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Friday, 03 July 2020 10:42

Prescription for abstinence or wine once a day for diabetes patients?

This review article supports a better translation of scientific evidence about moderate wine consumption as part of the Mediterranean diet into the clinical practice of type 2 diabetes patients. It is written by a physician who demands that a more balanced and accurate information is needed, so patients can make informed decisions.

The author describes that the spectre of uncertainty and fear of alcoholic beverages is haunting Europe and North America. It has affected a large part of the population but particularly type 2 diabetes patients and those with prediabetes. Consequently, a balanced information of the available scientific evidence is needed.

There is no doubt that risky and irresponsible drinking patterns (i.e. heavy consumption and binge drinking) are harmful to human health. However, adhering to a Mediterranean drinking pattern (moderate intake throughout the week, avoidance of binge drinking, preference of wine during the meals) is associated with several health benefits, especially for type 2 diabetics.

The author describes a shift in the management of diabetes patients away from limiting individual food components to a more qualitative nutritional style with proven benefits. However, the part of the diabetes guidelines concerning lifestyle management is contradictory and not up to date with the currents state of science. For example, it is accepted that the development of diabetes and the associated cardiovascular health problems and mortality decrease with an increasing adherence to a Mediterranean eating pattern, which includes moderate wine consumption. In contrast, the diabetes guidelines warn against the potential harm and addiction of excessive alcohol consumption and the risk of hypoglycemia (too low blood sugar). Health benefits of moderate consumption and the harm/benefit balance of the different types of alcoholic beverages are not adequately mentioned in the guidelines. Also, the J-curve which is the key to the question of the right quantity of alcoholic beverages in diabetics, is not addressed in the guidelines.

This leads to uncertainty and confusion among diabetes patients and health care professionals alike. Therefore, wise medical decisions are required to empower diabetes patients in the context of diabetes self-management education programs (DSMES) to protect them from media disinformation and notorious myths.

Rett examines existing experimental data and prospective studies and concludes that drinking alcoholic beverages in general should not be encouraged with diabetes patients. However, lifestyle advice in diabetes education programs requires evidence-based and balanced information about the fact that moderate wine consumption is one of the nine recommended components of the Mediterranean diet that might be particularly beneficial for them. He thus customized the traditional Mediterranean drinking pattern into a “prescription” for individuals with type 2 diabetes and prediabetes.

 

Rett K (2020) Should we prescribe abstinence or wine once a day with supper in diabetes and prediabetes? J Cardiovasc Med Cardiol 7(2): 152-156. DOI: https://dx.doi.org/10.17352/2455-2976.000131

 

For more information about this article, read the scientific abstract here.