Alcohol and the NIDDM patient
Alcohol and the NIDDM patient
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DOI：
10.2337/diacare.19.5.509
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发表时间：
1996-05-01
期刊：
影响因子：
16.2
通讯作者：
Bell, DSH
中科院分区：
文献类型：
--
作者：
Bell, DSH
历史上，糖尿病患者饮酒一直存在争议。最近对一般人群的研究表明，适量饮酒（每天一到三杯）可降低死亡率。对于缺血性心脏病风险较高的个体来说，死亡率的改善最为明显。酒精有益作用的机制包括对胰岛素抵抗、高密度脂蛋白胆固醇、血小板聚集和纤维蛋白溶解的积极作用。由于这些因素，糖尿病患者患缺血性心脏病的风险特别高，因此不应阻止适量饮酒。大量或持续饮酒的短期风险包括低血糖、葡萄糖不耐受以及酮和乳酸积累。从长远来看，大量饮酒与癌症、高血压、肝硬化和症状性神经病的患病率增加有关。研究表明，随餐摄入适量酒精对餐后血糖波动影响很小或没有影响。
Historically, alcohol use by the diabetic patient has been controversial. Recent studies in the general population have shown an improvement in mortality with moderate alcohol intake (one to three drinks per day). This improved mortality is greatest in those individuals who have a higher risk of ischemic heart disease. The mechanisms oi the beneficial effects of alcohol include positive effects on insulin resistance, HDL cholesterol, platelet aggregation, and fibrinolysis. Since the diabetic patient has an especially high risk of ischemic heart disease because of these factors, the use of a moderate amount of alcohol should not be discouraged. The short-term risks of heavy or continuous alcohol intake include hypoglycemia, glucose intolerance, and ketone and lactate accumulation. In the long term, heavy alcohol intake is associated with an increased prevalence of cancer, hypertension, cirrhosis of the liver, and symptomatic neuropathy. Moderate alcohol intake taken with a meal has been shown to have little or no effect on postprandial glycemic excursions.