Schrieks IC, et al. · 2015
🌱 La lettura di LEO
⚙️ Lavora su: Motore metabolico · lente Traiettoria · il corpo nel tempo
tocca anche 📉 Stabilità nel tempo
Revisione sistematica e meta-analisi di studi d'intervento (14 studi; campioni piccoli, durata breve)
La domandaBere in modo moderato peggiora la sensibilita' all'insulina o il controllo glicemico?
Cosa hanno trovato14 studi d'intervento, sei esiti glicemici messi insieme. Il consumo di alcol NON ha modificato la sensibilita' insulinica stimata (SMD 0,08; IC −0,09/0,24) ne' la glicemia a digiuno (0,07; −0,11/0,24), mentre ha RIDOTTO l'HbA1c (−0,62; −1,01/−0,23) e l'insulina a digiuno (−0,19; −0,35/−0,02). Nelle donne l'insulina a digiuno scendeva e la sensibilita' insulinica tendeva a migliorare; negli uomini no. Gli autori avvertono: studi piccoli e brevi, e i soggetti erano non diabetici.
Cosa significa per teUn dato scomodo per la vecchia regola che metteva l'alcol al primo posto fra le cose da evitare: in quantita' moderate non peggiora i numeri glicemici, e in questi studi li migliorava leggermente. Il vero problema dell'alcol nel diabete e' un altro — l'ipoglicemia — e riguarda soprattutto chi usa insulina o sulfaniluree.
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.