Effect of Alcohol on Glucose Tolerance in Normal and Noninsulin‐dependent Diabetic Subjects

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Abstract
Oral glucose tolerance tests were conducted in 10 noninsulin-dependent diabetic and 14 healthy control subjects with a 75-g glucose load. The tests were repeated 1 week later with 43 g of ethanol mixied with the glucose. Blood samples were analyzed for ethanol, glucose, insulin, C-peptide, and glucagon levels. The blood ethanol peak was nearly equal in diabetic and control subjects (mean .+-. SEM values of 55 .+-. 8 and 48 .+-. 6 mg/dl 45 min after ethanol ingestion). Ethanol did not affect glucose tolerance in either of the study groups. Mean .+-. SEM values of the sum of the increment above the baseline glucose level were 659 .+-. 48 vs. 675 .+-. 76 mg/dl with or without ethanol in diabetics and 227 .+-. 35 vs. 244 .+-. 36 mg/dl in control subjects. The plasma insulin and c-peptide responses to glucose were delayed in diabetic patients compared to controls but were not affected by ethanol. In vitro, ethanol, at a concentration of 100mg/dl or greater, significantly decreased insulin binding to erythrocytes in a dose-related manner. Scatchard analysis of competitive insulin binding to erythrocytes indicated that ethanol reduced insulin binding affinity (1.6 .+-. 0.5 vs. 4.2 .+-. 0.8 .times. 108/M), but not binding capacity (4.5 .+-. 2.4 vs. 4.4 .+-. 1.7 nM, with and without ethanol, respectively).