Does Moderate Alcohol Consumption Reduce Microvascular Complications of Type 1 Diabetes?
Epidemiologic studies have shown that people with diabetes who drink moderately are at a much lower risk of macrovascular complications such as heart disease, stroke, and peripheral vascular disease. This study investigated the cross-sectional association between moderate alcohol consumption and risk of microvascular complications, including retinopathy, neuropathy, and nephropathy, in 1857 patients with type 1 diabetes. The authors documented 304 cases of proliferative retinopathy, 660 cases of neuropathy, and 157 cases of nephropathy (macroalbuminuria >200 μg/min) among patients in the study sample.
- Alcohol consumption was associated with risk of microvascular complications in a U-shaped fashion:
- Moderate consumers (30–70 g per week) had a lower risk for proliferative retinopathy (odds ratio [OR], 0.60), neuropathy (OR, 0.61), and macroalbuminuria (OR, 0.36) in multivariable adjusted models.
- Drinking frequency was significantly inversely associated with risk of neuropathy, with a similar trend visible for proliferative retinopathy and macroalbuminuria.
- Results were similar when excluding patients who had been advised to drink less alcohol because of their health.
- The relationship was most pronounced in consumers of wine versus beer, while consumption of spirits was associated with an increased risk of microvascular complications.
This is one of few studies of type 1 diabetes large enough to evaluate whether microvascular complications are lower among moderate drinkers. These findings indicate that the risk for these complications is markedly reduced by moderate alcohol intake, especially for consumers of wine. However, the relative importance of drinking frequency and quantity consumed per drinking day could not be determined in this study, because too little variation in drinks per drinking day existed to draw valid conclusions.R. Curtis Ellison, MD
Beulens JW, Kruidhof JS, Grobbee DE, et al. Alcohol consumption and risk of microvascular complications in type 1 diabetes patients: the EURODIAB Prospective Complications Study. Diabetologia. 2008;51(9):1631–1638.