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Alcohol Use and Diabetes Mellitus
- Andrea A. Howard, MD, MS;
- Julia H. Arnsten, MD, MPH; and
- Marc N. Gourevitch, MD, MPH
- From Montefiore Medical Center, Bronx, NY 10467, and New York University School of Medicine, New York, NY 10016.
The Editors welcome submissions for possible publication in the Letters section. Authors of letters should:
•Include no more than 300 words of text, three authors, and five references
•Type with double-spacing
•Send three copies of the letter, an authors' form signed by all authors, and a cover letter describing any conflicts of interest related to the contents of the letter.
Letters commenting on an Annals article will be considered if they are received within 6 weeks of the time the article was published. Only some of the letters received can be published. Published letters are edited and may be shortened; tables and figures are included only selectively. Authors will be notified that the letter has been received. If the letter is selected for publication, the author will be notified about 3 weeks before the publication date. Unpublished letters cannot be returned.
Annals welcomes electronically submitted letters.
IN RESPONSE:
Sone and colleagues report a lack of association between baseline alcohol consumption and CHD incidence among a cohort of Japanese patients with diabetes. These preliminary findings may suggest that racial or ethnic differences are playing an unmeasured role in CHD incidence. However, because nearly half of Sone and colleagues' patients were randomly assigned to a lifestyle modification program that included abstinence from alcohol (1), it is difficult to have confidence in their conclusions without data on alcohol consumption during follow-up.
Drs. Mascitelli and Pezzetta correctly point out that we did not discuss anti-inflammatory effects of alcohol as a mechanism for the association between moderate alcohol consumption and decreased incidence of diabetes and of CHD in persons with diabetes. Instead, we focused on more established risk factors, including insulin resistance and high-density lipoprotein cholesterol levels. Emerging data suggest that inflammation may play a role in the pathogenesis of type 2 diabetes mellitus and cardiovascular disease (2). While the cross-sectional studies cited by Mascitelli and Pezzetta show an association between light to moderate alcohol consumption and lower levels of inflammatory markers, other studies have not found an association (3), and a causal relationship has not been established. Further research is warranted to determine whether alcohol affects systemic inflammation and whether this partially explains the association between moderate alcohol consumption and decreased risk for both diabetes and diabetes-related cardiovascular disease.
Andrea A. Howard, MD, MS
Julia H. Arnsten, MD, MPH
Montefiore Medical Center, Bronx, NY 10467
Marc N. Gourevitch, MD, MPH
New York University School of Medicine, New York, NY 10016
The Editors welcome submissions for possible publication in the Letters section. Authors of letters should:
•Include no more than 300 words of text, three authors, and five references
•Type with double-spacing
•Send three copies of the letter, an authors' form signed by all authors, and a cover letter describing any conflicts of interest related to the contents of the letter.
Letters commenting on an Annals article will be considered if they are received within 6 weeks of the time the article was published. Only some of the letters received can be published. Published letters are edited and may be shortened; tables and figures are included only selectively. Authors will be notified that the letter has been received. If the letter is selected for publication, the author will be notified about 3 weeks before the publication date. Unpublished letters cannot be returned.
Annals welcomes electronically submitted letters.
