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Diabetes, Drinking and Smoking: A Dangerous Combination

Diabetic black man reviews blood test at dining room tableA healthy lifestyle can help control diabetes. For instance, regular physical activity and a good diet play a big role in managing the disease. But unhealthy habits, such as smoking and drinking too much alcohol, can make diabetes and its complications worse.

Why? Let's take smoking first. According to the Department of Veterans Affairs (VA), people with diabetes who smoke are three times more likely to die of heart disease than those with diabetes who are nonsmokers. Both diabetes and smoking increase the risk of heart attack and stroke. Smoking also increases the risk for all diabetes-related health problems, such as kidney disease, nerve damage and leg and foot infections. According to research published in 2007 in the Journal of the American Medical Association, smoking also may increase the risk for developing diabetes if you don't already have it.

Diabetes and smoking are particularly relevant in the Veteran community. Nearly 25 percent of Veterans who receive health care through VA have diabetes and almost 20 percent smoke.

Quit Smoking

The best thing to do for your health, whether or not you have diabetes, is to quit smoking as soon as you can. Research shows most smokers want to quit. According to VA, 57 percent of Veterans who are current smokers reported that they tried to quit within the last year. The addictive nature of nicotine can make quitting a major challenge.

If you want to quit, talk to your health care team. You can work with a health behavior coordinator or join a class with other Veterans who are trying to quit. VA also offers smoking cessation medicines.

"If you are having trouble quitting, at least cut back," advised Dr. Sharon Watts, a Nurse Practitioner and Certified Diabetes Educator for VA. "Cutting back is better than nothing."

One way to cut back is to learn coping skills you can use in place of having a cigarette, said Watts. "Try taking a walk, talking with a friend, doing an activity you like or listening to a relaxation tape."

Everything in Moderation

Consuming alcohol when you have diabetes poses another danger to your health. For instance, if you take insulin or diabetes medicine by mouth, too much alcohol may lower your blood sugar for up to 12 hours after drinking, especially if you drink on an empty stomach or increase your physical activity.

"When you drink too much, your liver stops every other job it does, including making blood sugar, to work on getting rid of the alcohol, which it sees as a toxin," said Watts. "People think too much alcohol will increase their blood sugar, but actually the opposite is true."

Alcohol can also worsen nerve pain caused by diabetes and cause weight gain. Being obese or overweight can cause diabetes or make it worse if you already have it.

If you drink and have diabetes, do it in moderation. For a man, moderate drinking is up to two drinks per day; for a woman, one drink. A drink is a 12-ounce beer, 5-ounce glass of wine or 1.5 ounces of distilled spirits (such as vodka, gin or rum).

If you have diabetes and plan to drink:

  • Always eat some form of carbohydrate with your drink, such as crackers, bread or pretzels.

  • Avoid sweet wines, drinks and liqueurs.

  • Check your blood sugar more often.

  • Always have a ready source of sugar on hand, such as pieces of hard candy.

  • Talk to your health care provider.

  • Always carry identification that says that you have diabetes.

My HealtheVet Can Help

To help manage your diabetes, check out the following features on My My HealtheVet:

  • Use "Labs and Tests" and "Vitals and Readings" to keep track of your lab tests and blood sugar, body weight and other important health measures

  • The food journals and activity journals to help you stay focused on maintaining a healthy lifestyle

  • The Smoking and Tobacco Use Cessation section of the Healthy Living Centers to help you quit smoking

  • The diabetes section of the 'Diseases and Condition Centers' to learn more about diabetes

  • The alcohol use screening tool in the 'Mental Health' section to see if you should speak with someone about your alcohol use

VA has many resources available to Veterans who are concerned about their drinking habits. All VA care locations offer first-time alcohol screening and services for Veterans. If you want to quit or cut back on your drinking, your health care team can put you in touch with people who can help.

Read More

Living with Diabetes (Login Required)

Top Five Ways to Avoid Diabetes (Login Required)

Be Tobacco Free (YouTube)


Last Updated April 27, 2017