Abstract
BACKGROUND: Diabetes, a major global health concern, has reached 537 million cases worldwide as of 2021. While excessive alcohol consumption is a recognized health risk, its effects on diabetes vary by drinking patterns. This study evaluated the association between alcohol consumption and diabetes risk among Korean adults, emphasizing gender differences. METHODS: Using data from 31,091 adults in the Korea National Health and Nutrition Examination Survey (KNHANES, 2013-2018), alcohol consumption was assessed by average intake and binge drinking frequency. Fasting glucose levels categorized participants into normal, prediabetic, and diabetic states. Logistic regression analyses adjusted for demographic, lifestyle, and metabolic factors were conducted, with gender-specific subgroup analyses. RESULTS: Among the participants, 64.3% were normal, 23.7% prediabetic, and 12.0% diabetic. Moderate alcohol consumption (1-2 standard drinks per session, 10-20 g ethanol) was associated with a 17% lower diabetes prevalence compared to non-drinkers, but higher intake (≥ 5 standard drinks) and frequent binge drinking were associated with elevated risks of both prediabetes and diabetes. For instance, individuals consuming 5-6 standard drinks had a 1.26 times higher diabetes prevalence, and daily binge drinkers exhibited the greatest risk increases. Gender-specific analyses showed that men had stronger associations between heavy drinking and diabetes, while women exhibited weaker associations at moderate levels. Additionally, prediabetic individuals demonstrated increasing risk with higher alcohol intake, regardless of gender. CONCLUSION: This cross-sectional study reveals complex associations between alcohol consumption and diabetes prevalence, with moderate drinking associated with lower diabetes prevalence and heavy or frequent binge drinking associated with higher prevalence. Public health strategies should incorporate gender-specific guidance to address alcohol-related diabetes risks effectively.