Ethyl alcohol
Ethyl alcohol (ethanol) is a molecule typical of alcoholic beverages.
Despite being a fairly widespread element in the diet of adults, ethyl alcohol is NOT an essential molecule, nor a nutrient, much less a "healthy" molecule. It is considered a nerve because it interacts with the nervous system worsening the overall efficiency (even if with a slight anxiolytic power) and the abuse determines toxic effects on ALL the tissues of the body.
With regard to ethyl alcohol, the LARN (Recommended Nutrient Intake Levels for the Italian population) suggest a consumption interval (for the adult population of both sexes up to the third age) ranging between 25 and 40g / day .
NB . The systematic abuse of ethyl alcohol causes psychophysical dependence and is defined as alcoholism, alcoholism or binge-drinking.
Types of diabetes
Diabetes is a disease generally related to overweight / obesity, metabolic syndrome and genetic or family predispositions; different types are known, all linked by the alteration of sugar metabolism (Diabetes Mellitus and not Diabetes Insipidus). The types of diabetes are:
- Type 1: characterized by early onset (at a young age) and insulin dependence (which determines the need to inject synthetic insulin), is probably caused by autoimmune, genetic or environmental causes.
- Type 2: it has a late onset and is closely related to other metabolic disorders typical of food abuse, therefore of overweight / obesity; at metabolic level it can be characterized by alteration of insulin secretion and / or insulin peripheral resistance. Genetic / family predispositions are also implicated.
Alcohol in the diet
As anticipated, alcohol is a toxic element for all the cells of the body, moreover, being a nerve, the possible abuse can induce in the consumer a dependence both physical and psychological.
These few notions should be sufficient to understand that ethyl alcohol is NOT a harmless molecule, even if it is not even plausible to ELIMINATE it totally from the collective diet, since it represents an essential ingredient of wine, the Italian alcohol drink "par excellence". The wine, while containing alcohol, is also rich in natural antioxidants and its organoleptic value linked to the collective tradition makes it a forefather of the national culture (and not only).
It is also appropriate to specify that the negative effect of alcohol on the organism is dose-dependent, therefore, if it IS NOT RECOMMENDED above all the abuse ... although it is allowed to use it in compliance with the recommended rations (see the suggested levels above by LARN). Certainly, if not already contemplated in the subject's eating habits, it would be out of place to recommend supplementing them in the diet (even if deriving from a drink rich in antioxidants such as wine); but on the other hand, wanting to correct its consumption, it is certainly advisable to prefer its contribution with red and good quality wines, but never beyond the two daily alcoholic units (2 glasses a day).
Drinking alcohol with diabetes
Taking for granted an intelligent use of alcohol in the diet, it seems that there are no scientific assumptions that do not TOTALLY discourage consumption in the presence of diabetes mellitus; indeed ... some specialists of this dysmetabolism RECOMMEND their use in the right quantities.
On the basis of the scientific studies that have been carried out on the metabolic effects of alcohol, it seems that its intake can in some way be used to hyperglycemia; from the hormonal point of view it emerged that the administration of alcohol in the healthy subject can determine an INCREASE of the insulin response (Robert Metz, Sheldon Berger and Mary Mako) and a reduction of the secretion of hyperglycemic hormones (by inhibition of nicotinamide-adenine-dinucleotide ) ; at a first analysis, this might seem a positive aspect, as many diabetics suffer from a poor or absent production of insulin related to hyperglycemia. In my opinion (personal opinion), in most cases this is not the case:
- Type 1 diabetes is caused by the destruction of insulin-producing cells, therefore, both in the presence and in the absence of alcohol, endogenous secretion would remain unchanged.
- Type 2 diabetes is more often associated with hyperinsulinemia than with insulin deficiency, or an excess of insulin production caused by the failure of peripheral uptake (while the insulin deficiency can take over later, in the advanced stages of the disease that include impairment of pancreatic function ). In diabetes with hyperinsulinemia, the INHIBITION of hyperglycemic hormones is certainly a positive aspect, but encouraging the insulin response makes no sense ... indeed! Considering that hyperinsulinemia causes an increase in adipose deposition (already excessive in type 2 diabetics), also related to reduced insulin uptake, I would say that drinking alcohol in the presence of diabetes does not prove to be an appropriate dietary choice.
However, alcohol also interacts with the metabolism in a totally INDEPENDENT manner from hormonal cycles; It has been shown that inhibition of hepatic nicotinamide-adenine-dinucleotide, as well as reducing the production of hyperglycemic hormones, also drastically reduces the potential of NEOGLUCOGENESIS of the liver. This feature can be interpreted in two ways:
- Positively as it promotes glycemic control to type 2 diabetic
- Negatively if we consider that, in type 1 diabetes, insulin injection must be carefully evaluated based on the carbohydrate composition of the meal; just as an excess of insulin could cause drastic lowering of blood glucose and hypoglycemic coma, even a "deactivation" of the neoglucogenesis could participate in such an unfortunate event. Last and not least, we remind you that type 1 diabetes usually occurs at an early age and with hypoglycemic shock linked to a hyper MOMENTARY production of insulin; let alone if this circumstance took place in the presence of ethyl alcohol ... the chances of death would increase considerably! Even if, hopefully, the intake of ethyl alcohol should not be contemplated in the feeding of the subject in the development phase.
In conclusion, the hypoglycemic potential of ethyl alcohol is confirmed in the healthy subject probably linked to: increased insulin secretion and inhibition of hyperglycemic hormones and neoglucogenesis; on the other hand, considering the heterogeneity of the different clinical forms of diabetes, the various facets related to the severity and / or stage of the disease, as well as the widespread correlation between diabetes and obesity, it is certainly advisable to moderate the intake of ethyl alcohol and certainly not exceed the recommended rations (25-40g / day equal to about 2 total alcoholic units).
Bibliography:
- Endocrinological functional diagnostic treatise - D. Andreani, G. Menzinger - Piccin - pag 437
- Intensive care - MP Fink, E. Abraham, J.-L. Vincent, PM Kochanek - Elsevier Masson - page 75
- Drug addiction - PM Mannaioni - Piccin - pag 136
- Hormonal doses and their clinical application - JA Loraine, ET Bell - Piccin - page 345
- Diabetes mellitus. Pathophysiology, clinic and therapy - G. Restori - Piccin - 375: 377
- Complete treaty of abuses and addictions. Volume II – U. Nizzoli, M. Pissacroia - Piccin - pag 975
