Should Diabetics Stay Away from Wine? A Comprehensive Guide

November 6, 2025 •

4 min read

According to the American Diabetes Association, moderate alcohol consumption is generally considered safe for many people with diabetes whose condition is well-managed. However, the question of 'Should diabetics stay away from wine?' is more complex than a simple 'yes' or 'no', as it depends heavily on the type, quantity, and timing of consumption.

Quick Summary

People with diabetes can often drink wine in moderation, but careful consideration is crucial. Choosing dry varieties, monitoring blood sugar closely, and never drinking on an empty stomach are key to mitigating risks like hypoglycemia and medication interactions.

Key Points

Moderation is key: People with well-managed diabetes can typically enjoy dry wine in moderation, adhering to recommended daily limits (1 drink for women, 2 for men).
Choose Dry Varieties: Opt for low-sugar, dry wines like Cabernet Sauvignon, Merlot, Pinot Noir, or Brut sparkling wine, and avoid sweet and dessert wines to prevent blood sugar spikes.
Prevent Hypoglycemia: Never drink on an empty stomach. Alcohol inhibits the liver’s ability to release glucose, risking low blood sugar, especially for those on insulin or sulfonylureas.
Monitor Blood Sugar Closely: Check blood glucose levels before, during, and up to 24 hours after drinking to understand your body’s reaction and prevent nocturnal lows.
Consult a Doctor: Before drinking, discuss safe practices with your healthcare provider, especially concerning medication interactions and specific health conditions.
Don't Overlook Risk: While some research suggests benefits for red wine, it is not a cure-all, and excessive intake can worsen diabetes complications.

The Dual Impact of Wine on Blood Sugar

Wine's effect on blood sugar is not straightforward; it can cause both an increase and a dangerous decrease in blood glucose levels, depending on the circumstances. This dual impact is a primary reason why moderation and caution are so important for those managing diabetes.

Initially, if you consume sweet wine or drinks with sugary mixers, the high carbohydrate content can cause a rapid spike in blood sugar (hyperglycemia). However, the alcohol itself is broken down by the liver, which temporarily inhibits its ability to release stored glucose (glycogenolysis). This can lead to a delayed drop in blood sugar, potentially causing hypoglycemia hours later, even overnight. The risk is particularly high for individuals on insulin or certain oral diabetes medications.

Potential Risks of Wine for Diabetics

While not all diabetics need to abstain entirely, several risks require careful management:

Hypoglycemia: The most significant risk, especially when drinking on an empty stomach or excessively. The symptoms of low blood sugar, such as confusion, dizziness, and slurred speech, can be easily mistaken for intoxication, making it harder to get help.
Medication Interactions: Alcohol can interfere with many diabetes medications, including insulin and sulfonylureas, potentially amplifying their glucose-lowering effects. A dangerous condition called lactic acidosis is a rare risk when combining alcohol with metformin, particularly with heavy drinking.
Weight Gain: Wine, like all alcohol, contains empty calories. Regular, heavy drinking can contribute to weight gain, which worsens insulin resistance and makes diabetes management more difficult.
Worsening Complications: Excessive alcohol use can exacerbate existing diabetes complications, including nerve damage (neuropathy) and high blood pressure.

The Importance of Careful Wine Selection

Not all wines are created equal when it comes to diabetes management. The key difference lies in the sugar content, which is largely determined by how much residual sugar is left after the fermentation process.

To make safer choices, consider these guidelines:

Choose Dry Wines: Dry red and white wines have very low sugar content, making them the best option. Examples include Cabernet Sauvignon, Merlot, Pinot Noir, Chardonnay, and Sauvignon Blanc.
Avoid Sweet Wines: Sweet or dessert wines, like Moscato, Port, and Sherry, contain significantly higher sugar levels and should be avoided due to their potential for rapid blood sugar spikes.
Consider Sparkling Wine: Extra Brut sparkling wines are very low in sugar and can be a suitable choice for celebrations.
Mind the Volume: Even with dry wine, portion control is essential. A standard serving is just 5 ounces.

How to Drink Wine Safely with Diabetes

If you have a well-controlled condition and get your doctor's approval, here are some rules to follow:

Always Drink with Food: Never drink on an empty stomach. Pairing wine with a meal or a carbohydrate-rich snack helps stabilize blood sugar and reduces the risk of hypoglycemia.
Practice Moderation: Stick to the recommended daily limits: up to one drink for women and up to two for men.
Monitor Your Blood Sugar: Check your glucose levels before, during, and for up to 24 hours after drinking. This is critical for understanding how your body reacts and for preventing overnight hypoglycemia.
Stay Hydrated: Alternate between wine and water to prevent dehydration and help your liver function properly.
Carry ID and Snacks: Ensure you have a medical alert ID and carry fast-acting carbohydrates in case of a low blood sugar episode. Because the symptoms of intoxication and hypoglycemia can overlap, it is important that others know you have diabetes.
Avoid Binge Drinking: Consuming excessive amounts of alcohol in a short period is particularly dangerous and should be avoided.

The Role of Red Wine for Cardiovascular Health in Type 2 Diabetics

Some studies suggest that moderate consumption of red wine may offer heart-health benefits for individuals with well-managed type 2 diabetes due to its polyphenol content. These compounds may improve insulin sensitivity and increase 'good' HDL cholesterol levels. However, it is crucial to remember that this is not a reason to start drinking. The American Heart Association emphasizes that correlation does not equal causation and that any potential benefits are outweighed by the risks of excessive consumption.

Wine Comparison for Diabetics


Wine Type	Carbohydrate/Sugar Content	Effect on Blood Sugar	Risk Level	Best Practice for Diabetics
Dry Red Wine	Very Low (1-3g/L)	Can cause delayed hypoglycemia.	Low (with precautions)	Stick to 5oz serving with food; monitor levels.
Dry White Wine	Low (around 3.8g/5oz)	Can cause delayed hypoglycemia.	Low (with precautions)	Stick to 5oz serving with food; monitor levels.
Extra Brut Sparkling	Very Low	Minimal impact; can cause delayed hypoglycemia.	Low (with precautions)	Celebrate in moderation; monitor levels.
Sweet/Dessert Wine	Very High (up to 200g/L)	High risk of rapid blood sugar spike.	High	Avoid entirely.
Fortified Wine	High (around 150g/L)	High risk of rapid blood sugar spike.	High	Avoid entirely.

Conclusion

In summary, diabetics do not necessarily need to stay away from wine, but consumption requires strict moderation, careful planning, and a clear understanding of the risks. The key takeaway is to choose dry wines with lower sugar content, limit intake to one or two servings with food, and diligently monitor blood sugar levels. Always consult your healthcare provider before incorporating wine into your diet, as individual health conditions and medications can influence how alcohol affects you. For more comprehensive information on safe alcohol consumption, refer to the American Diabetes Association's guidelines.

Frequently Asked Questions

Yes, many people with well-controlled diabetes can drink wine in moderation. It is crucial to choose low-sugar, dry varieties and always consume it with food to minimize risks, especially hypoglycemia.

The best wines for diabetics are dry red and white wines, such as Cabernet Sauvignon, Merlot, Chardonnay, or Pinot Grigio. These have lower residual sugar compared to sweeter varieties like dessert wines.

Alcohol, including wine, can cause a drop in blood sugar (hypoglycemia) because it prevents the liver from releasing glucose into the bloodstream. This effect can last for several hours after consumption.

The American Diabetes Association recommends limiting alcohol consumption to no more than one drink per day for women and two drinks for men. One drink is defined as a 5-ounce glass of wine.

Risks include hypoglycemia, weight gain, medication interactions, and worsening diabetes complications like nerve damage. Excessive drinking can also impair judgment, making it harder to recognize low blood sugar symptoms.

No, it is highly recommended to never drink wine on an empty stomach. This significantly increases the risk of dangerous hypoglycemia, especially for those using insulin or other blood sugar-lowering medications.

Dry red and white wines have similar low sugar levels. However, some studies suggest red wine's antioxidants may offer additional cardiovascular benefits for some with type 2 diabetes, though this is not a reason to start drinking.