"Until One Cannot Distinguish Between Cursed Haman and Blessed Mordecai" – Is It Allowed for Diabetics?

Drinking wine on Purim is a custom and an integral part of the Purim feast and the joy of the holiday. But what about diabetics, are they allowed? There are official and systematic recommendations for alcohol consumption, advising women to drink up to one unit of alcohol a day, and men up to two units. A unit of alcohol contains 15 grams of alcohol, for example, 330 ml of beer, 140 ml of dry wine, 30 ml of vodka, whiskey, brandy, gin, or rum. Large quantities of alcohol are not recommended as they can be detrimental to health in several ways.

Alcohol Facts

1. One gram of alcohol contains 7 calories. In comparison, a gram of carbohydrates or protein contains 4 calories, and a gram of fat contains 9 calories. Those who consume large amounts of alcohol regularly and wish to lose weight might achieve their goal by giving up alcohol alone (without adding calories from another source).

2. If you suffer from fatty liver or any other liver disease, or have high levels of triglycerides (blood fats), it is advisable to avoid alcohol as it can worsen liver conditions and contribute to higher blood fat levels.

3. Red wine is one of the most researched alcoholic drinks in relation to heart and vascular health, thanks to its high amount of antioxidants.

4. Alcohol can lower blood sugar levels to hypoglycemia conditions for many hours after consumption, as it blocks glucose release from the liver and interferes with hormones that counteract insulin during hypoglycemia.

5. There are medications that alcohol might interfere with. If you take prescription medications regularly and want to drink alcohol, check with your pharmacist if it's possible.

6. Beer is a type of drink based on malt (barley) which belongs to the carbohydrate family. Drinking beer is like drinking bread, essentially. The carbohydrate amount from consuming a 330 ml bottle of beer is equivalent to about 15 grams of carbohydrates, similar to a slice of bread or two slices of light bread.

Do's and Don'ts for Diabetics Drinking on Purim

Don't

• Alcohol does not require insulin because it does not convert to glucose.

• Dry or semi-dry wine contains very few carbohydrates, thus no additional insulin is required. Wines can also lead to hypoglycemia, depending on the quantity consumed.
• Do not drink alcohol on an empty stomach, but only with a complex meal containing all food groups—primarily carbohydrates, but also proteins and fats.
• Monitor your blood sugar levels multiple times after drinking alcohol, especially at night and while sleeping.
• Eat an additional small meal (like a sandwich) before bed to decrease the chance of blood sugar dropping through the night.

(Photo: shutterstock)

• The treatment for loss of consciousness due to severe hypoglycemia from alcohol is different than usual due to alcohol's effects. In this case, a glucagon injection will not help; instead, a glucose injection directly into the vein is necessary. Ensure that those around you are aware that you are diabetic.
• Symptoms of intoxication can be similar to hypoglycemia (headache, nausea, trembling, and sweating), so it is recommended to monitor blood sugar after consuming alcohol. Always carry available sugar and identification or a bracelet, as people may not recognize hypoglycemia symptoms during intoxication.
• It is recommended to avoid highly sugary alcoholic beverages, such as sweet wines, sherry, ciders, cocktails, or sweet liqueurs.

Einat Mazor Beker is a clinical dietician at the DMC Obesity Clinic