Dear Alice,

Are there different sugar levels in different alcoholic beverages? I am hypoglycemic and have noticed different hangover levels contingent on the sugar level of alcohol consumed. Some have told me that Scotch has the least amount of sugar of all alcoholic beverages. Since I occasionally enjoy a drink, I would appreciate knowing the lowest sugar content.

Dear Reader,

It’s always a good idea to pay attention to the sugar content of the foods and beverages you consume, especially if you’re affected by hypoglycemia (low blood sugar). All types of alcohol have the same effect on people with hypoglycemia: while the liver is busy processing alcohol, it stops releasing stored glucose into the bloodstream, contributing to low blood sugar. According to the American Diabetes Association, this glucose-lowering effect can last for as long as eight to twelve hours. Interestingly, it’s not only the alcohol in your drink that causes blood sugar imbalances — in fact, research has shown that day-to-day glycemic control is not acutely affected by moderate alcohol consumption. Mixers, such fruit juices and sodas, may be the real culprits behind spikes and dips in your blood sugar when drinking. To counteract this effect, stick to non-sugary drinks and eat plenty of foods with proteins, fats, and complex carbohydrates to keep things balanced — before, during, and after the party.

Most alcoholic drinks are not composed solely of pure alcohol. Beer, wine, mixed drinks, spritzers, cocktails, and frozen drinks all contain additional ingredients and additives that often add lots of sugar and calories to your drink. To keep sugar levels balanced, use diet sodas, plain club soda, or water as mixers, and for some kick, add a spritz of lemon or lime to taste. If you enjoy the flavor of liquor on its own, try ordering your drink neat or on the rocks. If liquor is not your drink of choice, opt for light beers and steer clear of sweet dessert wines.

When drinking with hypoglycemia, the foods you eat and the timing with which you eat them can make or break your chances of a nasty hangover. The signs of intoxication — feeling dizzy, lack of coordination, and confusion — are the same as those of low blood sugar. Accordingly, it’s fairly easy to confuse intoxication with symptoms of low blood sugar. Eating the right foods at the right times can help. Here are some strategies to help prevent your blood sugar levels from dipping too low so you can gauge your level of intoxication more accurately:

  • Eat a well-balanced meal before drinking. Never drink on an empty stomach.
  • Sample plenty of finger foods throughout the night, particularly those high in complex carbohydrates. Try whole grain crackers or whole-wheat pita chips with cheese, guacamole, or hummus. Avoid foods high in simple sugars, such as candy and cookies.
  • Ask your bartender to precisely measure the amount of alcohol that goes into your drink so you can keep track of your intake. Once the drink is in your hand, sip slowly.
  • Continue snacking once you get home. If you're concerned about your blood sugar level dipping to uncomfortable levels while you sleep, you can have a snack before going to bed, or even wake up in the middle of the night to eat.
  • Have a backup plan — inform someone you'll be hanging out with of your hypoglycemia so that s/he can help you get food and medical help if necessary. Consider wearing an I.D. that identifies you as hypoglycemic, especially if you’re going out alone.
  • Because low blood sugar and alcohol both affect coordination, perception, and reflexes, don’t drive or engage in any other risky activities that require quick reflexes when under the influence of alcohol.

It’s good to note that there’s a difference between the short-term effects of alcohol on a person with hypoglycemia versus the ability of alcoholism to lead to the onset of hypoglycemia. Long term and frequent heavy drinking are associated with higher baseline glucose levels, which are in turn associated with an increased risk of diabetes, cardiovascular disease, and obesity. Fortunately, these effects may be reversible; in one study, following three months of abstinence from alcohol, research participants’ blood sugar was reduced to healthier levels. However, normal drinking is not associated with the onset of diabetes — several researchers have found that moderate drinking (one drink per day for women and two drinks per day for men) actually results in a reduced risk of diabetes.

For more ideas on healthy drinking and hangover helpers, take a gander at the Alcohol category of the Go Ask Alice! archives. For any remaining medical concerns, reach out and make an appointment with your health care provider. Cheers to healthy blood sugar!


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