13 Oct Moderate Red Wine May Improve Cardiac Profile In Type 2 Diabetes
MedicalResearch.com Interview with:
Iris Shai MD PhD
Professor of Nutrition and Epidemiology of Chronic Diseases
Dep. of Public Health
Faculty of Health Sciences
Medical Research: What is the background for this study? What are the main findings?
Dr. Shai: Despite enormous contribution of observational studies, clinical recommendations for moderate alcohol consumption remain controversial, particularly for people with diabetes, due to lack of long-term, randomized controlled trials, which are needed for evidence-based medicine. People with diabetes are more susceptible to developing cardiovascular diseases than the general population and have lower levels of HDL-c. Also, it is uncertain if red wine confers any advantage over white wine or whether the ethanol is the primary mediator of alcoholic beverages related beneficial associations.
The two-year CArdiovaSCulAr Diabetes and Ethanol (CASCADE) RCT was performed among 224 controlled diabetes patients (aged 45 to 75), who generally abstained from alcohol. Red wine was found to be superior in improving overall metabolic profiles, mainly by modestly improving the lipid profile. As for glycemic control and blood pressure, the effect of both, red or white wine, was dependent on ADH enzyme polymorphism, suggesting personalized approach. Overall, wine of either type did not effect change in liver function tests, adiposity, or adverse events/symptoms. However, sleep quality was significantly improved in both wine groups, compared with the water control group. All comparisons were adjusted for changes in clinical, medical and drug therapy parameters occurring among patients during the years of the study. The trial completed with adherence rate of 87 percent after 2 years.
Medical Research: What should clinicians and patients take away from your report?
Dr. Shai: The results suggest modest beneficial effects of initiating moderate wine consumption among alcohol-abstaining patients older than 40 years with Type 2 Diabetes Mellitus. These benefits should be weighed against potential risks when translated into clinical practice. There are some clinical implications of this 2-year trial that should be taken, however, carefully, with a high follow-up of each patient.
First, among patients with well-controlled Type 2 Diabetes Mellitus and a low risk for alcohol abuse, initiating moderate alcohol consumption in the context of a healthy diet is apparently safe and may modestly reduce cardiometabolic risk.
Second, red wine may be somewhat superior in improving lipid variables, which indicates the potential synergy of moderate alcohol intake with specific nonalcoholic wine constituents.
Third, differential effects on glycemic control we saw were based on ADH1B genetic variants, which indicate that ethanol may play a role in the glycemic effects of the wine intervention. Finally, ADH1B variants may assist in identifying patients with Type 2 Diabetes Mellitus for whom moderate wine consumption may be clinically beneficial.
Medical Research: What recommendations do you have for future research as a result of this study?
Dr. Shai: Future research should include, first, replications of this RCT design, to insure consistency in additional population groups, with further alcoholic beverages to address, and with other genetic polymorphisms. But the most important next step, however, is to perform the ultimate long-term, large-scale multi-center trial to follow morbidity and mortality incidence rates.
Citation:
[wysija_form id=”5″]
Iris Shai MD PhD (2015). Moderate Red Wine May Improve Cardiac Profile In Type 2 Diabetes
Iris Shai MD PhD (2015). Moderate Red Wine May Improve Cardiac Profile In Type 2 Diabetes MedicalResearch.com
Last Updated on October 13, 2015 by Marie Benz MD FAAD