Can I have a drink when I have Diabetes?

Diabetes Mellitus is condition where the sugar content of your blood goes higher than normal. In Type1 where pancreas in tummy can not produce insulin (the only hormone that lowers blood sugar), it is the common type in children.

More than 95% of Diabetes is type 2, here although the body produces insulin but it is insufficient and/or inefficient. Type 2 diabetes mellitus (T₂DM) has reached epidemic proportion in our country.

We believe the life style is one of the most important contributors for more and more cases of T₂DM. Various investigators have zeroed on regular exercise, a healthy diet i.e. low fat, high fiber diet and cessation of smoking to prevent or postpone T₂DM and its associated complications. What about alcohol?  Beneficial or harmful?

Is the diagnosis of Diabetes “THE END” of a drink? Or is it that taking a drink in moderation will increase the risk of T2DM? Till some days back, it was routine advice of doctors to stop drinking.

Some doctors and dieticians still practice this. Important is to remember the quantity of consumption, risk of getting drunk and snack consumed. When not in liking, it is better to avoid but when it is pleasurable better advice would be to see what current scientific evidence tells.

Various researchers dwelled into this problem with large number of studies. They included men and women, both middle aged and elderly. What the researchers have identified heartens many a friends of this beverage.

Alcohol consumed in moderation is likely to protect you from developing T₂DM. Moderate consumption in most studies amounted to around a drink equivalent of around 10 pegs of whisky in men and seven pegs in women spread over a full week.

 Joline W.J. Beulens and his team from the Netherlands published their study in Diabetes Care (2005) showing in comparison to abstainers, the relative risk of developing T2DM was lower (0.66 to 0.86) with moderate drinking.

Beverage type did not influence the outcome. Here RR or Relative risk is a measure of how much is the chance of developing T2DM when a person consumes alcohol in a permissible amount in comparison to somebody who does not touch alcohol. Thereby RR of less than one means chances are less, RR of one means chances are the same and more than one means chances are greater.

Lando L.J. Koppes compiled various study reports from all over the world (Diabetes Care 2005) interestingly found a U shaped curve, with abstainers and heavy drinkers having the same probability but moderate consumers having a low probability of developing T₂DM.

Wannamethee and friends studied younger women in 2003 (Archives of Internal Medicine, 2003) to find the same U shaped curve but the advantage was more apparent with beer or wine. A 12-year study published by a team led by Conigrave KM from USA (Diabetes 2001) noted that compared with abstainers, consumption of alcohol in moderation was associated with a 36% lower risk of developing T₂DM. Every day or at least 5 days in a week gave more protection than once a while drinking. Drink choice did not matter.

Now what could be the reason for this beneficial effect of alcohol? This was answered by Davies M.J and his team (Journal of American Medical Association, 2002). Alcohol increases the body’s sensitivity to insulin by 7.2%. In Simple language it makes insulin to act better. Alcohol also reduces triglycerides which are fat globules of the body.

Kim T.B. Knoops and his friends from Netherlands (Journal of American Medical Association, 2002) found a mix of healthy diet, exercise, non-smoking and moderate consumption of alcohol reduced all cause as well as cardiovascular death.

 Thus it is seen that alcohol in moderation not only reduces the risk of developing T₂DM but also reduces heart problem. Has Pancreas found an ally in Alcohol?

However, a word of caution or two. All these studies were conducted in the West and data with Indian people is not forthcoming and unlikely to be available till we can shrug off the taboo attached to alcohol.

For people with uncontrolled T2DM, a drink can make your sugar go up. Therefore, when uncontrolled, it is better to have a check on your drink. Remember not to eat fried snacks with a drink. This can lead to an increase in your calorie intake in turn leading to high sugars and cholesterol. Is this the final nail in the coffin?