Social drinkers have a reduced risk for developing type 2 diabetes vs. nondrinkers and regular or heavy drinkers, illustrating a U-shaped relationship between alcohol consumption and incident diabetes risk in men and women, study data show.
“Several studies have reported the biological mechanisms to explain the lower risk of development of diabetes in people with modest alcohol consumption,” Yun-Ju Lai, of the National Yang-Ming University School of Medicine in Taipei, Taiwan, and colleagues wrote. “Alcohol may improve insulin resistance by inhibiting gluconeogenesis, which leads to decreased risks of the development of diabetes. In addition, the so-called anti-inflammatory theory was also reported, which suggests that alcohol may positively change the expressions of inflammatory proteins such as adiponectin and interleukin-1b involved in metabolic processes.”
Lai and colleagues analyzed data from 43,000 Taiwanese adults without diabetes at baseline participating in the 2001, 2005 and 2009 waves of the National Health Interview Survey, which collects data on demographics, body weight and height, and health behaviors including frequency of alcohol consumption and smoking status (mean age, 42 years; 50.35% women). Frequency of alcohol consumption was classified as nondrinker, social consumption (less than once a week), regular consumption (more than once a week, but not drunkenness) and heavy consumption (more than once a week to the point of being drunk). Researchers followed the cohort from first interview through diagnosis of new-onset diabetes (identified through medical records) or December 2013 and used Cox proportional regression models to assess independent associations of alcohol consumption frequency with diabetes incidence.
During 357,908 person-years of follow-up, 3,650 people developed new-onset diabetes.
During 5 to 13 years of follow-up, researchers observed incident diabetes in 2,399 nondrinkers (9.2%), 573 social drinkers (5.32%), 636 regular drinkers (10.74%) and 42 heavy drinkers (19%).
Compared with social drinkers, nondrinkers had a higher risk for developing type 2 diabetes (HR = 1.47; 95% CI, 1.34-1.61), as did regular drinkers (HR = 1.82; 95% CI, 1.62-2.03) and heavy drinkers (HR = 3.27; 95% CI, 2.39-4.48). After adjusting for demographics, health behaviors and comorbidities, increased risk persisted for nondrinkers, regular and heavy drinkers vs. social drinkers (P < .01 for all).
The researchers noted that it is possible that the observed risk reductions may be due to overestimation by using a reference group contaminated by those who had quit consumption of alcohol. Additionally, most women in Taiwan were nondrinkers, and the unequal distribution across the four alcohol consumption groups may cause decreased power in the analysis, they wrote.
“Further studies are necessary to evaluate the effect of different beverage types and the quantity of alcohol on the risk of development of diabetes,” the researchers wrote. – by Regina Schaffer
Disclosures: The authors report no relevant financial disclosures.