Light to moderate drinking can be beneficial for diabetics' hearts in the same way it is for people who do not suffer from the disease. This is the finding of a new study that addresses concerns that alcohol may throw off diabetics' blood-sugar balance or promote other problems.
During the 12-year study, diabetics who consumed one to two drinks daily were much less likely to die of heart disease than diabetic teetotalers, said researchers. The study was led by Dr. Charles T. Valmadrid of the University of Wisconsin-Madison Medical School in Wednesday's Journal of the American Medical Association.
All 983 subjects in the study had adult-onset diabetes, or Type 2, the most common form of the disease. The researchers studied older diabetics because in previous studies alcohol's heart benefits have been found only in people over 40.
Diabetics who said they drank about one or more alcoholic drinks per day - a beer, glass of wine or a drink containing hard liquor - had a 79 percent lower risk of dying from heart disease than the teetotalers. Those who had less than one drink a week had a 46 percent lower risk.
Previously alcohol has been associated with risk reductions of 20 percent to 60 percent among nondiabetics, the researchers noted.
Alcohol hinders the liver's ability to deliver sugar to the bloodstream, so some have been concerned that drinking might throw off diabetics' blood sugar-insulin balance. But moderate drinking appears to improve blood-sugar balance by reducing insulin resistance, a problem in adult-onset diabetics, whose bodies make insulin but don't use it properly.
But the new findings don't necessarily mean nondrinking diabetics should take up alcohol, agreed the researchers and experts not associated with the study.
Benefits of alcohol consumption may be far outweighed by such risks as developing cancer and liver disease or suffering drug interactions, depression, unintentional injuries and social discord, wrote Drs. Michael H. Criqui and Beatrice A. Golomb of the University of California at San Diego in La Jolla in an editorial accompanying the study.
Alcohol could also be dangerous for diabetics by worsening nerve damage and increasing insulin resistance, they wrote. In general, they noted, half of all drinkers experience alcohol-related problems.
"Judicious recommendations can be made in cases when the patient is well known to the clinician, but without a randomized trial, alcohol consumption should not be a general recommendation, whether or not the patient has diabetes," they said.
Dr. Bruce Zimmerman, president of the American Diabetes Association, agreed. He said the findings support the association's current recommendation: The precautions regarding alcohol use that apply to the general public also apply to diabetics.
In response to the study, the American Heart Association said that while moderate drinking appears to increase high-density lipoprotein, or so-called good holesterol, as well as inhibit blood clots that can cause heart attacks, it also can boost heart risk by raising blood pressure and levels of blood fats called triglycerides.
"People in the general population and those who have Type 2 diabetes should limit themselves to one drink per day for women, and two drinks a day for men, if they drink," the association said in a statement.