WATER AND DIABETES: BENEFITS AND DAILY INTAKE RECOMMENDATIONS

Medically Reviewed by Dr. Sony Sherpa (MBBS) - September 30, 2024

Water intake plays an important role in managing diabetes. As a person with diabetes, you may already be familiar with monitoring your blood sugar levels, but did you know hydration is just as crucial?

This article explains the relationship between water and diabetes and why staying hydrated is essential for managing this condition.

Why Is Hydration Important in Diabetes?

Proper hydration is essential for maintaining cellular health and function.

When dehydrated, your cells cannot function optimally, leading to various health issues. Due to the relationship between water and glucose, dehydration can be problematic for people with diabetes.

Blood plasma comprises 91-92% water^[1], carrying nutrients, glucose, and oxygen to the cells. Glucose uptake by the cell needs water as it dissolves glucose^[2] and allows it to flow through insulin-activated channels on the cell membrane across a gradient, entering the cell.^[3]

Dehydration interferes with this process and leads to water retention, which causes the cells to take up less water and dissolve glucose.

Both dehydration and high blood glucose levels can affect kidney function. The kidneys are vital in filtering waste and excess fluids from the body. Under healthy circumstances, they reabsorb blood sugar. If blood glucose is too high, the kidneys allow the excess to leave the body in the urine, increasing the risk of dehydration.^[4]

When you are dehydrated, your kidneys work harder to sift out waste products, which can put added stress on them. This added stress can lead to a decline in kidney function and a spike in blood sugar levels.

Dehydration can also lead to stress on the body (as measured by elevated cortisol levels^[5]), which in turn raises blood glucose levels^[6] and exacerbates symptom severity.

On the other hand, drinking water may help to regulate blood sugar levels^[7] by aiding in glucose absorption and helping avoid excessive glucose in the urine. It may also curb cravings and excessive food intake, which might otherwise contribute to erratic blood glucose.

Not drinking enough water may also contribute to elevated blood pressure. High blood pressure can heighten the odds of developing heart disease and stroke. Staying hydrated can help regulate blood pressure and reduce the risk of these complications.

Addressing Common Concerns Among Diabetics

Those with diabetes mellitus and diabetes insipidus can experience excessive thirst and frequent urination (polyuria).

In diabetes mellitus, excessive blood glucose levels can lead to frequent urination as the body attempts to excrete glucose and lower blood sugar.

Diabetes insipidus is a rare condition in which blood glucose levels are normal, yet the kidneys battle to regulate water ^[8]. This condition can occur due to kidney damage or injury in a brain region responsible for maintaining water balance, such as the hypothalamus. Diabetes insipidus causes a much higher degree of excessive thirst and polyuria than in those with diabetes mellitus^[9]. It was named diabetes insipidus to distinguish it from diabetes mellitus, as the two conditions were initially diagnosable due to urine output.

Excessive urination can lead to dehydration and overhydration when the affected individuals drink excessive water to compensate (polydipsia). In diabetes mellitus, these symptoms may cause hypoglycemia. In diabetes insipidus, hypoglycemia is not as common as changes in mental state, movement disorders, nerve dysfunction, nausea, vomiting, abdominal discomfort, and low blood pressure when shifting posture (similar to POTS).

Studies have also shown that lower hydration may enhance the risk of diabetic complications such as diabetic retinopathy^[10], particularly in older adults.

How Fast Does Water Lower Blood Sugar?

Drinking water does not have an immediate effect on blood sugar levels. However, remaining hydrated can regulate blood sugar levels over time. It is critical to keep track of your blood sugar levels and modify your insulin accordingly, but staying hydrated can be a helpful tool in managing your diabetes.

How Much Water Should A Diabetic Drink Daily?

The amount of water you should drink daily depends on various factors, such as your age, weight, and activity level. However, as a general rule, it is recommended that adults drink at least nine 8-ounce glasses of water per day if you are a woman and up to 12 if you are a man^[11]. One should drink the recommended amount gradually throughout the day for optimal hydration and avoid drinking it all at once.

For people with diabetes, staying hydrated and aiming for this recommended amount is essential.

Can Drinking Too Much Water Be Harmful for Diabetics?

While it is crucial to keep well hydrated, it is possible to drink too much water. This condition is known as water intoxication^[12], and it often leads to hyponatremia (low blood sodium). It is more common in athletes or those who engage in intense physical activity, but people with diabetes need to be aware of this condition as well.

The kidneys can process a maximum of 800-1000ml of water per hour. It is important to drink water in moderation to avoid water intoxication and not force yourself to drink excessively.

Monitoring your electrolyte levels and replenishing them if necessary is also essential.

Monitoring Hydration

The risk of dehydration is higher for people with diabetes than for the general population. This risk compounds with older age, comorbidities, and stress.

Signs of dehydration include^[13]:

• Dry mouth
• Tiredness
• Headaches
• Dizziness
• Dark urine
• Muscle cramps
• Constipation
• Heat intolerance
• High or low blood pressure

If you experience any of these symptoms, increasing your water intake and monitoring your hydration levels is essential.

One way to keep tabs on your hydration levels is by paying attention to the color of your urine. Light-colored urine is a sign of proper hydration, while dark urine can indicate dehydration. If the urine looks clear and you have been urinating frequently, you might be over-hydrating.

The quality and timing of your water intake are also essential factors for staying hydrated.

What Can You Drink If You Have Diabetes?

Water is the best option for staying hydrated.

Other diabetes-friendly beverages that can assist with optimal hydration include:

• Vegetable juice
• Herbal tea
• Coconut water

Can a Diabetic Person Drink Sparkling Water?

Yes, sparkling water is a suitable option for people with diabetes. However, it is essential to check the label and ensure it contains no added sugars or artificial sweeteners.

Integrating Water into Daily Life

For some, drinking enough water can be challenging. Here are some tips for increasing daily water intake:

• Use a reusable glass water bottle and keep it with you everywhere you go.
• Set reminders on your phone to drink water throughout the day.
• Enhance the flavor of your water with fresh fruit, like lemon or herbs, to make it more appealing.
• Drink a glass of water before each meal.
• Keep a glass of water by your bed to drink first thing in the morning
• Make a conscious effort to trade some coffee or soda for a glass of water each day.

You can also get water from other sources, such as fruits and vegetables. Some high-water (low Glycemic Index) content foods include:

• Cucumbers and marrows
• Squashes
• Strawberries and other low Glycemic Index fruits
• Celery
• Tomatoes
• Leafy vegetables

The Ripple Effect of Hydration

Staying hydrated not only benefits your diabetes management but also has a ripple effect on your overall health and well-being.

Many individuals do not hydrate properly throughout the day and rely on dehydrating drinks, such as coffee or soda, which are not hydrating enough and may lead to many adverse health effects with long-term consumption. Even diet soda, which may not affect blood sugar levels, may elevate heart disease risk, promote arthritis, mental health problems, and speed aging.^[14]

Other hydration benefits^[15]:

• Improved digestion
• Clearer skin
• Increased energy
• Better sleep
• Improved cognition
• A more stable mood
• Better weight management
• Decreased joint pain
• Better temperature regulation
• Kidney stone prevention
• Healthier heart
• Improved detoxification
• Fewer headaches

Emerging Research and Advancements

Research is continually being conducted on the relationship between water and diabetes. Some emerging studies have shown that proper hydration improves insulin sensitivity and reduces the risk of developing type 2 diabetes.^[16]

Advancements in technology have also made it easier to observe your hydration levels. Wearable devices and smartphone apps can monitor your water intake and remind you to drink more throughout the day.^[17]

Conclusion

Optimal hydration can help keep blood sugar levels stable, enhance kidney function, and lower the risk of complications such as high blood pressure. Monitoring your hydration levels and aiming for at least eight glasses of water on a daily basis is essential. Remember, staying hydrated not only benefits your diabetes management but also has a positive impact on your overall health and well-being.

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