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The short-term effect of alcoholic beverage-intake on blood glucose levels in type 2 diabetic patients
diabetes research and clinical practice 79 (2008) 183–184
available at www.sciencedirect.com
journal homepage: www.elsevier.com/locate/diabres
The short-term effect of alcoholic beverage-intake on blood glucose levels in type 2 diabetic patients Shigetoshi Hosaka a,*, Manabi Miyashita b, Junichi Inoue b, Kazutoshi Maruyama a a b
Department of Internal Medicine, Hiroshima Teisin Hospital, 19-16 Higashihakushima-cho, Naka-ku, Hiroshima 730-8798, Japan Department of Medicine, Maruko General Hospital, Nagano, Japan
article info
abstract
Article history:
We examined changes in blood glucose levels within 2 h after the respective intake of three
Received 19 June 2007
kinds of alcoholic beverages in six type 2 diabetic men treated by diet alone. Blood glucose
Accepted 17 August 2007
level following beer consumption was 195.0 15.8 mg/dl after 60 min and those following
Published on line 25 September 2007
sake consumption was 151.2 9.0 mg/dl after 60 min. There was no significant increase in blood glucose levels after drinking shochu. It should be considered that in diabetic patients,
Keywords:
the elevation of blood glucose was induced by the sugar contained in the alcoholic
Alcoholic beverages
beverages, and the limited intake of alcoholic drinks is required to keep well blood glucose
Glucose level
levels. # 2007 Elsevier Ireland Ltd. All rights reserved.
Type 2 diabetes
It has been reported that moderate alcohol intake with a meal does not disturb blood glucose control in diabetic patients [1–3]. In six type 2 diabetic men treated by diet alone, we examined changes in blood glucose levels within 2 h after the respective intake of three kinds of alcoholic beverages. Patient characteristics were as follows: mean age 60 15 years; BMI 21.7 1.8; duration 10.6 5.2 years; HbA1c 6.4 0.4%; fasting immunoreactive insulin 3.2 2.3 mU/ml. The other laboratory data were: total protein 7.1 0.2 g/dl; serum albumin 4.5 0.2 g/dl; aspartate aminotransferase 22.0 6.9 IU/l; alanine aminotransferase 22.1 6.9 IU/l; lactate dehydrogenase 202 34.0; g-glutamyl transpeptidase 18.7 6.8 IU/l; hemoglobin level 15.0 1.2 g/dl. None of the patients had significant systemic disease. Informed consent was obtained from each participant, and the study protocol was approved by the Hospital Ethics Committee. Alcoholic beverages used in this study were beer (Asahi super dry, Asahi Breweries Ltd., Japan), sake (Senjyo, Senjyo Co., Ltd., Japan) and shochu (Nikaido, Nikaido-Shuzo, Inc., Japan), which is made from wheat and distilled alcoholic beverage. After an overnight fast of 12–14 h, six participants drank sake (300 ml), beer (800 ml) or shochu (180 ml) on different days and glucose
levels were serially measured before and 30 min, 60 min and 120 min after drinking each alcoholic beverage by the glucose oxidase method using Glutest-ace RR (Sanwa Kagaku Kenkyusho Co., Ltd., Japan). The mean glucose levels of the six patients were 104 2.8 mg/dl before drinking beer, 103.8 4.3 mg/dl before sake and 104 3.3 mg/dl before shochu, respectively. Blood glucose levels following beer consumption were 165.0 11.9 mg/dl after 30 min (P < 0.001 compared with that before drinking beer, t-test), 195.0 15.8 mg/dl after 60 min (P < 0.0001, t-test) and 166.2 6.4 mg/dl after 120 min (P < 0.001, t-test); and those following sake consumption were 130.4 17.6 mg/dl after 30 min (P < 0.07 as compared with that before drinking sake, t-test), 151.2 9.0 mg/dl after 60 min (P < 0.001, t-test) and 130 8.0 mg/dl after 120 min (P < 0.05, ttest) as shown in Fig. 1. Blood glucose levels following shochu consumption were 107.0 11.4 mg/dl after 30 min, 106.0 5.2 mg/dl after 60 min and 104.6 6.3 mg/dl after 120 min, showing that there was no significant increase in blood glucose levels after drinking. It has been indicated that ethanol intake is not associated with utilization of ingested calories or body weight gain [4–6].
* Corresponding author. Tel.: +81 82 224 5350; fax: +81 82 223 5378. E-mail address: [email protected] (S. Hosaka). 0168-8227/$ – see front matter # 2007 Elsevier Ireland Ltd. All rights reserved. doi:10.1016/j.diabres.2007.08.008
184
diabetes research and clinical practice 79 (2008) 183–184
induced by the sugar contained in the alcoholic beverages, and the limited intake of alcoholic drinks is required to keep well blood glucose levels.
Conflict of interest The authors state that they have no conflict of interest.
Acknowledgements
Fig. 1 – Blood glucose levels after drinking of three kinds of alcoholic beverages in type 2 diabetic patients. Each glucose level is shown as the mean of six patients. # P < 0.001 and ##P < 0.0001 are compared with the glucose levels before drinking beer. *P < 0.001 and **P < 0.05 are before drinking sake.
In the present study, the carbohydrate contents of beer, sake and shochu were as follows: ethanol, 3.7%, 12.3% and 20.5%, respectively; glucose, 3.1%, 4.9% and 0%, respectively. There were negligible traces of lipids and proteins in each of the three alcoholic beverages. Although, the consumption of ethanol was almost equal with each of the alcoholic beverages examined, the amounts of glucose were 24.8 g in 800 ml of beer, 14.7 g in 300 ml of sake and 0 g in 180 ml shochu, resulting in the highest blood glucose levels in patients having beer occurring 60 min after drinking. It should be considered that in diabetic patients, the elevation of blood glucose was
We are grateful for the contributions of Fumie Takayanagi, Harumi Hirata and Chisato Watanabe in the nutritional management of these patients.
references
[1] C.H. Walsh, D.J. O’Sullivan, Effect of moderate alcohol intake on control of diabetes, Diabetes 23 (1974) 440–442. [2] V.A. Koivisto, S. Tulocus, M. Toivonen, E. Haapa, R. Pelkonen, Alcohol with a meal has no adverse effects on postprandial glucose homeostasis in diabetic patients, Diab. Care 16 (1993) 1612–1614. [3] H. Gin, P. Morlat, J.M. Ragnaut, J. Aubertin, Short-term effect of red wine (consumed during meals) on insulin requirement and glucose tolerance in diabetic patients, Diab. Care 15 (1992) 546–548. [4] R.C. Pirola, C.S. Lieber, The energy cost of the metabolism of drugs, including ethanol, Pharmacology 7 (1972) 185–196. [5] J.F. Reinus, S.B. Heymsfield, R. Wiskind, K. Casper, J.T. Galambos, Ethanol: relative fuel value and metabolic effects in vivo, Metabolism 38 (1989) 125–135. [6] C.S. Lieber, Perspectives: do alcohol calories count? Am. J. Clin. Nutr. 54 (1991) 976–982.
available at www.sciencedirect.com
journal homepage: www.elsevier.com/locate/diabres
The short-term effect of alcoholic beverage-intake on blood glucose levels in type 2 diabetic patients Shigetoshi Hosaka a,*, Manabi Miyashita b, Junichi Inoue b, Kazutoshi Maruyama a a b
Department of Internal Medicine, Hiroshima Teisin Hospital, 19-16 Higashihakushima-cho, Naka-ku, Hiroshima 730-8798, Japan Department of Medicine, Maruko General Hospital, Nagano, Japan
article info
abstract
Article history:
We examined changes in blood glucose levels within 2 h after the respective intake of three
Received 19 June 2007
kinds of alcoholic beverages in six type 2 diabetic men treated by diet alone. Blood glucose
Accepted 17 August 2007
level following beer consumption was 195.0 15.8 mg/dl after 60 min and those following
Published on line 25 September 2007
sake consumption was 151.2 9.0 mg/dl after 60 min. There was no significant increase in blood glucose levels after drinking shochu. It should be considered that in diabetic patients,
Keywords:
the elevation of blood glucose was induced by the sugar contained in the alcoholic
Alcoholic beverages
beverages, and the limited intake of alcoholic drinks is required to keep well blood glucose
Glucose level
levels. # 2007 Elsevier Ireland Ltd. All rights reserved.
Type 2 diabetes
It has been reported that moderate alcohol intake with a meal does not disturb blood glucose control in diabetic patients [1–3]. In six type 2 diabetic men treated by diet alone, we examined changes in blood glucose levels within 2 h after the respective intake of three kinds of alcoholic beverages. Patient characteristics were as follows: mean age 60 15 years; BMI 21.7 1.8; duration 10.6 5.2 years; HbA1c 6.4 0.4%; fasting immunoreactive insulin 3.2 2.3 mU/ml. The other laboratory data were: total protein 7.1 0.2 g/dl; serum albumin 4.5 0.2 g/dl; aspartate aminotransferase 22.0 6.9 IU/l; alanine aminotransferase 22.1 6.9 IU/l; lactate dehydrogenase 202 34.0; g-glutamyl transpeptidase 18.7 6.8 IU/l; hemoglobin level 15.0 1.2 g/dl. None of the patients had significant systemic disease. Informed consent was obtained from each participant, and the study protocol was approved by the Hospital Ethics Committee. Alcoholic beverages used in this study were beer (Asahi super dry, Asahi Breweries Ltd., Japan), sake (Senjyo, Senjyo Co., Ltd., Japan) and shochu (Nikaido, Nikaido-Shuzo, Inc., Japan), which is made from wheat and distilled alcoholic beverage. After an overnight fast of 12–14 h, six participants drank sake (300 ml), beer (800 ml) or shochu (180 ml) on different days and glucose
levels were serially measured before and 30 min, 60 min and 120 min after drinking each alcoholic beverage by the glucose oxidase method using Glutest-ace RR (Sanwa Kagaku Kenkyusho Co., Ltd., Japan). The mean glucose levels of the six patients were 104 2.8 mg/dl before drinking beer, 103.8 4.3 mg/dl before sake and 104 3.3 mg/dl before shochu, respectively. Blood glucose levels following beer consumption were 165.0 11.9 mg/dl after 30 min (P < 0.001 compared with that before drinking beer, t-test), 195.0 15.8 mg/dl after 60 min (P < 0.0001, t-test) and 166.2 6.4 mg/dl after 120 min (P < 0.001, t-test); and those following sake consumption were 130.4 17.6 mg/dl after 30 min (P < 0.07 as compared with that before drinking sake, t-test), 151.2 9.0 mg/dl after 60 min (P < 0.001, t-test) and 130 8.0 mg/dl after 120 min (P < 0.05, ttest) as shown in Fig. 1. Blood glucose levels following shochu consumption were 107.0 11.4 mg/dl after 30 min, 106.0 5.2 mg/dl after 60 min and 104.6 6.3 mg/dl after 120 min, showing that there was no significant increase in blood glucose levels after drinking. It has been indicated that ethanol intake is not associated with utilization of ingested calories or body weight gain [4–6].
* Corresponding author. Tel.: +81 82 224 5350; fax: +81 82 223 5378. E-mail address: [email protected] (S. Hosaka). 0168-8227/$ – see front matter # 2007 Elsevier Ireland Ltd. All rights reserved. doi:10.1016/j.diabres.2007.08.008
184
diabetes research and clinical practice 79 (2008) 183–184
induced by the sugar contained in the alcoholic beverages, and the limited intake of alcoholic drinks is required to keep well blood glucose levels.
Conflict of interest The authors state that they have no conflict of interest.
Acknowledgements
Fig. 1 – Blood glucose levels after drinking of three kinds of alcoholic beverages in type 2 diabetic patients. Each glucose level is shown as the mean of six patients. # P < 0.001 and ##P < 0.0001 are compared with the glucose levels before drinking beer. *P < 0.001 and **P < 0.05 are before drinking sake.
In the present study, the carbohydrate contents of beer, sake and shochu were as follows: ethanol, 3.7%, 12.3% and 20.5%, respectively; glucose, 3.1%, 4.9% and 0%, respectively. There were negligible traces of lipids and proteins in each of the three alcoholic beverages. Although, the consumption of ethanol was almost equal with each of the alcoholic beverages examined, the amounts of glucose were 24.8 g in 800 ml of beer, 14.7 g in 300 ml of sake and 0 g in 180 ml shochu, resulting in the highest blood glucose levels in patients having beer occurring 60 min after drinking. It should be considered that in diabetic patients, the elevation of blood glucose was
We are grateful for the contributions of Fumie Takayanagi, Harumi Hirata and Chisato Watanabe in the nutritional management of these patients.
references
[1] C.H. Walsh, D.J. O’Sullivan, Effect of moderate alcohol intake on control of diabetes, Diabetes 23 (1974) 440–442. [2] V.A. Koivisto, S. Tulocus, M. Toivonen, E. Haapa, R. Pelkonen, Alcohol with a meal has no adverse effects on postprandial glucose homeostasis in diabetic patients, Diab. Care 16 (1993) 1612–1614. [3] H. Gin, P. Morlat, J.M. Ragnaut, J. Aubertin, Short-term effect of red wine (consumed during meals) on insulin requirement and glucose tolerance in diabetic patients, Diab. Care 15 (1992) 546–548. [4] R.C. Pirola, C.S. Lieber, The energy cost of the metabolism of drugs, including ethanol, Pharmacology 7 (1972) 185–196. [5] J.F. Reinus, S.B. Heymsfield, R. Wiskind, K. Casper, J.T. Galambos, Ethanol: relative fuel value and metabolic effects in vivo, Metabolism 38 (1989) 125–135. [6] C.S. Lieber, Perspectives: do alcohol calories count? Am. J. Clin. Nutr. 54 (1991) 976–982.