Day After the Night Before

Richardson, Tristan; Weiß, Melanie; Thomas, Peter; Kerr, David

doi:10.2337/diacare.28.7.1801

Cited by 81 publications

(64 citation statements)

References 3 publications

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“…This is particularly true in those using insulin or insulin secretagogue therapies. Consuming alcohol with food can minimize the risk of nocturnal hypoglycemia (3,225–227). Individuals with diabetes should receive education regarding the recognition and management of delayed hypoglycemia and the potential need for more frequent self-monitoring of blood glucose after consuming alcoholic beverages.…”

Section: Resistant Starch and Fructansmentioning

confidence: 99%

Nutrition Therapy Recommendations for the Management of Adults With Diabetes

et al. 2013

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Section: Resistant Starch and Fructansmentioning

confidence: 99%

Nutrition Therapy Recommendations for the Management of Adults With Diabetes

et al. 2013

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“…Both glycemic control and glucose production have been shown to be affected by alcohol [5;12]. Alcohol may also induce hypoglycemia [13;14]. Diabetic control may be negatively impacted by even small amounts of alcohol [6].…”

Section: The Direct Effect Of Alcohol Consumption On Diabetesmentioning

confidence: 99%

Alcohol use of diabetes patients: the need for assessment and intervention

2010

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It is well known that diabetes self-care behaviors are critical to disease progression. Unfortunately, many patients do not adhere to diabetes self-care recommendations despite their importance. Alcohol use has been identified as a barrier to diabetes self-care adherence. Excessive alcohol consumption not only negatively impacts diabetes self-care adherence but also affects the course of diabetes. Diabetes patients who are at-risk drinkers are likely to have poor diabetes treatment adherence, leading to increased morbidity and mortality. Alcohol consumption by diabetes patients is often inadequately assessed and addressed in their medical care. Brief interventions to reduce at-risk drinking have been well validated in a variety of patient populations and offer the potential to improve diabetes treatment adherence and outcome. Assessment and treatment of at-risk drinking could be readily incorporated into routine diabetes care. Strategies for brief assessment of and intervention for at-risk drinking are offered.

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“…for 2 prospective studies that found that a fifth of all severe hypoglycemic episodes in patients with diabetes necessitating medical assistance were related to alcohol use [3,4]. In human studies, although contrasting data exist [30][31][32][33][34][35], are experimental data that have shown that alcohol ingestion has the potential to either exacerbate hypoglycemia [6][7][8][9]12,36] even when administered to levels of intoxication [12]. Two studies have found that alcohol ingestion reduced glucagon, cortisol, and growth hormone responses to hypoglycemia but, in contrast to our study, found normal catecholamine responses to hypoglycemia [10,11].…”

Section: Discussionmentioning

confidence: 99%

“…Two prospective studies have suggested that alcohol ingestion is responsible for a fifth of all episodes of severe hypoglycemia admitted to emergency departments [3,4] and that it may reduce hypoglycemic symptom awareness [5]. In addition, other studies have suggested that the effects of alcohol-induced hypoglycemia is delayed from 2 hours [6] up to the morning after [7][8][9] and that alcohol impairs recovery from hypoglycemia in T1DM [10]. However, the neuroendocrine mechanisms by which alcohol causes hypoglycemia in T1DM have not been fully defined.…”

Section: Introductionmentioning

confidence: 99%

Forebrain and hindbrain effects of ethanol on counterregulatory responses to hypoglycemia in conscious rats

Sandoval

Gong

2007

Metabolism

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Ethanol (OH) has been reported to blunt counterregulation and increase insulin sensitivity, thereby causing greater hypoglycemia in patients with diabetes mellitus. The aim of this study was to determine if fore- or hindbrain sensing of OH differentially affects autonomic and metabolic counterregulatory responses to hypoglycemia. Forty-one Sprague-Dawley rats received 5% OH or isotonic sodium chloride solution (or normal saline; SAL) infused peripherally or into the lateral (forebrain) or fourth cerebral ventricles (hindbrain) from time 0 to 120 minutes. From time 120 to 240 minutes, rats were exposed to a hyperinsulinemic (5 mU/[kg min]) hypoglycemic (2.9 +/- 0.1 mmol/L) clamp. The 4 groups of rats studied were as follows: SAL (n = 8), peripheral alcohol (POH) (n = 10), lateral ventricle alcohol (LVOH) (n = 12), and left ventricle alcohol (4VOH) (n = 11). After OH, basal levels of norepinephrine were lower in the POH and 4VOH groups (P < .05). Epinephrine and norepinephrine responses to hypoglycemia were significantly lower in POH, 4VOH, and LVOH vs SAL. However, the magnitude of blunting was significantly greater in POH and 4VOH vs LVOH. Other counterregulatory hormones and glucose kinetics were not significantly different among all groups during hypoglycemia. In summary, peripheral and central nervous system OH infusion blunted autonomic nervous system counterregulatory (epinephrine, norepinephrine) responses to subsequent hypoglycemia. The greater impact of 4VOH compared with LVOH administration suggests that OH exerts its effects to blunt autonomic nervous system counterregulatory responses during hypoglycemia primarily by actions on the hindbrain.

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Day After the Night Before

Cited by 81 publications

References 3 publications

Nutrition Therapy Recommendations for the Management of Adults With Diabetes

Nutrition Therapy Recommendations for the Management of Adults With Diabetes

Alcohol use of diabetes patients: the need for assessment and intervention

Forebrain and hindbrain effects of ethanol on counterregulatory responses to hypoglycemia in conscious rats

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