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The recommendation at present is that, if you have diabetes, alcohol should be avoided or restricted. It is clear that for a significant proportion of people with diabetes this advice is ignored. However, there is now much evidence to challenge the once accepted view that alcohol is best avoided by the patient with diabetes. Current epidemiological evidence would support the view that moderate alcohol consumption has health benefits particularly in reducing the risk of vascular disease. The difficulty is how we translate this knowledge into advice for people living with diabetes on a daily basis. This article considers the relationships between alcohol and diabetes: from weighing the epidemiological evidence, to practical clinical advice. Copyright © 2006 John Wiley & Sons, Ltd.