Alcohol Consumption and the Risk of Type 2 Diabetes: A Systematic Review and Dose-Response Meta-analysis of More Than 1.9 Million Individuals From 38 Observational Studies.
American Diabetes Association
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Knott, C., Bell, S., & Britton, A. (2015). Alcohol Consumption and the Risk of Type 2 Diabetes: A Systematic Review and Dose-Response Meta-analysis of More Than 1.9 Million Individuals From 38 Observational Studies.. Diabetes Care, 38 (9), 1804-1812. https://doi.org/10.2337/dc15-0710
OBJECTIVE: Observational studies indicate that moderate levels of alcohol consumption may reduce the risk of type 2 diabetes. In addition to providing an updated summary of the existing literature, this meta-analysis explored whether reductions in risk may be the product of misclassification bias. RESEARCH DESIGN AND METHODS: A systematic search was undertaken, identifying studies that reported a temporal association between alcohol consumption and the risk of type 2 diabetes. No restrictions were placed upon the language or date of publication. Non-English publications were, where necessary, translated using online translation tools. Models were constructed using fractional polynomial regression to determine the best-fitting dose-response relationship between alcohol intake and type 2 diabetes, with a priori testing of sex and referent group interactions. RESULTS: Thirty-eight studies met the selection criteria, representing 1,902,605 participants and 125,926 cases of type 2 diabetes. A conventional noncurrent drinking category was reported by 33 studies, while five reported a never-drinking category. Relative to combined abstainers, reductions in the risk of type 2 diabetes were present at all levels of alcohol intake <63 g/day, with risks increasing above this threshold. Peak risk reduction was present between 10-14 g/day at an 18% decrease in hazards. Stratification of available data revealed that reductions in risk may be specific to women only and absent in studies that adopted a never-drinking abstention category or sampled an Asian population region. CONCLUSIONS: Reductions in risk among moderate alcohol drinkers may be confined to women and non-Asian populations. Although based on a minority of studies, there is also the possibility that reductions in risk may have been overestimated by studies using a referent group contaminated by less healthy former drinkers.
Adult, Alcohol Drinking, Blood Glucose, Diabetes Mellitus, Type 2, Ethanol, Female, Humans, Male, Risk Factors, Sex Factors
C.K., S.B., and A.B. are funded by the European Research Council (ERC-StG-2012-309337_AlcoholLifecourse; principal investigator A.B. [http://www.ucl.ac.uk/alcohol-lifecourse]) and the U.K. Medical Research Council/Alcohol Research UK (MR/M006638/1).
Medical Research Council (MR/M006638/1)
External DOI: https://doi.org/10.2337/dc15-0710
This record's URL: https://www.repository.cam.ac.uk/handle/1810/286550
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