Alcohol consumption and risk of pre-diabetes and type 2 diabetes development in a Swedish population


C.-G. Östenson, Department of Molecular Medicine and Surgery, Karolinska Institutet, Karolinska University Hospital, SE–171 76 Stockholm, Sweden. E-mail:


Diabet. Med. 29, 441–452 (2012)


Aims  Alcohol is a potential risk factor of Type 2 diabetes. However, more detailed information on effects of alcohol types and early phases of Type 2 diabetes development seems warranted. The aim of this study was to investigate the influence of alcohol consumption and specific alcoholic beverages on the risk of developing pre-diabetes and Type 2 diabetes in middle-aged Swedish men and women.

Methods  Subjects, who at baseline had normal glucose tolerance (2070 men and 3058 women) or pre-diabetes (70 men and 41 women), aged 35–56 years, were evaluated in this cohort study. Logistic regression was performed to estimate the risk [odds ratio (OR) and 95% confidence interval (CI)] to develop pre-diabetes and Type 2 diabetes at 8–10 years follow-up, in relation to self-reported alcohol intake at baseline. Adjustment was performed for several risk factors.

Results  Total alcohol consumption and binge drinking increased the risk of pre-diabetes and Type 2 diabetes in men (OR 1.42, 95% CI 1.00–2.03 and OR 1.67, 95% CI 1.11–2.50, respectively), while low consumption decreased diabetes risk in women (OR 0.41, 95% CI 0.22–0.79). Men showed higher risk of pre-diabetes with high beer consumption (OR 1.84, 95% CI 1.13–3.01) and of Type 2 diabetes with high consumption of spirits (OR 2.03, 95% CI 1.27–3.24). Women showed a reduced risk of pre-diabetes with high wine intake (OR 0.66, 95% CI 0.43–0.99) and of Type 2 diabetes with medium intake of both wine and spirits (OR 0.46, 95% CI 0.24–0.88 and OR 0.55, 95% CI 0.31–0.97, respectively), whereas high consumption of spirits increased the pre-diabetes risk(OR 2.41, 95% CI 1.47–3.96).

Conclusion  High alcohol consumption increases the risk of abnormal glucose regulation in men. In women the associations are more complex: decreased risk with low or medium intake and increased risk with high alcohol intake.