The 131st Annual Meeting (November 15-19, 2003) of APHA

Abstract #69051

Monique B. Williams, PhD, Alcohol Epidemiologic Data System, CSR, Incorporated, 2107 Wilson Boulevard, Suite 1000, Arlington, VA 22201, 703-321-5220, mwilliams@csrincorporated.com and Mary C. Dufour, MD, MPH, National Institute on Alcohol Abuse and Alcoholism, NIH, Willco Building, Suite 514, 6000 Executive Boulevard, Bethesda, MD 20892-7003.

The relationship between alcohol consumption and risk of type-2 diabetes is controversial. Some studies have shown that alcohol use impairs glucose metabolism, sometimes causing hyperglycemia. This evidence suggests that increased alcohol consumption yields higher levels of serum glucose and glycated hemoglobin (HbA1c). Two recent studies have provided evidence to the contrary, however, finding that predicted HbA1c levels are lowest at the highest levels of alcohol consumption among non-diabetic Europeans (Harding et al., 2002; Gulliford and Ukoumunne, 2001).

The objective of this analysis is to investigate the relationship between alcohol consumption and glycated hemoglobin among non-diabetic Americans exploring whether a similar relationship holds in Non-Hispanic white and black populations. If so, we test three hypotheses attempting to explain the negative association between alcohol and HbA1c : 1. The relationship is mediated by improved insulin-mediated uptake measured by QUICKI index. 2. Alcohol consumption impairs liver functioning reducing its capacity to produce glucose. 3. The proportion of glycated hemoglobin is lower among heavier drinkers because ethanol promotes the production of acetaldehyde which produces Hb-Ach adducts leaving less hemoglobin to bind with glucose.

Preliminary analysis shows that the first two hypotheses cannot fully explain the relationship under investigation but that glycated hemoglobin is less a function of the level of glucose present than the availability of hemoglobin to bind with it at higher levels of alcohol consumption in both races. We conclude that glycated hemoglobin may not be a suitable indicator of diabetic risk when accessing the effect of alcohol consumption.

Learning Objectives:

• At the conclusion of this session, the learner will be able to articulate the biological process by which heavier alcohol consumption yields lower levels of glycated hemoglobin in non-diabetic blacks and whites.

Keywords: Diabetes,

Presenting author's disclosure statement:
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.