Alcohol and the heart
	Alcohol and cancer
	Women and Alcohol
	Alcohol and diabetes
	Drinking as you get older?
	Alcohol and it's effects
	Alcohol and allergies
What the Doctor says

Type 1 or juvenile-onset or insulin-dependent diabetes mellitus is a disorder characterized by a lack of insulin production by the beta cells of pancreatic islets.

Type 2 or adult-onset diabetes mellitus, which accounts for more than 85% of all incidences of diabetes mellitus, is a disorder characterised by resistance to the effects of circulating insulin. This disorder leads to a substantial increase in risk of cardiovascular disease, which is the major cause of mortality, accounting for up to 80% of all deaths in individuals with type 2 diabetes mellitus; the age-adjusted relative risk of death due to cardiovascular disease is approximately three-fold higher than in the general population.

Apart from obesity and physical inactivity there are few well-established modifiable risk factors for type 2 diabetes mellitus. Recent evidence suggests, however, that alcohol consumption may be a potentially modifiable risk factor for type 2 diabetes mellitus and a J-shaped relationship has been observed between level of alcohol consumption and risk of developing diabetics in both men and women (de Vegt et al. 2002, Wannamethee et al. 2002, Wannamethee et al. 2003).

What the experts say…

A study in 2003 of twins with different alcohol habits found that those twins with moderate levels of alcohol consumption had half the risk of diabetes compared with those with low levels of alcohol consumption (Carlsson et al. 2003). The researchers say these results are consistent with a number of previous studies that have shown that moderate alcohol consumers have a 30-40% reduced risk of type 2 diabetes. The investigators also saw that levels of alcohol consumption of 20 g/day or more appeared to increase the likelihood of diabetes for lean women, but not for overweight women or men.

However, binge drinking increased the number of diabetes cases among women.

The J-shaped relationship between amount of alcohol consumption and risk of cardiovascular disease is also observed for diabetics, where excessive consumption can impair glycaemic control, and increase the risk of diabetic neuropathy and retinopathy.Reference: Carlsson S et al. Alcohol Consumption and the Incidence of Type 2 Diabetes: A 20-year follow-up of the Finnish Twin Cohort Study. Diabetes Care 2003;26:2785-

Until relatively recently alcohol was prohibited in diets recommended for diabetics, but newer concepts in the management of diabetes now favour a diet that is more liberal in carbohydrate content and provides more flexibility for diabetic individuals. These changes were employed to increase compliance with the dietary recommendations of medical practitioners. Indeed, prominent researchers, such as Janet McDonald of the US Food and Drug Administration (FDA), successively argued for the inclusion of moderate alcohol consumption in a diabetic diet once scientific research had demonstrated that moderate alcohol intake did not impair, and in some studies improved, glucose response.

While the American Diabetes Association (ADA) stresses the importance of individuals and physicians working together to make decisions regarding consumption, whether or not the patient has diabetes, they also state that “[if] used in moderation and with food, blood glucose levels are not affected by the ingestion of alcohol when diabetes is well controlled.” The only caveat is that alcohol consumption may predispose elderly type 2 diabetics treated with sulfonylurea agents to hypoglycaemia.

Referring to the US Dietary Guidelines for Americans, the ADA defines moderation as no more than two drinks/day (12g) for men and no more than one for women.

For in-depth information, please visit the AIM-Gateway site at www.aim-digest.com/gateway/

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