Red wine 'benefits

people with type 2

diabetes'
A glass of red wine a day can improve cardiac
health and help manage cholesterol for patients
with type 2 diabetes, according to findings in a
2-year study published in the journal Annals of
Internal Medicine.

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Red wine can help people with type 2 diabetes to avoid heart disease.
Moderate alcohol consumption has been linked to improved cardiovascular
and total mortality rates, and a glass of red wine a day as part of a healthy
diet has been considered beneficial for some time.

There is evidence that type 2 diabetes is less prevalent among moderate

drinkers, yet the risk-benefit balance is controversial for such patients, due
to a lack of long-term randomized studies.
Researchers from Ben-Gurion University of the Negev-Soroka Medical
Center and Nuclear Research Center Negev, Israel, wondered if both red
and white wine might improve glucose control, depending on alcohol
metabolism and genetic profiling.

Previous research has suggested that ethanol (alcohol) is the key, meaning
that alcoholic drinks other than red wine could be equally beneficial; others
claim that red wine has particularly advantageous properties.

Potential benefits for people with

type 2 diabetes
People with diabetes have a higher risk of developing cardiovascular
disease, as well as lower levels of “good” HDL cholesterol. High levels of
HDL cholesterol can reduce the risk for heart disease and stroke, as it
absorbs cholesterol and carries it back to the liver, where it is flushed from
the body.

Fast facts about diabetes

 29.1 million people in the US probably have diabetes, or 9.3% of the

population
 21 million have been diagnosed
 An estimated further 8.1 million have not been diagnosed.

Learn more about diabetes

Should patients with type 2 diabetes be recommended to take up moderate

alcohol consumption? The American Diabetes Association (ADA) leave the
decision to the individual; the American Heart Association (AHA)
recommend discussing alcohol with a physician.
The researchers wanted to find out what the cardiometabolic effects would
be when patients with type 2 diabetes took up drinking moderate amounts
of alcohol; they also wanted to assess whether the type of wine would
matter.

They hypothesized that initiating moderate wine consumption would lower

cardiometabolic risk, mainly because of the ethanol component. They
predicted similar effects of red and white wine. Because of genetic
variability in alcohol metabolism, they predicted that the effects of wine
would vary according to ADH1B genotype.

Among those excluded were: people already taking more than one
alcoholic drink per week, anyone with a history of addiction and patients
using two or more insulin injections a day.

Measurements taken at baseline included genetic markers, blood pressure,

liver biomarkers, medication use and symptoms, and quality of life.

From June 2010 to May 2012, participants were randomly assigned to 150
mL of mineral water, white wine or red wine with dinner. Wines and mineral
water were provided. All groups followed a Mediterranean diet without
caloric restriction. At intervals, blood samples were taken, questionnaires
completed and group sessions attended.

Lipid and glycemic control profiles were primarily measured. Secondary

outcomes included triglyceride levels, blood pressure, waist circumference,
genetic interaction, medication use, liver function tests and quality-of-life
indicators.

Red wine indicates a better

cardiometabolic rate
After 2 years, no material differences were identified across the groups in
blood pressure, adiposity, liver function, drug therapy, symptoms or quality
of life, except that sleep quality improved in both wine groups compared
with the water group.

However, patients who drank wine showed decreased

cardiometabolic risks compared with those drinking mineral water.
The red wine drinkers experienced the most significant changes in
lipid variables.

The researchers unexpectedly found that while the alcohol itself appears to
aid glycemic control, red wine has a stronger effect on lipid levels and
overall variables of the metabolic syndrome, suggesting that its non-
alcoholic constituents also play a role.

The red wine had seven times higher levels of total phenols than the white
wine. Whether the phenolic compounds increase the cardioprotectiveness
is still debated. The team calls for differences between red and white wine
to be further studied, with focus on the varied biodeliverability of the
compounds.

The team found that genetic differences affected glycemic control and
therefore suggest that genetic information could assist in identifying which
patients with type 2 diabetes would benefit from moderate wine
consumption.

Limitations include the participants not being blinded to treatment

allocation, but the long-term nature of the study is a strength.

The authors caution that the benefits of drinking wine should be weighed
against potential risks when translated into clinical practice.