Alcohol can interact with diabetes medications and impact your blood sugar. If you’re living with diabetes, talk to your doctor about how alcohol may impact your condition management plan, even if you only have an occasional alcoholic beverage.

People with diabetes should be particularly cautious when it comes to drinking alcohol because alcohol can make some of the complications of diabetes worse. First of all, alcohol impacts the liver in doing its job of regulating blood sugar. Alcohol can also interact with some medications that are prescribed to people with diabetes. Even if you only rarely drink alcohol, talk with your healthcare provider about it so that he or she knows which medications are best for you.

Here’s what you need to know:

Alcohol can cause blood glucose levels to rise or fall, depending on how much you drink. Some diabetes pills (including sulfonylureas and meglitinides) also lower blood glucose levels by stimulating the pancreas to make more insulin. Combining the blood-sugar-lowering effects of the medication with alcohol can lead to hypoglycemia or “insulin shock,” which is a medical emergency.

The main function of your liver is to store glycogen, which is the stored form of glucose, so that you will have a source of glucose when you haven’t eaten. When you drink alcohol, your liver has to work to remove it from your blood instead of working to regulate blood sugar, or blood glucose. For this reason, you should never drink alcohol when your blood glucose is already low.

Food slows down the rate at which alcohol is absorbed into the bloodstream. Be sure to eat a meal or snack containing carbohydrates if you are going to drink alcohol.

Alcohol impairs your liver’s ability to produce glucose, so be sure to know your blood glucose number before you drink an alcoholic beverage.

Within a few minutes of drinking alcohol, and for up to 12 hours afterward, alcohol can cause your blood glucose level to drop. After consuming alcohol, always check your blood glucose level to make sure it is in the safe zone. If your blood glucose is low, eat a snack to bring it up.

Drinking too much alcohol can make you feel dizzy, sleepy, and disoriented—the same symptoms as hypoglycemia. Be sure to wear a bracelet that alerts people around you to the fact that you have diabetes, so that if you start to behave like you are intoxicated they know that your symptoms could be caused by hypoglycemia. If you are hypoglycemic, you need food and/or glucose tablets to raise your blood glucose level.

Your healthcare provider will tell you how much alcohol is safe for you to drink. Depending on your health condition, that may mean no alcohol at all. In some cases, women with diabetes may have no more than one alcoholic beverage a day. Men should have no more than two.