1. Women with a history of gestational diabetes who consumed 5.0-14.9 g/day of alcohol demonstrated a reduced risk of type 2 diabetes development compared to those without any alcohol consumption.
2. Beer and wine, but not liquor, were associated with lowering the risk of type 2 diabetes incidence among women with gestational diabetes.
Evidence Rating Level: 2 (Good)
Study Rundown: Women with a history of gestational diabetes have an increased risk of developing type 2 diabetes (T2D). Several studies have demonstrated that light to moderate alcohol consumption may reduce the risk of T2D. However, it is not known whether alcohol consumption can reduce the risk of T2D in women with gestational diabetes. This prospective cohort study aimed to assess the associations between alcohol consumption and the risk of T2D development among women with a history of gestational diabetes. Participants were enrolled from the Nurses’ Health Study (NHSII), part of the Diabetes & Women’s Health Study. Women were separated into four groups based on alcohol consumption: no alcohol consumption (reference), 0.1-4.9 g/day, 5.0-14.9 g/day, and > 15.0 g/day. There were 4740 women (mean [SD] age: 38.2 [5.0] years) included with a median follow-up time of 24 years (IQR: 18-28 years). When adjusting for major dietary and lifestyle factors, women who consumed 5.0-14.9 g/day had decreased risk of T2D incidence (Hazard ratio [HR]: 0.45 [95% CI: 0.33-0.61]) compared to those who did not consume any alcohol. Those who consumed 0.1-4.9 g/day (HR: 0.87 [95% CI: 0.73-1.03]) or > 15.0 g/day (HR: 0.62 [95% CI: 0.37-1.04]) had similar risk of T2D development compared to women who did not consume alcohol. Furthermore, even after adjusting for body mass index, women who reported 5.0-14.9 g/day of alcohol consumption had reduced incidence of T2D (HR: 0.59 [95% CI: 0.42-0.81]). Upon assessment of the type of alcohol consumption and the risk of T2D development, > 1 beer serving/week (HR: 0.49 [95% CI: 0.34-0.72]) and > 3 wine servings/week (HR: 0.56 [95% CI: 0.37-0.86]) demonstrated a reduced risk of T2D development in the multivariable analysis. However, liquor consumption was not associated with decreased T2D incidence. Overall, this large, prospective cohort study with long-term follow-up demonstrated that 5.0-14.9 g/day of alcohol consumption was associated with a reduced risk of T2D among women with gestational diabetes. Notably, this study was limited by screening bias; women who were more health-conscious visited physicians more often and were, therefore, more likely to receive a medical diagnosis of T2D.
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