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202 Cardio Diabetes Medicine 2017

abetics who are taking insulin or oral hypoglycemic alcohol.
agents when they consume alcohol in excess level.
• Patients who abuse alcohol are at high risk of liver
Occasional episodes of alcohol consumption gen- damage and must not take metformin and trogl-
erally do not worsen blood sugar control in people itazone
with diabetes and may even have beneficial effects Wine is considered particularly beneficial, probably
.Regular consumption of 2 to 4 drinks per day clearly because it has chemical compounds that improve
interferes with diabetic blood sugar control and in- blood sugar balance. Gin have the opposite effect
creases the risk of peripheral neuropathy, retinopa- along with other spirits. Chances of getting hypogly-
thy and impotence.
caemia are higher in diabetics who are taking insulin
or oral hypoglycemic agents when they consume al-
Effects of alcohol consumption in fed state cohol in excess level.
• Chronic alcohol consumption increases the blood The American Diabetes Association (ADA) recom-
sugar level in the fed state.
mends the following for people diabetes when they
drink.
Effects of alcohol consumption in fasting
state • Women should not have more than one drink per
day
• Profound reduction in blood sugar level(Reduced
reserve of glycogen and impaired gluconeogenisis) • Men should not have more than two drinks per day
• Unawareness,of hypoglycaemia and delayed re- • Do not drink on an empty stomach or when blood
coveryfrom hypoglycaemia. sugar levels are low
• Do not replace food with alcohol in a meal plan-do
Effects of alcohol on DKA not account alcohol in a food plan as a carbohy-

Poor food intake and impaired gluconeogensis lead drate choice
to lower blood sugar level and as a result insulin se- • Sips drinks slowly to make them last
cretion is reduced. Because insulin restrains gucagon
secretion, lower insulin secretion allows increased Keep hydrated with zero-calorie drinks like water or
glucagon secretion, setting stage for development diet soda.
of ketoacidosis. Dehydration and reduced blood vol-
ume increases the levels of stress hormones which Alcohol and Lipid
further decrease the insulin production and increase Alcoholic hyperlipidemia results primarily from in-
glucagon production. Accordingly Physicians who creased hepatic secretion of very low density pro-
treat diabetics known to consume large amount of tein(VLDL) and secondarily from impairment in the
alcohol must be aware of risk of alcoholic ketoaci- removal of triacylglycerol rich lipoprotein from the
dosis in those patients. plasma. It is estimated that the cardioprotector effect
of alcohol may be attributed to 50% of HDL (High
Effects of alcohol on nerves Density Lipoprotein) cholesterol increase . Moderate
Diabetics and alcohol consumption are the two most consumption of Alcohol(30gm Ethanol per day) re-
common underlying causes of peripheral neuropathy. sults in increasing the concentration of HDL choles-
Symptomatic peripheral neuropathy is more common terol in approximately 4mg/dl, apoA1 in 8.82mg/dl,
in men who consumes a tleast 3 to 4 alcohol con- with a reduction to the risk of cardiac disease esti-
taining beverages almost every night compared with mated at 24.7%. In the postprandial period the alco-
men who drinks less alcohol and diabetics can en- hol is responsible for an increase in the triglycerides,
hance each others effects in terms of causing nerve with the inhibition of the oxidation of Free Fatty Acid
damage. (FFA). The hypertriglyceridemia or the increase of FFA
are associated to a reduction of the endothelial va-
Alcohol reduces blood levels of testosterone. Heavy sodilatation in normal individuals and those who are
drinkers are at high risk to develop impotence if they insulin resistant.
are diabetic too.
Conclusion
Effects of alcohol on OHA
Alcohol is a drug of complex physiological effects
• People treated with chlorpropamide experience an that vary according to gender, age, race, bodyweight
unpleasant disulfiram like reaction after drinking

GCDC 2017