Objective  To explore the interaction of alcohol drinking and obesity on diabetes mellitus among community residents over 35 years old and to provide evidences for developing diabetes prevention and control strategies and measures.

  Methods  We extracted diabetes screening data on 83 530 community residents over 35 years old collected in surveys for the China Patient – Centered Evaluative Assessment of Cardiac Events – Million Persons Project (PEACE-MPP) conducted in Jiangsu province from 2015 to 2017. Risk factors of diabetes were analyzed with multivariate unconditional logistic regression model and the interaction between alcohol consumption and obesity on diabetes was systematically evaluated.

  Results  Of all the participants, 15 755 diabetes patients were identified, with a prevalence rate of 18.86%. The regression analysis demonstrated that alcohol drinking, obesity and hypertension were the main risk factors of diabetes among the participants after adjusting for confounding factors such as sex, age, education, marital status, occupation, family income and occupation; the analysis also revealed an additive interaction between alcohol consumption and obesity; the participants having both alcohol drinking and obesity were at a significantly higher risk of diabetes mellitus (odds ratio = 1.67, 95% confidence interval: 1.52 – 1.83) in comparison to those without alcohol consumption and obesity.

  Conclusion  Alcohol consumption and obesity could interact additively and increase the risk of diabetes mellitus among 35 years old and above community residents.