Ethanol and risk of hypoglycemia in patients with type 1 diabetes mellitus: a brief overview for clinical practice

Česká verzia

Authors: Martina Tuháčková ¹; Jana Urbanová ²; Ludmila Brunerová ²; Pavlína Piťhová ¹; Milan Kvapil ¹; Jan Brož ¹
Authors place of work: Interní klinika 2. LF UK a FN Motol, Praha ¹; Centrum pro výzkum diabetu, metabolismu a výživy, II. interní klinika 3. LF UK a FN Královské Vinohrady, Praha ²
Published in the journal: Vnitř Lék 2019; 65(4): 303
Category:

Summary

Alcoholic drinks are one of the risk factors for hypoglycemia. Ethanol inhibits gluconeogenesis, decreases a level of growth hormone and impairs hypoglycemia awareness. The risk of hypoglycemia while drinking alcohol can be reduced by parallel ingestion of food (saccharides). Some recommendations also mention the change of insulin doses.

Keywords:

alcohol – Ethanol – hypoglycemia

Zdroje

Burton R, Sheron N No level of alcohol consumption improves health. Lancet 2018; 392(10152): 987–988. Dostupné z DOI: <http://dx.doi.org/10.1016/S0140–6736(18)31571-X>.
McCoy RG, Van Houten HK, Ziegenfuss JY et al. Increased mortality of patients with diabetes reporting severe hypoglycemia. Diabetes Care 2012; 35(9): 1897–1901. Dostupné z DOI: <http://dx.doi.org/10.2337/dc11–2054>.
Hemmingsen B, Lund SS, Gluud C et al. Intensive glycaemic control for patients with type 2 diabetes: systematic review with meta-analysis and trial sequential analysis of randomised clinical trials. BMJ 2011; 343: d6898. Dostupné z DOI: <http://dx.doi.org/10.1136/bmj.d6898>.
Bolek T, Samoš M, Mokáň M et al. Akútne príčiny náhlych úmrtí u pacientov so závažnou hypoglykémiou. Vnitř Lék 2016; 62(6): 462–466.
Brož J, Piťhová P, Janíčková Žďárská D. Syndrom porušeného vnímání hypoglykemie u diabetes mellitus. Vnitř Lék 2016; 62(7–8): 544–547.
Tetzscher R, Norgaard K, Ranjan A. Effects of alcohol on plasma glucose and prevention of alcohol-induced hypoglycemia in type 1 diabetes-A systematic review with GRADE. Diabetes Metab Res Rev. 2018;34(3). Dostupné z DOI: <http://dx.doi.org/10.1002/dmrr.2965>.
Ahmed AT, Karter AJ, Liu J. Alcohol consumption is inversely associated with adherence to diabetes self-care behaviours. Diabet Med 2006; 23(7): 795–802. Dostupné z DOI: <http://dx.doi.org/10.1111/j.1464–5491.2006.01878.x>.
Blomster JI, Zoungas S, Chalmers J et al. The relationship between alcohol consumption and vascular complications and mortality in individuals with type 2 diabetes mellitus. Diabetes Care 2014; 37(9): 1353–1359. Dostupné z DOI: <http://dx.doi.org/10.2337/dc13–2727>. Erratum in Erratum. The Relationship Between Alcohol Consumption and Vascular Complications and Mortality in Individuals With Type 2 Diabetes. Diabetes Care 2014; 37: 1353–1359. [Diabetes Care 2015].
Baliunas DO, Taylor BJ, Irving H et al. Alcohol as a risk factor for type 2 diabetes: a systematic review and metaanalysis. Diabetes Care 2009; 32(11): 2123–2132. Dostupné z DOI: <http://dx.doi.org/10.2337/dc09–0227>.
Koppes LL, Dekker JM, Hendriks HF et al. Moderate alcohol consumption lowers the risk of type 2 diabetes: a metaanalysis of prospective observational studies. Diabetes Care 2005; 28(3): 719–725.
Jakobsen ML, Larsen JR, Glümer C et al. Alcohol consumption among patients with diabetes: a survey-based cross-sectional study of Danish adults with diabetes. Scand J Public Health 2016; 44(5): 517–524. Dostupné z DOI: <http://dx.doi.org/10.1177/1403494816645223>.
Boffetta P, Garfinkel L. Alcohol drinking and mortality among men enrolled in an american Cancer Society prospective study. Epidemiology 1990; 1(5): 342–348.
Friedman L, Kimball W. Coronary heart disease mortality and alcohol consumption in Framingham. Am J Epidemiol 1986; 124(3): 481–489.
Pedersen-Bjergaard U, Reubsaet JLE, Nielsen SL et al. Psychoactive drugs, alcohol, and severe hypoglycemia in insulin-treated diabetes: Analysis of 141 cases. Am J Med 2005; 118(3): 307–310.
Sabitha Kandi, Neelesh Deshpande, Pragna Rao et al. Alcoholism and Its Relation to Hypoglycemia – An Overview. Asian Journal of Medical Sciences (Asian J Med Sci) 2014; 2(3): 64–66. Dostupné z DOI: Dostupné z DOI: <http://dx.doi.org/10.12691/ajmsm-2–3-3>.
De Feo P, Perriello G, Torlone E et al. Demonstration of a role for growth hormone in glucose counterregulation. Am J Physiol 1989; 256(6 Pt 1): E835-E843. Dostupné z DOI: <http://dx.doi.org/10.1152/ajpendo.1989.256.6.E835>.
Turner BC, Jenkins E, Kerr D et al. The effect of evening alcohol consumption on next-morning glucose control in Type 1 diabetes. Diabetes Care 2001; 24(11): 1888–1893.
Kerr D, Cheyne E, Thomas P et al. Influence of acute alcohol ingestion on the hormonal responses to modest hypoglycaemia in patients with Type 1 diabetes. Diabet Med 2007; 24(3): 312–316. Dostupné z DOI: <http://dx.doi.org/10.1111/j.1464–5491.2006.02054.x>.
Avogaro A, Beltramello P, Gnudi L et al. Alcohol intake impairs glucose conuterregulation during acute insulin-induced hypoglycemia in IDDM patients. Evidence for a critical role of free fatty acids. Diabetes 1993; 42(11): 1626–1634.
Kerr D, Macdonald IA, Heller SR et al. Alcohol causes hypoglycaemic unawareness in healthy volunteers and patients with Type 1 (insulin-dependent) diabetes. Diabetologia 1990; 33(4): 216–221.
Cheyne EH, Sherwin RS, Lunt MJ et al. Influence of alcohol on cognitive performance during mild hypoglycaemia; implications for Type 1 diabetes. Diabet Med 2004; 21(3): 230–237.
Arky AR, Freinkel N. Alcohol Hypoglycemia. Effects of ethanol on plasma. 3. glucose, ketones, and free fatty acids in „juvenile“ diabetics: a model for „nonketotic diabetic acidosis“? Arch Intern Med 1964; 114: 501–507.
Lange J, Arends J, Willms B. Alcohol-induced hypoglycemia in type 1 diabetic patients. Med Klin (Munich). 1991; 86(11): 551–554.
Richardson T, Weiss M, Thomas P et al. Day After the Night before: influence of evening alcohol on risk of hypoglycemia in patients with type 1 diabetes. Diabetes Care 2005; 28(7): 1801–1802.
Murad MH, Coto-Yglesias F, Wang AT et al. Clinical review: Drug-induced hypoglycemia: a systematic review. J Clin Endocrinol Metab 2009; 94(3): 741–745. Dostupné z DOI: <http://dx.doi.org/10.1210/jc.2008–1416>.
Koivisto AV, Tulokas S, Toivonen M et al. Alcohol With a Meal Has No Adverse Effect on Postprandial Glucose Homeostasis in Diabetic Patients. Diabetes Care 1993; 16(12): 1612–1614.
Plougmann S, Hejlesen O, Turner B et al. Modelling the effect of alcohol in Type 1 diabetes. Stud Health Technol Inform 2002; 90: 66–71.
Saunders B. Sometimes you‘ve just got to have fun, haven‘t you?‘: The discursive construction of social drinking practices in young adults‘ accounts of chronic illness. Commun Med 2011; 8(1): 77–87.
Kanny D, Liu Y, Brewer RD et al. Vital signs: binge drinking prevalence, frequency, and intensity among adults – United States, 2010. MMWR Morb Mortal Wkly Rep 2012; 61(01): 14–19.
Ismail D, Gebert R, Vuillermin PJ et al. Social consumption of alcohol in adolescents with Type 1 diabetes is associated with increased glucose lability, but not hypoglycaemia. Diabet Med 2006; 23(8): 830–833. Dostupné z DOI: <http://dx.doi.org/10.1111/j.1464–5491.2006.01868.x>.