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Chunk #21 — DISCUSSION

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Blood glucose level, alcohol heavy drinking, and alcohol craving during treatment for alcohol dependence: results from the Combined Pharmacotherapies and Behavioral Interventions for Alcohol Dependence (COMBINE) Study.
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This study did not find a significant correlation between blood glucose level and alcohol craving. A previous human study found a direct correlation between insulin and alcohol craving and between C-peptide and alcohol craving, but not between alcohol craving and IGF-1 nor between alcohol craving and glucose (Leggio et al., 2008a). Using a larger sample size but a similar population (treatment-seeking alcohol dependent subjects), the present findings confirm the lack of correlation between glucose and alcohol craving. Notably, in both studies the OCDS scale was used and analysis included both the total OCDS score as well as the two main subscales, namely obsessive and compulsive. These findings suggest that the putative role of glucose on heavy alcohol drinking may not be mediated by through the effects of glucose on alcohol craving and instead, other mechanisms underlying this association may be at play. Furthermore, the possible role of differences in the sample analyzed (i.e., alcohol dependent subtypes; see Leggio et al., 2009) cannot be ruled out.