title: Alcohol consumption and diabetes risk in the Diabetes Prevention Program.
abstract: BACKGROUND
  Moderate alcohol consumption is associated with a decreased risk of type 2 diabetes in the general population, but little is known about the effects in individuals at high risk of diabetes.
  
  
  OBJECTIVE
  The objectives were to determine associations between alcohol consumption and diabetes risk factors and whether alcohol consumption was a predictor of incident diabetes in individuals enrolled in the Diabetes Prevention Program (DPP).
  
  
  METHODS
  DPP participants (n = 3175) had impaired glucose tolerance (2-h glucose: 7.8-11.1 mmol/L), elevated fasting glucose (5.3-7.0 mmol/L), and a body mass index (in kg/m(2)) > or =24. Participants were randomly assigned to placebo, metformin, or lifestyle modification and were followed for a mean of 3.2 y. Alcohol intake was assessed at baseline and year 1 by using a semiquantitative food-frequency questionnaire. Diabetes was diagnosed by annual oral-glucose-tolerance testing and semiannual fasting plasma glucose measurement.
  
  
  RESULTS
  Participants who reported higher alcohol consumption tended to be male, older, white, and less obese and to have a higher calorie intake and a higher HDL-cholesterol concentration. Higher alcohol consumption was associated with lower insulin secretion at any level of insulin sensitivity. We found lower incidence rates of diabetes with higher alcohol consumption in the metformin (P < 0.01 for trend) and lifestyle modification (P = 0.02 for trend) groups, which remained significant after adjustment for multiple baseline covariates. No similar association was observed in the placebo group.
  
  
  CONCLUSIONS
  Despite overall low rates of alcohol consumption, there was a reduced risk of incident diabetes in those who reported modest daily alcohol intake and were assigned to metformin or lifestyle modification. Moderate daily alcohol intake is associated with lower insulin secretion-an effect that warrants further investigation. This trial was registered at clinicaltrials.gov as NCT00038727.
authors.affiliation: Albert Einstein College of Medicine, Bronx, NY, USA. dppmail@biostat.bsc.gwu.edu
authors.forename: Jill P
authors.initials: JP
authors.lastname: Crandall
authors.forename: Sarit
authors.initials: S
authors.lastname: Polsky
authors.forename: Andrea A
authors.initials: AA
authors.lastname: Howard
authors.forename: Leigh
authors.initials: L
authors.lastname: Perreault
authors.forename: George A
authors.initials: GA
authors.lastname: Bray
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Barrett-Connor
authors.forename: Janet
authors.initials: J
authors.lastname: Brown-Friday
authors.forename: Tracy
authors.initials: T
authors.lastname: Whittington
authors.forename: Sandra
authors.initials: S
authors.lastname: Foo
authors.forename: Yong
authors.initials: Y
authors.lastname: Ma
authors.forename: Sharon L
authors.initials: SL
authors.lastname: Edelstein
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000428:Alcohol Drinking; D008076:Cholesterol, HDL / Q000097:blood; D003924:Diabetes Mellitus, Type 2 / Q000453:epidemiology / Q000517:prevention & control*; D002149:Energy Intake; D005260:Female; D018149:Glucose Intolerance / Q000188:drug therapy; D005951:Glucose Tolerance Test; D015438:Health Behavior; D006801:Humans; D006943:Hyperglycemia / Q000188:drug therapy; D007004:Hypoglycemic Agents / Q000627:therapeutic use*; D015994:Incidence; D007328:Insulin / Q000378:metabolism*; D000078790:Insulin Secretion; D008019:Life Style; D008297:Male; D008687:Metformin / Q000627:therapeutic use*; D008875:Middle Aged; D009765:Obesity / Q000150:complications; D010919:Placebos / Q000627:therapeutic use; D012307:Risk Factors; D012737:Sex Factors
chemical_list: D008076:Cholesterol, HDL; D007004:Hypoglycemic Agents; D007328:Insulin; D010919:Placebos; D008687:Metformin