Regular, long-term use of alcohol has been shown to increase insulin resistance. It addresses some of the risks as well as some of the benefits of drinking alcohol when you have type 2 diabetes. It also provides guidelines for how to safely include alcohol in a type 2 diabetes diet (if you so choose).

Alcohol and Liver Function in Diabetes

The strong consensus from in vitro and ex vivo models, although not entirely consistent, suggests that alcohol inhibits insulin secretion. Using the isolated perfused pancreas, alcohol did not alter basal insulin secretion but did impair glucose-stimulated insulin secretion (GSIS) in a dose-dependent manner [101]. Other studies reported that alcohol inhibits both early- and late-phase insulin secretion by the perfused rat pancreas [101,102]. Acute in vitro treatment with alcohol or its metabolite, acetaldehyde, also dose-dependently reduces GSIS in isolated islets [103]. Moreover, a similar alcohol-induced reduction was observed when alcohol was administered in vivo and islet insulin secretion was assessed in vitro [104].

Alcohol’s Effects on Blood Sugar Levels of Diabetics

• But if you do drink, know that not all alcoholic beverages are created equal when it comes to diabetes.
• However, in recent studies the in vivo uptake of 2-DG by the whole brain did not differ in response to either acute [12,73,83] or chronic [14] alcohol in rats.
• Normal fasting blood sugar levels should be in the range of 70–100 milligrams per deciliter (mg/dl).

First, alcohol likely stimulates the generation of VLDL particles in the liver, which are rich in triglycerides. Third, alcohol may enhance the increase in triglyceride levels in the blood that usually occurs after a meal. The combination of alcohol-induced hypoglycemia, hypoglycemic unawareness, and delayed recovery from hypoglycemia can lead to deleterious health consequences. For example, Arky and colleagues (1968) studied five diabetics who experienced severe hypoglycemia after ingesting alcohol. In all five patients, the alcohol-induced hypoglycemia induced neurological changes, such as incontinence, inability to follow simple commands, perseveration,4 disorientation, and impairment of recent memory. In three patients, those changes did not reverse, even after months or years.

ALCOHOL CONSUMPTION AND RISK OF T2DM

Despite the consistent observation that acute and chronic alcohol impairs in vivo-determined IMGU by muscle, there is little consensus on the mechanism underlying the insulin resistance. Alcohol may theoretically blunt insulin action at a number of recognized regulatory steps including PI3K/AKT signal transduction and/or GLUT4 translocation [134]. can diabetics get drunk For example, GLUT4 protein in the plasma membrane fraction of the gastrocnemius, but not in whole muscle homogenate, was reduced in alcohol consuming rats [14,57]. Similarly, in vitro incubation of differentiated myotubes with alcohol acutely inhibited insulin-stimulated GLUT4 translocation [70] and this response is dose-dependent [56].

In people with diabetes, the pancreas does not produce sufficient insulin (type 1 diabetes) or the body does not respond appropriately to the insulin (type 2 diabetes). Alcohol consumption by diabetics can worsen blood sugar control in those patients. For example, long-term alcohol use in well-nourished diabetics can result in excessive blood sugar levels. Conversely, long-term alcohol ingestion in diabetics who are not adequately nourished can lead to dangerously low blood sugar levels. Heavy drinking, particularly in diabetics, also can cause the accumulation of certain acids in the blood that may result in severe health consequences.

• Neuropathy, in addition to other factors (e.g., vascular disease in the penis or altered hormone levels), also may contribute to impotence, which is a common and troublesome complication in diabetic men.
• Alanine is generated during the breakdown of proteins in the muscles, whereas glycerol is formed during the metabolism of certain fat molecules (i.e., triglycerides).
• When results were stratified by BMI, the protective association was only found in overweight and obese women.
• The effects of insulin and other blood glucose-lowering medications that work by increasing your body’s release of insulin, such as sulfonylureas and glinides, can also increase the risk of late-onset hypoglycemia, says endocrinologist Alan Graber.

Recruitment of GLUT4-containing vesicles to the cell membrane is dependent upon activation of AKT and the downstream phosphorylation of AS160 [135]. An alternative mechanism has been posited by Wan et al. [118] who reported that chronic alcohol feeding increases the mRNA and protein in muscle for the GTP-binding protein Gs-α, which in other conditions impairs IMGU [137]. Alcoholic patients with T2DM have repeatedly been found to have deregulation of the ghrelin and leptin systems, as indicated by impaired insulin secretion, increased hepatic glucose production and decreased peripheral glucose utilization.

Improves insulin sensitivity

As mentioned earlier in this article, poor food intake can lead to depleted glycogen levels. Furthermore, continued alcohol metabolism results in diminished gluconeogenesis. Both the depletion of glycogen and diminished gluconeogenesis lead to lower blood sugar levels. Because insulin restrains glucagon secretion, lower insulin secretion allows increased glucagon secretion, setting the stage for the development of ketoacidosis.

• As presented above there is considerable inconsistency in the literature for many of the specific areas related to glucose homeostasis, making general conclusions difficult.
• Similarly, in vitro-determined basal glucose uptake did not differ in incubated epitrochlearis muscle isolated from pair-fed and alcohol-fed rats [57].
• Glucagon kits, widely used to treat hypoglycemia in type 1 diabetes, do not work as well if someone has alcohol in their system.
• Among other cell types, the Islets of Langerhans include an inner core of insulin-producing beta cells surrounded by a layer of glucagon-producing alpha cells.
• OBJECTIVE—In a randomized controlled trial, we assessed the effect of daily moderate alcohol intake on glycemic control in the fasting and postprandial states in patients with type 2 diabetes who previously had abstained from alcohol.