Department of Non-Communicable Disease Prevention, Nanjing Center for Disease Control and Prevention Affiliated to Nanjing Medical University, Nanjing, China.
Department of Epidemiology, Nanjing Medical University School of Public Health, Nanjing, China.
J Diabetes Investig. 2024 Feb;15(2):237-244. doi: 10.1111/jdi.14108. Epub 2023 Nov 20.
To investigate the association between alcohol drinking and glycemic management among adult patients with type 2 diabetes in regional China.
In this cross-sectional survey conducted in Nanjing Municipality of China in 2018, adult type 2 diabetes patients were randomly selected from urban and rural communities. The outcome variable was the glycemic management status. The explanatory measure was alcohol drinking. Mixed-effects regression models were employed to estimate odds ratios (ORs) and 95% confidence interval (95% CI) for examining the associations of alcohol drinking with glycemic management among type 2 diabetes patients.
Among the overall 5,663 participants, the glycemic management rate was 39.8% (95% CI = 38.5, 41.1), with 41.2% (95% CI = 39.7, 42.7), 43.9% (95% CI = 38.9, 48.8), and 34.1% (95% CI = 31.5, 36.7) for non-drinkers, mild/moderate drinkers, and heavy drinkers, respectively. After adjustment for potential confounders and community-level clustering effect, heavy and mild/moderate alcohol drinkers were at 0.76 (95% CI = 0.66, 0.89) and 1.04 (95% CI = 0.87, 1.28) times odds to have glycemia under control than non-drinkers among the overall participants. Furthermore, when stratified separately by gender and use of anti-diabetes agents, the scenario within men, either regular or irregular users of anti-diabetes agents was the same as that for overall participants, while the association between alcohol drinking and glycemic management became non-significant among women.
Heavy alcohol drinking might have a negative effect on glycemic management among patients with type 2 diabetes irrespective of the use of anti-diabetes agents in regional China. This study has important public health implications regarding precision intervention on patients' glycemia control for type 2 diabetes management.
本研究旨在探讨中国某地区成年 2 型糖尿病患者饮酒与血糖管理之间的关系。
本横断面研究于 2018 年在中国南京市城乡社区中随机抽取成年 2 型糖尿病患者，以血糖管理状况为结局变量，以饮酒为解释变量。采用混合效应回归模型估计比值比（OR）及其 95%置信区间（95%CI），以检验 2 型糖尿病患者饮酒与血糖管理之间的关联。
在 5663 名参与者中，血糖管理率为 39.8%（95%CI=38.5, 41.1），非饮酒者、轻度/中度饮酒者和重度饮酒者的血糖管理率分别为 41.2%（95%CI=39.7, 42.7）、43.9%（95%CI=38.9, 48.8）和 34.1%（95%CI=31.5, 36.7）。在调整潜在混杂因素和社区水平聚类效应后，重度和轻度/中度饮酒者的血糖控制达标比值比（OR）分别为 0.76（95%CI=0.66, 0.89）和 1.04（95%CI=0.87, 1.28），低于非饮酒者。此外，按性别和抗糖尿病药物使用情况进行分层后，男性（无论是否规律使用抗糖尿病药物）的情况与总体参与者相同，而女性饮酒与血糖管理之间的关联变得不显著。
在中国某地区，重度饮酒可能对 2 型糖尿病患者的血糖管理产生负面影响，无论是否使用抗糖尿病药物。本研究对 2 型糖尿病管理中针对患者血糖控制的精准干预具有重要的公共卫生意义。
