2002, Number 4
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Rev Med Inst Mex Seguro Soc 2002; 40 (4)
Acute Alcohol Intake, a Risk Factor for Acute Diabetes Mellitus Complications Development?
Hernández PF, Ornelas BL
Language: Spanish
References: 20
Page: 293-299
PDF size: 133.23 Kb.
ABSTRACT
Objective: To determine whether acute intake of alcohol increases risk for development of acute complications such as diabetic ketoacidosis (DK), hyperglycemic hyperosmolar nonketotic syndrome (HHNS), and hypoglycemia.
Study design: Cases and controls in three urban Mexican hospitals.
Methods: We carried out the study in Hospitals 1, 26, and 47 of the Instituto Mexicano del Seguro Social (IMSS). Included were all patients who were treated at the emergency service with diagnosis of diabetic ketoacidosis, hypoglycemia, and hyperglycemic hyperosmolar nonketotic state. Diabetic patients who entered the emergency room for reasons other than acute complication of diabetes were considered controls. In both groups we investigated alcohol intake for the past 2 weeks, kind of alcohol and amount, as well as clinical manifestations when subjects entered emergency rooms (ethylic intoxi-cation, ethylic suppression syndrome, or with no symptom).
Results: We studied 61 cases and 65 controls, found 11 patients in each group who accepted to have consumed alcohol with a mean of 3 ± 2.7 days acute intake of alcohol, with 2.4 ± 2.7 days suspended alcohol intake. There were 18 patients with DK, 18 with HHNS, 13 with mixed state (DK and HHNS), and 12 with hypoglycemia; 86.9 % had type 2 diabetes mellitus, 59 % accepted not eating an appropriate diet, 24.6 % failed to take their medicine, and infections were present in 31 cases. There was no significant difference (p › 0.05). However, in the group and controls who accepted acute intake of alcohol, we found a significant difference only at time of evolution of diabetes; in this case with group 8.3 ± 5.2 years and control 16.1 ± 3.3 years, there was a significant difference (p ‹ 0.05).
Conclusions: We failed to demonstrate that acute intake of alcohol increased risk of development of acute complications of diabetes mellitus.
REFERENCES
1. Pope D, Dansky D. Cetoacidosis diabética. Clin Med Urg NA 1988;2:1013-1026.
2. Umpierrez G, Khajavi M, Kitabchi A. Diabetic ketoacidosis and hyperglucemic hyperosmolar nonketotic syndrome. Am J Med Sci 1996;311:225-233.
3. Zeinse T, Sobyhy T. Low doses ethanol is a mecha-nism for sulfonylurea induced hypoglycaemia in fasted elderly type 2 diabetic patients. Diabetes 1988;(Supl):A106.
4. Songaard O, Eskinldsen P, Vandstrup S. Diabetic ketoacidosis in Denmark: Epidemiology, incidences rates and mortality rates. J Inter Med 1989;226:223-228.
5. Umpierrerez G, Kelly J, Navarrete J, Casals M, Kitabchi A. Hyperglycaemic crisis in black. Arch Inter Med 1997;157:669-675.
6. Koivisto V, Tuloskas S, Toivonen M. Alcohol with a meal has no adverse effects on postprandial glu-cose homeostasis in diabetes patients. Diabetes Care 1993;16:1612-1614.
7. Fleckman A. Diabetic ketoacidosis. Endocrinol Metabolism Clinic NA 1993;22:181-207.
8. Ho T. Pathogenesis of glucose intolerance in alcoholic. Nippon Rinsho 1996;54:2333-2338.
9. Tao C. Can severe degree of ketoacidosis develop overnight? J Suc Nephrol 1996;7:92-97.
O’Connor P, Schottenfeld R. Patient with alcohol problem. N Engl J Med 1998;338:592-601.
López-Jiménez JL. Patrón de consumo de alcohol en pacientes captados en las salas de urgencias. Salud Publica Mex 1998;40:487-493.
Narro-Robles J, Gutiérrez J. Correlación ecológica entre el consumo de bebidas alcohólicas y mortali-dad por cirrosis hepática en México. Salud Publica Mex 1997;39:217-220.
Rimm E, Chan J, Stampfer M,Golditz G, Wilter W. Prospective study of cigarette smoking, alcohol use, and the risk of diabetes in men. BMJ 1995;310:555-559.
Linares M, Schunk J, Lindsay R. Laboratory pre-sentation in diabetic ketoacidosis and duration of therapy. Pediatric Emerg Care 1996;12:347-351.
American Diabetes Association. Hospital admission guidelines for diabetes mellitus. Diabetes Care 1998; (Suppl) 21:S77.
Schlesselman J. Case control studies: Design, conduct, analysis. USA: Oxford University Press; 1982. p. 144-170.
Souza M, Guisa V, Barriga E, Sánchez R. Farmaco-terapia de los síndromes de intoxicación y absti-nencia por psicotrópicos. México: Dirección de Pro-moción Institucional de los Centros de Integración Juvenil; 1997. p. 81-117.
Monterrosas A, Stern M, Haffner S, Hazuda H. Sex difference in life-style factors predictive of diabetes in Mexican-Americans. Diabetes Care 1995;18:448-456.
Musey V, Klatka M, Lee J, McAdams D, Crawford R, Phillips L. Diabetic in urban African-Americans. I. Cessation of insulin therapy is the major precipitating cause of diabetic ketoacidosis. Diabetes Care 1995; 18:483-489.
Wilson C, Krakoff J, Gohdes D. Ketoacidosis in Apache Indians with non-insulin-dependent diabetes mellitus. Arch Intern Med 1997;157:2098-2100.