Diabetes and Alcohol: Do the Two Mix? (Part 2)

Last week, in "Diabetes and Alcohol: Do the Two Mix? (Part 1)," we looked at one reason why diabetes and alcohol sometimes don’t mix: hypoglycemia. We know that hypoglycemia can occur after drinking alcohol because the liver may be "too busy" processing the alcohol to release enough glucose into the bloodstream.

But it looks like there’s another reason why hypoglycemia may occur after drinking alcohol. A new study out of Karolinska University in Stockholm, Sweden, published in this month’s issue of the journal Endocrinology, reveals that, in rats, alcohol sends large amounts of blood to the beta cells in the pancreas, stimulating them to release insulin, and thus lowering blood glucose levels.

While hypoglycemia is something that those prone to it aim to avoid, there is a benefit to alcohol’s ability to lower glucose levels. An Israeli study (published in the journal Diabetes Care in December 2007) of 109 people with Type 2 diabetes looked at fasting blood glucose (FBG) levels after the participants were given either wine or nonalcoholic beer at supper for three months. Prior to the study, the subjects did not drink alcohol. FBG in the wine-drinking group dropped from an average of about 140 mg/dl to 118 mg/dl. FBG didn’t drop in the control group. Alcohol had no effect on postmeal glucose levels.

The lead author of the study concluded that a glass of an alcoholic beverage could be prescribed for people with Type 2 diabetes as part of the evening meal. However, it would be important to include carbohydrate at the meal, and also to deduct about 100 calories from food so as to avoid weight gain from the added calories from the alcoholic beverage. And, of course, one should always discuss the use of alcohol with his or her health-care provider.

So, we’ve learned that drinking alcohol can lower blood glucose levels—which can be a good thing as long as the alcohol is consumed with some carbohydrate. But what about alcohol and other health issues? Sometimes we hear that alcohol is good for us; other times it seems like we should avoid it like the plague. While there is no clear-cut answer that suits everyone, it may be helpful to view alcohol in terms of a cost/benefit analysis.

Costs—drinking alcohol may increase the risk for:

• Hypoglycemia
• Cancer (of the pancreas, breast, mouth, larynx, and liver)
• Pancreatitis
• Cardiomyopathy (weakening of the heart muscle)
• Cirrhosis
• High blood pressure
• Miscarriage
• Fetal alcohol syndrome
• Accidents

Benefits—drinking alcohol may help:

• Lower the risk of heart disease
• Lower the risk of stroke
• Raise levels of HDL (”good”) cholesterol
• Lower the risk of developing Type 2 diabetes
• Prevent gallstone formation

Of course, some people shouldn’t drink alcohol at all. These include pregnant women, people with liver or pancreatic disease, people with uncontrolled diabetes, and those with a history of alcoholism. And be very careful if you take any of the following medicines, as they don’t mix well with alcohol: antibiotics, beta blockers, antihistamines, antidepressants, some diabetes medicines, and pain relievers.

Do your own cost/benefit analysis and ask for advice from your health-care team. Next week, we’ll look at how to fit alcohol into your meal plan, as well as some of the better choices, if you choose to imbibe.

POST A COMMENT