Meta-analysis of the relationship between alcohol consumption and coronary heart disease and mortality in type 2 diabetic patients

Abstract

Aims/hypothesis: This systematic review examines the relationship between alcohol consumption and long-term complications of type 2 diabetes. Meta-analyses could only be performed for total mortality, mortality from CHD, and CHD incidence, because the availability of articles on other complications was too limited. Materials and methods: A PubMed search through to September 2005 was performed and the reference lists of relevant articles examined. Among the relevant articles there were six cohort studies reporting on the risk of total mortality and/or fatal and/or incident CHD in alcohol non-consumers and in at least two groups of alcohol consumers. Results: Statistical pooling showed lower risks in alcohol consumers than in non-consumers (the reference category). The relative risk (RR) of total mortality was 0.64 (95% CI 0.49-0.82) in the <6 g/day category. In the higher alcohol consumption categories (6 to <18, and ≥18 g/day), the RRs of total mortality were not significant. Risks of fatal and total CHD were significantly lower in all three categories of alcohol consumers (<6, 6 to <18 and ≥18 g/day) than in nonconsumers, with RRs ranging from 0.34 to 0.75. Conclusions/interpretation: This meta-analysis shows that, as with findings in the general population, moderate alcohol consumption is associated with a lower risk of mortality and CHD in type 2 diabetic populations.

Alcohol consumption and risk of microvascular complications in type 1 diabetes patients: the EURODIAB Prospective Complications Study

“…The results of our study are consistent with the decreased risk of macrovascular complications with moderate alcohol consumption [3] and suggest that moderate alcohol consumption is associated with a generalised cardiovascular protective effect among diabetes patients. On the other hand, certain studies showed slightly different results for particular microvascular complications.…”

“…Of the invited patients, 85% took part in the study. Patients were stratified by sex, age (15-29, 30-44 and 45-60 years) and duration of illness (1)(2)(3)(4)(5)(6)(7)(8)(9)(10)(11)(12)(13)(14), ≥15 years) before ten patients were randomly selected from each stratum. Ethics committee approval was obtained at each centre and all participants provided written informed consent.…”

“…Similarly, diabetes patients who drink in moderation have an approximately 40% lower risk of cardiovascular disease than abstainers [3]. Consequently, both British and American Diabetes Association guidelines give limits in line with those for the general population in terms of alcohol intake and recommend no more than around two units of absolute alcohol at a single sitting [4].…”

Cardiovascular and Overall Mortality Risk in Relation to Alcohol Consumption in Patients With Cardiovascular Disease

“…72 A meta-analysis of 15 prospective cohort studies showed a J-shaped relation between alcohol consumption and risk of developing diabetes, with a 30% lower risk in moderate alcohol consumers (1 to 2 drinks per day). 12 Two quantitative reviews 73,74 concluded that moderate alcohol consumption was associated with a lower incidence of heart disease or total mortality in patients with type 2 diabetes mellitus. Obviously, the decrease in CVD risk associated with moderate alcohol consumption in hypertensive or diabetic subjects does not reduce the importance of controlling blood pressure or blood glucose, regardless of drinking habits.…”

Moderate alcohol use and health: A consensus document

“…In diabetic subjects a meta-analysis of six prospective studies evidenced a close association between moderate alcohol consumption and reduced coronary disease; the reduction of relative risk (RR) was similar in magnitude to that seen in the general population and in hypertensive patients [10].…”