25 August 2020 In Diabetes

BACKGROUND: Previous cohort studies have shown that moderate alcohol consumption was associated with a lower risk of type 2 diabetes (T2D). However, whether these associations differ according to the characteristics of patients with T2D remains controversial.

OBJECTIVE: The purpose of this study was to explore and summarize the evidence on the strength of the association between alcohol consumption and the subsequent risk of T2D by using a dose-response meta-analytic approach.

DESIGN: We identified potential studies by searching the PubMed, Embase, and Cochrane Library databases up to 24 March 2015. Prospective observational studies that evaluated the relation between alcohol consumption and the risk of T2D and reported its effect estimates with 95% CIs were included.

RESULTS: Analyses were based on 706,716 individuals (275,711 men and 431,005 women) from 26 studies with 31,621 T2D cases. We detected a nonlinear relation between alcohol consumption and the risk of T2D, which was identified in all cohorts (P-trend < 0.001, P-nonlinearity < 0.001), in men (P-trend < 0.001, P-nonlinearity < 0.001), and in women (P-trend < 0.001, P-nonlinearity < 0.001). Compared with the minimal category of alcohol consumption, light (RR: 0.83; 95% CI: 0.73, 0.95; P = 0.005) and moderate (RR: 0.74; 95% CI: 0.67, 0.82; P < 0.001) alcohol consumption was associated with a lower risk of T2D. However, heavy alcohol consumption had little or no effect on subsequent T2D risk. Furthermore, the summary RR ratio (RRR; male to female) of the comparison between moderate alcohol consumption and the minimal alcohol categories for T2D was significantly higher, and the pooled RRR (current smoker to never smoker) of light alcohol consumption was significantly reduced.

CONCLUSIONS: Light and moderate alcohol consumption was associated with a lower risk of T2D, whereas heavy alcohol consumption was not related to the risk of T2D

25 August 2020 In Diabetes

AIMS/INTRODUCTION: Previous meta-analyses identified an inverse association of total alcohol consumption with the risk of type 2 diabetes. The current study further explored the relationship between specific types of alcoholic beverage and the incidence of type 2 diabetes.

MATERIALS AND METHODS: A search of PubMed, Embase and Cochrane Library databases from January 1966 to February 2016 was carried out for prospective cohort studies that assessed the effects of specific types of alcoholic beverage on the risk of type 2 diabetes. The pooled relative risks with 95% confidence interval were calculated using random- or fixed-effect models when appropriate.

RESULTS: A total of 13 prospective studies were included in this meta-analysis, with 397,296 study participants and 20,641 cases of type 2 diabetes. Relative to no or rare alcohol consumption, wine consumption was associated with a significant reduction of the risk of type 2 diabetes, with the pooled relative risks of 0.85, whereas beer or spirits consumption led to a slight trend of decreasing risk of type 2 diabetes (relative risk 0.96, 0.95, respectively). Further dose-response analysis showed a U-shaped relationship between all three alcohol types and type 2 diabetes. Additionally, the peak risk reduction emerged at 20-30 g/day for wine and beer, and at 7-15 g/day for spirits, with a decrease of 20, 9 and 5%, respectively.

CONCLUSIONS: Compared with beer or spirits, wine was associated with a more significant decreased risk of type 2 diabetes. The present study showed that wine might be more helpful for protection against type 2 diabetes than beer or spirits

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.

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