In most populations studied, birth weight was inversely related to type 2 diabetes risk.

OBJECTIVE -The aim of this study was to investigate alcohol consumption in relation to the incidence of type 2 diabetes. 1975, 1981, and 1990. By record linkage to national registers of hospital discharge and prescribed medication, 580 incident cases of type 2 diabetes were identified during 20 years of follow-up. RESEARCH DESIGN AND METHODSRESULTS -Moderate alcohol consumption (5-29.9 g/day in men and 5-19.9 g/day in women) tended to be associated with a reduced incidence of type 2 diabetes compared with low consumption (Ͻ5 g/day). The estimates were lower in overweight (BMI Ն25.0 kg/m 2 ) subjects (relative risk 0.7, 95% CI 0.5-1.0 [men]; 0.6, 0.3-1.1 [women]). High alcohol consumption (Ն20 g/day) was associated with an increased incidence of type 2 diabetes in lean women (2.9, 1.1-7.5) but not in overweight women or in men. In women, binge drinking was associated with an increased incidence of type 2 diabetes (2.1, 1.0 -4.4). Analyses of alcohol-discordant twin pairs supported a reduced risk in moderate consuming twins compared with their lowconsuming cotwins (odds ratio 0.5, 95% CI 0.2-1.5).CONCLUSIONS -The results of this study suggested that moderate alcohol consumption may reduce the risk of type 2 diabetes. On the other hand, binge drinking and high alcohol consumption may increase the risk of type 2 diabetes in women.

Objective. To investigate the association between cigarette smoking and use of oral moist snuff and impaired glucose tolerance and type 2 diabetes. Design. We performed a population-based crosssectional study of glucose intolerance and tobacco use in Stockholm during 1992±94. The sample consisted of 3128 men, aged 35±56 years, of whom 52% had a family history of diabetes. In an oral glucose tolerance test, we detected 55 men with type 2 diabetes and 172 with impaired glucose tolerance. Information on cigarette smoking and oral moist snuff use was collected by a questionnaire. Results. The odds ratio of type 2 diabetes was increased for smokers of 25+ cigarettes day 21 (odds ratio = 2.6, 95% confidence interval = 1.1±5.9) as well as for moist snuff dippers of 3+ boxes week 21 (odds ratio = 2.7, 95% confidence interval = 1.3±5.5). The odds ratio of relatively high (highest tertile) fasting insulin levels in subjects with impaired glucose tolerance associated with cigarette smoking of 25+ cigarettes day 21 was 1.5 (95% confidence interval = 0.7±3.6). The corresponding estimate of a relatively low (lowest tertile) 2 h insulin response was 2.5 (95% confidence interval = 0.9±7.1). Conclusions. These results indicate that heavy users of cigarettes or moist snuff have an increased risk of type 2 diabetes. The results could suggest that tobacco use is associated with a low insulin response.

Objectives. The association between coffee consumption, type 2 diabetes and impaired glucose tolerance was examined. In addition, indicators of insulin sensitivity and b-cell function according to homeostasis model assessment were studied in relation to coffee consumption. Design. Population-based cross-sectional study. Setting and subjects. The study comprised 7949 healthy Swedish subjects aged 35-56 years residing within five municipalities of Stockholm. An oral glucose tolerance test identified 55 men and 52 women with previously undiagnosed type 2 diabetes and 172 men and 167 women with impaired glucose tolerance. Information about coffee consumption and other factors was obtained by questionnaire. .76) respectively. In subjects with type 2 diabetes and impaired glucose tolerance, high coffee consumption (!5 cups day À1 ) was inversely associated with insulin resistance. In addition, in those with type 2 diabetes and in women (not in men) with impaired glucose tolerance high coffee consumption was inversely associated with low b-cell function. In women, but not obviously in men, with normal glucose tolerance, coffee consumption was associated with a reduced risk of insulin resistance. Conclusions. The results of this study indicated that high consumers of coffee have a reduced risk of type 2 diabetes and impaired glucose tolerance. The beneficial effects may involve both improved insulin sensitivity and enhanced insulin response.