Alcohol and CHD in Men with Type 2 Diabetes DC

When blood sugar regulation is impaired, despite the availability of insulin, type 2 diabetes is suspected. Type 2 diabetes is characterized by elevated blood sugar and impaired insulin response. It is a non-ketotic form of diabetes. People with type 2 are not dependent on insulin to survive. The pathophysiology of type 2 diabetes is not fully understood. Three physiological abnormalities typically occur in type 2: insulin resistance, increased glucose production in the liver (hepatic gluconeogenesis), and poor beta cell function. These can occur individually or in combination.

The long-term complications associated with diabetes are serious, often life threatening, and diagnosed in the late stages of the disease. These complications are due to continuous hyperglycemia from poor glucose control. Many of these chronic complications can be traced to changes in blood vessels that cause a decreased blood flow. These changes include coronary heart disease and peripheral vascular disease, retinopathy, nephropathy, and neuropathy. Diabetic adults are 2 to 4 times more likely to develop heart disease than non-diabetics.¹

An investigation just published in the Journal of American College of Cardiology examined the role of alcohol intake among men with type 2 diabetes and the risk of coronary heart disease (CHD). Taken from the Health Professionals' Follow up study, 2,419 men diagnosed with diabetes after age 30 were studied. During the follow up after diagnosis, 150 new cases of CHD were recorded. 81 cases were non-fatal while 69 cases were fatal. The results were adjusted for body mass index, smoking, and supplementation among others. Compared with non-drinkers, relative risk of CHD in men who drank half a drink or less daily was .78, and men who drank half to 2 drinks daily the risk was .62. The benefits of alcohol intake did not differ by type of alcohol. The authors concluded that the risk of CHD in men with type 2 diabetes was lower in men who drank moderate amounts of alcohol.²