There is a wedding coming and wine will be poured at it. Two glasses used to be an ordinary evening for you, and the last single glass you had flattened you for the rest of the night. Since then you have been eating less, and lighter, and often nothing much at all before you go out. Read the bottle, count what you actually drink, and check one thing on your own medicine list, and you can walk into that room with the decision already made rather than making it at the table.
What is in your stomach when you drink is most of what decides how hard a drink lands, so the meal beforehand does more work than the size of the glass. The limits printed for adults are counted in standard drinks, and a standard drink is a fixed amount of alcohol rather than a size of glass, so what you are counting at a party depends on who poured it. And drinking too much alcohol without enough food behind it is a listed cause of low blood glucose, which matters to anyone whose medicine list already has something for blood sugar on it.
What food in your stomach does to a drink
What is in your stomach when you drink changes how hard the drink lands, and eating less means there is less in there. Alcohol is relatively slowly absorbed from the stomach and more rapidly from the small intestine, so how quickly it reaches you follows how quickly your stomach passes it along. Food, and carbohydrate in particular, holds up that passage: with a meal inside you, blood alcohol concentrations may not reach a quarter of what the same drink produces on an empty stomach.
So eat before you go out, and eat a proper meal rather than a handful of something at the door on the way in. Take the fizzy ones more slowly too: among the drinks aerated with carbon dioxide, champagne and whisky with soda both get into the system quicker.
How much is in the glass you are handed
The glass you are handed holds whatever the person pouring it poured, and the printed limits are counted in standard drinks instead. A standard drink in the United States holds roughly 14 grams of pure alcohol, and it arrives in three familiar sizes.
| Drink | One standard drink | At about |
|---|---|---|
| Regular beer | 12 ounces | 5% alcohol |
| Wine | 5 ounces | 12% alcohol |
| Distilled spirits | 1.5 ounces | 40% alcohol |
Nobody measures a pour at a party, and the alcohol content printed on the bottle in front of you may run above what the standard assumes, so one generous glass of a strong wine can sit closer to two of the drinks in that table than to one. The printed daily ceiling is two drinks or less in a day for men and one drink or less in a day for women, counted in those units rather than in glasses.
For some people the recommended amount is none at all, and the list is short enough to hold yourself against: pregnancy or the possibility of it, being under 21, certain medical conditions including some liver diseases, taking a medicine that can interact with alcohol, difficulty controlling the amount you drink, and recovery from alcohol use disorder.
Alcohol and a medicine for blood sugar
Alcohol without enough food is a listed cause of low blood glucose, and insulin, sulfonylureas and meglitinides are among the medicines that can cause one. If any of those is on your list, an evening of drinking on a light stomach stacks two causes rather than one.
Alcohol also blunts the early warning: it can keep you from feeling the first symptoms of a low, which is how a mild one turns into a severe one. So make the call before the event rather than after it. Ask the prescriber who wrote the blood-sugar medicine what they want you to do about eating, and about checking, on a night when you drink. Which of your other medicines the review needs to see is worth settling on an ordinary day rather than on the evening you need it.
The signs can include these, and they are worth carrying in your head before you are drinking rather than after: feeling shaky or jittery, hungry, tired, dizzy, lightheaded, confused or irritable, a heart beating too fast or unsteadily, a headache, or trouble seeing or speaking clearly. Losing consciousness and having a seizure are the severe end of the same thing. Tell whoever is with you that if you cannot be roused, or if you have a seizure, the instruction is to call 911 right away, and to call it after giving glucagon if you carry a kit.
Before you go out
- Eat a proper meal before the first drink, with carbohydrate in it, rather than arriving on an empty stomach.
- Look at the alcohol content printed on the bottle, and set your own number in standard drinks before the first pour.
- Ask for water alongside, and take champagne and anything mixed with soda more slowly than the rest.
- If a blood-sugar medicine is on your list, message that prescriber ahead of the event and ask what they want you to do about eating and checking that night.
- Tell whoever is with you that alcohol can hide the first signs of a low, and tell them what you want done about it.
The absorption facts describe everybody's stomach, and the printed limits are written for adults in general, so your liver, your other conditions and how the last few weeks of eating have actually gone sit outside both. The number you settle on is yours to set, and the moment to set it is while the arithmetic is still boring. Anyone can revise that number downward at the table. Almost nobody does.
