title: Alcohol consumption is inversely associated with adherence to diabetes self-care behaviours.
abstract: OBJECTIVE
  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, HbA1c 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.
authors.affiliation: Kaiser Permanente Division of Research, Oakland, CA 94612, USA. Ameena.T.Ahmed@kp.org
authors.forename: A T
authors.initials: AT
authors.lastname: Ahmed
authors.forename: A J
authors.initials: AJ
authors.lastname: Karter
authors.forename: J
authors.initials: J
authors.lastname: Liu
mesh_terms: D000428:Alcohol Drinking / Q000453:epidemiology*; D001786:Blood Glucose / Q000032:analysis; D002140:California / Q000453:epidemiology; D003430:Cross-Sectional Studies; D003922:Diabetes Mellitus, Type 1 / Q000453:epidemiology*; D003924:Diabetes Mellitus, Type 2 / Q000453:epidemiology*; D004032:Diet; D015444:Exercise; D005260:Female; D006442:Glycated Hemoglobin / Q000032:analysis; D015438:Health Behavior; D006801:Humans; D008297:Male; D008875:Middle Aged; D010349:Patient Compliance / Q000706:statistics & numerical data*; D012648:Self Care; D012907:Smoking / Q000453:epidemiology
chemical_list: D001786:Blood Glucose; D006442:Glycated Hemoglobin