“Oh, you’re a diabetic?” The hostess smiles, obviously mentally reviewing what non-alcoholics she’s got in the fridge. “Let me see if I’ve got something you can drink.”

Sound familiar? Almost everyone knows that diabetes and alcohol don’t go well together. Some even assume, sometimes incorrectly, sometimes not, that a mixed drink will kill a diabetic. That’s not always true. However, there is a relationship between diabetes and negative reactions to alcohol. What isn’t as well known is why.

That mystery might be resolving, thanks to a group of scientists at the Karolinska Institute. This leading Swedish medical university may have discovered how consuming alcohol impacts insulin secretion, which often results in diabetics experiencing severe hypoglycemia.

That’s a mouthful of a sentence, isn’t it? Pared down, we all know how it goes: a diabetic takes a drink, and chances are they’re going to go into shock. It’s ugly, it’s nasty, and it’s scary. But why does it happen?

The problem might be in the pancreas. In the study, scientists measured pancreatic function in diabetic and non-diabetic patients alike. There was a marked change in pancreatic activity, prompting the organ to produce excess amounts of insulin. There may also be a relationship between medication and treatment protocols used to treat Type 2 diabetes and the hypoglycemic reaction to alcohol. Additionally, the study pointed out that people who could be classified as alcoholics tend to have other health issues — poor nutrition, liver and pancreatic damage — that contribute to the reaction.

This is a very individual situation: some diabetics can drink moderate amounts of alcohol safely, while others experience very negative health consequences after even the smallest drink. You know your body better than anyone: talk with your physician about what amount of alcohol is safe for you.