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Using KNHANES 2013–2018 data, alcohol intake and binge-drinking frequency were compared across normal, prediabetic, and diabetic categories based on fasting glucose. Moderate drinking related to lower diabetes prevalence, whereas heavy intake and frequent binge drinking elevated risks. Men showed stronger heavy-drinking associations; women showed weaker effects at moderate levels. 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Diabetology & Metabolic Syndrome (2026) 18:9 [https://doi.org/10.1186/s13098-025-02034-7](https://doi.org/10.1186/s13098-025-02034-7)  \nDiabetology & Metabolic Syndrome  \nRESEARCH Open Access  \nAssociations between diabetes mellitus   and drinking patterns in Korean adults by sex: insights from the Korea National health and nutrition examination survey 2013–2018  \nHyunsoo Yoo 1†, Yoon-Seok Choi 1† and Young-Mo Yang 1*  \nAbstract  \nBackground 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.  \nMethods 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.  \nResults 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.  \nConclusion 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.  \nKeywords Alcohol consumption, Diabetes risk, Binge drinking, Gender differences, Korean adults  \n†Hyunsoo Yoo and Yoon-Seok Choi contributed equally to this article.  \n*Correspondence: Young-Mo Yang [yyang@chosun.ac.kr](yyang@chosun.ac.kr)  \n1Department of Pharmacy, College of Pharmacy, Chosun University, 309 Pil mun-daero, Dong-gu, Gwangju 61452, Republic of Korea  \n© The Author(s) 2025. Open Access This article is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License, which permits any non-commercial use, sharing, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if you modified the licensed material. You do not have permission under this licence to share adapted material derived from this article or parts of it. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit [http://creati](http://creati)[vecommons.org/l](vecommons.org/l)icenses/by-nc-nd/4.0/.  \nYoo et al. Diabetology & Metabolic Syndrome (2026) 18:9  \nBackground  \nDiabet","cbCaiqvy5WhiRgDz","https://ap.wps.com/l/cbCaiqvy5WhiRgDz","pdf",1346421,13,"English","# Abstract\n## Background\n## Methods\n## Results\n## Conclusion\n# Background\n## Diabetes prevalence and prediabetes risk\n## Metabolic disorders and fatty liver terminology\n## Controversy on direct alcohol–diabetes association","[{\"question\":\"What study design and data source were used to assess alcohol patterns and diabetes risk?\",\"answer\":\"The study used a cross-sectional design with data from 31,091 adults in the Korea National Health and Nutrition Examination Survey (KNHANES) for 2013–2018.\"},{\"question\":\"How were participants classified for diabetes status?\",\"answer\":\"Fasting glucose levels categorized participants into normal, prediabetic, and diabetic states.\"},{\"question\":\"How did moderate versus heavy or binge drinking relate to diabetes prevalence?\",\"answer\":\"Moderate drinking was associated with lower diabetes prevalence, while higher intake (≥5 standard drinks) and frequent binge drinking were associated with increased risks of both prediabetes and diabetes.\"}]","Associations between diabetes mellitus and drinking patterns in Korean adults by sex: insights from the Korea National health and nutrition examination survey 2013-2018 | PDF",1790750044,33]