Alcohol consumption is inversely associated with adherence to diabetes self‐care behaviours

Abstract

Aims-Our aim was to examine the associations of alcohol consumption with six diabetes self-care behaviours.Methods-We determined levels of alcohol consumption and examined associations between alcohol consumption and six self-care behaviours in 65 996 adults with diabetes who received care through Kaiser Permanente Northern California and who responded to a 1994−1997 survey. Adherence with recommendations for self monitoring of blood glucose, HbA 1c testing, and diabetes medications were determined from electronic records; smoking and use of diet and exercise to treat diabetes were self reported. Multiple logistic regression models were used to determine the associations between alcohol consumption (average number of drinks/day in the past year) and the probability of adherence to each self-care behaviour.Results-Current alcohol consumption was reported by 50.8% of adults with diabetes. In adjusted models, we observed a gradient of increasing risk for poor adherence to diabetes self-care behaviours with increasing alcohol consumption, starting with those who consume even one drink a day. Former drinkers had the greatest compliance with each self-care behaviour, except for current smoking.Conclusions-Alcohol consumption is a marker for poorer adherence to diabetes self-care behaviours. These findings highlight the importance of routine assessment of alcohol intake in people with diabetes, particularly as half of adults with diabetes consume alcohol. Given extant evidence that moderate alcohol intake may have cardiovascular benefits for patients with diabetes, examination of the trade-offs between cardiovascular benefits vs. potential risk of lower adherence with self-care behaviours deserves study.

The Relationship Between Alcohol Consumption and Glycemic Control Among Patients with Diabetes: The Kaiser Permanente Northern California Diabetes Registry

“…[20][21][22]61 Third, we were able to control for a wide variety of potential confounding variables, including diabetes self-care behaviors. 62 Fourth, the finding that the inverse relationship between alcohol and A1C persisted during the period 1-2 years after baseline suggests that the relationship is robust. Our study findings have implications for clinical practice and future research.…”

Drinking Patterns of Older Adults with Chronic Medical Conditions

“…Alcohol consumption (within and in excess of guidelines) can result in poor glucose control, increased risk of hypertension and lower compliance with diabetes self-management behaviors. [36][37][38][39] In persons with cardiovascular illness, heavy alcohol consumption can result in alcoholic cardiomyopathy and increased risk of negative cardiac events, including sudden death. A meta-analysis examining alcohol and depression found that at-risk drinking is associated with worse outcomes related to the course of depression, social functioning, suicide risk and health care utilization.…”

Medication Adherence among Type 2 Diabetes Ambulatory Patients in Zewditu Memorial Hospital, Addis Ababa, Ethiopia

“…Different literatures suggest that providerlevel factors such as the patient physician relationship and communication, provider attitudes toward diabetes and provider knowledge and skills related to diabetes treatment have the potential to influence adherence behavior. Training in communication is an essential, and effective, component of medical education and may be even more important in residency training for physicians [27,28].…”