title: Self-reported regular alcohol consumption in adolescents and emerging adults with type 1 diabetes: A neglected risk factor for diabetic ketoacidosis? Multicenter analysis of 29 630 patients from the DPV registry.
abstract: BACKGROUND
  The risk of hypoglycemia increases after alcohol consumption in patients with type 1 diabetes. This study aimed to investigate the association between metabolic control and self-reported alcohol consumption in young patients with type 1 diabetes.
  
  
  METHODS
  N = 29 630 patients with type 1 diabetes aged 12 to <30 years (median age 17.0 [14.9, 18.3] years, duration of diabetes 6.8 [3.3, 10.9] years, 53% male) from the German/Austrian DPV registry were analyzed. Patients were categorized into abstainers, low-risk drinkers, and at-risk drinkers. BMI, HbA1c, and rates of severe hypoglycemia (SH) and diabetic ketoacidosis (DKA) were compared between alcohol consumption groups using multivariable hierarchical regression models. The association between alcohol use and smoking status was assessed using χ2test.
  
  
  RESULTS
  Overall, 10.8% of the patients reported regular alcohol consumption. Proportion of alcohol use as well as the amount of alcohol consumed increased with age and were higher in males than in females (all P < .05). Patients with Turkish migration background reported less alcohol consumption. HbA1c, SH rate, and DKA rate (adjusted for age, gender, duration of diabetes, therapy) were significantly lower in abstainers than in patients drinking alcohol (all P < .05). Smoking status was significantly associated with alcohol consumption (P < .001).
  
  
  CONCLUSIONS
  Self-reported alcohol consumption is likely to be underreported when collected in face-to-face settings such as doctors' visits. Nevertheless, our data revealed a significant association between higher alcohol consumption and worse glycemic control, in particular higher DKA rates. Information about alcohol-induced complications is of great importance in diabetes education in young people with type 1 diabetes.
authors.affiliation: Institute of Epidemiology and Medical Biometry, ZIBMT, University of Ulm, Ulm, Germany.|German Center for Diabetes Research (DZD), München-Neuherberg, Germany.
authors.forename: Julia M
authors.initials: JM
authors.lastname: Hermann
authors.affiliation: Department of Child and Adolescent Psychiatry, Gemeinschaftskrankenhaus Herdecke, Herdecke, Germany.
authors.forename: Michael
authors.initials: M
authors.lastname: Meusers
authors.affiliation: Pediatric Practice, Oberhausen, Germany.
authors.forename: Rainer
authors.initials: R
authors.lastname: Bachran
authors.affiliation: Department of Pediatric Endocrinology and Diabetology, Diabetes practice, Gauting, Germany.
authors.forename: Ursula
authors.initials: U
authors.lastname: Kuhnle-Krahl
authors.affiliation: Department of Pediatrics, Evangelisches Krankenhaus Bielefeld, Bielefeld, Germany.
authors.forename: Norbert
authors.initials: N
authors.lastname: Jorch
authors.affiliation: Department of Pediatrics, Medical University of Innsbruck, Innsbruck, Austria.
authors.forename: Sabine E
authors.initials: SE
authors.lastname: Hofer
authors.affiliation: Institute of Epidemiology and Medical Biometry, ZIBMT, University of Ulm, Ulm, Germany.|German Center for Diabetes Research (DZD), München-Neuherberg, Germany.
authors.forename: Reinhard W
authors.initials: RW
authors.lastname: Holl
mesh_terms: D000293:Adolescent; D000328:Adult; D000428:Alcohol Drinking / Q000009:adverse effects* / Q000097:blood / Q000453:epidemiology; D001317:Austria / Q000453:epidemiology; D015992:Body Mass Index; D002648:Child; D003922:Diabetes Mellitus, Type 1 / Q000097:blood / Q000150:complications* / Q000523:psychology; D016883:Diabetic Ketoacidosis / Q000453:epidemiology / Q000209:etiology*; D005260:Female; D005858:Germany / Q000453:epidemiology; D006442:Glycated Hemoglobin / Q000378:metabolism; D006801:Humans; D007003:Hypoglycemia / Q000453:epidemiology / Q000209:etiology*; D008297:Male; D012042:Registries; D012907:Smoking / Q000453:epidemiology; D055815:Young Adult
chemical_list: D006442:Glycated Hemoglobin; C517652:hemoglobin A1c protein, human
keywords: adolescents; alcohol; glycemic control; type 1 diabetes; youth