The effect of alcohol on blood glucose in Type 1 diabetes--metabolic modelling and integration in a decision support system.
BACKGROUND
We have recently shown, in studies with patients with Type 1 (insulin dependent) diabetes, that alcohol intake at 21:00 h significantly reduced blood glucose values after 10-12 h, compared with control studies with no alcohol.


OBJECTIVE
We hypothesised that this was due to the following effects of alcohol: (1) alcohol metabolism increases NADH, leading to a reduction in hepatic gluconeogenesis; (2) increased glycogen phosphorylase activity depletes hepatic glycogen stores; (3) after the alcohol is metabolised, hepatic insulin sensitivity is increased, leading to the restoration of glycogen stores and reduction in blood glucose levels; and (4) consequently, after several hours, glycogen stores and insulin sensitivity return to normal.


RESULTS
A model describing these changes (DiasNet-Alcohol) was implemented into the DiasNet model of human glucose metabolism. Our study suggests that the DiasNet-Alcohol model gives a reasonable approximation of these effects of alcohol on blood glucose concentration observed in our study and supports our hypothesis for the mechanism behind these effects in Type 1 diabetes.
Plougmann
Søren
S
Department of Health Science and Technology, Aalborg University, Fredrik Bajers Vej 7D, 9220 Aalborg, Denmark. spp@hst.auc.dk
Hejlesen
Ole
O
Turner
Benjamin
B
Kerr
David
D
Cavan
David
D
D001499:Bayes Theorem; D001786:Blood Glucose / Q000378:metabolism*; D002492:Central Nervous System Depressants / Q000494:pharmacology*; D003658:Decision Making, Computer-Assisted; D020000:Decision Support Systems, Clinical; D003922:Diabetes Mellitus, Type 1; D000431:Ethanol / Q000494:pharmacology*; D006003:Glycogen / Q000378:metabolism; D024981:Glycogen Phosphorylase / Q000494:pharmacology; D006801:Humans; D007003:Hypoglycemia / Q000209:etiology*; D008962:Models, Theoretical; D009243:NAD / Q000378:metabolism
D001786:Blood Glucose; D002492:Central Nervous System Depressants; D009243:NAD; D000431:Ethanol; D006003:Glycogen; D024981:Glycogen Phosphorylase