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Diabetes and alcohol: distinctive interactions.

(1) Many diabetic patients, like the rest of the population, enjoy alcoholic drinks. We conducted a review of the literature for information on the possible risks of alcohol consumption for diabetic patients, based on our standard in-house methodology. (2) Many of the data we found are not very convincing, because alcohol consumption was not properly taken into account. Nevertheless, they provide some useful pointers for diabetic patients. (3) Most wines and spirits do not contain sugar. However, some alcoholic beverages contain sugar and can affect glycaemic control. (4) Light consumption of alcohol seems to have a favourable effect on the vascular complications of diabetes. Drinking one standard unit a day (about 10 grams of alcohol) seems to be an acceptable amount. (5) Alcohol consumption can cause episodes of severe hypoglycaemia in diabetic patients, sometimes occurring several hours later. Fasting, sustained physical exercise and malnutrition are precipitating factors. (6) Alcohol can provoke ketoacidosis, which should not be confused with diabetic ketoacidosis. Alcoholic ketoacidosis requires rehydration but not insulin. (7) Studies of alcohol withdrawal in patients with peripheral and vegetative neuropathies, severe foot lesions, erectile disorders, liver disease or depression have provided conflicting results. However, in practice, it seems better to recommend abstinence in patients with these conditions, as alcohol is an aggravating factor.