Ethyl alcohol
Ethyl alcohol (ethanol) is a typical molecule of alcoholic beverages.
Despite being a fairly common element in the adult diet, ethyl alcohol is NOT an essential molecule, nor a nutrient or even less a "healthy" molecule. It is considered a nerve because it interacts with the nervous system, worsening its overall efficiency (even if with a slight anxiolytic power) and its abuse determines toxic effects on ALL the tissues of the organism.
With regard to ethyl alcohol, the LARN (Recommended Nutrient Intake Levels for the Italian population) suggest a consumption range (for the adult population of both sexes up to the third age) that varies 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 united 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), it is most likely caused by autoimmune, genetic or environmental causes.
- Type 2: has late onset and is closely related to other dysmetabolisms typical of food abuse, therefore overweight / obesity; at the metabolic level it can be characterized by alteration of insulin secretion and / or peripheral insulin resistance. Genetic / family predispositions are also involved.
Alcohol in the diet
As anticipated, alcohol is a toxic element for all the cells of the organism, moreover, being a nerve, any abuse can induce both physical and psychological dependence in the consumer.
These few notions should be sufficient to understand that "ethyl alcohol is NOT a harmless molecule, even if it is not even plausible to completely ELIMINATE it from the collective diet, since it represents an essential ingredient of wine, the Italian alcoholic beverage" par excellence ". wine, while containing alcohol, is also rich in natural antioxidants and its organoleptic value linked to the collective tradition makes it a progenitor of national culture (and not only).
It is also advisable to specify that the negative effect of alcohol on the organism is dose-dependent, therefore its abuse is NOT RECOMMENDED above all ... although it is allowed to use it in compliance with the recommended rations (see above the suggested levels by LARN). Certainly, if not already contemplated in the eating habits of the subject, it would be out of place to recommend its integration in the diet (even if deriving from a drink rich in antioxidants such as wine); but on the other hand, if one wishes to correct consumption, it is certainly it is advisable to prefer it with good quality red wines, but never more than two alcoholic units per day (2 glasses per 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 TOTALLY advise against its consumption in the presence of diabetes mellitus; indeed ... some specialists in this dysmetabolism RECOMMEND its use in the right quantities.
On the basis of the scientific investigations that have been carried out on the metabolic effects of alcohol, it seems that its intake can in some way HELP the hyperglycemia; from the hormonal point of view it emerged that the administration of alcohol in the healthy subject can cause an INCREASE of the insulin response (Robert Metz, Sheldon Berger and Mary Mako) and a reduction in the secretion of HYPERglycemic hormones (by inhibition of nicotinamide-adenine-dinucleotide); at first glance, this might seem like a positive aspect, as many diabetics suffer from low or no insulin production 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 the cells that produce insulin, therefore, both in the presence and in the absence of alcohol, the endogenous secretion would remain unchanged.
- Type 2 diabetes is more often associated with hyperinsulinemia than with insulin deficiency, that is, an excess of insulin production caused by the lack of peripheral uptake (while insulin deficiency can occur later in the advanced stages of the disease which involve impaired pancreatic function. ). In diabetes with hyperinsulinemia, the INHIBITION of hyperglycemic hormones is certainly a positive aspect, but promoting the insulin response makes no sense ... indeed! Considering that hyperinsulinemia determines an increase in adipose deposition (already excessive in type 2 diabetic), also related to the reduced uptake of insulin itself, I would say that taking alcohol in the presence of diabetes does not prove to be an appropriate dietary choice at all.
However, alcohol also interacts with the metabolism in a totally INDEPENDENT way from hormonal cycles; it has been shown that the inhibition of nicotinamide-adenine-dinucleotide liver, in addition to reducing the production of hyperglycemic hormones, also drastically reduces the potential for NEOGLUCOGENESIS of the liver. This feature can be interpreted in two ways:
- In a positive way as it favors glycemic control in the type 2 diabetic
- In a negative way if we consider that, in type 1 diabetes, the "insulin injection must be carefully evaluated based on the carbohydrate composition of the meal; just as an excess of insulin could cause a" drastic lowering of blood sugar and hypoglycemic coma, even a " deactivation "of neoglucogenesis could participate in such an ominous 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 MOMENTARY hyper production of insulin; let alone if this circumstance took place in the presence of ethyl alcohol ... the chances of death would greatly increase! Although, hopefully, the intake of ethyl alcohol should not be included in the diet of the developing subject.
In conclusion, the hypoglycemic potential of ethyl alcohol in the healthy subject is confirmed, 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 linked 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 to exceed the recommended rations (25-40g / day equal to about 2 alcohol units overall).
Bibliography:
- Treatise on functional endocrinological diagnostics - D. Andreani, G. Menzinger - Piccin - page 437
- Intensive care - M. P. Fink, E. Abraham, J.-L. Vincent, P. M. Kochanek - Elsevier Masson - page 75
- Addiction - P. M. Mannaioni - Piccin - page 136
- Hormonal dosages and their clinical application - J. A. Loraine, E. T. Bell - Piccin - page 345
- Diabetes mellitus. Pathophysiology, clinic and therapy - G. Restori - Piccin - 375: 377
- Complete treatise on abuse and addiction. Volume II – U. Nizzoli, M. Pissacroia - Piccin - page 975
