The Relationship Between Alcohol Consumption and Glycemic Control Among Patients with Diabetes: The Kaiser Permanente Northern California Diabetes Registry

Kaiser Permanente Division of Research, Oakland, CA 94612, USA.
Journal of General Internal Medicine (Impact Factor: 3.42). 03/2008; 23(3):275-82. DOI: 10.1007/s11606-007-0502-z
Source: PubMed


Alcohol consumption is a common behavior. Little is known about the relationship between alcohol consumption and glycemic control among people with diabetes.
To evaluate the association between alcohol consumption and glycemic control.
Survey follow-up study, 1994-1997, among Kaiser Permanente Northern California members.
38,564 adult diabetes patients.
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.
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 consumption was linearly (p < 0.001) and inversely (p = 0.001) associated with A1C among diabetes patients.
Alcohol consumption is inversely associated with glycemic control among diabetes patients. This supports current clinical guidelines for moderate levels of alcohol consumption among diabetes patients. As glycemic control affects incidence of complications of diabetes, the lower A1C levels associated with moderate alcohol consumption may translate into lower risk for complications.

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Available from: Margaret Warton, May 22, 2015
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    • "Moderate alcohol consumption has minimal detrimental acute and/or long-term effects on blood glucose in people with diabetes. Studies of alcohol consumption in persons with diabetes report a U-shaped or J-shaped association, suggesting a benefit from moderate consumption.39,40 Moderate consumption in people with type 2 diabetes is also reported to be associated with a reduced risk of and mortality from coronary heart disease and lower total mortality rates,41 likely related to improved insulin sensitivity.42 "
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    • "Studies among both diabetics and nondiabetics demonstrate a J-or U-shaped curve between alcohol consumption and insulin sensitivity (Bell et al. 2000; Davies et al. 2002; Greenfield et al. 2003; Kroenke et al. 2003). Likewise, two large epidemiologic studies among diabetic subjects show that moderate alcohol consumption is associated with better glycemic control (Ahmed et al. 2008; Mackenzie et al. 2006). An important limitation of these studies, however, is that few included ethnic minority groups or failed to emphasize possible differences in relation to ethnicity in their analyses. "
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    • "However, other factors such as gender, educational status, type of diabetes (Table 2) alcohol drinking, cigarette smoking, and duration on insulin treatment (Table 3) did not show correlation with poor glycemic control. In the present study alcohol intake and cigarette smoking were not identified as risk factors, a finding that can be explained as most of the patients use to drink alcohol or smoke cigarette for refreshment habit and moderate alcohol consumption has been reported to enhance insulin sensitivity and improve glycemic control [13]. Other studies showed that cigarette smoking by diabetic patients is associated with an increased prevalence of microvascular complications, at least partly mediated through poor glycemic control [14]. "
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