbrella review of 53 meta-analyses on specific foods and type 2 diabetes risk found that people who were moderate drinkers (about one to two drinks per day) had a 25% lower incidence of type 2 diabetes compared to teetotalers. Foods that were associated with type 2 diabetes included processed meat, bacon and sugar-sweetened beverages. That said, it’s important to keep in mind that there are many drawbacks to consuming alcohol, the authors point out. Heavy drinking is associated with liver cirrhosis, which is linked to type 2 diabetes, as well as alcohol abuse and an increased risk of certain cancers.

So, how do you keep all this in perspective? While alcohol intake can influence the risk of developing type 2 diabetes, it is not a direct cause, says Vandana Sheth, RDN, a registered dietitian nutritionist and certified diabetes care and education specialist.

Imbibing may impact other lifestyle behaviors that can contribute to an increased risk of the disease. For example, if you have a few drinks on a Friday night, you might be more likely to sleep in and avoid going to a Saturday morning exercise class, or you might be lower-energy and generally less active the next day. These changes are not immediately causing diabetes in the short term, but when you look at these patterns throughout someone's life, it's possible that these behaviors can add up to an increased risk for type 2 diabetes.

“Excessive alcohol can affect blood sugar levels, insulin sensitivity and contribute to weight gain. For those with diabetes, it is especially important to limit intake to one drink per day for women and up to two drinks per day for men,” Sheth adds. The liver also stores calories from alcohol as fat, and this type of fat can contribute to insulin resistance.

Other Risk Factors for Diabetes

There isn’t just one thing that causes diabetes. There are multiple risk factors, including genetics and lifestyle factors, says dietitian and certified diabetes educator at MedStar Health, Shayna Frost, RD. It’s worth reevaluating your relationship with alcohol and making any necessary changes, whether that’s reducing the amount you drink or exploring what it means to be sober curious. In addition, consider these other risk factors that can contribute to the development of diabetes:

• Lack of physical activity: Regular movement helps improve insulin sensitivity and lower your blood sugar, reducing your risk of diabetes.
• Weight considered obese: Excess body fat, especially abdominal fat, can lead to insulin resistance and rising glucose levels. However, it’s important to note that type 2 diabetes can occur in bodies of all shapes and sizes.
• Family history: Having a family history of diabetes, particularly in first-degree relatives, like your parents or siblings, increases the risk of developing diabetes. Genetic factors play a significant role here, as well as learned behaviors during childhood.
• Age: The risk of developing type 2 diabetes increases with age, particularly after the age of 45. While this is one factor we can’t control, there are many lifestyle influences you can change even as you age.
• Ethnicity: Certain folks, such as African Americans, Hispanic/Latino Americans, Native Americans, Asian Americans and Pacific Islanders, are at higher risk of developing type 2 diabetes. This increased risk is attributed to a variety of genetic, environmental and socioeconomic factors.
• Other health conditions: High blood pressure and high cholesterol are two health markers that make you more vulnerable to type 2 diabetes. Elevated blood pressure and abnormal lipid levels, such as high levels of triglycerides and cholesterol are often correlated with insulin resistance and rising blood sugar levels.

What About Drinking Alcohol If You Have Diabetes?

While we know that drinking alcohol doesn't directly impact one's development of type 2 diabetes, drinking alcohol can have serious side effects for people who have diabetes or are prone to low blood sugar issues. Drink moderately and always be sure to eat a balanced meal if you are drinking booze, as food can mitigate the effect alcohol has on your glucose levels. Check with your doctor to ensure that you shouldn't have any adverse reactions and that your medication will not contribute to low blood sugars while drinking alcohol.

The Bottom Line

Diabetes is complicated—there's not one food or drink that can cause or cure diabetes. While alcohol alone is not a factor that solely causes diabetes, it can affect what you eat, how active you are and your sleep, which may also make you more prone to diabetes over time. The recommended daily limit is one drink per day for women and two drinks per day for men. Choose alcohol that is low in calories and total carbohydrates and pair your alcohol with a balanced meal for best blood sugars later.