disease interaction(s) of diabetes mellitus with alcohol abuse
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Introduction
Interactions:
- avoid medications that increase risk of lactic acidosis (metformin) or hypoglycemia (sulfonylurea, insulin, repaglinide) patients with alcohol abuse & type 2 diabetes.
Management
- DPP-4 inhibitors (gliptins), GLP-1 receptor agonists, SGLT-2 inhibitors (flozins) & thiazolidinediones are safe in patients with alcohol abuse, provide normal liver function[1]
- once-weekly semaglutide beneficial for patients with alcohol use disorder & obesity[2]
Notes
- alcohol is metabolized in the liver leading to an accumulation of NADH
- high concentrations of NADH inhibit gluconeogenesis by preventing oxidation of lactate to pyruvate, thus increasing risk of lactic acidosis & hypoglycemia
More general terms
References
- ↑ 1.0 1.1 NEJM Knowledge+ Endocrinology
- ↑ 2.0 2.1 Klausen MK, Justesen SK, Pedersen JN, et al Once-weekly semaglutide versus placebo in patients with alcohol use disorder and comorbid obesity: a randomised, double-blind, placebo-controlled trial. Lancet. 2026 May 2;407(10540):1687-1698 PMID: https://pubmed.ncbi.nlm.nih.gov/42070571 Free article. Clinical Trial. https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(26)00305-3/fulltext