Glycaemic control Review Article 23 0742-3071Publishing, alcohol Diabetic Medicine and2006 consumption D. Ismail et al. DME UK Oxford, article Blackwell Publishing Ltd
Social consumption of alcohol in adolescents with Type 1 diabetes is associated with increased glucose lability, but not hypoglycaemia
D. Ismail, R. Gebert, P. J. Vuillermin, L. Fraser*, C. M. McDonnell, S. M. Donath† and F. J. Cameron
Department of Endocrinology and Diabetes, Royal Children’s Hospital, Melbourne, *Wimmera Base Hospital*, Horsham and †Clinical Epidemiology and Biostatistics Unit, Royal Children’s Hospital, Melbourne, Australia Accepted 10 June 2005
Aims To determine the effects of social consumption of alcohol by diabetic
adolescents on glycaemic control.
Methods Fourteen (five male) patients aged > 16 years were recruited from the
diabetes clinic at the Royal Children’s Hospital. The continuous glucose monitoring system (CGMS) was attached at a weekend when alcohol consumption was planned for one night only. For each patient, the 12-h period from 18.00 h to 06.00 h for the night with alcohol consumption (study period) was compared with the same period with non-alcohol consumption (control period) either 24 h before or after the alcohol study night. Thus, each subject was his /her own control. Glycaemic outcomes calculated from continuous glucose monitoring included mean blood glucose (MBG), percentage of time spent at low glucose levels (CGMS < 4.0 mmol/l), normal glucose levels (CGMS 4.0–10.0 mmol/ l) and high glucose levels (> 10.0 mmol/ l) and continuous overall net glycaemic action (CONGA). Results The mean number of standard alcohol drinks consumed during the study period was 9.0 for males and 6.3 for females. There was no difference in percentage of time at high and normal glucose levels in the study and control periods. During the control period, there was a higher percentage of time with low glucose levels compared with the study period (P < 0.05). There was an increased level of glycaemic variation during the study time when compared with the control period. Conclusions In an uncontrolled, social context, moderately heavy alcohol consumption by adolescents with Type 1 diabetes appears to be associated with increased glycaemic variation, but not with low glucose levels.
Diabet. Med. 23, 830–833 (2006)
Keywords adolescence, alcohol, glycaemic control Abbreviations CGMS, continuous glucose monitoring system; CONGA, continuous overall net glycaemic action; MBG, mean blood glucose; RCH, Royal Children’s Hospital
Adolescents with Type 1 diabetes frequently engage in risk-taking activities . Amongst these activities is the social
Correspondence to: Dr Fergus Cameron, Deputy Director, Department of Endocrinology and Diabetes, Royal Children’s Hospital, Flemington Road, Parkville, Victoria 3052, Australia. E-mail: email@example.com
consumption of alcohol, frequently as underage drinkers . Whilst the effects of alcohol consumption upon glycaemia have been well described in a controlled setting [3– 6], little is known about the impact on glucose levels of alcohol consumption by adolescents within an ambulant, social context. The purpose of this project was to utilize continuous glucose monitoring to study the impact of social alcohol consumption on glycaemic control in a group of alcohol-using adolescents.
© 2006 The Authors.
Journal compilation © 2006 Diabetes UK. Diabetic Medicine, 23, 830–833
Patients and methods
This study was approved by the Human Ethics Research Committee of the Royal Children’s Hospital (RCH). That approval was contingent upon the fact that the investigators should not be seen to encourage underage drinking in adolescents. Consequently, we only approached adolescents who we knew were drinking socially and, despite our previous counselling, elected to continue to drink...