Ask the Dietitian: What Can I Drink with Type 2 Diabetes?

Dear Jillian,

My doctor told me to avoid any and all drinks that contain sugar. Is this true? Can I only drink water if I want to maintain healthy blood sugar levels?

— Bezzy Type 2 Diabetes Member

Even though most people primarily focus on food when it comes to diabetes management, drinks — including nonalcoholic and alcoholic beverages — can also impact your blood sugar, and in a big way.

But this doesn’t mean you have to completely give up your favorite drinks and cocktails.

I’ll explain how certain drinks affect blood sugar levels and give you tips on how to choose blood sugar-friendly beverages when you’re living with type 2 diabetes.

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How do drinks affect blood sugar?

Like food, drinks can impact blood sugar because all foods — and some beverages — contain macronutrients. The three macronutrients are carbohydrates, fats, and proteins.

Out of the three macronutrients, carbohydrates impact blood sugar the most. This is why many people with diabetes choose to follow a low carb diet, which can promote healthier blood sugar levels.

But not all carbs affect blood sugar in the same way. Some carbs are easier to digest and have a significant and quick impact on blood sugar levels. This is often referred to as a blood sugar spike.

On the other hand, high fiber carbs and carbs that are ingested with protein and fat sources are digested slower, meaning they have less of an effect on blood sugar.

For example, if you drink a glass of soda, your blood sugar will increase dramatically and quickly. This is because soda contains 0 fiber, protein, or fat and is mostly composed of sugar. Drinks that are high in carbs and lacking protein, fiber, and fats are rapidly digested, which leads to a blood sugar spike.

In addition to soda, beverages like sports drinks, sweetened coffee drinks, energy drinks, and juice — even 100% juice — can negatively affect blood sugar management because these beverages tend to be very high in sugar and low in fiber and protein.

Not only can sugary drinks negatively impact your blood sugar management, but consuming them too often can increase inflammation, raise your risk of heart disease, and harm your body in many other ways.

Because of this, everyone — not just those with type 2 diabetes — should significantly limit their intake of sugary drinks like soda, sports drinks, and energy drinks.

That said, enjoying a favorite high calorie or sugary beverage now and then won’t have a significant impact on your blood sugar levels. Just be sure to limit sugary and high carb beverages as much as possible in order to promote healthy blood sugar.

Which drinks are best for people with type 2 diabetes?

When you have type 2 diabetes, it’s important to choose foods and drinks that promote healthy blood sugar regulation.

Zero-calorie beverages like water and sparkling water are by far the best choice for people with diabetes as these drinks are free of carbs and calories, so they don’t affect blood sugar at all.

Plus, research has shown that drinking water before meals can help reduce fasting blood sugar levels and may even help you maintain body weight.

Unsweetened teas like ginger tea and green tea are also excellent choices since they contain zero calories and provide beneficial plant compounds that have anti-inflammatory and anti-diabetic properties.

Drinks that are high in fiber and protein can also be a good choice for people with type 2 diabetes.

For example, a protein- and fiber-rich smoothie that’s low in sugar will lead to a slower, steadier rise in blood sugar. This is because protein and fiber slow digestion, so your body absorbs nutrients — including carbs — at a slower rate.

What about alcoholic drinks?

Alcoholic beverages can be tricky to navigate when you’re living with type 2 diabetes.

Depending on a few factors, alcoholic beverages can either spike blood sugar or cause low blood sugar levels, which can be dangerous.

People with type 2 diabetes who are on insulin or take certain diabetes medications like sulfonylureas need to be especially careful when drinking alcohol. Your body prioritizes breaking down alcohol — which is a toxin — over maintaining your blood sugar levels.

In fact, research in 2017 has shown that gluconeogenesis — a process by which your liver creates glucose (blood sugar) — can decrease by about 45% after the consumption of 48 grams of alcohol (about 4 glasses).

So, if you drink too much, your blood sugar can tank. This is especially dangerous if you’re drinking on an empty stomach or taking certain medications that lower your blood sugar.

Drinking can also have the opposite effect. Alcoholic beverages that are high in carbs can spike blood sugar levels and make it harder to regulate your blood sugar.

For example, sugary drinks like soda-based cocktails, drinks that contain simple syrup or juice, and high carb beverages like beer can significantly affect blood sugar management.

But whether your drink of choice is high or low in carbs, drinking too much alcohol can affect your health in multiple ways, including increasing your risk of liver and heart disease, cognitive decline, and certain cancers.

Because of this, it’s recommended that men should drink no more than 2 alcoholic drinks per day, and women should limit themselves to 1 drink or less per day.

This is for a “standard” drink, which equals about 14 grams of pure alcohol. This amount is found in 5 ounces (142 ml) of wine, 12 ounces (354 ml) of beer, or 1.5 ounces (42 ml) of hard liquor.

Low carb, diabetes-friendly drink ideas

So, now that you know how drinks affect your blood sugar levels, you’re probably wondering which drinks are best for people with type 2 diabetes.

There are plenty of beverages — with and without alcohol — that can be safely enjoyed if you have diabetes.

Nonalcoholic drinks

• Infused waters: Add some flavor to your water without a ton of sugar. Try infusing your water with herbs and fruit for a refreshing, diabetes-friendly drink.
• Low carb green juice: While some green juices can be high in carbs from added fruit, juices that are made with low carb vegetables won’t significantly impact your blood sugar. Try making juice with vegetables like celery, kale, and cucumber and adding a bit of lemon and ginger for a boost of flavor.
• Zero and low carb sparkling waters: If you’re trying to cut back on your soda intake, there are plenty of sparkling water options that make a great substitute. Check out brands like Sound, Spindrift, and Waterloo.
• Unsweetened coffee and tea: Sweetened coffee and tea drinks can take a toll on your blood sugar. Try transitioning to unsweetened coffee or tea or use a diabetes-friendly sugar alternative like monk fruit.

Alcoholic drinks

• Keto mojito: If you like mixed drinks, try out this low carb mojito recipe. Instead of sugar, it’s flavored with lime juice and fresh mint. You can add a sugar alternative like monk fruit or stevia if you’d like to add a bit of sweetness.
• Low sugar wine: Some types of wine are lower in carbs than others. If you enjoy wine but are looking for lower carb options, check out brands like Dry Farm Wines and Maker Wine.
• Low carb beers: If you enjoy sipping on beers, you’ll be pleased to know that there’s a variety of low carb beers to choose from, including Lagunitas DayTime and Michelob Ultra.

While it’s best to choose zero or low carb drinks whenever possible, you can still enjoy your favorite carb-rich beverages from time to time without affecting long-term blood sugar management.

The bottom line

Even though foods tend to get the most attention when it comes to blood sugar management, choosing the right beverages is just as important.

Certain drinks like sugary sodas and high calorie cocktails can spike blood sugar and impact glycemic control, while zero calorie and low carb drinks like water and unsweetened teas can help keep you hydrated without affecting your blood sugar.

Whether you’re ordering a cocktail at your favorite bar or shopping for diabetes-friendly drinks at your local grocery store, it’s best to choose options that are low in calories and carbs in order to promote healthy blood sugar levels.