Alcohol consumption and risk of coronary heart disease among individuals with type 2 diabetes

Tănăsescu, Mihaela; Hu, Frank B.

doi:10.1007/s11892-001-0032-8

Cited by 10 publications

(5 citation statements)

References 39 publications

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“…Further study is warranted to assess whether physician advice to decrease alcohol consumption among heavy drinkers is associated with improved adherence to self‐care recommendations and reduced risk for diabetes complications. Additionally, given the evidence that low to moderate alcohol intake may have cardiovascular benefits for patients with diabetes [52–57], examination of the trade‐offs between cardiovascular benefits vs. risk of lower adherence with self‐care behaviours is needed. Similarly, clinical recommendations for alcohol consumption among people with diabetes need to balance the clinical benefits of moderate consumption and the potential risks of lowered adherence to self‐care behaviours.…”

Section: Discussionmentioning

confidence: 99%

Alcohol consumption is inversely associated with adherence to diabetes self‐care behaviours

2006

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Aims-Our aim was to examine the associations of alcohol consumption with six diabetes self-care behaviours.Methods-We determined levels of alcohol consumption and examined associations between alcohol consumption and six self-care behaviours in 65 996 adults with diabetes who received care through Kaiser Permanente Northern California and who responded to a 1994−1997 survey. Adherence with recommendations for self monitoring of blood glucose, HbA 1c testing, and diabetes medications were determined from electronic records; smoking and use of diet and exercise to treat diabetes were self reported. Multiple logistic regression models were used to determine the associations between alcohol consumption (average number of drinks/day in the past year) and the probability of adherence to each self-care behaviour.Results-Current alcohol consumption was reported by 50.8% of adults with diabetes. In adjusted models, we observed a gradient of increasing risk for poor adherence to diabetes self-care behaviours with increasing alcohol consumption, starting with those who consume even one drink a day. Former drinkers had the greatest compliance with each self-care behaviour, except for current smoking.Conclusions-Alcohol consumption is a marker for poorer adherence to diabetes self-care behaviours. These findings highlight the importance of routine assessment of alcohol intake in people with diabetes, particularly as half of adults with diabetes consume alcohol. Given extant evidence that moderate alcohol intake may have cardiovascular benefits for patients with diabetes, examination of the trade-offs between cardiovascular benefits vs. potential risk of lower adherence with self-care behaviours deserves study.

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Section: Discussionmentioning

confidence: 99%

Alcohol consumption is inversely associated with adherence to diabetes self‐care behaviours

2006

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“…The potential risks of alcohol in diabetic patients have recently been reviewed [15]. In diabetic patients, alcohol may induce hypoglycaemia, especially during prolonged fasting or in the presence of sulphonylurea medication [36].…”

Section: Discussionmentioning

confidence: 99%

“…Moderate alcohol consumption has been linked to reduced cardiovascular risk in Type 2 diabetic patients [11,12,13,14,15]; this beneficial effect is greater in diabetic individuals than in non-diabetic individuals [14], producing a 34% to 79% reduction in the risk of CHD [15]. Investigations into the mechanisms responsible for this association have focused primarily on lipid metabolism [16], coagulation, fibrinolysis [17] and insulin sensitivity [18].…”

Section: Introductionmentioning

confidence: 99%

Moderate alcohol intake and markers of inflammation and endothelial dysfunction among diabetic men

et al. 2004

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Aims/hypothesis. Type 2 diabetes mellitus is characterised by heightened inflammation and endothelial dysfunction. Moderate alcohol intake has been associated with a reduced risk of cardiovascular disease in Type 2 diabetic patients. It remains to be determined whether there is an association between alcohol and inflammation in individuals with diabetes. Methods. We investigated the relationship between alcohol intake and inflammation in 726 of 18,159 men who returned blood samples in the Health Professionals Follow-up Study and had confirmed Type 2 diabetes at blood draw. Results. In age-adjusted analyses, alcohol intake was associated with lower levels of HbA 1 c, fibrinogen, soluble tumour necrosis factor receptor-2 (sTNF-R2) and soluble vascular adhesion molecule-1 (sVCAM-1), and with higher levels of HDL cholesterol and adiponectin (p value for trends <0.05). After adjustment for age, HbA 1 c, insulin use, fasting status, smoking, BMI, physical activity, aspirin use, prevalence of cardiovascular disease and dietary factors, each additional drink per day was related to increased HDL cholesterol (0.053 mmol/l, p<0.0001) and adiponectin (0.8 µg/ml, p=0.01), and decreased sTNFR-2 (73 pg/ml, p=0.03), fibrinogen (0.302 µmol/l, p=0.02) and sVCAM-1 (33 ng/ml, p=0.02). The relationship between alcohol and inflammatory biomarkers persisted when subjects were stratified according to HbA 1 c levels. Conclusions/interpretation. Moderate alcohol intake may have a beneficial effect on markers of inflammation and endothelial dysfunction in Type 2 diabetic patients.Keywords Alcohol · Cardiovascular disease · Diabetes mellitus · Inflammation

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“…The references in included articles and relevant reviews [12][13][14][15][16][17] were checked for additional studies of interest. Included were original peer-reviewed publications on observational cohorts or nested case-control studies in type 2 diabetic populations on the relationship between alcohol consumption and the incidence of diabetic complications.…”

Section: Methodsmentioning

confidence: 99%

Meta-analysis of the relationship between alcohol consumption and coronary heart disease and mortality in type 2 diabetic patients

Koppes

Dekker

Hendriks³

et al. 2006

Diabetologia

113

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Aims/hypothesis: This systematic review examines the relationship between alcohol consumption and long-term complications of type 2 diabetes. Meta-analyses could only be performed for total mortality, mortality from CHD, and CHD incidence, because the availability of articles on other complications was too limited. Materials and methods: A PubMed search through to September 2005 was performed and the reference lists of relevant articles examined. Among the relevant articles there were six cohort studies reporting on the risk of total mortality and/or fatal and/or incident CHD in alcohol non-consumers and in at least two groups of alcohol consumers. Results: Statistical pooling showed lower risks in alcohol consumers than in non-consumers (the reference category). The relative risk (RR) of total mortality was 0.64 (95% CI 0.49-0.82) in the <6 g/day category. In the higher alcohol consumption categories (6 to <18, and ≥18 g/day), the RRs of total mortality were not significant. Risks of fatal and total CHD were significantly lower in all three categories of alcohol consumers (<6, 6 to <18 and ≥18 g/day) than in nonconsumers, with RRs ranging from 0.34 to 0.75. Conclusions/interpretation: This meta-analysis shows that, as with findings in the general population, moderate alcohol consumption is associated with a lower risk of mortality and CHD in type 2 diabetic populations.

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Alcohol consumption and risk of coronary heart disease among individuals with type 2 diabetes

Cited by 10 publications

References 39 publications

Alcohol consumption is inversely associated with adherence to diabetes self‐care behaviours

Alcohol consumption is inversely associated with adherence to diabetes self‐care behaviours

Moderate alcohol intake and markers of inflammation and endothelial dysfunction among diabetic men

Meta-analysis of the relationship between alcohol consumption and coronary heart disease and mortality in type 2 diabetic patients

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