***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: OBJECTIVE —In a r and omized controlled trial , we assessed the effect of daily moderate alcohol intake on glycemic control in the fasting and postpr and ial states in patients with type 2 diabetes who previously had abstained from alcohol . RESEARCH DESIGN AND METHODS —We r and omly assigned 109 patients ( 41–74 years old ) with established type 2 diabetes who abstained from alcohol to receive 150 ml wine ( 13 g alcohol ) or nonalcoholic diet beer ( control ) each day during a 3-month multicenter trial . The beverages were consumed during dinner . Diet and alcohol consumption were monitored . RESULTS —During the intervention , 17 % of participants ( 12 % from the alcohol group ) dropped out , leaving 91 who completed the trial . Within the alcohol group , fasting plasma glucose ( FPG ) decreased from 139.6 ± 41 to 118.0 ± 32.5 mg/dl after 3 months compared with 136.7 ± 15.4 to 138.6 ± 27.8 mg/dl in the control subjects ( Pv = 0.015 ) . However , alcohol consumption had no effect on 2-h postpr and ial glucose levels ( difference of 18.5 mg/dl in the control group vs. 17.7 mg/dl in the alcohol group , Pv = 0.97 ) . Patients in the alcohol group with higher baseline A1C levels had greater reductions in FPG ( age-adjusted correlation −0.57 , Pv < 0.001 ) . No significant changes were observed in the levels of bilirubin , alkaline phosphatase , alanine aminotransferase , or aspartate aminotransferase , and no notable adverse effects were reported . Participants in the alcohol group reported an improvement in the ability to fall asleep ( Pv < 0.001 ) . CONCLUSIONS —Among patients with type 2 diabetes who had previously abstained from alcohol , initiation of moderate daily alcohol consumption reduced FPG but not postpr and ial glucose . Patients with higher A1C may benefit more from the favorable glycemic effect of alcohol . Further intervention studies are needed to confirm the long-term effect of moderate alcohol intake BACKGROUND Moderate alcohol consumption is associated with reduced risk for coronary heart disease ( CHD )  in generally healthy population s. We assessed prospect ively the association between moderate alcohol intake and CHD risk in women with type 2 diabetes mellitus , a group at high risk for cardiovascular disease . METHODS AND RESULTS We studied women in the Nurses ' Health Study who reported a diagnosis of diabetes mellitus at > /=30 years of age . During 39 092 person-years of follow-up from 1980 to 1994 , there were 295 CHD events documented among this population , including 194 cases of nonfatal myocardial infa rct ion and 101 cases of fatal CHD . Odds ratios derived from logistic regression were used to estimate relative risks ( RRs ) for CHD as a function of usual alcohol intake , with adjustment for potential confounders . Compared with diabetic women reporting no alcohol intake , the age-adjusted RR for nonfatal or fatal CHD among diabetic women reporting usual intake of 0.1 to 4.9 g ( < 0.5 drinks ) of alcohol daily was 0.74 ( 95 % CI 0.56 to 0.98 ) , and among those reporting usual intake > /=5 g/d , it was 0.48 ( 95 % CI 0.32 to 0.72 ) ( P for trend < 0.0001 ) . Inverse associations between alcohol intake and CHD risk remained significant in multivariate analysis adjusting for several other coronary risk factors ( 0.1 to 4 . 9 g/d : RR 0.72 [ 95 % CI 0.54 to 0.96 ] ; > /=5 g/d : RR 0.45 [ 0.29 to 0.68 ] ) . CONCLUSIONS Although potential risks of alcohol consumption must be considered , these data suggest that moderate alcohol consumption is associated with reduced  CHD risk in women with diabetes and should not be routinely discouraged OBJECTIVE To investigate the association between  alcohol consumption and type 2 diabetes  , and determine whether this is modified by sex , body mass index ( BMI ) and beverage type . DESIGN Multicentre prospect i ve case-cohort study . SETTING Eight countries from the European Prospect i ve Investigation into Cancer and Nutrition cohort . SUBJECTS A representative baseline sample of 16 154 participants and 12 403 incident cases of type 2 diabetes . INTERVENTIONS Alcohol consumption assessed using vali date d dietary question naires . MAIN OUTCOME MEASURES Occurrence of type 2 diabetes based on multiple sources ( mainly self-reports ) , verified against medical information . RESULTS Amongst men , moderate alcohol consumption was nonsignificantly associated with a lower incidence of diabetes with a hazard ratio ( HR ) of 0.90 ( 95 % CI : 0.78 - 1.05 ) for 6.1 - 12.0 versus 0.1 - 6.0 g day(-1 ) , adjusted for dietary and diabetes risk factors . However , the lowest risk was observed at higher intakes of 24.1 - 96.0 g day(-1 ) with an HR of 0.86 ( 95 % CI : 0.75 - 0.98 ) . Amongst women , moderate alcohol consumption was associated with a lower incidence of diabetes with a hazard ratio of 0.82 ( 95 % CI : 0.72 - 0.92 ) for 6.1 - 12.0 g day(-1 ) ( P interaction gender < 0.01 ) . The inverse association between alcohol consumption and diabetes was more pronounced amongst overweight ( BMI ≥ 25 kg m(-2 ) ) than normal-weight men and women ( P interaction < 0.05 ) . Adjusting for waist and hip circumference did not alter the results for men , but attenuated the association for women ( HR=0.90 , 95 % CI : 0.79 - 1.03 for 6.1 - 12.0 g day(-1 ) ) . Wine consumption for men and fortified wine consumption for women were most strongly associated with a reduced risk of diabetes . CONCLUSIONS The results of this study show that moderate alcohol consumption is associated with a lower risk of type 2 diabetes amongst women only . However , this risk reduction is in part explained by fat distribution . The relation between alcohol consumption and type 2 diabetes was stronger for overweight than normal-weight women and men Alcohol-induced hypoglycaemia is a well-known phenomenon in insulin-treated diabetic subjects . Less attention has been paid to the impact of alcohol on blood glucose and insulin responses in non-insulin dependent diabetic subjects . The aim of this study was to investigate the acute metabolic effects of different alcohol contents added to a non-alcohol beer in 10 non-insulin-dependent diabetes mellitus ( NIDDM ) subjects . The patients received 500 ml non-alcohol beer with an alcohol percentage ( v/v ) of 0 ( A ) , 2.7 ( B ) , and 5.4 ( C ) , implying identical contents of ingredients except for alcohol . Blood glucose ( mean + /- SE ) responses were similar in the three situations ( 395 + /- 59 , 365 + /- 86 and 261 + /- 26 mmol/l x 240 min ) . In contrast , the incremental insulin response areas increased dose dependently to alcohol ( 5430 + /- 1158 , 9336 + /- 2172 and 12336 + /- 2922 pmol/l x 240 min ) and showed a linear correlation ( r = 0.39 ; P < 0.03 ) . The average suppression of serum free fatty acid was similar in the three situations ( 72.4 + /- 4.4 % , 76.3 + /- 6.0 % and 68.2 + /- 6.3 % ) . In conclusion , intake of small amounts of alcohol does not acutely deteriorate the glycaemic control in NIDDM . The fact that alcohol results in a dose-related elevation in insulin levels with unaltered blood glucose and free fatty acid responses in NIDDM points to an aggravation of insulin resistance Increased postpr and ial lipemia is a risk marker of cardiovascular disease ( CVD ) . While moderate alcohol drinking is associated with a reduced risk of CVD in nondiabetic and type 2 diabetic patients , it is also known that alcohol increases postpr and ial triacylglycerol levels . The incretins , glucose-dependent insulinotropic polypeptide ( GIP ) and glucagon-like peptide 1 ( GLP-1 ) , are important hormones from the gut that enhance nutrient-stimulated insulin secretion . Their responses to a moderate alcohol dose in type 2 diabetes have not previously been studied . We sought to determine how alcohol influences postpr and ial lipid and incretin levels in patients with type 2 diabetes when taken in combination with a fat-rich mixed meal .  Eleven patients with type 2 diabetes ingested on 3 separate days in r and om order 3 different meals containing : 100 g butter alone or 100 g butter in combination with 40 g alcohol and 50 g carbohydrate , or 100 g butter and 120 g carbohydrate . The meal with alcohol and 50 g carbohydrate was isocaloric to that of 120 g carbohydrate . Triacylglycerol levels were measured after separation by ultracentrifugation into a chylomicron-rich fraction with Svedberg flotation unit values ( Sf ) > 1,000 , and a chylomicron-poor fraction with Sf < 1,000 . Supplementation of a fat-rich mixed meal with alcohol in type 2 diabetic subjects suppressed GLP-1 early in the postpr and ial phase and increased the late triacylglycerol responses compared with the 2 other meals . In the chylomicron-rich fraction , both triacylglycerol and cholesterol were increased by alcohol . No significant differences in high-density lipoprotein (HDL)-cholesterol levels were seen . Isocaloric amounts of carbohydrate and alcohol suppressed equally the postpr and ial free fatty acid levels , but carbohydrate increased the postpr and ial glucose , GIP , and insulin levels the most . Early in the postpr and ial phase , alcohol suppresses the incretin responses and increases the late postpr and ial triacylglycerol levels in type 2 diabetic patients . Whether this reflects an alcohol-induced suppression of the incretin response , which adds to the alcohol-induced impairment of triacylglycerol clearance in type 2 diabetic patients , remains to be eluci date The aim of the present study was to determine whether red or white wine affects urinary protein , 8-hydroxydeoxyguanosine ( 8-OHdG ) , and liver-type fatty acid-binding protein ( L-FABP ) excretion in type 2 diabetic nephropathy patients . Twenty-four type 2 diabetes mellitus patients with nephropathy were r and omly allocated to drink a 118-mL ( 4-oz ) glass of red wine ( n = 12 , group A ) or white wine ( n = 12 , group B ) daily for 6 months . Twelve type 2 diabetes mellitus patients with nephropathy who did not drink any wines  served as control subjects ( group C ) . Serum creatinine , 24-hour creatinine clearance , hemoglobin A(1c ) , urinary protein , urinary 8-OHdG , and urinary L-FABP were measured before and 3 and 6 months after the start of the study . In groups A , B , and C , serum creatinine , 24-hour creatinine clearance , and hemoglobin A(1c ) changed little during the experimental period . However , urinary protein , 8-OHdG , and L-FABP excretions were significantly decreased at 3 ( P < .05 ) and 6 months ( P < .01 ) compared with the baseline values in group A. In contrast , these markers changed little during the experimental period in groups B and C. Thus , these urinary markers were significantly lower in group A than in groups B and C at 3 and 6 months . These results suggest that red wine is renoprotective whereas white wine has no such effect in type 2 diabetes mellitus patients with nephropathy . The renoprotective effect of red wine may be due in part to its ability to reduce oxidative stress Abstract Objectives : To assess the relation between regular alcohol consumption and insulin sensitivity , and to estimate the importance of insulin in the association of alcohol with multiple vascular risk factors and cardiovascular disease . Design : Prospect i ve and cross sectional study of a large r and omly selected population sample . Setting : Part of the Bruneck study 1990–5 ( Bolzano province , Italy ) . Subjects : 820 healthy non-diabetic women and men aged 40–79 years . Main outcome measure : Con 
    Output:
    
Studies to date have not provided evidence that drinking light to moderate amounts of alcohol , with or without a meal , affects any measure of glycaemic control in people with Type 2 diabetes .
These results suggest that current advice that people with diabetes do not need to refrain from drinking moderate quantities of alcohol does not need to be changed ; risks to those with Type 1 diabetes remain uncertain