Mixed together, alcohol and diabetes can spell trouble. For one, alcohol can raise the risk of heart problems for people with diabetes, who are already at an increased risk of heart disease. Two, alcohol can impact your blood sugar and make it difficult for you to identify when problems arise. However, if you enjoy a daily glass of red wine or the occasional cocktail, is it time to become a teetotaler? The answer is a little more nuanced.

According to a study published by the Journal of the American Heart Association, people with Type 2 diabetes already at high risk for cardiovascular disease who drink alcohol, even moderately, have an increased risk of high blood pressure. Uncontrolled high blood pressure can increase the likelihood of other serious health problems, including heart attack and stroke.

The study examined over 10,000 U.S. adults who have Type 2 diabetes already a high risk for cardiovascular disease. The research found that drinking seven or fewer drinks per week had no effect on blood pressure risk but:

• Eight to 14 drinks per week (moderate drinking) was associated with a 79% increased odds of high blood pressure.
• More than 15 drinks per week (heavy drinking) was associated with a 91% increased odds of high blood pressure.

This study only researched people with Type 2 diabetes, so you should check with your primary care provider to see if it is safe to drink if you have Type 1 diabetes.

Beyond its impacts on blood pressure, alcohol can be problematic because of how it impacts blood sugar and other conditions that occur in people with Type 2 diabetes.

Your liver regulates blood sugar levels and filters alcohol, but it is not good at doing both at the same time. So, when faced with both tasks, the liver will choose to filter alcohol and stop working to control blood sugar levels. This can lead to hypoglycemia or low blood sugar. Alcohol can also affect how some diabetes medications work, so if you're taking diabetes medications and drinking alcohol, you can experience extremely low blood sugar, especially if you're drinking on an empty stomach.

Complicating the issue, symptoms of hypoglycemia – blurry vision, racing heart, hunger, shaking, and a foggy mind – mimic those of drinking too much. You may think you're tipsy when in fact you need treatment for low blood sugar levels.

Nerve damage is also a concern for people who have diabetes and drink. Type 1 diabetes on its own can cause peripheral neuropathy, a type of nerve damage that typically affects the hands and feet, and consuming more than eight drinks per week increases that risk even more.

There's no hard and fast rule for drinking if you have diabetes. According to the American Diabetes Association, your best bet, if you enjoy the occasional drink, is to talk to your primary care provider. He or she can give you advice about what's appropriate for you.

If you choose to drink, remember these amounts so you can keep tabs on how much you consume. One alcoholic beverage equals:

• 1.5 ounces of hard liquor that's 80 proof (or 40% alcohol)
• One 5-ounce glass of wine with about 12% alcohol
• One 12-ounce beer with about a 5% alcohol content

Also, keep a close eye on your A1C and blood pressure levels. Aim to get your A1C levels under 7%. Keep your blood pressure as low as possible. Providers use the following measurements for blood pressure: 

• Normal blood pressure = less than 120/80
• Elevated blood pressure = 120-129 less than 80
• Stage 1 high blood pressure = 130-139 over 80-89
• Stage 2 high blood pressure = 140/90 or higher

Finally, follow your diabetes care plan. Make sure to eat a healthy diet and stay physically active, while also taking diabetes medication as prescribed and routinely checking your blood sugar levels.