Alcohol & Hypoglycemia

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Hypoglycemia is a potentially severe condition that indicates the brain and body don’t have enough glucose to function correctly. Alcohol’s effect on blood sugar could make heavy drinking hazardous for a person with diabetes. Consuming alcoholic drinks with high sugar content could lead to “hypoglycemia unawareness+” (1), in which a person whose been drinking doesn’t notice warning signs of low blood sugar and is, therefore, at risk for severe reactions.

People with diabetes who need to manage their blood sugar are urged to discontinue alcohol use. If you’re having difficulty doing so, you might have an alcohol use disorder. In this event, it might be best to consider seeking a professional opinion or formal treatment to find out for sure.

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What Is Hypoglycemia?

In people with type I diabetes, the pancreas doesn’t produce sufficient amounts of insulin, a hormone that regulates blood sugar. In individuals with Type II diabetes, adequate insulin is available, but the body does not respond correctly. Both types of diabetes have been associated with hypoglycemia, most often in those who take insulin.

Blood sugar (blood glucose) is the primary sugar found in the blood. Blood sugar levels can vary throughout the day, depending on several factors, which is normal. Hypoglycemia, sometimes called insulin shock, occurs when a person’s blood glucose levels become low enough to warrant attention. This is often below 70mg/dL but can vary between individuals. (2) Failure to address this problem and ensure blood sugar increases to normal levels can be dangerous.

Symptoms of low blood sugar range from mild to severe. However, the only way to know if your blood glucose is low is to check your glucose levels whenever possible. If you can’t, you are advised to assume it’s hypoglycemia and treat it accordingly.

Signs/Symptoms of Low Blood Glucose Include: (3)

  • Shakiness.
  • Anxiety and nervousness.
  • Chills and clamminess.
  • Headaches.
  • Sweating.
  • Irritability.
  • Confusion.
  • Rapid heart rate.
  • Nausea.
  • Dizziness or lightheadedness.
  • Hunger.
  • Pallor.
  • Drowsiness.
  • Weakness and low energy.
  • Blurry or impaired vision.
  • Tingling or numbness in the tongue or lips.
  • Impaired coordination and clumsiness.
  • Nightmares and sleep disturbances.
  • Seizures.

What Happens During Hypoglycemia?

When blood sugar is low, this triggers the body to release adrenaline (epinephrine). (4) This causes a “fight-a-flight” response that can result in symptoms such as tinging, sweating, anxiety, and heart palpitations. The epinephrine response prompts the liver to improve blood glucose levels or raise them long enough for a person to consume carbohydrates.

If blood sugar levels continue to decrease, however, the brain cannot get enough glucose and stops functioning correctly. This can cause numbness, blurry vision, confusion, poor concentration, and drowsiness. If blood sugar remains too low for too long, the brain is starved of glucose, which can result in seizures, coma, and, uncommonly, death. (5)

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Why Drinking Alcohol Can Cause Hypoglycemia

One of the liver’s key roles is steadily releasing glucose into the bloodstream throughout the day, and consuming alcohol can undermine this function. (6) For people taking insulin to reduce blood sugar, this can be significant because the liver isn’t releasing enough glucose to prevent blood sugar levels from becoming too low. As a result, long-term alcohol consumption by people with diabetes, particularly those malnourished, can result in perilously low blood sugar levels.

Severely low blood sugar is especially dangerous while a person is sleeping (also known as nocturnal hypoglycemia). (7) It can easily occur in those who haven’t consumed additional carbohydrates or eaten several hours before bed.

Alcohol consumption might also induce sustained hypoglycemia in people with type 2 diabetes being treated with hypoglycemic drugs with a long half-life. In addition, alcohol can interact with or reduce the effectiveness of many of these medications.

Furthermore, many people with alcohol dependence have liver cirrhosis, meaning this organ cannot react to hypoglycemia by releasing glucose. (8) Alcohol use can also exacerbate diabetes-related complications, such as disruptions in fat metabolism, nerve damage, and eye disease. (9)

What Is Hypoglycemia Unawareness?

People with hypoglycemia unawareness are unable to recognize when their blood sugar is low and address it accordingly. This can lead to a substantially higher risk of experiencing severely low, dangerous blood glucose levels and effects such as cardiac arrhythmia, myocardial infarction, and brain damage. Hypoglycemia unawareness is more common among people with long-standing diabetes or who have frequent episodes of low blood sugar, as they may be less likely to recognize its early warning signs. (10)

Critically, alcohol use can contribute to unawareness of low blood sugar due to intoxication and also because some of alcohol’s effects are similar to those of hypoglycemia.

Other Factors That Contribute to Hypoglycemia

Mildly low blood sugar is common for individuals with type 1 diabetes and averages about two episodes per week. (11) It occurs less often in those with type 2 diabetes who inject insulin or take specific medications. The following factors are also involved in the development of hypoglycemia:

Incorrect Insulin Use

Having too much insulin is a common cause of low blood sugar. Newer insulins are typically preferred because they’re less likely to cause low glucose than others. In any case, however, inadvertently administering the wrong type of insulin, too much insulin, or injecting it into the muscle instead of right underneath the skin can result in low blood sugar. 

Food Intake

Certain eating and drinking practices can cause low blood glucose, including the following:

  • Intaking insufficient carbohydrates.
  • Skipping or delaying a meal.
  • Consuming foods and drinks with fewer carbohydrates than usual without decreasing the dose of insulin administered.
  • Not timing an insulin injection based on whether carbohydrates are coming from solids or liquids can impact sugar levels. Carb-rich liquids like juice will cause blood sugar to increase faster than carb-rich solids such as bread. 
  • Consuming meals with a significant amount of protein, fiber, and fat, as this will lead to slow carbohydrate digestion and a longer time for glucose to rise.
  • Consuming smaller amounts of food, as these will not cause blood sugar levels to increase as much as large portions. (12)


Being physically active has many health benefits, but for those with type 1 diabetes, it can reduce blood sugar short- and long term. The duration, intensity, and timing of activity can influence the risk of blood glucose becoming low. According to the National Institute of Health, nearly half (46%) of studied children who exercised one hour during the day had a low blood sugar reaction overnight. (13)

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If you need help breaking free from alcohol misuse, you are urged to consider seeking professional treatment to address this issue before it worsens and results in severe health issues, such as hypoglycemia. Contact us today for a free assessment and no-obligation benefits check. We offer multiple levels of care to suit your unique needs, including medical detox, residential treatment, partial hospitalization, intensive outpatient treatment, and aftercare. 

At Guardian Recovery, we are dedicated to helping people suffering from addiction foster the healthy, drug- and alcohol-free lives they deserve. When you are ready to reclaim your life, feel free to get in touch with us so we can help you begin your recovery journey.


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Disclaimer: Does not guarantee specific treatment outcomes, as individual results may vary. Our services are not a substitute for professional medical advice or diagnosis; please consult a qualified healthcare provider for such matters.

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Reviewed professionally for accuracy by:

Ryan Soave


Ryan Soave brings deep experience as a Licensed Mental Health Counselor, certified trauma therapist, program developer, and research consultant for Huberman Lab at Stanford University Department of Neurobiology. Post-graduation from Wake Forest University, Ryan quickly discovered his acumen for the business world. After almost a decade of successful entrepreneurship and world traveling, he encountered a wave of personal and spiritual challenges; he felt a calling for something more. Ryan returned to school and completed his Master’s Degree in Mental Health Counseling. When he started working with those suffering from addiction and PTSD, he found his passion. He has never looked back.

Written by:

Cayla Clark

Cayla Clark

Cayla Clark grew up in Santa Barbara, CA and graduated from UCLA with a degree in playwriting. Since then she has been writing on addiction recovery and psychology full-time, and has found a home as part of the Guardian Recovery team.

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