Drinking beer with Type 1 Diabetes

March 2021 Risely Coaching graduate Maria writing from Cincinnati, OH, here to talk about my experience with diabetes and craft beer! First, background on me: I was diagnosed with T1D at age 9, well before I was drinking any beer, and I have lived with T1D for 23 years. Five years ago I transitioned from education to the craft beer industry and I have learned a lot along the way about how to manage my blood sugars with beer. 

Prior to working in the beer industry, my relationship with alcohol could best be described as “experimental.” I was never sure how a drink would affect my blood sugar and would spend most of a day or evening that involved drinking playing catch up with my blood sugar. I never really got it right unless I chose something that felt boring or wasn’t always available like a clear spirit and club soda.

Early in my career in craft I spent about a year studying for the Certified Cicerone exam, sort of like a sommelier exam but for beer. In the process I learned so much about the ingredients in different beer styles, which helped me piece together a better understanding of how to dose insulin for beer.

I’m sharing the following guidelines with the disclaimer that what I have learned worked for me but it may not work for everyone. My hope is that this information could be a good jumping off point to build some of your own guidelines for your experience drinking beer. 

Higher carbohydrate (15-30g per 12oz) - Beers containing adjuncts, which is any source of sugar that is not malted barley (e.g. wheat, oats, rice, corn, lactose, fruit juice, or food products). Styles like Hefeweizen, Witbier, Hazy IPA, or Pastry Stout. Also, beers with an elevated ABV (e.g. Imperial IPA, Barleywine, Imperial Stout).

• Adjuncts can be starchy, and not contain as much fermentable sugar as malted barley. This means that the yeast in beer may not convert all of the sugars in those ingredients into alcohol so they are added carbohydrates to your beverage.
• High ABV beers contain more malt ingredients in order to give the yeast more sugar to convert into alcohol. More malt means more carbohydrates.
  

Average carbohydrate (10-15g per 12oz) - Pale Ale, Amber, Pilsner. Think of beers that feel “generic” or “old school”.

• Beers in this category are typically traditional. They contain malt, water, hops, and yeast and create the usual product we know as beer. They contain carbs, but aren’t off the charts in terms of ABV or added sugar.
  

Lower carbohydrate (2-10g per 12oz) - Light lagers, some craft cider, sour beer. 

• A lot of new domestic light lagers have been engineered to be low carbohydrate, which is great for us since they usually have the carbohydrate count listed in the label!
• Not all cider is created equal. Cider from large manufacturers can often be “back sweetened” meaning more juice is added after fermentation to sweeten the cider which means more carbohydrates and sugar for the consumer. Many craft brands don’t back sweeten their products or don’t sweeten them as much. The fruit juice in the recipe is fermented to create the alcoholic product and not much carbohydrate is left behind (unlike beer). Luckily, you will often find nutrition facts on cider cans so you can make more informed decisions when shopping.
• Sour beer is similar to cider in that the yeast and bacteria that create the alcoholic product convert so much of the sugar into alcohol that there isn’t much residual carbohydrate left behind. Be careful with sour beer though, it is becoming more popular to add other ingredients like lactose or vanilla to sour beer to make them more palatable. Adjuncts can add more carbohydrates to the finished product.
  

In Risely’s Decide and Conquer Group Coaching Bootcamp, I learned that experimentation with Type 1 Diabetes  is an important part of the process of building confidence with different insulin strategies. The information that I learned during my Cicerone training helped me create a roadmap for making decisions about what I want to drink and when. While there is still some experimenting along the way, I feel confident in my ability to predict my blood sugar response to different beers. 

Don’t forget to trust your instincts, too! Get a sample, give it a taste and if it tastes too sweet it's more likely that beer will spike your blood sugar. Trust yourself! 

If you are a craft beer loving diabetic, your relationship with craft beer definitely doesn’t have to end. Just like we reevaluate many other relationships in our lives, I hope my experience can inspire you to check in with your relationship with beer or other alcohol if you need it. 

Cheers to you, and many more beers in range!