A Dutch randomized trial conducted in diabetic teetotalers suggests that a glass of wine with dinner may improve glucose control, particularly in those with higher HbA1c levels to begin with. The study, while small, adds to anecdotal evidence and meta-analyses that suggest wine, whose cardiovascular benefits have been widely touted, may hold specific benefits for diabetics.
Dr Iris Shai (Ben Gurion University, Beer-Sheva, Israel) presented the results of the study here at the European Association for the Study of Diabetes 2007 Meeting.
Shai noted that the proportion of alcohol abstainers is relatively high in Israel, where the study was conducted; however, the potential health benefits of moderate alcohol consumption persuaded 109 adults between the ages of 40 and 75 to participate. Indeed, dropouts during the three-month trial were higher among those randomized to the nonalcoholic diet malt beer than among those randomized to their choice of red or white wine, with many of the dropouts citing their disappointment over not being assigned to the alcohol group.
At the end of three months, 91 subjects remained in the study; those in the alcohol-intervention group experienced a statistically significant drop in fasting plasma glucose, from a mean of 139.6 mg/dL to 118 mg/dL. By contrast, subjects in the nonalcoholic-beer group experienced no real change in fasting plasma glucose.
Of note, alcohol consumption did not appear to affect two-hour postprandial glucose levels. Shai pointed out that ethanol metabolism is believed to inhibit gluconeogenesis, which could increase the risk of hypoglycemia. “Because of this, patients were guided to drink their beverage during dinner, which was a carbohydrate-based meal. But this process largely controls fasting, rather than postmeal, glycemia,” she said, which might help explain the lack of an effect on two-hour postprandial glucose.
Better glucose, better sleep
Changes in fasting plasma glucose levels were particularly marked among patients who had higher baseline HbA1c levels, Shai noted. Waist circumference and LDL levels were also reduced from baseline over the three-month period in the alcohol-intervention group, but no changes from baseline were seen in HDL levels. While “surprising,” Shai suggested that the lack of effect on HDL might be due to the relatively short duration of the trial.
Three months after the termination of the trial, 61% of the study subjects told investigators that they believed alcohol was likely beneficial and 49% were continuing to drink alcohol in moderation.
Source : European Association for the Study of Diabetes 2007 Meeting