Normalization of fasting blood glucose levels in insulin-requiring diabetes: the role of ethanol abstention.

The long-term remission of insulin-dependent diabetes mellitus is an unusual occurrence. The present report describes three cases of typical insulin-dependent diabetes in which the metabolic abnormalities greatly improved after the patients abstained from excessive ethanol intake. Our patients presented with polyuria, polydipsea, and weight loss of several weeks duration and laboratory studies revealed marked elevations in blood glucose concentrations and, in two of the three patients, mild ketosis. When these patients subsequently abstained from excessive ethanol intake, the elevations in blood glucose levels and the clinical symptoms of diabetes resolved. Two of our three patients have a strong family history of diabetes mellitus and we have therefore hypothesized that excessive ethanol intake only results in hyperglycemia in individuals with either an underlying predisposition to develop diabetes or mild unrecognized preexisting diabetes. It is important that clinicians recognize that excessive ethanol intake can lead to hyperglycemia and that abstention from ethanol may result in the marked improvement of the metabolic abnormalities.