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Wine is healthy. Wine is poisonous. Both are true in their own way - it's all a question of dose. For more than a decade, a somehow particularly healthy wine could be found on shelves and wine lists. At least, that was what the label said: The "diabetic wine". This is now a thing of the past: Since 1 July 2007, this designation may no longer be used due to the EU regulation on "nutrition and health claims made on foods". The label "Suitable for diabetics - only after consulting a doctor" also had to disappear. The author followed this request - and received interesting answers.

Dr. Gert Nitzsche

Dr. Gerd Nitzsche, specialist for internal medicine and diabetologist from Offenbach am Main, explains when asked about the medical background of the official wine recommendation for diabetics: "It has always been a deception." In his view, there has never been any medical justification for this recommendation.

"Two factors of wine have an influence on the metabolism in healthy people and in diabetics: alcohol and sugar," the specialist explains. Whoever drinks a litre of white wine with 12.5 per cent alcohol consumes 4-10 grams of sugar, depending on the ageing - but at the same time 100 grams of pure alcohol. "The amount of sugar is thus less than that in half a bread roll, but the amount of alcohol fills a nice water glass with 50-percent schnapps." Diabetic wine is "thought to be sugar-centred" and completely ignores the consequences of alcohol.

First of all, according to Nitzsche, diabetics are divided into two groups: In type 2 diabetes, the metabolism is disturbed; the concentration of the hormone insulin in the blood, which is necessary to break down sugar from food, actually increases in early stages. Due to poor nutrition, obesity and lack of exercise as well as genetic factors, the receptors on the cell walls become increasingly insensitive to insulin. The islet cells of the pancreas must therefore produce more and more insulin to normalise the blood sugar level. At some point, they no longer manage to provide sufficient amounts of insulin to keep the levels within the normal range. Blood glucose levels rise even though large amounts of insulin appear to be circulating in the body. If left untreated and poorly controlled, this can lead to serious damage in the long term.

Type 1 diabetes has a different cause: the islet cells of the pancreas stop working due to an autoimmune reaction; insulin production stops. The result: the blood sugar level rises massively. From now on, the missing insulin must be supplied by the patient himself.

For diabetics, unfortunately, the enjoyment of wine is not always so carefree


"There are a lot of studies that indicate that moderate amounts of wine have positive effects on health, and too much alcohol is known to have the opposite," explains the diabetologist. One factor that is often left out of diabetic wine, he says, is the effect of alcohol on the liver. Because of its detoxification function, the energetic utilisation of sugar is blocked, as it prevents the release of sugar breakdown substances back into the organism. This compensates for part of the sugar ingested with the wine anyway. Therefore, wine - whether diabetic wine or not - almost never increases blood sugar. On the contrary: diabetics who like to drink to the bottom of the bottle should therefore consume even smaller amounts of carbohydrates in order to avoid hypoglycaemia. Because the disturbed blood sugar regulation in both types of diabetes can lead to hypoglycaemia, which in the worst case ends in fainting.

This also happens to some extent in healthy people: "People who have had a lot of wine repeatedly reach the hypoglycaemia threshold unnoticed during sleep. This means that the brain receives too little sugar for hours, which it needs as an energy source. One of the consequences, together with other factors, is the well-known buzzing head in the morning," Nitzsche explains the connection.

In one respect, however, even small amounts of wine are massively harmful for diabetics, - thus also the "diabetic wine": "If the patient has neuropathy, i.e. nerve damage, as a result of a blood sugar level that is too high in the long term, even small amounts of wine can significantly worsen the damage. The alcohol has a direct toxic effect on pre-damaged nerve cells

"I make it clear to each of my patients with existing neuropathy that it is better not to drink alcohol at all," emphasises Dr. Gerd Nitzsche. If the diabetes has not caused any damage, for example through good blood sugar control, the positive effect of moderate amounts of alcohol is the same as in people without diabetes. Therefore, it was "a good decision by the EU" to finally take diabetic wine off the menu. So in the end, there is only one wine for everyone. Pleasure and poison - it's all a question of dose. Also for diabetics.

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