根据一项为期两年的随机对照试验，每天晚上一杯红酒或许可以帮助2型糖尿病病人更好地控制胆固醇水平和心血管健康，除此之外研究还显示红酒和白酒都可以改善血糖控制情况，但这依赖于不同个体的酒精代谢基因表达情况。
在这项发表在国际学术期刊Annals of Internal Medicine上的研究中，来自以色列本-古里安大学的研究人员对糖尿病病人适度饮酒的作用和安全性进行了评估，并试图确定酒的类型是否具有影响。
在这项最新研究中，研究人员将病人随机分为三组，分别在每天晚餐时候饮用150ml矿泉水，白酒或红酒，该研究共持续两年。研究人员严格监测了病人对酒精的摄入情况，每个病人都要用空酒瓶换取新的饮品。每组病人都按照无卡路里限制的地中海饮食方式进行进食。在研究过程中，参与研究的病人都会得到一系列医学检测，其中包括血压，心率和血糖水平变化的连续监测以及动脉粥样硬化情况和身体脂肪含量的评估。
结果表明，对于糖尿病病情控制良好的病人来说，适度饮酒特别是红酒是非常安全的，并会适度降低心血管代谢病风险，研究人员发现红酒能够适度改善整体代谢指标，主要是脂质代谢方面。
研究人员还发现只有酒精代谢缓慢的病人才会改善血糖控制情况，而酒精代谢较快的病人并不会得到血糖控制方面的获益。除此之外，不管是红酒还是白酒都不会影响血压，肝功能，脂肪含量以及其他有害症状，并且相比于喝水的病人，喝酒还可以显著改善病人的睡眠质量。
总的来说，这项研究对于帮助2型糖尿病病人建立更加合理健康的饮食方式具有一定意义。
Effects of Initiating Moderate Alcohol Intake on Cardiometabolic Risk in Adults With Type 2 Diabetes: A 2-Year Randomized, Controlled Trial
Yftach Gepner, MPH*; Rachel Golan, RD, PhD*; Ilana Harman-Boehm, MD; Yaakov Henkin, MD; Dan Schwarzfuchs, MD; Ilan Shelef, MD; Ronen Durst, MD; Julia Kovsan, MSc; Arkady Bolotin, PhD; Eran Leitersdorf, MD; Shoshana Shpitzen, MA; Shai Balag, MD; Elad Shemesh, MD; Shula Witkow, RD, MPH; Osnat Tangi-Rosental, BA?; Yoash Chassidim, PhD; Idit F. Liberty, MD; Benjamin Sarusi, MSc; Sivan Ben-Avraham, RD, MPH; Anders Helander, PhD; Uta Ceglarek, PhD; Michael Stumvoll, MD; Matthias Blüher, MD; Joachim Thiery, MD; Assaf Rudich, MD, PhD; Meir J. Stampfer, MD, DrPH; and Iris Shai, RD, PhD
Background: Recommendations for moderate alcohol consumption remain controversial, particularly in type 2 diabetes mellitus (T2DM). Long-term randomized, controlled trials (RCTs) are lacking.
Objective: To assess cardiometabolic effects of initiating moderate alcohol intake in persons with T2DM and whether the type of wine matters.
Design: 2-year RCT (CASCADE [CArdiovaSCulAr Diabetes & Ethanol] trial). (ClinicalTrials.gov: NCT00784433)
Setting: Ben-Gurion University of the Negev-Soroka Medical Center and Nuclear Research Center Negev, Israel.
Patients: Alcohol-abstaining adults with well-controlled T2DM.
Intervention: Patients were randomly assigned to 150 mL of mineral water, white wine, or red wine with dinner for 2 years. Wines and mineral water were provided. All groups followed a Mediterranean diet without caloric restriction.
Measurements: Primary outcomes were lipid and glycemic control profiles. Genetic measurements were done, and patients were followed for blood pressure, liver biomarkers, medication use, symptoms, and quality of life.
Results: Of the 224 patients who were randomly assigned, 94% had follow-up data at 1 year and 87% at 2 years. In addition to the changes in the water group (Mediterranean diet only), red wine significantly increased high-density lipoprotein cholesterol (HDL-C) level by 0.05 mmol/L (2.0 mg/dL) (95% CI, 0.04 to 0.06 mmol/L [1.6 to 2.2 mg/dL]; P < 0.001) and apolipoprotein(a)1 level by 0.03 g/L (CI, 0.01 to 0.06 g/L;P = 0.05) and decreased the total cholesterol-HDL-C ratio by 0.27 (CI, ?0.52 to ?0.01; P = 0.039). Only slow ethanol metabolizers (alcohol dehydrogenase alleles [ADH1B*1] carriers) significantly benefited from the effect of both wines on glycemic control (fasting plasma glucose, homeostatic model assessment of insulin resistance, and hemoglobin A1c) compared with fast ethanol metabolizers (persons homozygous forADH1B*2). Across the 3 groups, no material differences were identified in blood pressure, adiposity, liver function, drug therapy, symptoms, or quality of life, except that sleep quality improved in both wine groups compared with the water group (P = 0.040). Overall, compared with the changes in the water group, red wine further reduced the number of components of the metabolic syndrome by 0.34 (CI, ?0.68 to ?0.001;P = 0.049).
Limitation: Participants were not blinded to treatment allocation.
Conclusion: This long-term RCT suggests that initiating moderate wine intake, especially red wine, among well-controlled diabetics as part of a healthy diet is apparently safe and modestly decreases cardiometabolic risk. The genetic interactions suggest that ethanol plays an important role in glucose metabolism, and red wine's effects also involve nonalcoholic constituents.
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