Abstract P149: The Effect of Alcohol Consumption on Insulin Sensitivity and Glycemic Status: A Systematic Review and Meta-analysis of Intervention Studies

Introduction: Moderate alcohol consumption is associated with a reduced risk of type 2 diabetes, but this relation appears stronger for women than men. The reduced risk of diabetes could be explained by improved insulin sensitivity or glycemic status, but results of intervention studies on this relation are inconsistent. Our aim was to conduct a systematic review and meta-analysis of intervention studies investigating the effect of alcohol consumption on insulin sensitivity and glycemic status. Design: Systematic review and meta-analysis of intervention studies. Data sources: PubMed and Embase were searched until May 2013 using a pre-specified search string. Methods: Intervention studies on the effect of more than 2 weeks alcohol consumption on biological markers of insulin sensitivity or glycemic status were identified and assessed on their quality. Pooled standardized mean differences (SMD) were calculated using either fixed or random effects models. Gender-stratified analyses and sensitivity analyses excluding studies with high doses of alcohol (> 40 g/day). In a meta-regression the influence of dosage and duration of intervention was tested. Results: We included 14 intervention studies in a meta-analysis on 6 glycemic endpoints. Alcohol consumption did not influence insulin sensitivity (SMD=0.06 [-0.13 to 0.26]) or fasting glucose (SMD=0.09 [-0.09 to 0.27]). Alcohol consumption reduced HbA1c (SMD=-0.62 [-1.01 to -0.23], P=0.002) and insulin concentrations (SMD=-0.17 [-0.34 to 0.00] P=0.049) compared with the control group. In women, alcohol consumption reduced fasting insulin (SMD=-0.23 [-0.41 to -0.04], P=0.019) and improved insulin sensitivity (SMD=0.19 [-0.03 to 0.41], P=0.087), but no significant differences were observed among men. Results were similar when only studies with moderate alcohol dosages were analysed and were not influenced by dosage and duration of the intervention. Conclusions: This study showed that moderate alcohol consumption may reduce fasting insulin and improve insulin sensitivity among women, but not among men. These effects may provide an explanation for the relation between alcohol consumption and type 2 diabetes. Furthermore, moderate alcohol consumption may reduce HbA1c levels among both men and women.

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The Effect of Alcohol Consumption on Insulin Sensitivity and Glycemic Status: A Systematic Review and Meta-analysis of Intervention Studies

Diabetes Care ◽

10.2337/dc14-1556 ◽

2015 ◽

Vol 38 (4) ◽

pp. 723-732

Author(s):

Ilse C. Schrieks ◽

Annelijn L.J. Heil ◽

Henk F.J. Hendriks ◽

Kenneth J. Mukamal ◽

Joline W.J. Beulens

Keyword(s):

Systematic Review ◽

Insulin Sensitivity ◽

Alcohol Consumption ◽

Intervention Studies ◽

Meta Analysis ◽

Moderate Alcohol Consumption ◽

Fasting Insulin ◽

Improve Insulin Sensitivity ◽

Glycemic Status ◽

Reduced Risk

OBJECTIVE Moderate alcohol consumption is associated with a reduced risk of type 2 diabetes. This reduced risk might be explained by improved insulin sensitivity or improved glycemic status, but results of intervention studies on this relation are inconsistent. The purpose of this study was to conduct a systematic review and meta-analysis of intervention studies investigating the effect of alcohol consumption on insulin sensitivity and glycemic status. RESEARCH DESIGN AND METHODS PubMed and Embase were searched up to August 2014. Intervention studies on the effect of alcohol consumption on biological markers of insulin sensitivity or glycemic status of at least 2 weeks' duration were included. Investigators extracted data on study characteristics, outcome measures, and methodological quality. RESULTS Fourteen intervention studies were included in a meta-analysis of six glycemic end points. Alcohol consumption did not influence estimated insulin sensitivity (standardized mean difference [SMD] 0.08 [−0.09 to 0.24]) or fasting glucose (SMD 0.07 [−0.11 to 0.24]) but reduced HbA1c (SMD −0.62 [−1.01 to −0.23]) and fasting insulin concentrations (SMD −0.19 [−0.35 to −0.02]) compared with the control condition. Alcohol consumption among women reduced fasting insulin (SMD −0.23 [−0.41 to −0.04]) and tended to improve insulin sensitivity (SMD 0.16 [−0.04 to 0.37]) but not among men. Results were similar after excluding studies with high alcohol dosages (>40 g/day) and were not influenced by dosage and duration of the intervention. CONCLUSIONS Although the studies had small sample sizes and were of short duration, the current evidence suggests that moderate alcohol consumption may decrease fasting insulin and HbA1c concentrations among nondiabetic subjects. Alcohol consumption might improve insulin sensitivity among women but did not do so overall.

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Effects of Whole Grain Intake, Compared to Refined Grain, on Glycemia and Insulinemia: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

Current Developments in Nutrition ◽

10.1093/cdn/nzab041_036 ◽

2021 ◽

Vol 5 (Supplement_2) ◽

pp. 521-521

Author(s):

Lisa Sanders ◽

Yong Zhu ◽

Meredith Wilcox ◽

Katie Koecher ◽

Kevin Maki

Keyword(s):

Systematic Review ◽

Type 2 Diabetes ◽

Insulin Sensitivity ◽

Meta Analysis ◽

Whole Grain ◽

Postprandial Glycemia ◽

Randomized Controlled ◽

Reduced Risk

Abstract Objectives Epidemiological study results suggest that whole grain (WG) consumption is associated with a reduced risk of type 2 diabetes; however, the potential mechanism behind this observation is unclear. WG intake may lower postprandial glycemia and insulinemia and improve insulin sensitivity, thereby contributing to a reduced risk of type 2 diabetes. The objective of this systematic review and meta-analysis was to evaluate the impact of WG on postprandial glycemia and insulinemia and markers of glycemic control and insulin sensitivity/resistance. Methods A systematic review and meta-analysis was conducted on randomized controlled trials (RCTs) evaluating the effect of WG intake, compared to refined grain (RG) intake, on postprandial glycemia and insulinemia area under the curve and markers of glycemic control and insulin sensitivity/resistance in adults. A search of PubMed and Scopus yielded 80 relevant RCTs. Pooled estimates were expressed as standardized mean differences (SMD) between the WG intervention and RG control group. Results WG intake resulted in a significant reduction of postprandial glycemia (SMD: −0.46, 95% CI: −0.59, −0.33, P < 0.001) and insulinemia (SMD: −0.29, 95% CI: −0.39, −0.20, P < 0.001), compared to RG intake. There were no significant effects of WG on fasting glucose, fasting insulin, or homeostatic model assessment of insulin resistance (HOMA-IR); however, there was a marginally significant benefit of WG intake for glycated hemoglobin (HbA1c) (P = 0.050). Conclusions Compared to RG foods, WG foods improve postprandial glycemia and insulinemia which may partially explain the association of WG intake and reduced risk of type 2 diabetes. However, WG intake did not impact long-term markers of glycemic and insulinemic control, except for a marginally significant effect on HbA1c. While short term improvements in glycemic response may be beneficial, more investigations are needed to determine if these lead to long-term benefits in reducing the risk of type 2 diabetes. PROSPERO Registration: CRD42020180069 Funding Sources This research was funded by General Mills, Inc.

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