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.

 

 

 

 

BACKGROUND: Alcohol consumption is a common behavior. Little is known about the relationship between alcohol consumption and glycemic control among people with diabetes. OBJECTIVE: To evaluate the association between alcohol consumption and glycemic control. DESIGN: Survey follow-up study, 1994-1997, among Kaiser Permanente Northern California members. PATIENTS: 38,564 adult diabetes patients. MEASUREMENTS: Self-reported alcohol consumption, and hemoglobin A1C (A1C), assessed within 1 year of survey date. Linear regression of A1C by alcohol consumption was performed, adjusted for sociodemographic variables, clinical variables, and diabetes disease severity. Least squares means estimates were derived. RESULTS: In multivariate-adjusted models, A1C values were 8.88 (lifetime abstainers), 8.79 (former drinkers), 8.90 (<0.1 drink/day), 8.71 (0.1-0.9 drink/day), 8.51 (1-1.9 drinks/day), 8.39 (2-2.9 drinks/day), and 8.47 (>/=3 drinks/day). Alcohol…
BACKGROUND: In the past two decades, the metabolic syndrome has given rise to much clinical and research interest. The broad overlap of alcohol consumption with different components of metabolic syndrome makes alcohol-metabolic syndrome relationship a controversial topic. OBJECTIVES: To support the evidence available about the relationship between alcohol consumption and metabolic syndrome as a comprehensive clinical entity, as well as to identify the gender-specific dose-response, by performing a meta-analysis based on information from published data. METHODS: Manual and computer searches in different bibliographic databases were performed to identify the relevant scientific publications, on the relation between alcohol consumption and metabolic syndrome. Alcohol intake was converted into a same unit (g/day) and then categorized using standard classification in order to provide…
The purpose of this study was to investigate the relationship between alcohol consumption and the prevalence of the metabolic syndrome (MetS), type 2 diabetes mellitus (DM), coronary heart disease (CHD), stroke, peripheral arterial disease (PAD), and overall cardiovascular disease (CVD) in a Mediterranean cohort. It consisted of a cross-sectional analysis of a representative sample of Greek adults (n = 4,153) classified as never, occasional, mild, moderate, or heavy drinkers. Cases with overt CHD, stroke, or PAD were recorded. In our population, 17% were never, 23% occasional, 27% mild, 24% moderate, and 9% heavy drinkers. Moderate alcohol consumption was associated with a lower trend for the prevalence of the MetS (P = .0001), DM (P < .0001), CHD (P = .0002),…
BACKGROUND: Alcohol consumption is related to the prevalent metabolic syndrome. Few studies have evaluated the effects of alcohol consumption on the development of metabolic syndrome. OBJECTIVE: We examined the association between alcohol consumption and incident metabolic syndrome. DESIGN: This was a prospective cohort study of 3833 male and female Koreans aged 40-69 y and free of the metabolic syndrome at baseline. Information on alcohol consumption was obtained periodically from interviewer-administered questionnaires. Incident cases of the metabolic syndrome were identified by biennial health examinations during 4 y of follow-up between 2003 and 2006. RESULTS: Compared with nondrinkers, the multivariate relative risk [RR (95% CI)] of the metabolic syndrome for very light drinkers consuming 0.1 to 5 g of alcohol per day…
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…
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