Changes in Alcohol Consumption and Subsequent Risk of Type 2 Diabetes in Men

Department of Nutrition, Harvard School of Public Health, Boston, Massachusetts, USA.
Diabetes (Impact Factor: 7.9). 09/2010; 60(1):74-9. DOI: 10.2337/db10-1052
Source: PubMed

ABSTRACT The objective of this study was to investigate the association of 4-year changes in alcohol consumption with a subsequent risk of type 2 diabetes.
We prospectively examined 38,031 men from the Health Professionals Follow-Up Study who were free of diagnosed diabetes or cancer in 1990. Alcohol consumption was reported on food frequency questionnaires and updated every 4 years.
A total of 1,905 cases of type 2 diabetes occurred during 428,497 person-years of follow-up. A 7.5 g/day (approximately half a glass) increase in alcohol consumption over 4 years was associated with lower diabetes risk among initial nondrinkers (multivariable hazard ratio [HR] 0.78; 95% CI: 0.60-1.00) and drinkers initially consuming <15 g/day (HR 0.89; 95% CI: 0.83-0.96), but not among men initially drinking ≥15 g/day (HR 0.99; 95% CI: 0.95-1.02; P(interaction) < 0.01). A similar pattern was observed for levels of total adiponectin and hemoglobin A(1c), with a better metabolic profile among abstainers and light drinkers who modestly increased their alcohol intake, compared with men who either drank less or among men who were already moderate drinkers and increased their intake. Likewise, compared with stable light drinkers (0-4.9 g/day), light drinkers who increased their intake to moderate levels (5.0-29.9 g/day) had a significantly lower risk of type 2 diabetes (HR 0.75; 95% CI: 0.62-0.90).
Increases in alcohol consumption over time were associated with lower risk of type 2 diabetes among initially rare and light drinkers. This lower risk was evident within a 4-year period following increased alcohol intake.


Available from: Michel M Joosten, Apr 01, 2015
  • [Show abstract] [Hide abstract]
    ABSTRACT: Alcohol has previously been shown to have a U-shaped association with type 2 diabetes (T2D) risk, but less is known regarding the specific association with wine. To evaluate for the first time the associations between T2D risk and both baseline wine consumption and trajectories of wine consumption frequency throughout life, estimated using an innovative group-based trajectory modeling strategy. A total of 66,485 women from the French prospective E3N-EPIC cohort were followed between 1993 and 2007; 1,372 incident cases of T2D were diagnosed during the follow-up. Multivariable Cox regression models were used to estimate hazard ratios (HRs) and 95 % confidence intervals (95 % CI) for T2D risk. The average consumption of wine, among alcohol consumers, was 0.81 drinks/day (1 drink = 150 mL). Associations between wine and T2D were restricted to overweight women (Pinteraction = 0.0084). Among them, wine consumption was inversely associated with T2D risk (Ptrend = 0.0022). A lower risk was observed for overweight women having two or more drinks/day [HR 0.59 (0.43-0.82)] when compared with non-alcohol consumers. Women who started to drink wine early in life (around age 10-15 years) were at a significantly lower risk than lifetime abstainers. In our study, wine drinking was inversely associated with T2D risk but only in overweight women. Our results also suggest a potential beneficial, cumulative effect of moderate wine consumption throughout life for overweight women, who would already be at higher risk of T2D. We encourage other cohort studies with information on wine consumption to investigate these associations.
    European Journal of Epidemiology 10/2014; 29(11). DOI:10.1007/s10654-014-9955-7 · 5.15 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: Moderate alcohol consumption has been shown to decrease the risk of type 2 diabetes (T2DM), but whether this association is also valid for impaired fasting glucose (IFG) is less well known. We aimed at assessing the impact of alcohol consumption and of type of alcoholic beverage on the incidence of T2DM and T2DM + IFG. As many as 4765 participants (2613 women, mean age 51.7 ± 10.5 years) without T2DM at baseline and followed for an average of 5.5 years. The association between alcohol consumption, type of alcoholic beverage and outcomes was assessed after adjustment for a validated T2DM risk score. During follow-up 284 participants developed T2DM and 643 developed IFG. On bivariate analysis, alcohol consumption was positively associated with the risk of developing T2DM or T2DM + IFG. Moderate (14-27 units/week) alcohol consumption tended to be associated with a lower risk of T2DM, but no protective effect was found for T2DM + IFG. Multivariable-adjusted odds ratio (OR) and (95% confidence interval) for T2DM: 0.89 (0.65-1.22), 0.66 (0.42-1.03) and 1.63 (0.93-2.84) for 1-13, 14-27 and 28 + units/week, respectively (p for quadratic trend < 0.005). For T2DM + IFG, the corresponding ORs were 1.09 (0.90-1.32), 1.33 (1.02-1.74) and 1.54 (0.99-2.39), respectively, p for trend = 0.03. No specific effect of alcoholic beverage (wine, beer or spirits) was found for T2DM or for T2DM + IFG. Moderate alcohol consumption is associated with a reduced risk of developing T2DM, but not of developing T2DM + IFG. No specific effect of type of alcoholic beverage was found. Copyright © 2014 Elsevier B.V. All rights reserved.
    Nutrition, metabolism, and cardiovascular diseases: NMCD 09/2014; 25(1). DOI:10.1016/j.numecd.2014.08.010 · 3.52 Impact Factor
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Objectives: Since it has been suggested that moderate alcohol drinking would increase insulin sensitivity, which could benefit Gestational Diabetes Mellitus (GDM), the study aimed at evaluating alcohol con-sumption during pregnancy, and seeing whether this consumption influences GDM detection and mater-nal/perinatal outcomes. Study design: Women with already known diabetes and those with multiple pre-gnancy were excluded. All other pregnant women attending antenatal care unit of the university clinics, Kinshasa, DR Congo during the period from 1 March throughout 31 October 2010, were invited at 24-week gestation to enroll in O'Sullivan blood glucose testing and if eligible in 100-gram oral glucose tolerance test. Alcohol consumption, risk factors for GDM, and ge-neral characteristics such as age, parity, gestity, BMI, fat mass were registered. Diagnosed GDM was first treated with diet and exercise, thereafter with Met-formin, and if necessary with insulin. For other (nor-mal) women data remained blinded until confinement. Maternal and infant's adverse outcomes such as ma-ternal urinary infection, preeclampsia, cesarean sec-tion, intrauterine growth retardation, birth weight < 2500 g, birth weight ≥ 3800 g (as stated > percentile 90 in our milieu), Apgar score at the first minute < 7, shoulder dystocia or other birth injury, neonatal hy-poglycemia and fetal alcohol syndrome (FAS) were compared and analyzed according to GDM diagnosis as well to alcohol status. Results: Up to 240 pregnant women accepted to enroll into the study. Alcohol con-sumption concerned 78 (32.5%) of the women, most of them (61 = 25.42%) being heavy consumers. Risk factors for GDM and Physical and blood glucose characteristics were alike (p not significant) in both consumers and non consumers, except for history of HTA in the family that was significantly more fre-quent (p = 0.02) among drinkers. GDM's prevalence was 9%. No adverse outcome was more prominent in any subgroup, except Apgar score < 7 at the first minute that was more frequent (p = 0.038) among neonates of GDM mothers. No FAS, neither shoulder dystocia nor neonatal hypoglycemia were diagnosed. When alcohol status was considered, Birthweight ≥ 3800 g was found more frequent (p = 0.0284) in alco-hol consumers than in abstainers. Risk of this out-come was three times higher when history of family hypertension was present (odds ratio 2.694; CI: 0.536 -13.544). Conclusions: The prevalence of alcohol con-sumption by pregnant women of our series (32.5%) seems not to impact the detection of GDM (9%). FAS was not diagnosed. Lack of significant differences in adverse outcomes between GDM and non GDM could be attributed to huge follow-up of GDM women. In-fluence of alcohol consumption on birth weight mo-stly in setting of familial history of hypertension re-mains to be addressed.