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July 21, 1999

Should Patients With Diabetes Drink to Their Health?

Author Affiliations

Author Affiliations: Departments of Family and Preventive Medicine (Dr Criqui) and Medicine (Drs Criqui and Golomb), University of California, San Diego, La Jolla, Calif.

JAMA. 1999;282(3):279-280. doi:10.1001/jama.282.3.279

In this issue of THE JOURNAL, Valmadrid and other investigators from the Wisconsin Epidemiologic Study of Diabetic Retinopathy (WESDR)1 report a progressive reduction in risk of coronary heart disease (CHD) death and overall mortality with increasing levels of alcohol consumption, within the mild to moderate range, in patients with older-onset diabetes. This finding complements and extends findings from numerous previous studies that have reported reduced CHD and all-cause mortality in light to moderate drinkers.2 Case-control, population, and twin studies have observed a relation of moderate alcohol consumption and reduced insulin resistance (with lower fasting and postprandial glucose and insulin levels).35 Other studies, meanwhile, have found that higher amounts of acute or long-term alcohol ingestion increase insulin resistance,6,7 as well as triglyceride levels, blood pressure, and all-cause mortality. The present study by Valmadrid et al was unable to evaluate risk with high levels of alcohol consumption, since only 1.8% of subjects consumed more than 3 drinks per day, but the study showed, in the highest consumption category, a discordance of CHD and total mortality benefit.

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