Journal List > J Korean Diabetes > v.13(2) > 1054863

Jang and Koh: The Impacts of Alcohol Consumption on Glucose Metabolism

Abstract

The relationship between alcohol consumption and carbohydrate metabolism is complex and is not fully understood. Alcohol not only increases oxidative stress during metabolism, but also inhibits both gluconeogenesis and glycogenolysis in liver. Thus, acute alcohol intake can lead to hypoglycemia, particularly when glycogen stores are depleted or when alcohol is taken without meals. In addition, carbohydrate-rich food taken together with alcohol exaggerates insulin secretion and can cause reactive hypoglycemia about 2 to 3 hours after the meal.
It is well established that mild to moderate alcohol consumption (3 drinks/day) is associated with reduced cardiovascular mortality through improvements in insulin sensitivity, lipid profiles, and blood pressure. These beneficial effects of alcohol may also be responsible for a decreased incidence of type 2 diabetes mellitus (T2DM) and a reduced risk of coronary heart disease (CHD) in patients with T2DM. However, excessive alcohol consumption causes higher insulin resistance and increases the risk of T2DM, and even reverses the favorable effects of moderate alcohol intake on CHD.

References

1. Sherlock S. Alcoholic liver disease. Lancet. 1995. 345:227–229.
crossref
2. Alkerwi A, Boutsen M, Vaillant M, Barre J, Lair ML, Albert A, Guillaume M, Dramaix M. Alcohol consumption and the prevalence of metabolic syndrome: a meta-analysis of observational studies. Atherosclerosis. 2009. 204:624–635.
crossref
3. Jackson R, Scragg R, Beaglehole R. Alcohol consumption and risk of coronary heart disease. BMJ. 1991. 303:211–216.
crossref
4. Rimm EB, Giovannucci EL, Willett WC, Colditz GA, Ascherio A, Rosner B, Stampfer MJ. Prospective study of alcohol consumption and risk of coronary disease in men. Lancet. 1991. 338:464–468.
crossref
5. Rimm EB, Williams P, Fosher K, Criqui M, Stampfer MJ. Moderate alcohol intake and lower risk of coronary heart disease: meta-analysis of effects on lipids and haemostatic factors. BMJ. 1999. 319:1523–1528.
crossref
6. Das SK, Vasudevan DM. Alcohol-induced oxidative stress. Life Sci. 2007. 81:177–187.
crossref
7. Watson WH, Song Z, Kirpich IA, Deaciuc IV, Chen T, McClain CJ. Ethanol exposure modulates hepatic S-adenosylmethionine and S-adenosylhomocysteine levels in the isolated perfused rat liver through changes in the redox state of the NADH/NAD(+) system. Biochim Biophys Acta. 2011. 1812:613–618.
crossref
8. van de Wiel A. Diabetes mellitus and alcohol. Diabetes Metab Res Rev. 2004. 20:263–267.
crossref
9. O'Keefe SJ, Marks V. Lunchtime gin and tonic a cause of reactive hypoglycaemia. Lancet. 1977. 1:1286–1288.
10. Shelmet JJ, Reichard GA, Skutches CL, Hoeldtke RD, Owen OE, Boden G. Ethanol causes acute inhibition of carbohydrate, fat, and protein oxidation and insulin resistance. J Clin Invest. 1988. 81:1137–1145.
crossref
11. Yki-Jarvinen H, Nikkila EA. Ethanol decreases glucose utilization in healthy man. J Clin Endocrinol Metab. 1985. 61:941–945.
crossref
12. Joffe BI, Shires R, Lamprey JM, Baker SG, Seftel HC. Effect of drinking bottled beer on plasma insulin and glucose responses in normal subjects. S Afr Med J. 1982. 62:95–97.
13. Dornhorst A, Ouyang A. Effect of alcohol on glucose tolerance. Lancet. 1971. 2:957–959.
crossref
14. Sereny G, Endrenyi L. Mechanism and significance of carbohydrate intolerance in chronic alcoholism. Metabolism. 1978. 27:1041–1046.
crossref
15. Nguyen KH, Lee JH, Nyomba BL. Ethanol causes endoplasmic reticulum stress and impairment of insulin secretion in pancreatic β-cells. Alcohol. 2012. 46:89–99.
crossref
16. Hafko R, Orecná M, Bacová Z, Kolláriková G, Lacík I, Strbák V. Mechanism of ethanol-induced insulin secretion from INS-1 and INS-1E tumor cell lines. Cell Physiol Biochem. 2009. 24:441–450.
crossref
17. Huang Z, Sjöholm A. Ethanol acutely stimulates islet blood flow, amplifies insulin secretion, and induces hypoglycemia via nitric oxide and vagally mediated mechanisms. Endocrinology. 2008. 149:232–236.
crossref
18. Howard AA, Arnsten JH, Gourevitch MN. Effect of alcohol consumption on diabetes mellitus: a systematic review. Ann Intern Med. 2004. 140:211–219.
19. American Diabetes Association. Standards of medical care in diabetes-2012. Diabetes Care. 2012. 35:Suppl 1. S11–S63.
20. Koivisto VA, Tulokas S, Toivonen M, Haapa E, Pelkonen R. Alcohol with a meal has no adverse effects on postprandial glucose homeostasis in diabetic patients. Diabetes Care. 1993. 16:1612–1614.
crossref
21. Bell RA, Mayer-Davis EJ, Martin MA, D'Agostino RB Jr, Haffner SM. Associations between alcohol consumption and insulin sensitivity and cardiovascular disease risk factors: the Insulin Resistance and Atherosclerosis Study. Diabetes Care. 2000. 23:1630–1636.
crossref
22. Tanasescu M, Hu FB, Willett WC, Stampfer MJ, Rimm EB. Alcohol consumption and risk of coronary heart disease among men with type 2 diabetes mellitus. J Am Coll Cardiol. 2001. 38:1836–1842.
crossref
23. Baliunas DO, Taylor BJ, Irving H, Roerecke M, Patra J, Mohapatra S, Rehm J. Alcohol as a risk factor for type 2 diabetes: A systematic review and meta-analysis. Diabetes Care. 2009. 32:2123–2132.
24. Holbrook TL, Barrett-Connor E, Wingard DL. A prospective population-based study of alcohol use and non-insulin-dependent diabetes mellitus. Am J Epidemiol. 1990. 132:902–909.
crossref
25. Wei M, Gibbons LW, Mitchell TL, Kampert JB, Blair SN. Alcohol intake and incidence of type 2 diabetes in men. Diabetes Care. 2000. 23:18–22.
crossref
26. Facchini F, Chen YD, Reaven GM. Light-to-moderate alcohol intake is associated with enhanced insulin sensitivity. Diabetes Care. 1994. 17:115–119.
crossref
27. Shai I, Wainstein J, Harman-Boehm I, Raz I, Fraser D, Rudich A, Stampfer MJ. Glycemic effects of moderate alcohol intake among patients with type 2 diabetes: a multicenter, randomized, clinical intervention trial. Diabetes Care. 2007. 30:3011–3016.
crossref
28. Bantle AE, Thomas W, Bantle JP. Metabolic effects of alcohol in the form of wine in persons with type 2 diabetes mellitus. Metabolism. 2008. 57:241–245.
crossref
29. Lao B, Czyzyk A, Szutowski M, Szczepanik Z. Alcohol tolerance in patients with non-insulin-dependent (type 2) diabetes treated with sulphonylurea derivatives. Arzneimittelforschung. 1994. 44:727–734.
30. Park SH, Kang YH, Park HY. Alcohol consumption and the coronary heart disease-related risk factors in Korean adults: the Third Korea National Health and Nutrition Examination Survey (KNHANES III), 2005. Korean J Nutr. 2008. 41:232–241.
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