disease interaction(s) of diabetes mellitus with alcohol abuse

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

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

• disease interaction