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Alcohol use of diabetes patients: The need for assessment and intervention PMC

By 10 juin 2021juillet 11th, 2024No Comments

diabetes and alcohol abuse

Monitoring this measure could complement monitoring less common outcomes such as alcohol-related mortality, allowing identification of smaller, at-risk patient subgroups that require urgent and early interventions. Although beneficial effects of moderate alcohol consumption have been strongly suggested by observational studies, data from randomized trials of alcohol, especially among patients with type 2 diabetes, are sparse. In a trial among patients with diabetes after a first myocardial infarction (29), red wine taken with meals significantly reduced oxidative stress and proinflammatory cytokines. Basal in vivo-determined glucose disposal by skeletal muscle, both fast- and slow-twitch fiber types, also did not differ between control and chronic alcohol-fed rats [14].

Risk factors

“Alcohol can cause rapid changes in blood sugar in people with diabetes,” said Dr. Jordan Pinsker, Vice Present and Medical Director at Tandem Diabetes Care. “While some drinks can raise blood sugar, the major concern is a rapid decline in blood sugar with alcohol use, causing a severe hypoglycemic reaction, even a seizure.” There are many resources available to help people cope with alcohol and substance abuse. However, the organization recommends that females can diabetics get drunk with diabetes limit their consumption to one drink per day and males limit their consumption to two drinks per day. Doctors advise some people with diabetes to abstain from alcohol for reasons unrelated to their blood sugar. The Department of Veterans Affairs (DVA) warns that individuals with diabetes may have other conditions that alcohol could affect. A 2015 meta-analysis reviewed 38 cohort studies to determine whether alcohol is a risk factor for diabetes.

The Direct Effect of Alcohol Consumption on Diabetes

diabetes and alcohol abuse

For instance, the 4-item CAGE questionnaire [37] is widely used but assesses lifetime alcohol use disorders as opposed to at-risk drinking or even current alcohol use disorders [38]. The Alcohol Use Disorders Identification Test (AUDIT; [39]) identifies individuals with recent heavy drinking or alcohol dependence. However, its 10 items make it less feasible to imbed into health screening questionnaires or physician interviews [36]. To address this limitation, a briefer version of the AUDIT containing its three consumption items (AUDIT-C) has been utilized. This measure can be readily incorporated into health screening questionnaires.

Data Synthesis and Analysis

With hazard ratios being a form of RR that is independent of study length (24), hazard ratios were considered equivalent to RRs for the purpose of the meta-analysis. PubMed (MEDLINE), Embase, the Cumulative Index to Nursing and Allied Health Literature (CINAHL), and the Alcohol and Alcohol Problems Science (ETOH) databases were searched for relevant studies. Liquid sugars are quickly absorbed by the body, so those carbs won’t be much help in preventing or treating a low that may occur hours after you drink. Food, on the other hand, is digested gradually, so it provides better protection against lows.

diabetes and alcohol abuse

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Both complete abstainers and people drinking more than 34 grams of alcohol per day had higher death rates, with abstainers exhibiting the highest death rates from cardiovascular disease and heavy drinkers exhibiting the highest death rates from noncardiovascular disease. Those findings suggest that alcohol consumption, particularly moderate consumption, may have a protective effect against cardiovascular disease. Moreover, elevated triglyceride levels can cause severe inflammation of the pancreas (i.e., pancreatitis). In addition to being highly painful and potentially fatal, this inflammation may interfere with the production of insulin, thereby potentially worsening control of blood sugar levels and making hypertriglyceridemia a particularly serious complication in diabetics. Heavy drinking (i.e., more than 140 grams of pure alcohol, or approximately 12 standard drinks, per day) can cause alcohol-induced hypertriglyceridemia in both diabetics and nondiabetics (Chait et al. 1972). In fact, from a practical standpoint, heavy drinking should be considered as a possible contributing factor in all patients with hypertriglyceridemia.

diabetes and alcohol abuse

Alcohol-Induced Changes in Basal Insulin and Glucose Tolerance

Results from models utilizing the second set of alcohol measures, where only reports of drinking patterns that were strictly prior, as ages progressed in the risk estimation for the age of diabetes onset are presented in Table 4. Only the alcohol measure results are presented as the results for other variables are very similar to those given in Table 1. Generally, compared to the results from the first set of alcohol measures presented in Tables ​Tables22 and ​and3,3, the HRs increased toward 1 in the groups where significant effects were found. These changes in estimated HRs were particularly notable for Black respondents, for whom the groups showing significantly reduced risk in the Table 3 results no longer show HRs that are close to significant. These changes in results under this more conservative version of the alcohol measures suggest that there may be some bias in the first set of results, due perhaps to the effects of diabetes onset on drinking biasing downward the self-report of drinking in that decade.

The Long-Term Effect of Moderate Drinking With Diabetes

  • After the consumption of 48 g alcohol (about four glasses), hepatic gluconeogenesis decreases by ~ 45%.
  • These criticisms range from the tool’s focus upon the generalizability of a given sample to the general population as opposed to its internal validity (59) to the arbitrary nature of some questions that appear to weaken interrater reliability (60,61).
  • Differences among studies, such as whether alcohol is administered with or without a meal and whether a fasting glucose level is measured make comparisons across studies difficult [7] and may partially explain inconsistencies.
  • In addition to the direct effects on diabetes, negative interactions between alcohol and diabetes medications have been documented.
  • Brief alcohol interventions are well validated in the outpatient medical setting with other patient populations and offer the potential to improve diabetes treatment adherence and outcomes.

In his role at Sansum, he was a lead investigator in numerous clinical trials on automated insulin delivery systems, including Basal-IQ technology and Control-IQ technology. Prior to this, he was Chief of Pediatric Endocrinology at Tripler Army Medical Center in Hawaii. Dr. Pinsker served as a physician in the United States Army in both Active Duty and in the California Army National Guard for more than 20 years. He completed a combined seven-year BS/MD program with Union College and Albany Medical College in New York.

After the consumption of 48 g alcohol (about four glasses), hepatic gluconeogenesis decreases by ~ 45%. Table 3 shows HRs of drinking patterns from stratified Cox models for White, Black and Hispanic groups separately. Results for the White group are quite similar to those for the total sample, with the exception that the at least weekly group of heavy occasion 5+ drinking was also found to be protective. For Blacks, groups drinking at least weekly but less than monthly 5+ and drinking at least monthly but less than monthly 5+ had significantly lower risk for diabetes. None of the drinking pattern categories was found to be significantly predictive of diabetes for Hispanics, however. Studies of the role of alcohol use in diabetes risk have rarely included lifetime alcohol use measures, including the frequency of heavy occasions, or evaluated risks among Black or Hispanic respondents in US samples.

  • Diagnoses were independently developed and cross-verified by 2 authors (B.S. and J.F.W.).
  • All volunteers gave written informed consent and did not receive compensation for their participation.
  • It’s also the body’s detoxification center, breaking down toxins like alcohol so the kidneys can easily flush them away.
  • It is possible that reductions in risk identified between moderate alcohol exposure and incident type 2 diabetes may occur partly as an artifact of referent group selection, particularly where confounder adjustment is weak (14,15).
  • Where averages were not reported for each exposure category, the medians of the lower and upper limits were selected.

Alcohol’s Impact on Blood Sugar

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