The relationship between alcohol consumption and glycemic control among patients with diabetes: the Kaiser Permanente Northern California Diabetes Registry
Open accessAbstract
Background Alcohol consumption is a common behavior. Little is known about the relationship between alcohol consumption and glycemic control among people with diabetes.Objective To evaluate the association between alcohol consumption and glycemic control.Design Survey follow-up study, 1994-1997, among Kaiser Permanente Northern California members.Patients 38,564 adult diabetes patients.Measurements Self-reported alcohol consumption, and hemoglobin A1C (A1C), assessed within 1 year of survey date. Linear regression of A1C by alcohol consumption was performed, adjusted for sociodemographic variables, clinical variables, and diabetes disease severity. Least squares means estimates were derived.Results In multivariate-adjusted models, A1C values were 8.88 (lifetime abstainers), 8.79 (former drinkers), 8.90 (<0.1 drink/day), 8.71 (0.1-0.9 drink/day), 8.51 (1-1.9 drinks/day), 8.39 (2-2.9 drinks/day), and 8.47 (>/=3 drinks/day). Alcohol consumption was linearly (p < 0.001) and inversely (p = 0.001) associated with A1C among diabetes patients.Conclusions Alcohol consumption is inversely associated with glycemic control among diabetes patients. This supports current clinical guidelines for moderate levels of alcohol consumption among diabetes patients. As glycemic control affects incidence of complications of diabetes, the lower A1C levels associated with moderate alcohol consumption may translate into lower risk for complications.
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Cites
Stratton, I. M. (2000) · BMJ · doi:10.1136/bmj.321.7258.405 · Cited by 9,059 · see citing works
Prevalence of obesity, diabetes, and obesity-related health risk factors, 2001
Mokdad, A. H., Ford, E. S., Bowman, B. A., Dietz, W. H., Vinicor, F., Bales, V. S., & Marks, J. S. (2003) · JAMA · doi:10.1001/jama.289.1.76 · Cited by 5,866 · see citing works
Economic Costs of Diabetes in the U.S. in 2002
American Diabetes Association (2003) · Diabetes Care · doi:10.2337/diacare.26.3.917 · Cited by 4,147 · see citing works
Standards of Medical Care in Diabetes–2006
American Diabetes Association (2006) · Diabetes Care · doi:10.2337/diacare.29.s1.06.s4 · Cited by 1,884 · see citing works
Krieger, N. R. (1992) · American Journal of Public Health · doi:10.2105/ajph.82.5.703 · Cited by 1,661 · see citing works
Standards of Medical Care in Diabetes—2007
American Diabetes Association (2007) · Diabetes Care · doi:10.2337/dc07-s004 · Cited by 1,190 · see citing works
Standards of Medical Care in Diabetes–2006
Tseng, K. H. (2006) · Diabetes Care · doi:10.2337/dc06-0805 · Cited by 1,099 · see citing works
Ethnic disparities in diabetic complications in an insured population
Karter, A. J. (2002) · JAMA · doi:10.1001/jama.287.19.2519 · Cited by 840 · see citing works
Self-citationGlycemic Control and Heart Failure Among Adult Patients With Diabetes
Iribarren, C., Karter, A. J., Go, A. S., Ferrara, A. M., Liu, J. Y., Sidney, S. S., & Selby, J. V. (2001) · Circulation · doi:10.1161/01.cir.103.22.2668 · Cited by 703 · see citing works
Self-citationGlycemic Control From 1988 to 2000 Among U.S. Adults Diagnosed With Type 2 Diabetes
Koro, C. E., Bowlin, S. J., Bourgeois, N., & Fedder, D. O. (2004) · Diabetes Care · doi:10.2337/diacare.27.1.17 · Cited by 648 · see citing works
Karter, A. J., Ackerson, L. M., Darbinian, J. A., D’Agostino, R. B., Ferrara, A., Liu, J., & Selby, J. V. (2001) · The American Journal of Medicine · doi:10.1016/s0002-9343(01)00742-2 · Cited by 595 · see citing works
Self-citationThe Epidemiology of Lower Extremity Amputations in Diabetic Individuals
Most, R. S., & Sinnock, P. (1983) · Diabetes Care · doi:10.2337/diacare.6.1.87 · Cited by 564 · see citing works
Effect of Alcohol Consumption on Diabetes Mellitus: A Systematic Review
Howard, A. A., Arnsten, J. H., & Gourevitch, M. N. (2004) · Annals of Internal Medicine · doi:10.7326/0003-4819-140-6-200403160-00011 · Cited by 526 · see citing works
Karter, A. J., Ferrara, A. M., Darbinian, J. A., Ackerson, L., & Selby, J. V. (2000) · Diabetes Care · doi:10.2337/diacare.23.4.477 · Cited by 488 · see citing works
Self-citationEconomic Costs of Diabetes in the U.S. in 2002Preprint
Dall, T. M., Nikolov, P., & Hogan, P. F. (2003) · RePEc: Research Papers in Economics · Cited by 483 · see citing works
Davies, M. J., Baer, D. J., Judd, J. T., Brown, E. D., Campbell, W. S., & Taylor, P. R. (2002) · JAMA · doi:10.1001/jama.287.19.2559 · Cited by 459 · see citing works
A General Method of Compliance Assessment Using Centralized Pharmacy Records
Steiner, J. F., Koepsell, T. D., Fihn, S. D., & Inui, T. S. (1988) · Medical Care · doi:10.1097/00005650-198808000-00007 · Cited by 458 · see citing works
Survey non-response in the Netherlands: Effects on prevalence estimates and associations
Van Loon, A. (2003) · Annals of Epidemiology · doi:10.1016/s1047-2797(02)00257-0 · Cited by 423 · see citing works
Nutrition Principles and Recommendations in Diabetes
American Diabetes Association (2004) · Diabetes Care · doi:10.2337/diacare.27.2007.s36 · Cited by 396 · see citing works
Excess Costs of Medical Care for Patients With Diabetes in a Managed Care Population
Selby, J. V., Ray, G. T., Zhang, D., & Colby, C. (1997) · Diabetes Care · doi:10.2337/diacare.20.9.1396 · Cited by 344 · see citing works
Kiechl, S. J., Willeit, J., Poewe, W. H., Egger, G., Oberhollenzer, F., Muggeo, M., & Bonora, E. (1996) · BMJ · doi:10.1136/bmj.313.7064.1040 · Cited by 343 · see citing works
Light-to-Moderate Alcohol Intake Is Associated With Enhanced Insulin Sensitivity
Facchini, F., Chen, Y.-D. I., & Reaven, G. M. (1994) · Diabetes Care · doi:10.2337/diacare.17.2.115 · Cited by 324 · see citing works
Gual, A. (2002) · Alcohol and Alcoholism · doi:10.1093/alcalc/37.6.591 · Cited by 312 · see citing works
Sierksma, A., Patel, H. J., Ouchi, N., Kihara, S., Funahashi, T., Heine, R. J., Grobbee, D. E., Kluft, C., & Hendriks, H. (2004) · Diabetes Care · doi:10.2337/diacare.27.1.184 · Cited by 290 · see citing works
Alcohol Drinking Patterns and Risk of Type 2 Diabetes Mellitus Among Younger Women
Wannamethee, S. G., Camargo, C. A., Manson, J. E., Willett, W. C., & Rimm, E. B. (2003) · Archives of Internal Medicine · doi:10.1001/archinte.163.11.1329 · Cited by 206 · see citing works
Siitonen, O., NISKANEN, L. K., Laakso, M., et al. (1993) · Diabetes Care · doi:10.2337/diacare.16.1.16 · Cited by 203 · see citing works
Mayer, E. J., Newman, B. M., Quesenberry, C. P., FRIEDMAN, G. D., & Selby, J. V. (1993) · Circulation · doi:10.1161/01.cir.88.5.2190 · Cited by 193 · see citing works
Incidence of Lower Limb Amputations and Diabetes
Trautner, C., Haastert, B., Giani, G., & Berger, M. (1996) · Diabetes Care · doi:10.2337/diacare.19.9.1006 · Cited by 187 · see citing works
Alcohol consumption is inversely associated with adherence to diabetes self‐care behaviours
Ahmed, A., Karter, A. J., & Liu, J. (2006) · Diabetic Medicine · doi:10.1111/j.1464-5491.2006.01878.x · Cited by 171 · see citing works
Self-citationBell, R. A., Mayer‐Davis, E. J., Martin, M. A., Agostino, R. B. D., & Haffner, S. M. (2000) · Diabetes Care · doi:10.2337/diacare.23.11.1630 · Cited by 170 · see citing works
Alcohol Consumption and the Incidence of Type 2 Diabetes
Carlsson, S., Hammar, N., Grill, V., & Kaprio, J. A. (2003) · Diabetes Care · doi:10.2337/diacare.26.10.2785 · Cited by 169 · see citing works
Diabetes and Lower-Limb Amputations in the Community: A retrospective cohort study
Morris, A. D., McAlpine, R., Steinke, D. T., Boyle, D. I., Ebrahim, A.-R., Vasudev, N. S., Stewart, C. P., Jung, R. T., Leese, G., MacDonald, T. M., et al. (1998) · Diabetes Care · doi:10.2337/diacare.21.5.738 · Cited by 154 · see citing works
Glycemic Effects of Moderate Alcohol Intake Among Patients With Type 2 Diabetes
Shai, I., Wainstein, J., Harman-Boehm, I., Raz, I., Fraser, D., Rudich, A., & Stampfer, M. J. (2007) · Diabetes Care · doi:10.2337/dc07-1103 · Cited by 134 · see citing works
Nakanishi, N., Suzuki, K., & Tatara, K. (2003) · Diabetes Care · doi:10.2337/diacare.26.1.48 · Cited by 120 · see citing works
Karter, A. J., Rowell, S. E., Ackerson, L., Mitchell, B. D., Ferrara, A. M., Selby, J. V., & Newman, B. M. (1999) · Diabetes Care · doi:10.2337/diacare.22.6.938 · Cited by 120 · see citing works
Self-citationHarald, K., Salomaa, V. V., Jousilahti, P., Koskinen, S. V. P., & Vartiainen, E. A. (2007) · Journal of Epidemiology & Community Health · doi:10.1136/jech.2006.049908 · Cited by 117 · see citing works
Caballero, A. E. (2004) · Current Diabetes Reports · doi:10.1007/s11892-004-0074-9 · Cited by 114 · see citing works
Selby, J. V., Karter, A., Ackerson, L. M., Ferrara, A., & Liu, J. (2001) · Diabetes Care · doi:10.2337/diacare.24.9.1547 · Cited by 106 · see citing works
Self-citationThe impact of diabetes-related lower-extremity amputations in the Netherlands
van Houtum, W. H., Lavery, L. A., & Harkless, L. B. (1996) · Journal of Diabetes and its Complications · doi:10.1016/1056-8727(95)00088-7 · Cited by 105 · see citing works
Alcohol consumption and its relation to cardiovascular risk factors in British women.
Razay, G., Heaton, K. W., Bolton, C., & Hughes, A. (1992) · BMJ · doi:10.1136/bmj.304.6819.80 · Cited by 105 · see citing works
Reijneveld, S. A. (1999) · International Journal of Epidemiology · doi:10.1093/ije/28.6.1134 · Cited by 104 · see citing works
Validity of self-reported intakes of wine, beer and spirits in population studies.
Grønbæk, M., & Heitmann, B. L. (1996) · PubMed · Cited by 100 · see citing works
Hormone Replacement Therapy Is Associated With Better Glycemic Control in Women With Type 2 Diabetes
Ferrara, A. M., Karter, A. J., Ackerson, L., Liu, J. Y., & Selby, J. V. (2001) · Diabetes Care · doi:10.2337/diacare.24.7.1144 · Cited by 98 · see citing works
Self-citationRESPONSE BIAS IN THE HONOLULU HEART PROGRAM
Benfante, R., REED, D. M., MacLEAN, C., & Kagan, A. (1989) · American Journal of Epidemiology · doi:10.1093/oxfordjournals.aje.a115436 · Cited by 85 · see citing works
Overview of Findings from the 2003 National Survey on Drug Use and Health
Administration, S. A. A. M. H. S. (2004) · PsycEXTRA Dataset · doi:10.1037/e400452005-001 · Cited by 83 · see citing works
Hodge, A. M., Dowse, G. K., Collins, V., & Zimmet, P. (1993) · American Journal of Epidemiology · doi:10.1093/oxfordjournals.aje.a116658 · Cited by 81 · see citing works
Beverage intake, diabetes, and glucose control of adults in America
Mackenzie, T., Brooks, B., & O'Connor, G. (2006) · Annals of Epidemiology · doi:10.1016/j.annepidem.2005.11.009 · Cited by 66 · see citing works
Gulliford, M. C., & Ukoumunne, O. C. (2001) · European Journal of Clinical Nutrition · doi:10.1038/sj.ejcn.1601233 · Cited by 65 · see citing works
Selby, J. V., Ettinger, B. B., Swain, B. E., & Brown, J. B. (1999) · Diabetes Care · doi:10.2337/diacare.22.1.38 · Cited by 58 · see citing works
Bongers, I. M. B., & OERS, H. A. M. V. (1998) · Journal of Studies on Alcohol · doi:10.15288/jsa.1998.59.280 · Cited by 58 · see citing works
Kroenke, C. H., Chu, N., Rifai, N., Spiegelman, D. L., Hankinson, S. E., Manson, J. E., & Rimm, E. B. (2003) · Diabetes Care · doi:10.2337/diacare.26.7.1971 · Cited by 52 · see citing works
Some evidence refuting the HMO "favorable selection" hypothesis: the case of Kaiser Permanente.
Gordon, N. P., & Kaplan, G. A. (1991) · PubMed · Cited by 51 · see citing works
Measurement of Lifetime Alcohol Intake: Utility of a Self-administered Questionnaire
Friesema, I. H. M. (2004) · American Journal of Epidemiology · doi:10.1093/aje/kwh102 · Cited by 49 · see citing works
Hiatt, R. A., & Friedman, G. D. (1982) · American Journal of Public Health · doi:10.2105/ajph.72.8.829 · Cited by 44 · see citing works
Avogaro, A., Watanabe, R., Gottardo, L., de Kreutzenberg, S., Tiengo, A., & Pacini, G. (2002) · Journal of Clinical Endocrinology and Metabolism · doi:10.1210/jcem.87.3.8347 · Cited by 44 · see citing works
Alcohol and cardiovascular disease - more than one paradox to consider
Beilin, L. J., & Puddey, I. B. (2003) · Journal of Cardiovascular Risk · doi:10.1097/00043798-200302000-00001 · Cited by 43 · see citing works
The impact of gender on amputation
Armstrong, D. G., Lavery, L. A., van Houtum, W. H., et al. (1997) · The Journal of Foot & Ankle Surgery · doi:10.1016/s1067-2516(97)80014-2 · Cited by 42 · see citing works
Alcohol consumption and the risk of diabetes by body mass index levels in a cohort of 5,636 Japanese
Watanabe, M., Barzi, F., Neal, B. C., Ueshima, H., Miyoshi, Y., Okayama, A., & Choudhury, S. R. (2002) · Diabetes Research and Clinical Practice · doi:10.1016/s0168-8227(02)00083-9 · Cited by 41 · see citing works
Alcohol Consumption Patterns and HbA1c, C-Peptide and Insulin Concentrations in Men
Meyer, K. A., Conigrave, K. M., Chu, N.-F., Rifai, N., Spiegelman, D., Stampfer, M. J., & Rimm, E. B. (2003) · Journal of the American College of Nutrition · doi:10.1080/07315724.2003.10719292 · Cited by 40 · see citing works
Harding, A.-H., Sargeant, L. A., Khaw, K., Welch, A. A., Oakes, S., Luben, R., Bingham, S. A., Day, N., & Wareham, N. J. (2002) · European Journal of Clinical Nutrition · doi:10.1038/sj.ejcn.1601408 · Cited by 39 · see citing works
Harris, T. R., Wilsnack, R. W., & Klassen, A. D. (1994) · Journal of Studies on Alcohol · doi:10.15288/jsa.1994.55.309 · Cited by 39 · see citing works
Alcohol and Type 2 Diabetes - Another Paradox?
Zilkens, R., & Puddey, I. B. (2003) · European Journal of Cardiovascular Prevention & Rehabilitation · doi:10.1177/174182670301000106 · Cited by 33 · see citing works
The DECODE Study Group (2005) · Diabetic Medicine · doi:10.1111/j.1464-5491.2005.01655.x · Cited by 28 · see citing works
Zilkens, R., & Puddey, I. B. (2003) · PubMed · doi:10.1097/01.hjr.0000051965.16636.3c · Cited by 27 · see citing works
Alcohol intake and glycemia in American Indians: The strong heart study
Lu, W., Jablonski, K. A., Resnick, H. E., Jain, A. K., Jones, K. L., Gottlieb, A. M., Welty, T. K., Lee, E. T., Fabsitz, R. R., & Howard, B. V. (2003) · Metabolism · doi:10.1053/meta.2003.50020 · Cited by 22 · see citing works
Alcohol and type 2 diabetes - another paradox
Zilkens, R., & Puddey, I. B. (2003) · Journal of Cardiovascular Risk · doi:10.1097/00043798-200302000-00006 · Cited by 21 · see citing works
Li, C., Tsai, S., & Chou, P. (2005) · Journal of Clinical Epidemiology · doi:10.1016/j.jclinepi.2004.11.023 · Cited by 5 · see citing works
Flagged first, then by citations
Research works printed but not linked: 2
- Hogan P, Dall T, Nikolov P. Economic costs of diabetes in the US in 2002. Diabetes Care. 2003;26:917-32.
- Gordon NP, Kaplan GA. Some evidence refuting the HMO "favorable selection" hypothesis: the case of Kaiser Permanente. Adv Health Econ Health Serv Res. 1991;12:19-39.
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- Authors
- Ahmed, A. T., Karter, A. J., Warton, E. M., Doan, J. U., & Weisner, C. M.
- Affiliations
- Kaiser Permanente (US)
- Corresponding author
- Ahmed, Ameena T.
- Venue
- Journal of General Internal Medicine
- Published
- 2008-01-08
- Volume
- 23
- Issue
- 3
- Pages
- 275-282
- ISSN
- 0884-8734 (ISSN-L)
- 1525-1497
- PMC
- PMC2359478
- OpenAlex
- W1968199141
- Cited by
- 132
- References
- 69
- Citations by year
- 2026: 4 · 2025: 5 · 2024: 10 · 2023: 11 · 2022: 18 · 2021: 4 · 2020: 8 · 2019: 4 · 2018: 7 · 2017: 7 · 2016: 5 · 2015: 8 · 2014: 7 · 2013: 12 · 2012: 8
- FWCI
- 3.32
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Licence
- www.springer.com/tdm (tdm)
- Locations
- Journal of General Internal Medicine (publishedVersion)
- Europe PMC (PubMed Central) (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Funders
- National Institute on Alcohol Abuse and Alcoholism (R21AA015721)
- National Institute of Diabetes and Digestive and Kidney Diseases (R01DK065664)
- Eunice Kennedy Shriver National Institute of Child Health and Human Development (R01HD046113)
- Topics
- Health Sciences › Medicine › Pathology and Forensic Medicine › Alcohol Consumption and Health Effects
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Research
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Education
- Keywords
- alcohol consumption, glycemic control, diabetes mellitus, HbA1c, moderate drinking, diabetes complications
- MeSH terms
- Adult, Alcohol Drinking, Blood Glucose, California, Cross-Sectional Studies, Diabetes Mellitus, Type 1, Diabetes Mellitus, Type 2, Female, Glycated Hemoglobin, Humans, Male, Middle Aged, Probability, Prognosis, Reference Values, Registries, Health Behavior, Incidence, Survival Rate, Multivariate Analysis, Age Distribution, Sex Distribution, Risk Assessment
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