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It didn’t take long into her adult years for Julia Blanchette, a nurse and diabetes educator at the Cleveland Clinic, to discover she’s a wine enthusiast.

The fact that she has celiac disease pushed her toward it in the first place, because she was steering clear of wheat-based beer, she said. And the fact that she has type 1 diabetes (T1D) need not have dissuaded her. With a lot of (fun) sampling and trial and error, Blanchette learned how to embrace her love of wine, she tells DiabetesMine.

“It took experimentation for sure. I had to find the wines that didn’t raise my blood sugar as much, and I savor the ones that do as more of a dessert,” she says.

“And once I found the ones that didn’t impact my blood sugar immediately, I had to understand how it impacted me later. Did it make me low? Did I have to always eat with it? Did it make me high?” Whatever the answer, she says, each one led her to be a confident wine connoisseur who happens to have T1D on board.

Such can be the case for most people with diabetes (PWDs). With study, thought, and guidance from your medical team, experts say there’s no reason not to savor the art and joy of wine.

The first thing PWDs need to know about wine is how it works in the body, which does differ a bit from other types of alcohol.

Wine, unlike, say, vodka or beer, is created very much by the hand — and mood — of nature.

That’s why there are good years and not so good years for wine production.

That dynamic means that even the same wine can vary a bit from season to season.

“That’s one of the things about wine, and it goes across every type,” Keith Wallace, author, winemaker, sommelier, and a professor and founder of the Wine School of Philadelphia tells DiabetesMine.

“Sugar gets fermented, yes, but you are going to find hidden sugar in there, and with wine, it can sometimes be a significant amount,” he says.

“As a winemaker, I always insist on fermenting everything bone dry so it’s not as much an issue,” he explains.

Wallace does that for his clients, yes. But he does it for himself too. Diagnosed with type 2 diabetes some years ago, he quickly realized that the dryer the wine, the less impact on his glucose readings.

But that doesn’t mean PWDs need to limit their wine choices, he says. Rather, understanding the possible impact and what action to take to make it work is the key, he says.

What do doctors say about consuming wine with diabetes? Often not enough, according to Mary Ellen Phipps, registered dietitian nutritionist, founder of MilkAndHoneyNutrition.com, and author of The Easy Diabetes Cookbook. Phipps has lived with T1D since age 5.

“There are two camps, generally,” she tells DiabetesMine. “The doctor who says no, don’t drink alcohol at all, and the doctor who says it’s fine. But here’s the thing: They tend to say that with no explanation, without putting a framework of understanding of it for the person with diabetes.”
Her suggestion? Ask the question and then ask for more details.

Her opinion?

“If you are going to drink, wine is a good choice.”

Unlike, say, vodka, when you can pretty much know the impact on your blood sugars no matter the brand, wines vary greatly.

Understanding that can help a person with diabetes plan and study it as they begin.

When Phipps advises patients, she speaks of what she knows, not just as a trained nutritionist but as a person living with T1D who also happens to love wine.

Her basic breakdown of wine and blood sugars? A dry white has the least sugar, reds come in a bit higher (“but there’s no need to avoid them” she says) and dessert wines are “just like they sound.”

Wallace breaks them down like this:

The lower the alcohol, the higher the sugar

Lower alcohol wines often have more sugar for taste reasons, he said. And so do lower-cost wines, which, he said, are often amped up in sugar for taste reasons.

That, he said, is because the pedestrian wine drinker tends to lean toward sweeter, having not learned the nuances of wine tastes.

A surprise, though: The same can go for a moderately expensive wine.

“They’re trying to appeal to that same general consumer, just a wealthy one,” he explains.

To look for a wine with the right alcohol content, he says, look for a label that reads 12.5 percent to 16 percent alcohol. More or less than that can mean added sugars.

Location matters

As for types, he said, the location of the grape grown can give you hints as well.

Germany, he said, is known for Rieslings, which have a higher sugar content by design. But they also have wines with almost no sugar, known as Trocken (dry).

“It has to say that,” he says, “and it has to say ‘Trocken’ by itself on the label.”

Italian and French wines tend to have less residual sugar overall, he says, “because it’s a cultural thing. Countries that tend to pair wines with food usually make wines with less sugar.”

Australian wine drinkers, he says, tend to drink it by itself, and therefore tend toward a bit more sugar.

The modern styles of white wines, Wallace says, (other than Chardonnay) are “light, fresh, crisp styles. Those actually have almost no sugar at all.”
Another hint for hidden sugar? Ironically, Wallace says, it can be the popularity of the brand.

“We’re seeing this more with, for example, the popularity of Oregon wines,” he says. “As wines like Pinot Noir get more popular, you often see more sugar. People like it; it’s as simple as that.”

Karen Graham, registered dietitian, diabetes educator, and author of three best-selling books on living with diabetes, is also a wine lover — who happens to live a stone’s throw from vineyards in British Columbia.

Her advice to the wine enthusiast with diabetes is to start with the basics and go from there.

She suggests that you “hone in” on a few different wine styles you like, experiment with brands, and learn what works for you. Then stick to those as much as you can.

In her book “The Complete Diabetes Guide,” Graham outlines the general carbohydrate/sugar content of the most popular wines, something she says can be used as a starting point for handling the wines you like best.

Be aware that when it comes to drinking alcohol of any kind, including wine, there are some steps all PWDs should take.

“Make sure you never drink on an empty stomach,” Graham tells DiabetesMine.

She also reminds PWDs to always have a source of fast-acting glucose on hand, because alcohol can lower blood sugars, and do so quickly.

You should also let any friends you may be enjoying wine with know about your condition, and make sure they’re familiar with the signs of a low blood sugar, which can mimic drunkenness. They should know not to hesitate to ask you about your situation should they see signs.

And, of course, you should pay close attention to your blood sugars both before, during, and for a long time after a wine outing.

With those steps handled, PWDs can enjoy wine and do so “without guilt,” Graham says.

“Choose one or a few you really love and stick with them, or with similar selections,” she adds. Going to a friend’s house for dinner? Bring along a bottle or two and that way you know what you’re drinking. And for a restaurant, it’s always a good idea to peruse the wine list in advance online, to see what you can find that you like and know, or learn about one that sounds interesting ahead of time.

Phipps agrees that preparation — and a bit of study — makes being a wine lover with diabetes easier, even if it takes more effort upfront.

She suggests keeping a journal, which isn’t as odd as it sounds. Many wine aficionados keep a journal of the wines they try. But instead of just recording what you like and why, keep track of how your blood sugars were during and after, what you may have eaten with it, and if any tweaks are needed.

“Pay attention to how you respond to it, and then you’ll know what to choose next time, or what to do if you choose that one again,” Phipps says.

And what about a wine tasting evening? Yes, Graham and Phipps agree, it can be not only done but fully enjoyed.

Phipps suggests finding out ahead of time how many ounces a vineyard or event organizer will be pouring, as well as what kinds of wine. That way, you can keep track as you go along.

Graham points out that food may not be readily available at some wine tastings, and may lean toward protein (such as cheeses) rather than carbs. So it’s a good idea to eat a meal before going, and/or pack some snacks just in case.

Wines with less sugar, in particular, may lower blood sugars, so being prepared is your best bet, she says.

If you should be unsure of the sugar content in a wine, Wallace offers a simple tip, one that will make you look like a true wine pro: Hold your nose for the first sip.

“Sweet, sour, bitter, and salty comes from the taste buds,” he says. “If you block your nose and you taste sugar (as the main flavor), it will inform you that this wine has a lot of sugar.”

He reminds us that it’s important to focus on getting the right amount of food to go along with your wine when it comes to diabetes.

“Don’t worry about the wine as much as the food you may eat,” he says. “That’s what can get you in trouble. Don’t arrive hungry. Eat a small prep meal beforehand so you can totally enjoy the wine.”

Wallace does have some good news: This all could get less challenging in the future. In his classes, he’s teaching future winemakers and servers about how different types impact diabetes, so they can help guide consumers better.

“One in six people either have diabetes of some kind or are pre-diabetic,” he says. “It’s a huge market, and you don’t want to harm your customers. And wine is good, in so many ways. PWDs have so much stress and wine is a great stress reducer. This doesn’t have to be a worrisome thing. Done right, it’s excellent.”

In the end, while extra thought is needed, PWDs who love wine say the effort is worth it.

Kelly Kunik, patient advocate and author of the popular blog Diabetesaliciousness, says nearly a lifetime of living with T1D has taught her to do what she must and know all the facts — but in the end, it’s taught her to go with the flow, too.

“I wouldn’t say I’m a sommelier,” she tells DiabetesMine. “I just like wine. But to be clear: I don’t study wine for my diabetes, I study it for my palate. Sometimes a glass of wine is just a glass of wine. And that’s totally okay.”