title: Alcohol Toxicity in Diabetes and Its Complications: A Double Trouble?
abstract: BACKGROUND
  Eight percent of the U.S. population has been diagnosed with diabetes mellitus (DM), while another large percentage has gone undiagnosed. As the epidemiology of this disease constitutes a larger percentage of the American population, another factor presents a dangerous dilemma that can exacerbate the hazardous effects imposed by DM. Excessive alcohol consumption concerns the health of more than 50% of all adults. When this heavy-alcohol-drinking population overlaps with DM and its complications, the effects can be dangerous. In this review, we term it as "double trouble."
  
  
  METHODS
  We provide evidence of alcohol-induced exacerbation of organ damage in diabetic conditions. In certain cases, we have explained how diabetes and alcohol induce similar pathological effects.
  
  
  RESULTS
  Known exacerbated complications include those related to heart diseases, liver damage, kidney dysfunction, as well as retinal and neurological impairment. Often, pathophysiological damage concludes with end-stage disorders and even mortality. The metabolic, cell signaling, and pathophysiological changes associated with "double trouble" would lead to the identification of novel therapeutic targets.
  
  
  CONCLUSIONS
  This review summarizes the epidemiology, diagnosis, pathophysiology, metabolic, and cell signaling alterations and finally brushes upon issues and strategies to manage the "double trouble."
authors.affiliation: Division of Hypertension and Vascular Research, Department of Internal Medicine, Henry Ford Health System, Detroit, Michigan.
authors.forename: Srikar
authors.initials: S
authors.lastname: Munukutla
authors.affiliation: Division of Hypertension and Vascular Research, Department of Internal Medicine, Henry Ford Health System, Detroit, Michigan.
authors.forename: Guodong
authors.initials: G
authors.lastname: Pan
authors.affiliation: Division of Hypertension and Vascular Research, Department of Internal Medicine, Henry Ford Health System, Detroit, Michigan.
authors.forename: Mandar
authors.initials: M
authors.lastname: Deshpande
authors.affiliation: Department of Cardiovascular Sciences, Center for Cardiovascular Regeneration, Houston Methodist Research Institute, Houston, Texas.
authors.forename: Rajarajan A
authors.initials: RA
authors.lastname: Thandavarayan
authors.affiliation: Department of Cardiovascular Sciences, Center for Cardiovascular Regeneration, Houston Methodist Research Institute, Houston, Texas.
authors.forename: Prasanna
authors.initials: P
authors.lastname: Krishnamurthy
authors.affiliation: Division of Hypertension and Vascular Research, Department of Internal Medicine, Henry Ford Health System, Detroit, Michigan.|Department of Physiology, Wayne State University, Detroit, Michigan.
authors.forename: Suresh S
authors.initials: SS
authors.lastname: Palaniyandi
mesh_terms: D000428:Alcohol Drinking / Q000009:adverse effects* / Q000453:epidemiology* / Q000503:physiopathology; D000437:Alcoholism / Q000175:diagnosis / Q000453:epidemiology / Q000503:physiopathology; D048909:Diabetes Complications / Q000175:diagnosis / Q000453:epidemiology* / Q000503:physiopathology; D003920:Diabetes Mellitus / Q000175:diagnosis / Q000453:epidemiology* / Q000503:physiopathology; D006801:Humans
keywords: Alcohol Toxicity; Aldehyde Dehydrogenase; Cell Signaling; Diabetes Mellitus; Epidemiology; Mitochondrial Dysfunction; Pathophysiology