Wine and Diabetes

Wine and Diabetes

The wine

Wine is an alcoholic beverage produced by the bacterial fermentation of grapes . The general composition and alcoholic concentration of the wine depend above all on the type of grape, the fermentation and the winemaking process, even if the “meal” products average an alcohol content of 10-11%.
Wine is a beverage which – contrary to distillates, other fermented beverages and liqueurs – provides a good quantity of nutritional molecules; we are talking about phenolic substances . These powerful antioxidants – anticancer – antiatherogenic ( tannins and isoflavones ), of which the most present is undoubtedly the trans-resveratrol , are transmitted from the grape to the wine during maceration; it follows that: with the same grape, the longer the maceration time, the higher the content of phenolic substances. Often the polyphenol
content is not sufficient to justify the consumption of wine; there are special pathological or physiological conditions which do not derive any benefit from the consumption of wine, on the contrary, they could potentially receive metabolic damage. According to the Recommended Nutrient Intake Levels (LARN), wine and other alcoholic beverages in general should NOT be consumed by: people under the age of 18, pregnant women, diabetics, drivers, treated with certain drugs, etc.



Diabetes is a metabolic alteration resulting from a reduction in the effectiveness of the mechanism between INSULIN and RECEPTOR. On the basis of the etiology and the clinical condition, diabetes mellitus is classified into type 1 and type 2, which are respectively of the INSULIN-DEPENDENT type (due to an endocrine defect of the pancreas ) and (usually!) NON- INSULIN DEPENDENT but characterized by INEFFECTIVENESS of peripheral hormonal uptake.
Diabetes can be due to a reduced production of the hormone, to an alteration of its action (molecular defect of insulin, molecular defect of the receptor, insulin resistance induced by diet andobesity ) or by one or more of these factors. A feature that is always present in diabetes mellitus is hyperglycemia , even if in type 1 diabetes (INSULINO-FREE, THEN INSULIN-DEPENDENT) the interruption of pancreatic hormone production is preceded by a moment (or period) of HYPER secretion insulin that often manifests itself with fainting and subsequent HYPOGLYCEMIC COMA.


Diabetes: wine yes or wine no?

To date, the opinion of specialists is sufficiently unequivocal: in the case of diabetes (both type 1 and type 2) the systematic consumption of alcoholic beverages exceeding the recommended ration , therefore including wine, is not recommended. However, there are some experimental facets that deserve to be reported.
A study by Robert Metz, Sheldon Berger and Mary Mako entitled “Potentiation of the Plasma Insulin Response to Glucose by Prior Administration of Alcohol: An Apparent Islet-Priming Effect “ and published in “Diabetes August 1969 18:517-522; doi: 10.2337/diab.18.8.517”, described a direct correlation between the administration of ethyl alcoholin humans and INCREASE in insulin response. In type 2 diabetes , which is often associated with obesity and other dysmetabolic complications such as lipidemia alterations , maintaining low levels of circulating insulin is absolutely essential. The excess in the endocrine production of insulin is caused by hyperglycemia and peripheral resistance , which together determine some imbalances including: excess liposynthesis (fat storage) and lipoprotein oxidation (reduced cholesterol transport efficiency and atherogenesis ). In consideration of the results obtained by Metz,the assumption of wine in type 2 diabetics is absolutely inadvisable .
… But that is not all!
To date, numerous studies have brought to light a further interaction between ethyl alcohol and glycemic regulation. This time it is an INSULIN-INDEPENDENT mechanism and mainly affects the onset of type 1 diabetics:
It is known that glycemic homeostasis is the result of the hormonal balance for which if the glycemia rises, the insulin increases (which has a hypoglycaemic function) and if blood sugar drops, glucagon , catecholamines and cortisol increase(which have a HYPERglycaemic function), which intervene on the liver receptors ( glycogen reserve) determining the release of glucose into the blood by GLICOGENOLISIS . Well, it seems that the administration of ethyl alcohol in humans can determine

  • the INHIBITION of a LIVER enzyme called nicotinamide -adenine-dinucleotide responsible for NEOGLUCOGENESIS (therefore the production of glucose from glycerol , amino acids and lactic acid ),
  • the inhibition of cortisol , growth hormone and adrenaline ( three HYPERglycaemic hormones ).

This means that the intake of ethyl alcohol contained in wine significantly affects the glycemic balance and that, depending on the levels of hepatic glycogen, after a few hours it can induce HYPOGLYCEMIC COMA. Considering that type 1 diabetes is a juvenile-onset pathology which, as anticipated, manifests itself with an over-production of insulin ( hypoglycaemic ), the possible intake of wine could significantly WORSEN the glycemic homeostasis , increasing the risk of COMA. Therefore, the indications of the LARN to avoid the consumption of alcohol (therefore also of wine) in age are confirmedunder 18 years of age, and absolutely in subjects potentially at risk or in the onset phase of type 1 diabetes; in parallel, diabetics on exogenous therapy are advised to be careful when estimating insulin doses, as by drinking alcoholic products a different dosage calculation than usual may be necessary.



In the case of hypoglycemic shock in the alcoholic it has been found that the administration of fructose (instead of glucose) and small doses of insulin, in addition to restoring blood sugar, can also ACCELERATE THE DISPOSAL OF circulating ETHYL ALCOHOL.
Furthermore, although the intake of wine and other alcoholic beverages does not directly affect the onset of diabetes (except in alcoholic pancreatitis ), the statistical and clinical observation of patients who ABUSE ALCOHOL leads us to reflect on the existence of a subtype of type 2 diabetes mellitus , called alol-related.
In conclusion, the systematic consumption of wine in diabetics is not recommended; although it has been demonstrated that alcohol induces a hypoglycaemic effect (desirable in full-blown diabetes), it is an alcoholic beverage potentially responsible for abuse or drug addiction attributable to various clinical complications, including a form of alcohol-related diabetes .



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