It is occasionally safe to drink a moderate amount of alcohol while on a course of metformin. However, regularly drinking excessive amounts can reduce the effectiveness of the medication and increase the risk of serious complications.
Alcohol and Metformin should not be combined since doing so has harmful impacts on your health. If you have diabetes, you should avoid heavy drinking because it can cause low blood sugar. Before taking Metformin, you should consult your doctor.
Both of these behaviors elevate your risks for metformin-related side effects. Drinking in moderation — or less — is key. This means no more than two drinks per day for men and one drink per day for women.
Alcohol can interfere with the effects of some diabetes medicines, putting you at risk for low blood sugar or high blood sugar (hyperglycemia), depending on how much you drink and what medicine you take. Drinking alcohol carries the same health risks for people with diabetes as it does in otherwise healthy people.
Alcohol and blood sugar
If you take metformin, you may have noticed this warning on the label: “Do not drink alcoholic beverages while taking this medication.” This is good advice. Drinking alcohol can cause blood sugar to fall too fast in people with diabetes.
If you miss a dose of metformin, skip the missed dose and take the next dose at the usual time. Do not take 2 doses to make up for a forgotten dose. If you often forget doses, it may help to set an alarm to remind you.
Wear or carry some form of ID that says you have diabetes. The ADA recommends: no more than one alcoholic drink per day for women • no more than two drinks per day for men.
While alcohol can lower blood sugar levels, it also has the potential to increase them. Regular, long-term use of alcohol has been shown to increase insulin resistance. This means drinking can make it even harder for people with type 2 diabetes—which is defined by elevated glucose levels—to manage their blood sugar.
A medical provider can run a few tests to see how metformin is affecting your health: Blood work can check if your glucose, insulin, and HbA1C levels are in range. If they are, the medication is working.
Alcoholic drinks such as beer and sweetened mixed drinks are high in carbohydrates, which can raise blood sugar levels. Alcohol has a lot of calories, which can lead to weight gain. This makes it harder to manage diabetes.
More serious side effects are rare. They include severe allergic reactions and a condition called lactic acidosis, a buildup of lactic acid in the bloodstream. The risk for this is higher among people with significant kidney disease, so doctors tend to avoid prescribing metformin for them.
Heavy drinking, particularly in diabetics, also can cause the accumulation of certain acids in the blood that may result in severe health consequences. Finally, alcohol consumption can worsen diabetes-related medical complications, such as disturbances in fat metabolism, nerve damage, and eye disease.
While quitting alcohol cannot reverse diabetes, abstaining has proven to be beneficial for lowering insulin resistance, even for a short period. It also reduces obesity risk, which helps stabilize glucose levels.
"Clear liquors like vodka, tequila, and gin are lowest in sugar and calories and are easiest for our bodies to metabolize," Kober says.
Is Metformin an Effective Weight Loss Pill? No. The amount of weight you're likely to lose is low. In one diabetes prevention study, 29% of people lost 5% or more of their body weight and just 8% lost around 10%.
Metformin and weight loss
In a much larger trial in over 4,000 people with type 2 diabetes, it was found metformin use was associated with a 2.4 kg (roughly 5.3 lbs) weight loss over a four-year period. There are a few ways that metformin might impact weight.
Another study, published in May 2020 in the journal Diabetes Care, found that when participants increased their metformin dose by 1,000 mg or more, they lost significantly more weight than those who didn't change their metformin dose or decrease their dose.
Metformin is an oral medication used to treat type 2 diabetes that is generally well tolerated. GI upset, especially diarrhea, is the most common side effect. This typically decreases over time. Although rare, lactic acidosis, hypoglycemia, and vitamin B12 deficiency can occur.
Moreover, metformin as an insulin sensitizer can affect sleep via altering glucose metabolism. Metformin improves the neural glucose resorption and it can affect the nervous system health, and therefore affecting sleep quality.
Metformin has a black box warning for lactic acidosis — a condition where too much lactic acid builds up in the blood. It's a serious problem and can lead to death. If you experience these symptoms, seek medical attention right away.