Abstract
Aims: Using two data-sets, this study aimed to determine the prevalence of alcohol consumption among people with type 2 diabetes mellitus (T2DM) in England and Wales, compared with people without T2DM, and to explore associations between alcohol consumption and both psychological and behavioural outcome measures in people with T2DM. Methods: Two data-sets were used. 7,848 participants from the Health Survey for England (HSE) 2016 (549 with T2DM) completed the General Health Questionnaire-12 (GHQ-12) and Warwick-Edinburgh Mental Wellbeing Scale (WEMWBS) and reported average weekly alcohol consumption in units. Sixty-one UK participants with T2DM were recruited through diabetes peer-support websites to complete a survey, comprising the Alcohol Use Disorder Identification Test (AUDIT), WEMWBS, Diabetes Self-Management Questionnaire (DSMQ), and Diabetes Distress Scale (DDS). Spearman’s rank correlations, Chi-squared, Mann-Whitney U, and Kruskal-Wallis tests were used to explore the relationships between alcohol consumption and mental wellbeing (WEMWBS) in both samples, psychological distress (GHQ-12) from the HSE, and diabetes-related distress (DDS) and self-management (DSMQ) from the online survey. Results: From HSE data, people with T2DM were more likely to be non-drinkers (OR=2.087) and to have poorer mental wellbeing (p<0.0005) and psychological distress (p<0.0005) than people without T2DM. Non-drinkers with T2DM had poorer mental wellbeing (p<0.0005) and psychological distress (p<0.0005) than drinkers. From the online survey, AUDIT score was not associated with general (p=0.323) or diabetes-related distress (p=0.475). A greater AUDIT score was associated with poorer glucose management (p<0.0005) and dietary control (p=0.041), but not with physical activity (p=0.229) or healthcare use (p=0.708). Conclusions: Alcohol consumption is less prevalent among people with T2DM than the general population but may be associated with difficulties in some aspects of self-management. Drinking is associated with lower psychological distress than non-drinking among people with T2DM. Tentative clinical recommendations are made based on these findings and areas for further research are suggested. Keywords: type 2 diabetes, alcohol, self-management, distress, wellbeing