Glycaemic control Review Article 23 0742-3071Publishing, alcohol Diabetic Medicine and2006 consumption D. Ismail et al. DME UK Oxford, article Blackwell Publishing Ltd
Social consumption of alcohol in adolescents with Type 1 diabetes is associated with increased glucose lability, but not hypoglycaemia
D. Ismail, R. Gebert, P. J. Vuillermin, L. Fraser*, C. M. McDonnell, S. M. Donath† and F. J. Cameron
Abstract
Department of Endocrinology and Diabetes, Royal Children’s Hospital, Melbourne, *Wimmera Base Hospital*, Horsham and †Clinical Epidemiology and Biostatistics Unit, Royal Children’s Hospital, Melbourne, Australia Accepted 10 June 2005
Aims To determine the effects of social consumption of alcohol by diabetic
adolescents on glycaemic control.
Methods Fourteen (five male) patients aged > 16 years were recruited from the
diabetes clinic at the Royal Children’s Hospital. The continuous glucose monitoring system (CGMS) was attached at a weekend when alcohol consumption was planned for one night only. For each patient, the 12-h period from 18.00 h to 06.00 h for the night with alcohol consumption (study period) was compared with the same period with non-alcohol consumption (control period) either 24 h before or after the alcohol study night. Thus, each subject was his /her own control. Glycaemic outcomes calculated from continuous glucose monitoring included mean blood glucose (MBG), percentage of time spent at low glucose levels (CGMS < 4.0 mmol/l), normal glucose levels (CGMS 4.0–10.0 mmol/ l) and high glucose levels (> 10.0 mmol/ l) and continuous overall net glycaemic action (CONGA).
Results The mean number of standard alcohol drinks consumed during the study period was 9.0 for males and 6.3 for females. There was no difference in percentage of time at high and normal glucose levels in the study and control periods. During the control period, there was a higher percentage of time with low glucose levels compared with
References: 1 Cameron F, Werther G. Adolescents with diabetes mellitus. In: Menon, RK, Sperling, MA, eds. Pediatric Diabetes. Boston: Kluwer Academic Publishers, 2003: 319–335. 2 Frey MA, Guthrie B, Lovelandcherry C, Park PS, Foster CM. Risky behaviours and risk in adolescents with IDDM. J Adol Health 1997; 20: 38–45. 3 Avogaro A, Beltramello P, Gnudi L, Maran A, Valerio A, Miola M et al. Alcohol intake impairs glucose counterregulation during acute insulin-induced hypoglycaemia in IDDM patients. Diabetes 1993; 42: 1626–1634. 4 Kerr D, Macdonald IA, Heller SR, Tattersal RB. Alcohol causes hypoglycaemic unawareness in healthy volunteers and patients with type 1 diabetes. Diabetologia 1990; 33: 216–221. 5 Turner BC, Jenkins E, Kerr D, Sherwin RS, Cavan DA. The effect of evening alcohol consumption on next morning glucose control in type 1 diabetes. Diabetes Care 2001; 24: 1888–1893. 6 Koivisto VA, Tulokas S, Toivonen M, Haapa E, Pelkonen R. Alcohol with a meal has no adverse effects on postprandial glucose homeostasis in diabetic patients. Diabetes Care 1993; 16: 1612–1614. 7 National Health and Medical Research Council. Australian Alcohol Guidelines: Health Risks and Benefits. DS9. Available from: http://www7.health.gov.au/nhmrc/publications/synopses/ds9syn.htm. 8 McDonnell CM, Donath SM, Vidmar SI, Werther GA, Cameron FJ. A novel approach to continuous glucose analysis utilising glycaemic variation. Diab Tech Therap 2005; 7: 253–263. 9 StataCorp. Stata statistical software. Release 8.0. College Station, TX: Stata Corporation, 2003. 10 Kyngas H, Hentinen M, Barlow JH. Adolescents perceptions of physicians, nurses, parents and friends: help or hindrance in compliance with diabetes self-care? J Adv Nurs 1998; 27: 760–769. 11 Patterson JM, Garwick AW. Coping with chronic illness. In: Werther, GA, Court, JM, eds. Diabetes and the Adolescent. Melbourne: Miranova Publishers 1998, 3–34. © 2006 The Authors. Journal compilation © 2006 Diabetes UK. Diabetic Medicine, 23, 830–833