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ORIGINAL RESEARCH COMMUNICATION |
1 From the Albert Einstein College of Medicine, Bronx, NY (JPC, SP, and JB-F); Mailman School of Public Health, Columbia University, New York, NY (AAH); the University of Colorado at Denver School of Medicine, Aurora, CO (LP); the Pennington Biomedical Research Center of Louisiana State University, Baton Rouge, LA (GAB); School of Medicine, University of California San Diego, La Jolla, CA (EB-C); Johns Hopkins School of Medicine, Baltimore, MD (TW); Roosevelt-St Luke's Hospital, New York, NY (SF); and the George Washington University Biostatistics Center, Rockville, MD (YM, SLE).
2 Members of the Diabetes Prevention Program Research Group are listed in the online data supplement. 3 Supported by the Diabetes Prevention Program, National Institutes of Health/National Institute of Diabetes and Digestive and Kidney Diseases, the National Institute of Child Health and Human Development, and the National Institute on Aging; The Office of Research on Minority Health and Health Disparities, the Office of Women’s Health; the Indian Health Service; the Centers for Disease Control and Prevention; the General Clinical Research Program, the National Center for Research Resources; the American Diabetes Association; Bristol-Myers Squibb; Lipha Pharmaceuticals, Inc; and Parke-Davis. LifeScan Inc, Health O Meter, Hoechst Marion Roussel, Inc, Merck-Medco Managed Care Inc, Merck and Co, Nike Sports Marketing, Slim Fast Foods Co, and Quaker Oats Co donated the materials, equipment, or medicines for concomitant conditions. 4 Address correspondence to JP Crandall, Diabetes Prevention Program Coordinating Center, The Biostatistics Center, George Washington University, 6110 Executive Boulevard, Suite 750, Rockville, MD 20852. E-mail: dppmail{at}biostat.bsc.gwu.edu.
Background: Moderate alcohol consumption is associated with a decreased risk of type 2 diabetes in the general population, but little is known about the effects in individuals at high risk of diabetes.
Objectives: The objectives were to determine associations between alcohol consumption and diabetes risk factors and whether alcohol consumption was a predictor of incident diabetes in individuals enrolled in the Diabetes Prevention Program (DPP).
Design: DPP participants (n = 3175) had impaired glucose tolerance (2-h glucose: 7.8–11.1 mmol/L), elevated fasting glucose (5.3–7.0 mmol/L), and a body mass index (in kg/m2) 
24. Participants were randomly assigned to placebo, metformin, or lifestyle modification and were followed for a mean of 3.2 y. Alcohol intake was assessed at baseline and year 1 by using a semiquantitative food-frequency questionnaire. Diabetes was diagnosed by annual oral-glucose-tolerance testing and semiannual fasting plasma glucose measurement.
Results: Participants who reported higher alcohol consumption tended to be male, older, white, and less obese and to have a higher calorie intake and a higher HDL-cholesterol concentration. Higher alcohol consumption was associated with lower insulin secretion at any level of insulin sensitivity. We found lower incidence rates of diabetes with higher alcohol consumption in the metformin (P < 0.01 for trend) and lifestyle modification (P = 0.02 for trend) groups, which remained significant after adjustment for multiple baseline covariates. No similar association was observed in the placebo group.
Conclusions: Despite overall low rates of alcohol consumption, there was a reduced risk of incident diabetes in those who reported modest daily alcohol intake and were assigned to metformin or lifestyle modification. Moderate daily alcohol intake is associated with lower insulin secretion—an effect that warrants further investigation. This trial was registered at clinicaltrials.gov as NCT00038727.
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