Drinking small amounts of alcohol may be okay if you have good control of your diabetes, don’t have complications, and fit the alcohol into your meal plan. But drinking alcohol on an empty stomach can cause low blood glucose if you then exercise or if you are taking diabetes pills or insulin.

Insulin lowers your blood glucose. Diabetes pills (except metformin, acarbose, and troglitazone) make your body release more insulin to lower blood glucose. Exercise makes your insulin work better at lowering blood glucose.

Usually, if your blood glucose drops too low, the liver puts more glucose into the blood. (The liver has its own supply of glucose, called glycogen.) But when alcohol, a toxin, is in the body, the liver wants to get rid of it first. While the liver is taking care of the alcohol it may let blood glucose drop dangerous levels.

• Eat something when you drink alcohol.

• Check your blood glucose before, during, and after drinking. Alcohol can lower blood glucose as long as 8 to 12 hours after your last drink.

• Plan ahead how much you will drink. Don’t drink more than is included in your meal plan.

If you have low blood glucose after you drink, people might smell the alcohol and think you are drunk. The signs are the same. Tell them you have low blood glucose. Tell them what they need to do to help you take care of it. Wear a medical I.D. bracelet stating that you have diabetes. This will help in case you can’t talk.

Alcohol can worsen nerve damage, eye diseases, high blood pressure, and high blood fats. If you have any of these problems, ask your doctor how much alcohol, if any, is safe for you to drink.

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