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Alcohol consumption and risk of microvascular complications in type 1 diabetes patients
The EURODIAB Prospective Complications Study is a follow-up study including 3,250 type 1 diabetes mellitus patients from 16 different European countries. The authors investigated the cross-sectional association between moderate alcohol consumption and risk of retinopathy, neuropathy and nephropathy among 1,857 of these patients.

Moderate consumers (30–70 g alcohol per week) had a lower risk of microvascular complications with odds ratios of 0.60 (95% CI 0.37–0.99) for proliferative retinopathy, 0.61 (0.41–0.91) for neuropathy and 0.36 (0.18–0.71) for macroalbuminuria in multivariate-adjusted models. These results were similar when excluding patients who had been advised to drink less alcohol because of their health. The relation was most pronounced for alcohol consumption from wine. Drinking frequency was significantly, inversely associated with risk of neuropathy, and a similar trend was visible for proliferative retinopathy and macroalbuminuria. Alcohol consumption was not associated with occurrence of ketoacidosis or hypoglycaemic attacks. The authors conclude that consistent with its effects on macrovascular complications, moderate alcohol consumption is associated with a lower risk of all microvascular complications among type 1 diabetes patients.

Professor R Curtis Ellison comments: Data from most prospective epidemiologic studies have shown that healthy moderate drinkers have an approximately 30% lower risk of developing type 2 (adult-onset) diabetes. Further, it is clear that diabetics who drink moderately are at a much lower risk of the macrovascular complications of diabetes, those involving major arteries (such as coronary heart disease, stroke, and peripheral vascular disease).

This is one of few studies of early-onset (type 1) diabetes that is large enough to evaluate whether microvascular complications (those involving the eyes, kidneys, nerves) are also lower among moderate drinkers. The main findings are that moderate drinking, especially of wine and to some extent of beer, was associated with lower occurrence of these complications of type 1 diabetes. The effect was especially seen for wine drinkers of between about 3 and 18 drinks per week. There was a tendency for frequent drinkers (5-7 days/week) to have fewer complications than those drinking less frequently. Thus, this study suggests that the microvascular, as well as the macrovascular, complications of diabetes are lower among moderate drinkers.

Article: Beulens JWJ, Kruidhof JS, Grobbee DE, Chaturvedi N, Fuller JH, Soedamah-Muthu SS. Alcohol consumption and risk of microvascular complications in type 1 diabetes patients: the EURODIAB Prospective Complications Study. Diabetologia 2008;51:1631–1638.

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