The effect of alcohol on blood glucose in Type 1 diabetes--metabolic modelling and integration in a decision support system

Int J Med Inform. 2003 Jul;70(2-3):337-44. doi: 10.1016/s1386-5056(03)00038-8.

Abstract

Introduction: We have recently shown, in studies with patients with Type 1 (insulin dependent) diabetes, that alcohol intake at 21:00 h significantly reduced blood glucose values after 10-12 h, compared with control studies with no alcohol.

Hypothesis: We hypothesised that this was due to the following effects of alcohol: (1) alcohol metabolism increases NADH, leading to a reduction in hepatic gluconeogenesis; (2) increased glycogen phosphorylase activity depletes hepatic glycogen stores; (3) after the alcohol is metabolised, hepatic insulin sensitivity is increased, leading to the restoration of glycogen stores and reduction in blood glucose levels; and (4) consequently, after several hours, glycogen stores and insulin sensitivity return to normal.

Results: A model describing these changes (DiasNet-Alcohol) was implemented into the DiasNet model of human glucose metabolism. Our study suggests that the DiasNet-Alcohol model gives a reasonable approximation of these effects of alcohol on blood glucose concentration observed in our study and supports our hypothesis for the mechanism behind these effects in Type 1 diabetes.

MeSH terms

  • Bayes Theorem
  • Blood Glucose / metabolism*
  • Central Nervous System Depressants / pharmacology*
  • Decision Making, Computer-Assisted
  • Decision Support Systems, Clinical*
  • Diabetes Mellitus, Type 1*
  • Ethanol / pharmacology*
  • Glycogen / metabolism
  • Glycogen Phosphorylase / pharmacology
  • Humans
  • Hypoglycemia / etiology*
  • Models, Theoretical*
  • NAD / metabolism

Substances

  • Blood Glucose
  • Central Nervous System Depressants
  • NAD
  • Ethanol
  • Glycogen
  • Glycogen Phosphorylase