Interactions and Side Effects of Alcohol and Metformin

Side Effects of Alcohol Use & Vertigo

Alcohol use can directly cause vertigo due to dehydration and its effect on inner ear fluid balances. Or, if you have a damaged auditory cortex from chronic alcoholism or another underlying condition, you can make these problems worse by continuing to drink. 

Moreover, side effects caused by vertigo or alcohol independently may be amplified when occurring together.

Side Effects of Alcohol and Vertigo Include:

• Impaired coordination and balance
• Dizziness
• Feelings of tilting, swaying or shifting
• Feelings of motion sickness
• Nausea and vomiting
• Impaired hearing
• Lethargy
• Reduced inhibitions and impulsivity
• Memory loss
• Slurred or slowed speech

Severe Effects of Alcohol Intoxication Include:

• Cyanosis (pale or bluish skin, fingers, and toes)
• Profound confusion
• Slowed, labored, or stopped breathing
• Seizures
• Continuous vomiting
• Stupor or lack of responsiveness
• Unconsciousness or coma

Vitamin B12 Deficiency

Taking metformin can also cause vitamin B12 deficiency, which can be a medical emergency in extreme cases. Contact your doctor or call 911 if you experience the following.

Symptoms of Vitamin B12 Deficiency Include:

• Extreme fatigue
• Muscle weakness
• Painful, red tongue
• Mouth ulcers
• Vision problems
• Pins and needles feelings
• Pale or yellow skin, or changes in skin color
• Yellow eyes

In most instances, your doctor can check your vitamin B12 serum levels and prescribe supplements if they are too low.

Is It Possible to Manage Diabetes While Drinking Alcohol?

It is not possible to manage diabetes when consuming alcohol in excess. Most alcoholic drinks are full of carbohydrates, which convert to sugar in the body. Binge drinking or heavy drinking over a prolonged period will adversely affect blood sugar and contribute to other conditions associated with diabetes, such as high blood pressure and weight gain.

Overall, alcoholic drinks are high in calories which quickly add up. As a result, drinking alcohol can make it more challenging to lose weight or maintain your current weight. It also hinders your body from burning fat, contributing to weight gain. Alcohol also lowers inhibitions, and it’s not uncommon to be drawn to fatty, high-calories foods while drinking.

Alcohol consumption can also potentially worsen other diabetes-related medical complications, such as fat metabolism disturbances, nerve damage, and eye disease.

According to the Centers for Disease Control and Prevention (CDC), excessive drinking is defined as:

Binge drinking, or having at least 4 or 5 standard drinks in one sitting (2-3 hours) for women and men, respectively.

Heavy drinking, or having eight standard drinks per week for women and 15 for men.

Standard Drinks Are Described As:

• 12 oz of 5% ABV beer or hard seltzer
• 8 oz of 7% ABV malt liquor
• 5 oz of 12% ABV wine
• 1.5 oz of 40% ABV liquor 

Keeping all of this in mind, those who choose to drink alcohol should do so in mild-moderate amounts and consider the following:

Avoid Drinks High in Sugar

Some alcoholic beverages have as much added sugar as some desserts. Avoid mixing alcohol with soft drinks, punches, and sweet liqueurs like Kahlua, Irish cream, or Schnapps.

Have Fast Access to a Continuous Glucose Monitor (CGM) and Diabetic Supplies 

If you aren’t going to be at home while drinking, bring a CGM if you have one, and if not, a glucose test kit. Have enough supplies at the ready to test frequently, such as strips, lancets, emergency glucagon, etc. and do the following:

1. Ensure your electronic supplies are working correctly and aren’t low on power.
2. If you use an insulin pump, fill it with insulin.
3. If you have a CGM and need to change the sensor, do so in advance.

Avoid Drinking on an Empty Stomach

Eat an appropriate amount of food before drinking, and keep track of your carb count. According to the Cleveland Clinic, “Too much alcohol can block production and release of glucose from the liver, causing your blood sugar levels to drop.“

Avoid Exercise After Drinking

The Cleveland Clinic also advises, “Don’t drink immediately before, during, or after exercise.” This includes dancing. Physical activity can lower blood sugar, and if the liver cannot adequately maintain glucose production, you may be at an increased risk of hypoglycemia. 

Know Your Limit

Above all, avoid drinking to excess. And before you start, make sure your glucose level is in range. Your healthcare provider can advise you on how much alcohol is safe to drink. Depending on your health status, that may mean no alcohol at all. Or in some cases, people with diabetes may be able to have 1-2 alcoholic beverages a day, but no more than that.