Journal of Clinical Endocrinology & Metabolism, Vol 81, 2285-2290, Copyright © 1996 by Endocrine Society

ARTICLES

Ethanol impairs insulin-mediated glucose uptake by an indirect mechanism

A Avogaro, A Valerio, M Miola, C Crepaldi, P Pavan, A Tiengo and S del Prato
Divisione di Malattie del Ricambio, Universita' degli Studi, Azienda Ospedaliera di Padova, Italy.

The effect of ethanol (ETOH) on muscle metabolism was assessed in both normal (NC) and noninsulin-dependent (NIDDM) subjects in the basal state and during isoglycemic hyperinsulinemia (450 pmol/L) clamp studies carried out either with systemic (NC, n = 5; NIDDM, n = 5) or intrabrachially (NC, n = 5; NIDDM, n = 5)ETOH infusion. On a repeat study, each subject underwent the same experimental procedures, except that saline was infused instead of ETOH. Systemic ETOH significantly decreased whole body glucose disposal in both NC and NIDDM patients. In NC, ETOH infusion decreased basal forearm glucose uptake (FGU) from 1.22 +/- 0.20 to 0.32 +/- 0.04 mumol/min.100 mL tissue (P < 0.01), whereas in NIDDM, this decrement was not significant (from 0.95 +/- 0.31 to 0.66 +/- 0.23). With saline infusion, hyperinsulinemia significantly stimulated FGU to 4.09 +/- 0.46 mumol/min.100 mL tissue in NC and to 2.50 +/- 0.76 in NIDDM. During ETOH, FGU was depressed by 81% in NC (delta = 3.32 mumol/min.100 mL tissue) and by 48% (P < 0.05) in NIDDM (delta = 1.21 mumol/min.100 mL tissue). Local ETOH infusion did not affect FGU in either NC (1.18 +/- 0.23 vs. 1.1 +/= 0.11 mumol/min.100 mL tissue in the baseline condition and 4.12 +/- 0.65 vs. 3.97 +/- 0.35 in insulin-stimulated conditions) or NIDDM (1.05 +/- 0.29 vs. 1.1 +/- 0.19 mumol/min.100 mL tissue in baseline condition and 2.72 +/- 0.82 vs. 2.83 +/- 0.51 in insulin-stimulated conditions) subjects. With systemic ETOH, but not local infusion, there was a reduction in baseline plasma free fatty acid level and an increase in blood lactate concentration during isoglycemic hyperinsulinemia. In summary, systemic ETOH infusion impairs both whole body and forearm glucose uptake in NC and NIDDM subjects; this effect was more apparent in NC than in NIDDM at both the whole body and forearm level. On the contrary, intrabrachial ETOH infusion did not affect forearm glucose balance in either group. These results suggest that the reduction in muscle glucose disposal associated with increased systemic ETOH concentrations is not caused by a direct ETOH effect on muscle glucose metabolism.

This article has been cited by other articles:

				K. D. Sumida, J. M. Hill, and A. V. Matveyenko Sex Differences in Hepatic Gluconeogenic Capacity After Chronic Alcohol Consumption Clin. Med. Res., October 1, 2007; 5(3): 193 - 202. [Abstract] [Full Text] [PDF]

				A. Avogaro, R. M. Watanabe, A. Dall'Arche, S. Vigili De Kreutzenberg, A. Tiengo, and G. Pacini Acute Alcohol Consumption Improves Insulin Action Without Affecting Insulin Secretion in Type 2 Diabetic Subjects Diabetes Care, June 1, 2004; 27(6): 1369 - 1374. [Abstract] [Full Text] [PDF]

				C. H. Kroenke, N.-F. Chu, N. Rifai, D. Spiegelman, S. E. Hankinson, J. E. Manson, and E. B. Rimm A Cross-Sectional Study of Alcohol Consumption Patterns and Biologic Markers of Glycemic Control Among 459 Women Diabetes Care, July 1, 2003; 26(7): 1971 - 1978. [Abstract] [Full Text] [PDF]

				K. A. Meyer, K. M. Conigrave, N.-F. Chu, N. Rifai, D. Spiegelman, M. J. Stampfer, and E. B. Rimm Alcohol Consumption Patterns and HbA1c, C-Peptide and Insulin Concentrations in Men J. Am. Coll. Nutr., June 1, 2003; 22(3): 185 - 194. [Abstract] [Full Text] [PDF]

				W. H. L. Kao, I. B. Puddey, L. L. Boland, R. L. Watson, and F. L. Brancati Alcohol Consumption and the Risk of Type 2 Diabetes Mellitus: Atherosclerosis Risk in Communities Study Am. J. Epidemiol., October 15, 2001; 154(8): 748 - 757. [Abstract] [Full Text] [PDF]

				K. M. Conigrave, B. F. Hu, C. A. Camargo, M. J. Stampfer, W. C. Willett, and E. B. Rimm A Prospective Study of Drinking Patterns in Relation to Risk of Type 2 Diabetes Among Men Diabetes, October 1, 2001; 50(10): 2390 - 2395. [Abstract] [Full Text]

				B. Yu, A. Schroeder, and L. E. Nagy Ethanol stimulates glucose uptake and translocation of GLUT-4 in H9c2 myotubes via a Ca2+-dependent mechanism Am J Physiol Endocrinol Metab, December 1, 2000; 279(6): E1358 - E1365. [Abstract] [Full Text] [PDF]

				H. J. Pownall, C. M. Ballantyne, K. T. Kimball, S. L. Simpson, D. Yeshurun, and A. M. Gotto Jr Effect of Moderate Alcohol Consumption on Hypertriglyceridemia: A Study in the Fasting State Arch Intern Med, May 10, 1999; 159(9): 981 - 987. [Abstract] [Full Text] [PDF]

				S. Q. Siler, R. A. Neese, M. P. Christiansen, and M. K. Hellerstein The inhibition of gluconeogenesis following alcohol in humans Am J Physiol Endocrinol Metab, November 1, 1998; 275(5): E897 - E907. [Abstract] [Full Text] [PDF]