Alcohol Consumption and Diabetes Mellitus
A number of recent studies have addressed questions regarding alcohol consumption and the risk and control of diabetes. Researchers conducted a systematic review and summarized the findings of 32 such studies (27 involved type 2 diabetes only).
- Moderate drinking (defined variably in each study), compared with not drinking, reduced diabetes risk in 11 of 18 studies (2 with borderline significant findings, 1 with significant findings only in people with a normal body mass index).
- Drinking (defined variably: >=1.4 drinks per day, >5.5 drinks per day, any current drinking in people with a low body mass index, >=2–3 times per week of unspecified amounts) significantly increased risk of diabetes in 4 of 18 studies.
- Consumption (about 1–6 drinks on an occasion under experimental conditions) did not impair, and sometimes improved, glycemic control in the 6 small studies that examined it.
- In patients with diabetes, moderate drinking, compared with not drinking, significantly decreased risk of death from coronary heart disease (CHD) (by up to 79% in 3 of 4 studies) and CHD-related events (by up to 55% in 2 of 3 studies).
- Consuming about 3 drinks on an occasion with troglitazone or a sulfonylurea, assessed in 2 small studies, did not affect glycemic control.
- Heavy use (defined variably) significantly increased diabetic retinopathy in 1 study and had no effect in another.
Moderate alcohol use may decrease risk of type 2 diabetes and diabetes-related cardiovascular events. However, results from this review are inconsistent, and some included studies suggest increased risk at drinking levels often considered to be moderate. Given current evidence, it is likely safe for people with type 2 diabetes to follow usual drinking recommendations (<=1 drink per day for women and people over 65 years; <=2 drinks per day for men 65 years and younger). Further study is needed to determine the effect of alcohol use and alcohol problems on long-term glycemic control and self-care.Kevin L. Kraemer, MD, MSc
Howard AA, Arnsten
JH, Gourevitch MN. Effect of alcohol consumption on diabetes mellitus. Ann
Intern Med. 2004;140(3):211–219.