The relationship between alcohol consumption, BMI, and type 2 diabetes

Moderate alcohol use may be associated with lower risk of type 2 diabetes mellitus (T2DM). Previous reviews have reached mixed conclusions. A study aimed to quantify the dose-response relationship between alcohol consumption and T2DM, accounting for differential effects by sex and BMI. A search of medical research databases for cohort studies on the relationship between alcohol use and T2DM identified fifty-five studies and one secondary data source for inclusion, with a combined sample size of 1,363,355 men and 1,290,628 women, with 89,983 and 57,974 individuals, respectively, diagnosed with T2DM.
For women, a J-shaped relationship was found with a maximum risk reduction of 31% (relative risk [RR] 0.69, 95% CI 0.64–0.74) at an intake of 16 g of pure alcohol per day compared with lifetime abstainers. The protective association ceased above 49 g per day (RR 0.82, 95% CI 0.68–0.99). For men, no statistically significant relationship was identified. When results were stratified by BMI, the protective association was only found in overweight and obese women
The authors caution that the analysis relied on aggregate data and some articles were included that determined exposure and cases via self-report, and the studies did not account for temporal variations in alcohol use. The observed reduced risk seems to be specific to women in general and women with a BMI ≥25 kg/m2. The findings allow for a more precise prediction of the sex-specific relationship between T2DM and alcohol use, as the results differ from those of previous studies.
Source: Laura Llamosas-Falcón, Jürgen Rehm, Sophie Bright, Charlotte Buckley, Tessa Carr, Carolin Kilian, Aurélie M. Lasserre, Julia M. Lemp, Yachen Zhu, Charlotte Probst; The Relationship Between Alcohol Consumption, BMI, and Type 2 Diabetes: A Systematic Review and Dose-Response Meta-analysis. Diabetes Care 1 November 2023; 46 (11): 2076–2083.