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Moderate wine consumption decreased risk for CV events, death in type 2 diabetes
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In patients with type 2 diabetes, moderate consumption of alcohol, particularly wine, appears to be linked to a decreased risk for cardiovascular events and all-cause mortality, according to study results.
The study researchers utilized data from 11,140 patients enrolled in the ADVANCE trial and obtained baseline information about participants’ alcohol consumption by self-report, which addressed the current average number of alcohol drinks consumed in a week. The type of alcoholic beverage consumed was further categorized as wine, beer or spirits. This information also was acquired at the 24-month follow-up and the final study visit.
The extent of alcohol consumption was classified at baseline as nil, moderate or heavy. Heavy consumption was defined as more than 21 drinks per week for men and more than 14 drinks per week for women; moderate consumption was defined as 21 or fewer drinks per week for men and 14 or fewer alcoholic drinks per week for women.
Cox regression models, adjusted for confounders, were used to assess the relationship between alcoholic beverage consumption and CV/microvascular events and mortality. CV events (CV death, myocardial infarction and stroke), microvascular complications (new or worsening nephropathy or retinopathy) and all-cause mortality were defined as the study endpoints.
The researchers found that, during the 5-year follow-up, there were 1,031 (9%) patient deaths, 1,147 (10%) CV events and 1,136 (10%) microvascular complications. In comparison to those who reported nil alcohol consumption, patients who drank moderately had fewer CV events (adjusted HR=0.83; 95% CI, 0.72-0.95), less microvascular complications (HR=0.85; 95% CI, 0.73-0.99) and lower all-cause mortality (HR=0.87; 96% CI, 0.75-1). Patients who mainly drank wine experienced the most pronounced benefits (CV events adjusted HR=0.78; 95% CI, 0.63-0.95; all-cause mortality HR=0.77; 95% CI, 0.62-0.95).
The benefits seen with moderate consumption did not appear to extend to heavy consumption. Compared with those who reported no alcohol intake, patients who reported heavy drinking had dose-dependent increased risks for CV events and all-cause mortality.
The researchers said although these findings do not seem to be explicable through any other co-associated lifestyle or risk factors, they do not equate to causality. They added that the potential benefits must be factored against possible adverse effects of alcohol, such as increased hypoglycemia risk for hepatic complications and increased risk for certain cancers.
“In light of these caveats, it would be premature to make any firm clinical recommendations regarding alcohol consumption by patients with type 2 diabetes,” the researchers wrote. “Nevertheless, the current study finds no grounds to discourage mild to moderate alcohol consumption, at least in terms of its vascular effects.”
Disclosure: Many of the researchers report receiving lecture fees and/or travel expenses and grant support from Servier.
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