Andrea A. Howard, MD, MS; Julia H. Arnsten, MD, MPH; Marc N. Gourevitch, MD, MPH
Acknowledgments: The authors thank Racheline G. Habousha, MSLS, AHIP, for assistance with the MEDLINE database searches, Alex D. Federman, MD, MPH, for assistance in refining the study questions, and Barbara J. Turner, MD, MSEd; A. Thomas McLellan, PhD; and Harry Shamoon, MD, for helpful comments on the manuscript.
Grant Support: By the Robert Wood Johnson Foundation.
Potential Financial Conflicts of Interest: None disclosed.
Requests for Single Reprints: Andrea A. Howard, MD, MS, AIDS Research Program, Montefiore Medical Center, 111 East 210th Street, Bronx, NY 10467; e-mail, firstname.lastname@example.org.
Current Author Addresses: Drs. Howard and Arnsten: AIDS Research Program, Montefiore Medical Center, 111 East 210th Street, Bronx, NY 10467.
Dr. Gourevitch: Division of Substance Abuse, Albert Einstein College of Medicine, 1500 Waters Place, Parker Building, 6th Floor, Ward 20, Bronx, NY 10461.
Both diabetes mellitus and alcohol consumption are prevalent in the United States, yet physicians are poorly informed about how alcohol use affects risk for or management of diabetes.
To conduct a systematic review assessing the effect of alcohol use on the incidence, management, and complications of diabetes mellitus in adults.
English-language studies in persons 19 years of age or older that were identified by searching the MEDLINE database from 1966 to the third week of August 2003 and the reference lists of key articles.
Two independent assessors reviewed 974 retrieved citations to identify all experimental, cohort, or case–control studies that assessed the effect of alcohol use on diabetes risk, control, self-management, adverse drug events, or complications.
Two independent reviewers extracted data and evaluated study quality on the basis of established criteria.
Thirty-two studies that met inclusion criteria were reviewed. Compared with no alcohol use, moderate consumption (one to 3 drinks/d) is associated with a 33% to 56% lower incidence of diabetes and a 34% to 55% lower incidence of diabetes-related coronary heart disease. Compared with moderate consumption, heavy consumption (>3 drinks/d) may be associated with up to a 43% increased incidence of diabetes. Moderate alcohol consumption does not acutely impair glycemic control in persons with diabetes.
Moderate alcohol consumption is associated with a decreased incidence of diabetes mellitus and a decreased incidence of heart disease in persons with diabetes. Further studies are needed to assess the long-term effects of alcohol consumption on glycemic control and noncardiac complications in persons with diabetes.
Andrea A. Howard, Julia H. Arnsten, Marc N. Gourevitch. Effect of Alcohol Consumption on Diabetes Mellitus: A Systematic Review. Ann Intern Med. 2004;140:211–219. doi: 10.7326/0003-4819-140-6-200403160-00011
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Published: Ann Intern Med. 2004;140(3):211-219.
Cardiology, Coronary Risk Factors, Diabetes, Endocrine and Metabolism, Tobacco, Alcohol, and Other Substance Abuse.
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Print ISSN: 0003-4819 | Online ISSN: 1539-3704
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