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

A multicenter, randomized, clinical intervention trial

  1. Iris Shai, RD, PHD1,
  2. Julio Wainstein, MD2,
  3. Ilana Harman-Boehm, MD3,
  4. Itamar Raz, MD4,
  5. Drora Fraser, PHD1,
  6. Assaf Rudich, MD, PHD5 and
  7. Meir J. Stampfer, MD, DRPH6
  1. 1S. 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. 2Diabetes Unit, Wolfson Medical Center, Holon, Israel
  3. 3Department of Internal Medicine C and the Diabetes Unit, Soroka University Medical Center, Beer-Sheva, Israel
  4. 4Diabetes Unit, Hadassah Hebrew University Medical Center, Jerusalem, Israel
  5. 5S. 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. 6Channing 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
  1. 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

Abstract

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 (Pv = 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, Pv = 0.97). Patients in the alcohol group with higher baseline A1C levels had greater reductions in FPG (age-adjusted correlation −0.57, Pv < 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 (Pv < 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.

Footnotes

  • Published ahead of print at http://care.diabetesjournals.org on 11 September 2007. DOI: 10.2337/dc07-1103. Clinical trial reg. no. NCT00295334, clinicaltrials.gov.

    I.S. and J.W. contributed equally to this work.

    Additional information for this article can be found in an online appendix at http://dx.doi.org/10.2337/dc07-1103.

    A table elsewhere in this issue shows conventional and Système International (SI) units and conversion factors for many substances.

    The costs of publication of this article were defrayed in part by the payment of page charges. This article must therefore be hereby marked “advertisement” in accordance with 18 U.S.C Section 1734 solely to indicate this fact.

    • Accepted September 8, 2007.
    • Received June 11, 2007.
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  1. Published online before print September 11, 2007, doi: 10.2337/dc07-1103 Diabetes Care December 2007 vol. 30 no. 12 3011-3016
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