Drinking on Purim with Diabetes: What You Need to Know

Purim is a time of simchah, joy, laughter, giving, and of course, celebration. For many, that includes drinking wine or alcohol as part of the mitzvah of being joyful on this special day. But for those living with diabetes, it’s important to understand how alcohol can affect blood sugar and what steps you can take to enjoy the holiday safely.

Alcohol has a unique effect on the body. One key concern is that it blocks the liver’s natural ability to produce sugar. Usually, when we fast overnight or after physical activity, the body relies on the liver to release glucose into the bloodstream. Alcohol disrupts this process, which can lead to low blood sugar especially for people who use insulin or medications that stimulate the pancreas to produce more insulin.

What’s more, the effects of alcohol can be delayed. Hypoglycemia (low blood sugar) may not appear right away, it can happen up to 12 hours after drinking. And if someone becomes confused due to low sugar levels caused by alcohol, a glucagon shot (commonly used for such emergencies) won’t work. This is because glucagon works by signaling the liver to release sugar but alcohol has already blocked that response. In that case, the only emergency treatment, aside from going to the hospital, is rubbing honey or a sugary gel inside the cheek, where it can be absorbed into the bloodstream.

Which Drinks Are Safest for Diabetics?

For people with diabetes, the best choices are drinks that are low in sugar and have lower alcohol content. Dry red or white wine and champagne are generally safe options. They contain very few carbohydrates and have a lower alcohol percentage compared to hard liquors. Low-carb beers are another good alternative that can help keep blood sugar more stable.

What Should You Avoid?

Be cautious with distilled spirits like whiskey, vodka, tequila, cognac, gin, or dry martinis. While these drinks have no carbs, their high alcohol content can sharply increase the risk of a blood sugar crash. Even more risky are mixed drinks like vodka with orange juice which combine strong alcohol with sugary mixers. These can cause a quick spike in blood sugar, leading you to give extra insulin, only for the alcohol to later cause a drop. That swing between high and low can be dangerous. Cocktails such as gin and tonic, whiskey with cola, and sweet liqueurs all have similar effects and are best avoided.

What Foods Should You Pair with Alcohol?

Certain foods can help balance the effect of alcohol. Peanuts are a great option because they’re high in protein, fiber, and healthy fats, which slow alcohol absorption and can help prevent blood sugar crashes. They also contain a moderate amount of carbohydrates (about 8 grams per 100 grams). Olives are another excellent choice, especially for lighter drinks. On the other hand, it’s best to stay away from high-carb foods like pizza, pasta, or burgers with buns when drinking. These meals, combined with alcohol, can act just like sweet cocktails causing spikes and crashes in blood sugar.

What to Keep in Mind During and After Drinking

Above all, stay aware of how alcohol may affect your blood sugar, not just immediately, but hours later. The safest approach is to monitor your levels regularly, especially if you use a continuous glucose monitor (CGM). These devices provide real-time updates and can alert you if your sugar levels are dropping quickly. If you don’t have a CGM, make sure to check your levels throughout the evening and overnight. And if you're considering adjusting your insulin dose because of alcohol, always consult your doctor beforehand.

Purim is a beautiful time to rejoice and connect with others. With a bit of care, planning, and awareness, even those with diabetes can enjoy the celebration, l’chaim to a joyful and healthy Purim!

Adina Bachar is a Diabetes and Ketogenic Nutritionist at the DMC Center for Diabetes Care, Chair of the Future Association, and author of “The Ketogenic Diet Book.”