Alcohol consumption can exacerbate the diabetes-related lipid abnormalities, because numerous studies have shown that heavy drinking can alter lipid levels even in nondiabetics. In contrast to the limited data available on alcohol-induced changes in glucose uptake for most peripheral tissues, there is a considerable body of literature pertaining to glucose uptake by whole brain and by various brain regions. In human volunteers, acute alcohol decreased the glucose arterial-jugular vein difference suggesting a reduction in total brain glucose uptake 76. Similarly, an early study using PET imaging in humans also reported a reduction in brain glucose uptake after acute alcohol intoxication 77. Likewise, rodent studies show acute alcohol-induced inhibition of glucose uptake in several brain regions 78,79,80,81 and a decrease in the rate of glucose utilization by numerous regions in the isolated perfused mouse brain 82. However, in recent studies the in vivo uptake of 2-DG by the whole brain did not differ in response to either acute 12,73,83 or chronic 14 alcohol in rats.
Alcohol and type 2 diabetes: The role of socioeconomic, lifestyle and psychosocial factors
Ultimately, insulin secretion declines even further, to levels below those seen in nondiabetics (although generally still higher than those seen in type 1 diabetics). At that point, when a deficit in insulin secretion is combined with a state of insulin resistance, the person develops type 2 diabetes. Thus, whereas type 1 diabetes is characterized by a complete lack of insulin production, type 2 is characterized by reduced insulin production plus insulin resistance. The reasons underlying defective insulin secretion and insulin resistance, which are still under investigation, are complex and beyond the scope of this article (for a review, see DeFronzo 1997). There’s a risk that drinking alcohol can lead to low blood sugar (hypoglycemia), especially for people with diabetes. Alcohol can inhibit the liver’s ability to regulate glucose levels, and it can interact with some medications to cause hypoglycemia.
3.1. Skeletal Muscle Insulin Resistance
Thus, a person who has been drinking alcohol and not eating for 1 or more days has exhausted his or her glycogen supply. Numerous studies have investigated alcohol’s effects on the control of blood sugar levels in diabetics. Two additional medications—metformin and troglitazone—are now being used to treat people with type 2 diabetes.
Never drink on an empty stomach
- In those people, insulin levels are diminished, because the fasting has considerably lowered their blood sugar levels, thereby depriving the pancreas of its stimulus to produce and secrete insulin.
- In fact, some studies have indicated that isolated episodes of drinking with a meal may have a beneficial effect by slightly lowering blood sugar levels that tend to rise too high in diabetics (Swade and Emanuele 1997).
- Thus, whereas type 1 diabetes is characterized by a complete lack of insulin production, type 2 is characterized by reduced insulin production plus insulin resistance.
One mechanism through which chronic use of alcohol might affect numerous processes that are aligned with neuroendocrinology of T2DM is through the alteration of appetite regulating peptides, particularly, ghrelin and leptin. Alcoholic drinks can cause both blood sugar rises and blood sugar drops, making it important to think cautiously and plan ahead. When consumed with food, an occasional drink is OK, and if you choose wisely, it may have some positive effects on health. Low carbohydrate and low-alcohol drinks may be better than standard alcohol, but the dangers still need to be considered. Often alcohol is mixed with fizzy, diabetes and alcohol blackouts sugary drinks that can impact on blood sugars.
While studies have shown that non-drinkers have less favourable psychosocial characteristics compared to moderate drinkers 15, the role of psychosocial factors in the alcohol–diabetes association has not yet been examined. It is important to note that consuming alcohol on an empty stomach may lead to low blood glucose levels or hypoglycemia, especially posing a risk for individuals on oral medications or insulin. Drinking reduces the liver’s ability to regulate blood sugar and may interfere with certain diabetes medications. Likewise, there was no change in glucose tolerance in chronic alcohol-fed rats 89,90,91 or mice 92. The effect of alcohol on glucose tolerance in nondiabetic subjects and animals is often contradictory making data interpretation problematic. In general, glucose tolerance has been reported to impaired, improved and unaffected by alcohol, as described below.
Many people with alcoholic liver disease also have either glucose intolerance or diabetes. Diabetic eye disease (i.e., retinopathy) is another troublesome tissue complication of diabetes and one of the leading causes of blindness in the United States Alcoholics Anonymous today. Good blood sugar and blood pressure control as well as regular eye examinations are essential for the prevention of retinopathy. Heavy alcohol consumption may increase a person’s risk for developing this disease.
Abstinence from alcohol generally leads to normalization of the triglyceride levels, unless the person has an underlying genetic predisposition for hypertriglyceridemia. Cardiovascular disease continues to be one of the leading causes of death among all Americans and is the leading cause of death in people with type 2 diabetes (Bierman 1992). The relationship of alcohol consumption to cardiovascular disease in diabetic people has not been well evaluated. However, substantial information on the association of alcohol and cardiovascular disease exists from population studies that included an unknown percentage of diabetics. Those findings suggest that alcohol consumption, particularly moderate consumption, may have a protective effect against cardiovascular disease. Heavy alcohol consumption (i.e., 200 grams of pure alcohol, or approximately 16 standard drinks, per day) can cause ketoacidosis in both diabetics and nondiabetics (Wrenn et al. 1991).
Elevated HDL Cholesterol Levels
The researchers found that the levels of vitamin E, an agent that in part is bound to LDL cholesterol and which may decrease the risk of cardiovascular disease, also are lower in alcoholics than in nonalcoholics. Those observations suggest that the reduced levels of vitamin E in alcoholics actually may have harmful long-term effects. The findings discussed here presents that the role of chronic use of alcohol on diabetes might be high of importance for clinical research and practice.
If you rely on carbohydrate counting for meal planning, understand and consider how the type and amount of drinks you select will impact your blood glucose levels. Adjusting your insulin dosage may be necessary if you plan to have multiple beverages. T1DM (insulin-dependent diabetes) results due to autoimmune progressive destruction of insulin-secreting β-cells of the pancreas by CD4+ and CD8+ T cells and macrophage infiltrating the islets 19. The hormone insulin, secreted by the pancreas, involved in regulating body’s blood glucose levels and other metabolic function. Most importantly, blood glucose is taken up into the muscle and fat tissues, by insulin, and existing glucose is converted into a storage form (i.e., glycogen), thereby lowering the blood glucose levels (e.g., after a meal).