alcohol consumption

January 10, 2008

Moderate Alcohol Consumption Lowers Fasting Glucose 20mg/dL

A daily glass of wine with dinner for those with type 2 diabetes lowers

fasting plasma glucose (FPG), Israeli researchers report in the December

issue of

Diabetes Care.

Dr. Iris Shai of Ben Gurion University of the Negev in Beer Sheva and

colleagues randomized 109 patients with type 2 diabetes who had

previously abstained

from alcohol to have 150 mL of wine (13 g alcohol) or a nonalcoholic

diet beer (control) daily with dinner for 3 months.

A total of 91 patients completed the trial. The age range of the

subjects was 41 to 74 years.

Mean FPG was 139.6 mg/dL at baseline in the intervention group, and it

fell to 118.0 mg/dL after 3 months with alcohol consumption. Baseline

FPG was 136.7

in controls, and remained essentially unchanged 3 months later at 138.6

mg/dl.

Patients with higher A1C levels at baseline had greater reductions in

FPG with alcohol consumption than those with lower A1C levels.

Alcohol consumption had no effect on postprandial plasma glucose, and

there were no changes in bilirubin, alkaline phosphatase, alanine

aminotransferase

or aspartate aminotransferase levels.

It Dr. Shai commented that it was important that the subjects drank

alcohol with their evening meal, which contained carbohydrates.

Dr. Shai explained that, " The decline in hepatic glucose production can

provoke hypoglycemia when alcohol is ingested in the fasting state.

Since ethanol

does not appear to directly affect insulin secretion or glucose

disposal, a hypoglycemic effect of ethanol is likely to be highly

dependent on nutritional

state. "

" The trial might suggest that moderate alcohol consumption could be

considered as prescription for patients with type 2 diabetes in very

specifically eligible

groups, " she noted, but added a caveat. " A patient who drinks one glass

of wine a day should balance the extra calories by omitting 100 kcal

that come

from a carbohydrate source.... It is important to note that higher doses

of alcohol are dangerous, and each patient should talk with his

physician before

initiation. "

Diabetes Care 2007;30:3011-3016.

================================

FACT:

Weight gain when going on insulin therapy is due to:

decreased glycosuria due to improved glycemic control, the anabolic

effects of insulin itself, decreased metabolic rate, aggressive

treatment of hypoglycemia,

and defensive eating to prevent hypoglycemia or deal with the fear of

hypoglycemia.

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