Red wine and diabetes: Can you still enjoy a glass?
There’s something about autumn and winter that makes a glass of red wine particularly appealing.
Perhaps it’s the darker evenings, a slow-cooked beef stew bubbling away on the hob, or the prospect of settling in with a good film and a little cheese. And don’t even get me started on red wine and chocolate.
In our household, we love a good red. My partner lives with type 1 diabetes, and while we’re certainly not drinking wine every evening, it’s one of those small pleasures we enjoy together.
Which brings us to a question that often comes up when talking about diabetes and lifestyle: can you still enjoy a glass of red wine if you have diabetes?
The short answer is yes, for many people, provided alcohol is appropriate for their individual health circumstances.
But there’s a little more to consider than whether the wine is dry, sweet or full-bodied.
Alcohol affects the body in ways that aren’t always immediately obvious, particularly when insulin or certain other diabetes medications are involved.
And while red wine has enjoyed a rather glamorous reputation as a heart-healthy indulgence, the science behind that claim deserves a closer look.
Red wine’s healthy reputation: Where did it come from?
For years, red wine has been associated with the Mediterranean diet.
Think olive oil, vegetables, legumes, fish, wholegrains, leisurely meals and, occasionally, a glass of wine at the table.
The Mediterranean way of eating has been widely studied for its association with better cardiovascular health, and red wine has sometimes been credited with contributing to those benefits.
Much of that attention centres on polyphenols, naturally occurring compounds found in grapes and other plant foods.
One of the best-known is resveratrol, an antioxidant found in grape skins and, consequently, red wine.
Laboratory and animal studies have explored its potential effects on inflammation, cardiovascular function and glucose metabolism.
It sounds promising.
But there’s an important distinction between studying a compound in isolation and demonstrating that drinking red wine improves someone’s health.
The quantities used in research may be considerably higher than those found in an ordinary glass of wine. And observational studies linking moderate wine consumption with better health outcomes can be influenced by other factors, including diet, income, exercise and lifestyle.
More importantly, alcohol itself carries established health risks.
So while red wine contains interesting plant compounds, there isn’t convincing evidence that drinking it is a good way to protect your heart or manage diabetes.
If you’re interested in polyphenols, you’ll also find them in foods such as berries, grapes, nuts and dark chocolate — without needing the alcohol.
What happens to blood glucose when you drink red wine?
This is where things become particularly relevant for people living with diabetes.
Alcohol can affect blood glucose in different ways, and the response isn’t always immediate. When you drink alcohol, your liver prioritises breaking it down.
Normally, the liver helps maintain blood glucose by releasing glucose into the bloodstream, particularly between meals and overnight.
But while it’s processing alcohol, its ability to produce and release glucose can be reduced. For someone taking insulin or certain glucose-lowering medications, this can increase the risk of hypoglycaemia — commonly called a hypo.
And the effect can continue for hours after the last drink. That means someone might have a perfectly ordinary glucose reading while enjoying dinner, only to experience falling levels later in the evening or overnight.
The risk can be greater after drinking without food, following physical activity or when other circumstances make glucose levels harder to predict.
For people with type 1 diabetes, understanding this delayed effect is especially important.
Does red wine contain sugar?
Yes, although the amount varies considerably depending on the wine.
During winemaking, yeast converts much of the grape’s natural sugar into alcohol. In dry wines, relatively little residual sugar remains.
That’s why a dry red wine will generally contain less sugar than a sweet dessert wine or port.
But the amount of sugar in a glass isn’t the whole story. A sweeter wine may contribute carbohydrate that raises blood glucose, while the alcohol itself can increase the risk of glucose falling later.
The result can be a more complicated pattern than simply assuming that a low-sugar wine will have little effect.
It’s also worth remembering that serving sizes matter. A generous glass at home can contain considerably more alcohol than a standard pub measure, even when the wine itself is identical.
Can red wine cause a hypo?
Yes, particularly for people using insulin or medications such as sulfonylureas.
Alcohol-related hypos can be especially troublesome because some symptoms overlap with the effects of drinking. Feeling unsteady, confused, sleepy or having difficulty concentrating could be mistaken for intoxication when blood glucose is actually too low.
Alcohol can also make it harder to recognise early warning signs. And because the effects can be delayed, the risk doesn’t necessarily end when you stop drinking.
For someone living with type 1 diabetes, this is an important reason to consider glucose monitoring before bed and to follow their diabetes team’s advice about managing alcohol-related risks.
A continuous glucose monitor can be helpful, particularly when alerts are enabled, but it doesn’t eliminate the possibility of a hypo.
If you’re drinking with someone who uses insulin, it’s useful to understand their usual hypo symptoms and what to do if they need help.
Severe hypoglycaemia is a medical emergency. If someone is unconscious or unable to swallow safely, never give them food or drink by mouth; follow their emergency plan and call 999.
A few things worth considering before pouring a glass
Enjoying wine with diabetes doesn’t have to involve an elaborate set of rules. But a little awareness can make the experience safer.
Enjoy it with a proper meal
Drinking on an empty stomach increases the risk of alcohol-related hypoglycaemia.
Eating a meal that includes carbohydrate can help reduce that risk, although it doesn’t eliminate it.
And while olives and cheese might make excellent companions for red wine, they aren’t necessarily sufficient carbohydrate on their own to help protect against a hypo.
For someone using insulin, the carbohydrate content of the meal and their individual treatment plan remain important considerations.
Remember that the effects can be delayed
Alcohol can influence glucose levels long after dinner is finished.
For people at risk of hypos, checking glucose as advised by their diabetes team, including before sleep and sometimes overnight, may be particularly important.
It’s also sensible to have hypo treatment readily available.
Be mindful of how much you’re drinking
In the UK, the Chief Medical Officers recommend that adults who drink regularly consume no more than 14 units of alcohol per week, spread across three or more days.
These are low-risk guidelines, not a guarantee that drinking is harmless.
For perspective, a 175 ml glass of wine at 13% ABV contains approximately 2.3 units of alcohol.
A 250 ml glass of the same wine contains approximately 3.3 units.
It’s surprisingly easy for a few generous glasses to add up.
Know your own circumstances
Not everyone with diabetes will respond to alcohol in the same way.
Medication, glucose patterns, liver health, other medical conditions and personal experiences all influence what is appropriate.
Some people may be advised to avoid alcohol entirely.
And if you take insulin or medication that can cause hypoglycaemia, it’s worth discussing alcohol with your diabetes team rather than improvising changes to medication doses.
What about red wine and heart health?
This is probably the most persistent part of red wine’s reputation.
For a long time, moderate red wine consumption was portrayed as potentially protective against heart disease.
But the relationship between alcohol and cardiovascular health is complicated.
Some earlier studies suggested benefits among moderate drinkers, while more recent research has raised questions about whether those findings reflect alcohol itself or differences between the people being studied.
We also know that alcohol can contribute to high blood pressure, certain heart rhythm problems and other health conditions. And because diabetes already increases cardiovascular risk, it’s particularly important not to mistake red wine for a preventative treatment.
The Mediterranean diet offers plenty of evidence-supported ways to look after cardiovascular health without relying on alcohol. Vegetables, legumes, olive oil, nuts, wholegrains, fish and enjoyable, balanced meals are all part of that picture.
A glass of red wine may accompany the meal, but it isn’t what makes the meal healthy.
What if you prefer not to drink?
Then there’s absolutely no reason to start.
Red wine isn’t an essential part of a Mediterranean-style diet, and abstaining doesn’t mean missing out on its nutritional benefits.
Alcohol-free alternatives can offer some of the ritual of pouring a glass with dinner, although it’s worth checking labels: some contain appreciable amounts of sugar, and products labelled alcohol-free or low-alcohol may differ in their residual alcohol content.
A sparkling water with citrus, a good alcohol-free aperitif or simply a drink you enjoy can be just as much a part of a lovely evening.
The important thing is choosing what suits you.
A little pleasure, with a little perspective
I don’t think enjoying food and drink should feel like an endless exercise in calculating what’s good or bad for us.
A beautifully cooked dinner, a piece of dark chocolate, a little cheese and a glass of red wine can be genuinely lovely parts of life.
And living with diabetes doesn’t automatically mean those experiences have to disappear.
But there’s also no need to dress them up as health interventions.
We enjoy red wine because we like it. Because it pairs beautifully with certain foods. Because sometimes a quiet evening at home feels all the nicer with a glass shared over dinner.
Not because we believe it’s improving our glucose levels or protecting our hearts.
For people living with diabetes, the key is understanding how alcohol can affect glucose, recognising the potential risks and making choices that work with their individual treatment and health needs.
And if a glass of red wine fits comfortably and safely into that picture, there’s room to enjoy it for exactly what it is.
A pleasure, rather than a prescription.
This article is intended for general information and does not replace personalised medical advice. Alcohol can increase the risk of hypoglycaemia in people using insulin or certain diabetes medications. Discuss your individual circumstances with your diabetes healthcare team, and never change prescribed medication doses based on general online information.