Db131318 31..38

It was an unexpected pleasure to be invited to write a Perspectives in Diabetes article considering the proposition that moderate consumption of red wine provides health benefits for people with diabetes. At the outset, I want to make clear that since Perspectives in Diabetes are not review articles in the conventional sense, this one does not exhaustively analyze the effects of beer, hard liquor, or alcohol per se on health. This one is all about wine, especially red wine. This is an important point because of the intrinsic psychic influences of wine. Beer is associated with boisterous behavior at sporting events. Hard liquor is associated with serious drinking and dark moods. Wine, on the other hand, is associated with relaxation, reflection, celebration, conviviality, toasting, and a certain amount of dry humor. So, in this spirit, I will lace this article with a modicum of these winerelated characteristics. Archeologists tell us that humans made and drank wine in the Middle East (Fig. 1) beginning in ~7000 BCE—well before recorded time. During its 9,000-year history, wine has been used for many purposes, including religious (Fig. 2) and medical ones. The scientific literature over the past half century does not explicitly warn against drinking wine in moderate amounts, except during pregnancy. Yet, in the U.S. there continues to be a lurking hesitancy in some social circles about its use for relaxation or recreational purposes. Some religious faiths specifically proscribe wine, which also makes it interesting that some other religious faiths include wine in their services. Beyond use of moderate amounts, it is clear that drinking wine excessively leads to inebriation and likely endangerment of self and others, just as with any alcohol-containing beverage. In view of this spectrum of opinion and in keeping with the fashion of the day, it seems appropriate at the outset of this Perspectives in Diabetes and in the spirit of full disclosure to state that my mother, a full-blooded Italian from Vinchiaturo in Molise, always told her sons that a day without wine is a day without sunshine. Being a Seattle resident, I relish a sunny day. In preparing to write, I submitted three topics to PubMed: wine and diabetes, wine and mental health, and wine and social health. Note that I purposely did not include beer, liquor, or alcohol in my search. These searches garnered 265 references from 1963–2013, 58 references from 1967–2013, and 200 references from 1970–2013, respectively. After reading titles and abstracts, I excluded articles that were not peer reviewed or original work, did not specifically address drinking wine in moderate quantities in humans, or did not consider the impacts on health in people with diabetes or cardiovascular disease. I read the full manuscripts for the remainder. This Perspectives in Diabetes is organized to consider 1) epidemiologic and metabolic studies of the consequences of red wine drinking for people with type 2 diabetes (T2D), 2) the question of whether the health effects of wine are intrinsic to grapes or a function of the alcohol in wine, and 3) potential mechanism(s) of action for the beneficial effects of red wine.