alcohol and alcohol

Wine and Diabetes

The wine

Wine is an alcoholic beverage produced by the bacterial fermentation of grapes. The general composition and the alcoholic concentration of the wine depend above all on the type of grape, on the fermentation and on the wine-making process, even if the "meal" products average about 10-11 ° of alcohol

.

Wine is a drink that - unlike distillates, other fermented wines and liqueurs - provides a fair amount of nutritional molecules; we are talking about phenolic substances . These powerful antioxidant-anticarcinogenic-antiatherogenic (tannins and isoflavones), of which the most present is undoubtedly the trans- resveratrol , are transmitted from grapes to 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 the wine; there are special pathological or physiological conditions that do not take advantage of wine consumption, on the contrary, they could potentially receive metabolic damage. According to the Recommended Nutrient Intake Levels (LARN), wine and other alcoholic beverages generally should NOT be consumed by: subjects under the age of 18, pregnant women, diabetics, drivers, therapists with certain drugs, etc.

Diabetes

Diabetes is a metabolic alteration resulting from a reduction in the effectiveness of the mechanism between INSULIN and RECEPTOR. Based on the aetiology and clinical condition, diabetes mellitus is classified into type 1 and type 2, which are respectively INSULIN-DEPENDENT (due to endocrine deficiency of the pancreas) and (usually!) NON-DEPENDENT NON-INSULIN but characterized by INEFFICACY 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 and obesity) or by one or more of these factors . A feature always present in diabetes mellitus is hyperglycemia, even if in the type 1 diabetes (INSULIN WITHOUT, THEN INSULATE-DEPENDENT) the interruption of pancreatic production of the hormone is preceded by a moment (or by a period) of IPER secretion. insulin which often manifests itself with fainting and subsequent HYPOGLYCEMIC COMA.

Diabetes: yes wine or wine no?

To date, the opinion of specialists is sufficiently unambiguous: in the case of diabetes (both type 1 and type 2) systematic consumption that exceeds the recommended ration of alcoholic beverages, and therefore of 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 alcohol in humans and INCREASE of the insulin response. In type 2 diabetes, which is often associated with obesity and other dysmetabolic complications such as changes in lipidemia, maintaining low levels of circulating insulin is absolutely fundamental. The excess in the endocrine production of insulin is caused by perglycemia and peripheral resistance, which together cause some imbalances including: excess liposynthesis (fat storage) and lipoprotein oxidation (reduced cholesterol transport efficiencies) and atherogenesis). In consideration of the results obtained by Metz, the intake of wine in type 2 diabetics is absolutely not advisable .

... 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 it mainly concerns the onset of type 1 diabetics:

It is known that glycemic homeostasis is the result of the hormonal balance for which, if the blood sugar rises, insulin increases (which has a function of hypo-glycemic) and if the blood sugar drops, glucagon, catecholamines and cortisol increase (which have a function). HYPERglycemic agent), which act on the receptors of the liver (glycogen reserve) causing the release of glucose in the blood for GLYCOGENOLYSIS. Well, it seems that the administration of ethyl alcohol in humans can determine

  • the INHIBITION of a HEPATIC enzyme called nicotinamide -adenine-dinucleotide responsible for NEOGLUCOGENESIS (ie the production of glucose from glycerol, amino acids and lactic acid),
  • inhibition of cortisol, somatotrope and adrenaline (three hyperglycemic hormones).

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

Curiosity

In the case of hypoglycemic shock in the alcoholic, it was found that the administration of fructose (instead of glucose) and small doses of insulin, in addition to restoring blood sugar levels, 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 ABUSATE OF ALCOHOL causes 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 the diabetic is not recommended ; although it has been shown that alcohol induces an IPO-glycemic effect (desirable in established diabetes), it is an alcoholic beverage potentially responsible for abuse or toxic addiction due to various clinical complications, including a form of alcohol-related diabetes .