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Glycemic Effects of Moderate Alcohol Intake Among Patients With Type 2 Diabetes

A multicenter, randomized, clinical intervention trial

¹ S. Daniel Abraham International Center for Health and Nutrition, Department of Epidemiology, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel
² Diabetes Unit, Wolfson Medical Center, Holon, Israel
³ Department of Internal Medicine C and the Diabetes Unit, Soroka University Medical Center, Beer-Sheva, Israel
⁴ Diabetes Unit, Hadassah Hebrew University Medical Center, Jerusalem, Israel
⁵ S. Daniel Abraham International Center for Health and Nutrition, Department of Biochemistry, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel
⁶ Channing Laboratory, Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School and Departments of Epidemiology and Nutrition, Harvard School of Public Health, Boston, Massachusetts

Address correspondence and reprint requests to Iris Shai, RD, PhD, S. Daniel Abraham International Center for Health and Nutrition, Department of Epidemiology and Health Systems Evaluation, Ben-Gurion University of the Negev, P.O. Box 653, Beer-Sheva 84105, Israel. E-mail: irish{at}bgu.ac.il

OBJECTIVE—In a randomized controlled trial, we assessed the effect of daily moderate alcohol intake on glycemic control in the fasting and postprandial states in patients with type 2 diabetes who previously had abstained from alcohol.

RESEARCH DESIGN AND METHODS—We randomly assigned 109 patients (41–74 years old) with established type 2 diabetes who abstained from alcohol to receive 150 ml wine (13 g alcohol) or nonalcoholic diet beer (control) each day during a 3-month multicenter trial. The beverages were consumed during dinner. Diet and alcohol consumption were monitored.

RESULTS—During the intervention, 17% of participants (12% from the alcohol group) dropped out, leaving 91 who completed the trial. Within the alcohol group, fasting plasma glucose (FPG) decreased from 139.6 ± 41 to 118.0 ± 32.5 mg/dl after 3 months compared with 136.7 ± 15.4 to 138.6 ± 27.8 mg/dl in the control subjects (P_v = 0.015). However, alcohol consumption had no effect on 2-h postprandial glucose levels (difference of 18.5 mg/dl in the control group vs. 17.7 mg/dl in the alcohol group, P_v = 0.97). Patients in the alcohol group with higher baseline A1C levels had greater reductions in FPG (age-adjusted correlation –0.57, P_v < 0.001). No significant changes were observed in the levels of bilirubin, alkaline phosphatase, alanine aminotransferase, or aspartate aminotransferase, and no notable adverse effects were reported. Participants in the alcohol group reported an improvement in the ability to fall asleep (P_v < 0.001).

CONCLUSIONS—Among patients with type 2 diabetes who had previously abstained from alcohol, initiation of moderate daily alcohol consumption reduced FPG but not postprandial glucose. Patients with higher A1C may benefit more from the favorable glycemic effect of alcohol. Further intervention studies are needed to confirm the long-term effect of moderate alcohol intake.

Abbreviations: ALT, alanine aminotransferase • AST, aspartate aminotransferase • FPG, fasting plasma glucose

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