Diabetes

Diabetes mellitus - often referred to simply as diabetes - is a condition in which the body either does not produce any insulin (Type 1) or not enough insulin. Insulin is a hormone produced in the pancreas to overcome the underlying insulin resistance of the cells in the body (Type 2). Insulin enables glucose (sugar) to enter the cells in order to be stored as glycogen or oxidized for energy. These defects cause glucose to accumulate in the blood, inevitably leading to serious complications. The positive effects of moderate wine and other alcoholic beverage consumption are only relevant for individuals with type-2 diabetes.

 

Type 2 Diabetes

 

The underlying defect is insulin resistance due to obesity and lack of exercise. Insulin resistance means that the cells do not respond to the insulin signal. In return, the pancreas tries to overcome this resistance by increasing the insulin output which enables the glucose to enter the cells. Once the beta-cells cannot compensate the high demand of insulin for proper function, the glucose will remain in the blood leading to an increased blood sugar level. Approximately 90% of all cases of diabetes worldwide are type 2.

 

In 2010, the International Diabetes Federation estimated the global prevalence of diabetes mellitus at 6.6% in adults. Type-2 diabetes is now one of the most common non-communicable diseases in the world and a major cause of premature illness and death in most countries. To prevent diabetic complications and premature death, patients are recommended to adopt a healthy lifestyle.  

 

Evidence from randomized-controlled intervention studies as well as from population studies have demonstrated that light to moderate consumption of alcoholic beverages will improve insulin sensitivity in insulin resistant people. Accordingly, large prospective studies have shown a reduced risk for developing the metabolic syndrome (MS, name for a group of risk factors that raise the risk for heart disease, stroke and diabetes. A metabolic syndrome exists when at least 3 of the following risk factors are present: overweight, high triglyceride level, elevated plasma glucose level,  low HDL cholesterol level and high blood pressure) . A moderate intake of  wine as well as other alcoholic beverages exerts a beneficial effect on MS. In addition, large population studies suggest that light to moderate consumption of alcoholic beverages is associated with a lower diabetic risk than abstaining or heavy drinking, independently of the type of alcoholic beverage consumed. Meta-analyses reported a J-shaped relationship for men and women with a reduced risk for a moderate intake of alcoholic beverages and an increased risk for more than 50-60 g/d. With regards to wine and diabetes, most studies found  beneficial effects. But not only the risk of developing type 2 diabetes is decreased with moderate drinking; it may also reduce CHD and CVD mortality in diabetics as well as potential cardiac complications relating to diabetes. This is especially important considering that coronary heart disease (CHD) is the leading cause of death among individuals with type-2 diabetes, who also have a 4-fold increased risk of having a heart attack or stroke. Research indicates that this risk decreases considerably when they consume wine moderately with meals.

 

Considering the world-wide epidemic of type 2 diabetes which is expected to rise even further and is associated with major health care costs, preventing diabetes is a major public health issue. It seems that drinking wine in moderation could  help reduce type 2 diabetes and thereby contribute to public health.


The above summary provides an overview of the topic, for more details and specific questions, please refer to the articles in the database.

 

 

 

 

OBJECTIVE: To clarify the dose-response relationship between alcohol consumption and type 2 diabetes. RESEARCH DESIGN AND METHODS: A systematic computer-assisted and hand search was conducted to identify relevant articles with longitudinal design and quantitative measurement of alcohol consumption. Adjustment was made for the sick-quitter effect. We used fractional polynomials in a meta-regression to determine the dose-response relationships by sex and end point using lifetime abstainers as the reference group. RESULTS: The search revealed 20 cohort studies that met our inclusion criteria. A U-shaped relationship was found for both sexes. Compared with lifetime abstainers, the relative risk (RR) for type 2 diabetes among men was most protective when consuming 22 g/day alcohol (RR 0.87 [95% CI 0.76-1.00]) and became deleterious at…
Moderate alcohol consumption is associated with reduced cardiovascular disease rates in nondiabetic populations. However, the effects of alcohol in people with diabetes are not well defined. Accordingly, we tested the hypothesis that alcohol would raise plasma high-density lipoprotein (HDL) cholesterol or have other beneficial metabolic effects in persons with type 2 diabetes mellitus. To assess the acute effects of alcohol on plasma glucose and serum insulin, subjects were inpatients for 2 days during which they received, in random order, 240 mL wine or grape juice with their evening meal. To assess the chronic effects of alcohol on fasting plasma lipids, subjects consumed, in random order, 120 to 240 mL wine daily for 30 days and abstained from alcohol for 30…
OBJECTIVE: This study investigated the relation between alcohol consumption and specific vascular events and mortality in a high risk population of patients with clinical manifestations of vascular disease and diabetes. METHODS: Patients with clinically manifest vascular disease or diabetes (n=5447) from the SMART study were followed for cardiovascular events and mortality. Alcohol consumption was assessed with a baseline questionnaire and analysed in relation with coronary heart disease (CHD), amputations, stroke, and all-cause and vascular death. RESULTS: After a follow up of 4.7 years, we documented 363 cases of CHD, 187 cases of stroke, 79 amputations and 641 cases of all-cause death, of which 382 were vascular. In multivariate-adjusted models, alcohol consumption was inversely associated with CHD (p(linear trend)=0.007) and stroke…
Objective: To investigate the association between alcohol consumption and type 2 diabetes, and determine whether this is modified by sex, body mass index (BMI) and beverage type. Design: Multicentre prospective case-cohort study. Setting: Eight countries from the European Prospective Investigation into Cancer and Nutrition cohort. Subjects: A representative baseline sample of 16 154 participants and 12 403 incident cases of type 2 diabetes. Interventions: Alcohol consumption assessed using validated dietary questionnaires. Main outcome measures: Occurrence of type 2 diabetes based on multiple sources (mainly self-reports), verified against medical information. Results: Amongst men, moderate alcohol consumption was nonsignificantly associated with a lower incidence of diabetes with a hazard ratio (HR) of 0.90 (95% CI: 0.78-1.05) for 6.1-12.0 versus 0.1-6.0 g day(-1)…
OBJECTIVE: We sought to investigate whether a polymorphism in the alcohol dehydrogenase 1c (ADH1C) gene modifies the association between alcohol consumption and type 2 diabetes. RESEARCH DESIGN AND METHODS: In nested case-control studies of 640 women with incident diabetes and 1,000 control subjects from the Nurses' Health Study and 383 men with incident diabetes and 382 control subjects from the Health Professionals Follow-Up Study, we determined associations between the ADH1C polymorphism, alcohol consumption, and diabetes risk. RESULTS: Moderate to heavy alcohol consumption (>5 g/day for women and >10 g/day for men) was associated with a decreased risk of diabetes among women (odds ratio [OR] 0.45 [95% CI 0.33-0.63]) but not men (1.08 [0.67-1.75]). ADH1C genotype modified the relation between alcohol…
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The authors have taken reasonable care in ensuring the accuracy of the information herein at the time of publication and are not responsible for any errors or omissions. Read more on our disclaimer.