The Complex Interplay Between Alcohol Consumption and Diabetes Mellitus: Insights from Experimental Models and Clinical Studies

International Journal of Biomedicine 15(4) (2025) 627-633 http://dx.doi.org/10.21103/Article15(4)_RA1 REVIEW ARTICLE INTERNATIONAL JOURNAL OF BIOMEDICINE The Complex Interplay Between Alcohol Consumption and Diabetes Mellitus: Insights from Experimental Models and Clinical Studies N. Kocharyan1, I. Sahakyan1*, L. Grigoryan1, S. Abrahamyan1, N. Tumasyan1 1 Institute of Biochemistry after H. Buniatyan, NAS RA, Yerevan, Armenia Abstract Background: This review examines how different patterns of alcohol consumption—moderate, acute, and chronic—affect the development and management of diabetes mellitus, based on experimental and clinical studies. Methods and Results: A comprehensive literature search was conducted across PubMed, Scopus, Web of Science, Google Scholar, and gray literature sources. Alcohol impacts diabetes pathophysiology, notably insulin resistance and β-cell function. Chronic heavy drinking worsens glucose tolerance and promotes diabetes progression. In contrast, moderate intake with meals may enhance insulin sensitivity and reduce cardiovascular risk. Acute alcohol use, especially without food, can cause hypoglycemia. Effects vary depending on the dose, timing, and individual health. Conclusions: Alcohol has both beneficial and harmful effects on diabetes. Moderate consumption may help, but chronic use increases risks. Personalized medical advice is essential for safe alcohol use in diabetic patients.(International Journal of Biomedicine. 2025;15(4):627-633.) Keywords: alcohol consumption • insulin sensitivity • diabetes mellitus • cardiovascular diseases For citation: Kocharyan N, Sahakyan I, Grigoryan L, Abrahamyan S, Tumasyan N. The Complex Interplay Between Alcohol Consumption and Diabetes Mellitus: Insights from Experimental Models and Clinical Studies. International Journal of Biomedicine. 2025;15(4):627-633. doi:10.21103/Article15(4)_RA1 Abbreviations AT, adipose tissue; BDNF, brain-derived neurotrophic factor; CNS, central nervous system; DM, diabetes mellitus; DRW, dealcoholized red wine; HDL-C, high-density lipoprotein cholesterol; LDL-C, low-density lipoprotein cholesterol; ROS, reactive oxygen species; RW, red wine; STZ, streptozotocin; T1DM, type 1 diabetes mellitus; T2DM, type 2 diabetes mellitus. Introduction Despite extensive research on diabetes mellitus (DM) and the application of modern treatment methods, the disease persists in its progression, particularly in industrialized nations. According to the World Health Organization (WHO) DM is classified into several types: Type 1 diabetes mellitus (T1DM); Type 2 diabetes mellitus (T2DM); Hybrid forms of diabetes (Slowly evolving immune-mediated diabetes of adults, so called Latent autoimmune diabetes in adults (LADA) and Ketosis-prone type 2 diabetes); Hyperglycemia first detected during pregnancy (DM in pregnancy and Gestational DM); Specific types of diabetes (Monogenic diabetes, Diseases of the exocrine pancreas, Endocrine disorders, Drug- or chemical-induced Infections); Unclassified diabetes.1 But the two major types are T1DM and T2DM. T1DM, also known as the insulin-dependent form, develops as a consequence of the autoimmune-mediated gradual destruction of pancreatic β-cells responsible for insulin production.2 Approximately, 5-10% of all DM cases are attributed to T1DM. T2DM is a noninsulin-dependent acquired metabolic disorder characterized by diminished insulin sensitivity in tissue cells.3 In adults, T2DM accounts for 90-95% of all DM cases. Its prevalence is on the rise, particularly among people over 40.1 According to the WHO, the number of adults with diabetes worldwide in 2014 has doubled in recent decades, reaching 422 million, with projections estimating a rise to 629 million by 2045. The surge is predominantly observed in children and adolescents with T2DM. T1DM is defined by an absolute deficiency in insulin production, while T2DM involves both diminished insulin 628 N. Kocharyan et al. / International Journal of Biomedicine 15(4) (2025) 627-633 secretion and increased insulin resistance.4 In contrast to T1DM, where insulin replacement therapy is highly effective, managing T2DM necessitates addressing insulin resistance alongside impaired insulin secretion. Gestational diabetes is associated with high blood glucose during pregnancy.5 The manifestations of diabetes encompass a spectrum of disorders, including hyperglycemia, altered metabolism of lipids, carbohydrates, and proteins, as well as complications related to vascular injuries,6 strokes, heart and kidney diseases, impaired immune function, changes in intestinal processes, neuropathy,7 retinopathy, and gangrene of the extremities.8 These complications contribute to premature disability and mortality. It is recognized that during DM, the body’s antioxidant defenses are weakened.9 This, in combination with hyperglycemia and lipid metabolism disorders, contributes to a decrease in the permeability of phospholipid membranes in peripheral tissue cells, as well as in the islets of Langerhans of the pancreas. This disorder ultimately leads to damage to the β-cells of the islets.10 Although alcohol consumption is approached cautiously by both clinicians and diabetes patients due to risks like hypoglycemia, metabolic imbalance, and longterm complications, recent biomedical research highlights potential benefits of moderate ethanol intake. Alcohol-related disorders often precede diabetes and remain a public health concern, prompting growing interest in managing diabetes among individuals with alcohol dependence. Epidemiological data suggest a possible inverse link between moderate alcohol use and atherosclerotic risk, raising questions about its role in diabetes care. Alcohol consumption over time is linked to a lower risk of T2DM in initially light or rare drinkers, evident within four years.11 This review summarizes recent scientific findings on the complex relationship between alcohol consumption and diabetes mellitus, recognizing their shared impact on multiple physiological systems. A comprehensive literature search was conducted across PubMed, Scopus, Web of Science, Google Scholar, and gray literature sources. Experimental Models of Diabetes Analyzing and summarizing recent scientific research on the link between alcohol consumption and DM requires data integrating from both experimental models and clinical studies. Ethical constraints significantly limit diabetes research in humans, as deliberately inducing the disease is strictly prohibited. Research in experimental diabetology plays a crucial role in elucidating pathogenesis, clinical presentation, prevention, and treatment of diabetes. Experimental models of DM provide valuable insights into the pathophysiology of the disease and explain the antidiabetic mechanisms of various drugs through targeted use. Consequently, experimental animal models play a vital role in biomedical studies, offering valuable insights into the mechanisms and potential treatment (...truncated)