26 June 2020 In Diabetes

BACKGROUND: This study aims to examine the association between alcohol consumption and the risk of pre- or type 2 diabetes mellitus (T2DM) by alcohol-induced flushing response in Korean male adults, particularly based on their body mass index (BMI).

METHODS: This study selected 1,030 (158 non-drinkers, 364 flushers, and 508 non-flushers) male adults who had medical checkups. A logistic regression analysis was used to compare the association between alcohol consumption and the risk of pre- or T2DM.

RESULTS: In both the normal-weight group (BMI /=23 kg/m(2) and 4 and 8 drinks: 2.42, 1.11-5.27). However, obese non-flushers had only a significant higher risk of pre- or T2DM when consuming more than 8 drinks of alcohol per week than the non-drinkers (2.72, 1.39-5.30).

CONCLUSION: These results suggest that obese flushers have an increased risk of developing pre- or T2DM even with less alcohol consumption.

26 June 2020 In Diabetes

The ultimate goal of diabetes management is to minimize complications and maintain quality of life in the context of comprehensive cardiovascular risk management and patient-centered care. This includes lifestyle management and diabetes self-management education and support.

In contrast to current pharmacological guidelines, which are patient-centered and evidence based, lifestyle guidelines still carry potential for improvement. Despite current best evidence from prospective controlled trials showing, that moderate wine consumption is associated with survival benefi t, reduced risk of cardiovascular endpoints in both subjects with and without diabetes as well as reduced diabetes incidence in the context of the mediterranean diet, translation into clinical practice is unsatisfactory.

Patients with diabetes and prediabetes need balanced and accurate information so they can make informed decisions about the risk-benefi t balance of the traditional mediterranean drinking pattern and translate it into their personal lifestyle and diabetes self-management – if applicable and suitable. In this regard, balanced analysis of the available evidence as a counterbalance to notorious myths is necessary.

This requires consideration of the broader context of european art of living, of direct and indirect effects of ethanol on glucose and lipid metabolism, distinction between harmful (binge drinking) and benefi cial (regular with meals) drinking patterns, distinction between distilled (spirits) and fermented (wine and beer) beverages, appreciation of the phenomenon of dose-dependent effect reversal (hormesis or J-curve), which is common to all alcoholic beverages and fi nally respect of ethnical and regional as well as gender- and age-related differences.

05 June 2020 In Diabetes

We aimed to elucidate the effect of chronic alcohol consumption on fatty liver. We assessed the consumption of alcohol in 2429 Japanese males (mean age: 54.2 +/- 9 years); they were classified according to average consumption into non-drinkers (ND), light drinkers (LD), moderate drinkers (MD), and heavy drinkers (HD).

The prevalence of fatty liver was the lowest in the MD and highest in the ND group (p < 0.001), while obesity was not significantly different among the groups (p = 0.133). Elevated levels of alanine aminotransferase (ALT) were the lowest in the MD group (p = 0.011) along with resistance to insulin (homeostasis model assessment-insulin resistance (HOMA-IR)), which was highest in the ND group (p = 0.001).

Chronic consumption of alcohol was independently and inversely associated with fatty liver and insulin resistance after adjusting for obesity, hypertension, fasting hyperglycemia, habit of drinking sweet beverages, physical activity, and age (odds ratios are as follows: ND, 1; LD, 0.682; MD, 0.771; HD, 0.840 and ND, 1; LD, 0.724; MD, 0.701; HD, 0.800, respectively).

We found that regardless of the type of alcoholic beverage, chronic consumption of alcohol is inversely associated with insulin resistance and fatty liver in Japanese males. This study had limitations, most notably the lack of investigation into diet and nutrition.

04 May 2020 In Diabetes

BACKGROUND: A Mediterranean-style eating pattern is consistently associated with a decreased diabetes risk in Mediterranean and European populations. However, results in U.S. populations are inconsistent. The objective of this study was to assess whether a Mediterranean-style eating pattern would be associated with diabetes risk in a large, nationally representative U.S. cohort of black and white men and women.

METHODS: Participants from the Atherosclerosis Risk in Communities study prospective cohort without diabetes, cardiovascular disease, or cancer at baseline (visit 1, 1987-1989; n = 11,991) were included (mean age 54 years, 56% female, 75% white). Alternate Mediterranean Diet scores (aMed) were calculated using the mean dietary intake self-reported at visit 1 and visit 3 (1993-1995) or visit 1 only for participants censored before visit 3. Participants were followed from visit 1 through 31 December 2016 for incident diabetes. We used Cox regression models to characterize associations of aMed (quintiles as well as per 1-point higher) with incident diabetes adjusted for energy intake, age, sex, race and study center, and education (Model 1) for all participants then stratified by race and body mass index (BMI). Model 2 included potential mediating behavioral and clinical measures associated with diabetes. Results are presented as hazard ratios and 95% confidence intervals.

RESULTS: Over a median follow-up of 22 years, there were 4024 incident cases of diabetes. Higher aMed scores were associated with lower diabetes risk [Model 1: 0.83 (0.73-0.94) for Q5 vs Q1 (p-trend < 0.001) and 0.96 (0.95-0.98) for 1-point higher]. Associations were stronger for black vs white participants (interaction p < 0.001) and weaker for obese vs normal BMI (interaction p < 0.01). Associations were attenuated but statistically significant in Model 2.

CONCLUSIONS: An eating pattern high in fruits, vegetables, whole grains, legumes, nuts, and fish, and moderate in alcohol was associated with a lower risk of diabetes in a community-based U.S. population.

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