Alcohol and Prediabetes: What You Need To Know
If you’ve recently been diagnosed with prediabetes, you probably have a lot of questions- especially about alcohol and prediabetes. Can you still drink? What types of alcohol are best? Will alcohol raise your A1C?
It's totally normal to feel overwhelmed by the thought of changing your lifestyle. I’m here to tell you that you can balance your blood sugar, enjoy your favorite foods (yes, even carbs), and see real improvements- without rigid diets. And yes, that includes understanding how alcohol fits into the picture.
In this blog, we’ll walk through how alcohol affects prediabetes, the science behind its impact on blood sugar, practical tips for drinking mindfully (if you choose to), and how to navigate taking a break from alcohol.
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Why Alcohol Is Harmful to the Body
Let’s start with why alcohol poses unique risks- especially for those with prediabetes.
Alcohol (ethanol) is classified as a toxin. Once consumed, your body converts it to acetaldehyde, a highly reactive and unstable compound that promotes inflammation and oxidative stress. This reaction can also generate reactive oxygen species (ROS)- harmful molecules that damage your cells and tissues.
While most people know the liver metabolizes alcohol, the pancreas does too, which is particularly important for those with prediabetes. Damage to the pancreas can impair insulin production, further complicating blood sugar regulation.
Alcohol and Blood Sugar
When it comes to alcohol and prediabetes, blood sugar regulation is front and center.
Some studies suggest that moderate alcohol consumption (1–2 drinks per day) might improve insulin sensitivity. But this research is likely correlational, not causal- meaning it may be other lifestyle factors influencing those outcomes.
More importantly, drinking more than three alcoholic beverages per day has been associated with increased blood glucose, elevated A1C levels, and a greater risk of developing type 2 diabetes.
A special note on hypoglycemia:
If you're taking a medication like metformin, alcohol may increase the risk of low blood sugar- especially if consumed on an empty stomach. That’s because your liver prioritizes detoxifying alcohol over maintaining your blood glucose, which can lead to hypoglycemia.
Symptoms of low blood sugar may include:
Drowsiness
Dizziness
Confusion
Weakness
If you’re not on blood sugar-lowering medication, the added sugars in some alcoholic drinks (like cocktails or sweet wines) can cause a blood sugar spike. Eating a balanced meal before or while drinking can help buffer these effects.
Tips for Drinking in Moderation with Prediabetes
In general, it is safe for individuals with prediabetes to drink alcohol in moderation. If you have prediabetes, you can follow the same alcohol safety guidelines as people without prediabetes.
While alcohol does have harmful effects, it’s not always realistic to eliminate it completely. You might use a drink to ease social anxiety at events or enjoy going to wineries with friends- and that’s okay. My goal is to equip you with strategies to manage your intake and keep it at a moderate level. That brings us to the first tip:
1..Understand what “moderation” really means:
Women: Up to 1 drink per day
Men: Up to 2 drinks per day
*One drink= 5 oz wine or 12 oz beer or 1.5 oz spirits.
It’s important to note that these are daily maximums, not weekly averages. “Saving up” for the weekend is not part of the recommendation. Aiming to stick as closely to these guidelines as possible will support your health.
2. Choose wine over beer and spirits
Wine may offer anti-inflammatory properties and has been associated with lower risk of type 2 diabetes in some studies. Beer and many mixed drinks often contain added sugars and refined carbohydrates.
3. Customize your cocktails
A major concern with alcoholic beverages, especially cocktails, is the added sugar. Many are made with sugar-sweetened mixers like soda or juice. To avoid the excess, ask for low-sugar modifications, such as soda water, fresh citrus, or a splash of simple syrup instead of pre-made sugary mixers.
4. Alternate with water or mocktails
In social settings, it can feel awkward not to have something to sip on if everyone else has a drink. To help pace yourself and stay hydrated, aim to alternate each alcoholic drink with a glass of water or a mocktail. Many restaurants and bars now offer creative non-alcoholic options! A couple of dietitian-owned mocktail brands to check out are Kul Mocks and Pesche.
Want to Take a Break From Alcohol? Here’s How
After reading this blog, you might be curious about what would happen if you gave alcohol a break- whether for a week, a month, or longer. Taking time off from drinking can help you tune into your body, stabilize your blood sugar, and build healthier habits.
Here are a few ways to make your alcohol-free time more enjoyable and sustainable:
Try fun alcohol-free drinks
You don’t have to settle for plain water. Here are some creative drink ideas that feel exciting:
Sparkling water, citrus slices, and fresh herbs (like mint or rosemary)
Kombucha in a wine glass
Dirty sodas made with Olipop or Poppi
Ready-to-drink mocktails like Kul Mocks or Pesche
Plan sober activities with friends or family
Instead of centering plans around bars or wine nights, try:
Morning coffee dates or brunches
Nature walks, bike rides, or pickleball with friends
Cooking or mocktail-making nights
Movie marathons, game nights, or puzzles with a cozy drink
Creative workshops or local events (pottery, yoga, trivia night, etc.)
Do it with a partner
Committing to a dry week or month with a friend or partner can help you feel supported- and even make it fun. Set a shared goal, swap drink ideas or recipes, and check in with each other throughout the week. You could even plan a small celebration at the end of your dry period to reflect on how it went.
Alcohol and Prediabetes: Final Takeaways
Alcohol and prediabetes can coexist, but the key is moderation and awareness.
Alcohol affects the pancreas and liver, both of which play major roles in blood sugar regulation.
Excessive drinking can lead to elevated blood sugar and A1C levels, increasing your risk of progressing to type 2 diabetes.
If you’re on medications like metformin, alcohol may increase the risk of low blood sugar, especially without food.
Choose low-sugar options, eat before drinking, and stick to the recommended limits for best results.
A dry week (or month) doesn’t have to be boring- grab a friend, try some fun mocktails, and see how good it feels to give your body a little break.
You don’t have to give up everything you enjoy to manage your prediabetes effectively. With the right strategies, you can maintain a healthy, balanced lifestyle- and feel confident in your choices.
If you are interested in personalized nutrition support, click here to book a free discovery call with me!
