December 22/29, 2015
Patients with well-controlled diabetes can safely consume moderate amounts of wine and may benefit from an associated modest decrease in cardiometabolic risk, according to a recent randomized clinical trial (Gepner Y et al. Ann Intern Med. 2015;163:569-579).
The 224 trial participants, adults 40 years or older with well-controlled type 2 diabetes mellitus, were randomly assigned to consume 150 mL of mineral water, white wine, or red wine with dinner for 2 years. All the participants followed a Mediterranean diet without calorie restrictions.
Anita Slomski, MA
Relative to water, only red wine consumption was associated with significantly improved lipid levels, including increased high-density lipoprotein cholesterol (HDL-C) and apolipoprotein(a)1 levels (2.0 mg/dL and 0.03 g/L, respectively) and decreased total cholesterol–HDL-C ratio (−0.27). Although both wines improved some glucose metabolism components, only white wine consumption was associated with significant decreases in fasting plasma glucose level (−17.2 mg/dL) and homeostasis model assessment of insulin resistance score (−1.2).
Wine consumption was associated with improved metabolic control in patients with slow alcohol metabolism (alcohol dehydrogenase allele ADH1B*1 carriers); this association was not observed in patients with fast metabolism (ADH1B*2homozygotes). The findings suggest the effects of wine on glucose metabolism may be mediated mainly by alcohol, whereas red wine’s beneficial effects may also involve nonalcoholic constituents.
Wine consumption did not affect blood pressure, adiposity, liver function, drug therapy, or quality of life. The researchers suggest genetic typing may identify patients with type 2 diabetes mellitus who will benefit from moderate wine consumption.