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Imagine_David 3 months, 3 weeks ago.
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Greetings, and Happy New Year.
How do you manage alcohol safely when you socialise?
What are the risks of over-indulging in alcohol?
Are there actually benefits to drinking alcohol?
“Single bouts of ethanol do not worsen and may improve glucose tolerance in diabetics. However, daily drinking in moderate amounts (i.e., 0.5 to 1.0 mg/kg) clearly worsens diabetic control and increases the prevalence of impotence, retinopathy, and possibly peripheral neuropathy. Approximately the same consumption of ethanol is associated with a decreased risk of myocardial infarction and a decreased risk of cardiovascular mortality. These latter studies are in a mixed population, making it difficult to discern whether these beneficial ethanol effects are actually operative in diabetics. Therefore, more data is needed to determine whether the beneficial effects of daily drinking of moderate amounts of ethanol outweighs the deleterious ones. The prudent course at this time would be to avoid daily drinking. Clearly, drinking large amounts of ethanol is to be avoided as such behavior can cause ketoacidosis, hypertriglyceridemia, and if taken outside the context of a meal, can cause hypoglycemia and ultimately increased death from noncardiovascular causes.” from http://www.ncbi.nlm.nih.gov/pubmed/9083725
“Newer concepts regarding the management of diabetes favor a diet that is more liberal in carbohydrate content and more personalized for the patient. Ideally, the end result will be improved glycemic control and fewer complications. Allowing more flexibility in the diet is a way of fostering better patient compliance. Alcohol, for example, which is frequently disallowed, can safely be included in the diet of many diabetic patients who desire a drink with meals, provided that certain guidelines are followed. Dietary substitutions can be made with relative ease. Although there are contraindications to its use by certain people, alcohol in moderation does not appear to compromise carbohydrate homeostasis in most individuals and, if early studies are confirmed, could possibly have some beneficial side-effects. More open discussion of alcohol use with patients is needed to give them the know-how to alter their diets and to inform them of the necessary precautions.” from http://care.diabetesjournals.org/content/3/5/629.short
“It has been said that alcohol ‘…improves the lipid profile, is one of the few interventions to increase HDL cholesterol, improves quality of life and has been shown to reduce the risk of heart disease… Take two doses each night with your evening meal.’ It could be good medicine for people with diabetes who commonly have dyslipidaemia, a low HDL cholesterol and increased risk of cardiovascular disease. It has also been said that alcohol ‘…increases weight, triglyceride, blood pressure and the risk of hypoglycaemia… and is a major cause of marital disharmony and violent death.’ Perhaps not so good after all.” from http://www.medicinetoday.com.au/home/article/view/434
“Alcohol influences glucose metabolism in several ways in diabetic patients as well as in non-diabetic patients. Since alcohol inhibits both gluconeogenesis and glycogenolysis, its acute intake without food may provoke hypoglycaemia, especially in cases of depleted glycogen stores and in combination with sulphonylurea. Consumed with a meal including carbohydrates, it is the preferred fuel, which may initially lead to somewhat higher blood glucose levels and hence an insulin response in type 2 diabetic patients. Depending on the nature of the carbohydrates in the meal, this may be followed by reactive hypoglycaemia.
Moderate consumption of alcohol is associated with a reduced risk of atherosclerotic disorders. Diabetic patients benefit from this favourable effect as much as non-diabetic patients. Apart from effects on lipid metabolism, haemostatic balance and blood pressure, alcohol improves insulin sensitivity. This improvement of insulin sensitivity may also be responsible for the lower incidence of type 2 diabetes mellitus reported to be associated with light-to-moderate drinking. In case of moderate and sensible use, risks of disturbances in glycaemic control, weight and blood pressure are limited.
Excessive intake of alcohol, however, may not only cause loss of metabolic control, but also annihilate the favourable effects on the cardiovascular system.” from http://onlinelibrary.wiley.com/doi/10.1002/dmrr.492/abstract;jsessionid=155CEC3576D7B1417F4149CBC037BE43.d01t04?deniedAccessCustomisedMessage=&userIsAuthenticated=false
Cheers!
David
Diabetes Eductor
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