ALCOHOL AND DIABETES MELLITUS

ALCOHOL AND DIABETES MELLITUS

            For persons with diabetes, the same precautions apply regarding the use of alcohol that applies to the general population. Abstinence from alcohol should be advised for women during pregnancy and for people of with other medical problems such as pancreatitis, advanced neuropathy, severe hypertriglyceridemia, or alcohol abuse. If individuals chose to drink alcohol, no more than two alcohol containing drinks per day for adult men and no more than one drink per day for adult women is recommended.

            One drink or alcoholic beverage is commonly defined as 12 OZ of beer, 5 OZ of wine, or 1.5 OZ of distilled sprits, each of which contain ~ 15g of alcohol. The cardio protective effect of alcohol appears not to be determined by the type of alcoholic beverage consumed.

            Alcohol can have both hypoglycemic and hyperglycemic effects in people with diabetes. These effects are determined by the amount of alcohol acutely ingested, if consumed with or without food and if use is chronic and excessive. In studies using moderate amount of alcohol ingested with food in people with type I and type II diabetes, alcohol had no acute effect on blood glucose/insulin levels. Therefore, alcoholic beverages should be considered in addition to the regular food / meal plan for all people with diabetes and no food should be omitted.

            Heavy or excessive alcohol consumption is a leading avoidable cause of death. In non diabetic a light to moderate alcohol ingestion in adults in associated with increased insulin sensitivity and decreased risk of type II diabetes, CHD and stroke. In adults with diabetes, chronic intake of light to moderate amounts (5-15 g/day) was associated with decreased risk for CHD presumably due to the concomitant increase in plasma HDL cholesterol. There appears to be a U or J shaped relationship of alcohol intake and BP.

            While light to moderate amount of alcohol do not raise BP, a strong association exists between chronic excessive intake of alcohol (>30-60g/day) and BP in men and women.

Note:

            If individuals chose to drink alcohol, daily intake should be limited to one drink for adult women and two drinks for adult men. One drink is defined as 12 OZ of beer, 5 OZ of wine, or 1.5 OZ of distilled spirit.

            To reduce risk of hypoglycermia, alcohol should be consumed with food. Excessive alcohol consumption by a person who is fasting or skipping meals can lead to hypoglycemia via inhibition of gluconeogenesis and may pose a serious risk for persons taking insulin or oral agents. Alcohol may exacerbate neuropathy, dyslipidemia, obesity and disturb the control of diabetes.

REFERENCE:

            Clinical Practice Recommendations, ADA