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Caffeine worsens insulin resistance in prediabetics
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Caffeine worsens insulin resistance in prediabetics


Interestingly, a study showed that when diabetics had caffeine equivalent to four cups of coffee, their average daily blood sugar levels rose 8 per cent.  On the other hand, pre-diabetics (fasting blood sugar higher than 100) had the equivalent to 3 cups of coffee and three hours later, their blood sugar increased by 15 percent and the insulin production by 18 percent.  So pre-diabetics may not see a big increase in their blood sugar, but the hyperinsulinemia is getting worse.  And as we know, hyperinsulinemia makes interferon ineffective.

Co


Caffeine worsens insulin resistance in prediabetics.
Family Practice News
April 15 2007

WASHINGTON -- Caffeine intake appears to exaggerate post-meal insulin resistance in prediabetic adults who regularly drink several cups of coffee each day, according to preliminary results of a randomized, double-blind, crossover study of 50 individuals.

The results "suggest that caffeine consumption promotes the development of type 2 diabetes in those people who are at greatest risk for this disease," James D. Lane, Ph.D., said at the annual meeting of the Society of Behavioral Medicine.

This is the first time that caffeine's effects on insulin resistance have been measured in habitual coffee drinkers with prediabetes, said Dr. Lane of the department of psychiatry and behavioral medicine at Duke University, Durham, N.C. More than 12 other studies have shown that caffeine administration acutely raises insulin resistance both in healthy, nondiabetic volunteers and in patients with type 2 diabetes.

Other studies have shown that coffee drinking is associated with a significantly reduced risk of type 2 diabetes, but these conclusions have been "based on correlational observations, not controlled, experimental studies," he noted.
In the current study, all participants had prediabetes (average impaired fasting blood glucose level of 111 mg/dL) and drank at least 2 cups of coffee per day, which was confirmed by a 7-day food diary. Each person fasted overnight and did not consume any caffeine, which preserved any tolerance that they had developed from their continued exposure to caffeine.

On the first day of testing, the participants received either 250 mg caffeine or placebo pills and had their fasting blood glucose levels measured. On the second day, they received the opposite of what they had taken on day 1. After 60 minutes, they had their blood glucose levels measured again, and they received a booster dose of 125 mg caffeine or placebo. They also drank a BoostPlus liquid meal replacement shake (75 g carbohydrates, plus fat and protein), which is similar to an oral glucose tolerance test except that it is more like a real meal, Dr. Lane said. Blood samples were drawn during each of the next 3 hours.

The total 375-mg dose of caffeine was equivalent to about 3 cups of brewed coffee, similar to what subjects consumed on average each day (409 mg).

For the first 41 participants with full results available, caffeine increased the 3-hour area under the curve (AUC) for plasma glucose by 15% more than placebo, though the result was not statistically significant. But the 3-hour AUC for plasma insulin was 18% greater with caffeine than with placebo--a significant difference. AUC is the standard method for measuring responses to oral glucose tolerance tests, said Dr. Lane. "'This pattern of results shows that caffeine did increase insulin resistance in these prediabetic subjects."

A normal response to the extra insulin produced with caffeine would have been to reduce the peak glucose level to a point lower than what was seen with placebo. But "'the glucose response was, if anything, a little larger in the caffeine condition," he said. "Given the conditions of our study, we think that this insulin resistance effect occurs every day as these prediabetic individuals and others like them consume caffeinated beverages in the real world."
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46 Comments Post a Comment
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Avatar_m_tn
before everybody start switching to oranges instead of coffee -- what sets not good for insulin resistance either LOL -- keep in mind a couple of things. First, this study was for pre-diabetics, meaning their glucose is a little out of lack anyway. Second, there have been a number of recent studies suggesting that coffee may have a liver protectant benefit in terms of liver cancer. And third, there are other causes of insulin resistance, such as obesity and specifically mid-waist girth. I'm not saying someone pre-diabetic resistant should keep drinking coffee, but perhaps a change in their diet and weight might make even a bigger difference.
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Avatar_m_tn
forgot to mention exercise
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619345_tn?1310345021
CO How come you are so mean?  NOW Gotta give up coffee too
I am trying
mixing decaf with regular getting to half and half mix  

Cigarettes tried the Champix pills  almost made me ready for the loney bin  I was so stupid and goofy I was scaring my employees as I am goofy enough with the brain fog  So  No smoking and no Caffieine no Booze god how will I live no vices
Next I will have to go to church
I left my cigs at work and am having a nicotine fit going to bed early
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Avatar_m_tn
This may not be exactly on topic but since I believe that the reason you post about IR is that it lowers response rates.  This may pertain to that.

You may recall I was in a recent Vertex trial (but pulled out due to a good biopsy result- I can wait to treat).  One thing that I recall was being told by the NP that I should reduce my coffee intake during the trial.  I believe that the jist I discerned was that it was thought to diminish response rates.  The NP was in a hurry and it was no time to explore that thought and see if they would explain it further.  When I got my 1/6 ISHAK staging it was about the end of our communications.  I have continued to wonder about that however since I love my coffee.

I recently came across this bit in another cutting edge FDA HCV study;
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http://clinicaltrials.gov/ct2/show/NCT00382798?term=R7128+AND+HCV&rank=1

Adaptive Phase I HCV Study With Nucleoside Analogue, in Combination With Interferon and Ribavirin (R7128)

"Able to abstain from any alcohol (including alcohol-containing products) and able to limit caffeine consumption to two 8-ounce cups of coffee or the equivalent per day, from 72 hours before receiving study drug through the end of the study (Day 56 or early termination). "
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I hope that this isn't considered too far off topic to discuss, but IF SO..... one could in another thread.  

Do you consider this germane?  Could you talk about why my NP mentioned this and why it is included as a part of this study?

Hope you are well,

Willy

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144210_tn?1273092382
You and CS are doing me some good. CS noticed that i am IR. The doc missed it, and so did I. Funny that the doc did mention that he suspected I was IR with possible nash a couple of years ago. He never mentioned it again. I suppose the diet and exercise regimen I was on must have got it under control pre tox. It is back though, so diet and exercise are also back. I drink alot of diet soda, so that has got to go too. Thanks to you guys for staying on top of this.
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568322_tn?1370169040
"before everybody start switching to oranges instead of coffee"
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If they eat the oranges with some protein they can prevent the big spike in blood sugar.



"First, this study was for pre-diabetics, meaning their glucose is a little out of lack anyway."
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A fasting blood sugar above 100 is pre-diabetes so you don't have far to go.  Studies have shown that insulin resistance starts in childhood.....50% of obese teenagers are insulin resistant.  Glucose tolerance deteriorates with age....and if you add the Hep C virus to the mix, your chances of being IR (even if the glucometer doesn't show it) are high.



"Second, there have been a number of recent studies suggesting that coffee may have a liver protectant benefit in terms of liver cancer."
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SVR is probably a more effective way of preventing liver cancer.  I am all for using different measures to try to prevent liver cancer in the future.  But during tx, an 18 percent increase in insulin, even if transient, may hurt their chances of SVR.



"I'm not saying someone pre-diabetic resistant should keep drinking coffee, but perhaps a change in their diet and weight might make even a bigger difference."

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Pre-diabetic---->drink coffee--->18 % increase in insulin levels....whether they exercised yesterday or not----->too much insulin, no SVR.  

Co
P.S.  I hear the coffee companies have put a price on my head....LOL
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568322_tn?1370169040

"forgot to mention exercise "
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Exercise every time you drink coffee.....great idea Jim!  Think they'll do it?

Co
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568322_tn?1370169040
"mixing decaf with regular getting to half and half mix"
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That's a great way of doing it.  You should be very proud of yourself for all the positive changes you've made to your lifestyle.  


"Cigarettes tried the Champix pills  almost made me ready for the loney bin"
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CS and I tried to tell you.  But maybe we didn't say enough bad things about it.  We'll have to do better next time...LOL


"Next I will have to go to church"
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I won't be promoting that....unless I see studies that show it increases SVR.

Co
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568322_tn?1370169040
"One thing that I recall was being told by the NP that I should reduce my coffee intake during the trial.  I believe that the jist I discerned was that it was thought to diminish response rates."
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Many of the Study Coordinators are Hep C speakers...so they would promote decreasing caffeine intake to prevent dehydration, is my guess.  

But putting it on the inclusion criteria and listing an amount (two 8-ounce cups) is very interesting.  Maybe they know something we don't know.  I wonder if it's on the Telaprevir and Boceprevir consents.  Maybe somebody will jump in and tell us what they were told when they enrolled.

Thanks for pointing that out Willy.  It's made me very curious, of course.  

Co
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Avatar_m_tn
I thought you could do better than that :)

However you twist it, diet and exercise are the first line defense against IR per accepted protocols. If you continue to fail to mention it, I will continue to. :) And btw eating "protein" with the orange will not help much. You would have to eat an adequate amount of fat as well with the orange to slow down the sugar absorption.

-- Jim
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Avatar_m_tn
To paraphrase "HR" on similar discussions on nutrition. While he does strongly advocate selective supplements, he still maintains that the protective pyramid is based on smart lifestyle choices such as proper diet, exercise, weight control, etc. My problem is not with valuable information you provice re the IR drugs , but that you tend skip over the base of the pyramid, and jump right into the drugs. Like much in life, there is no free lunch and unfortunately sometimes heavy lifting (i.e. diet, exercise and weight loss) are sometimes called for. To simply say, as you have in the past, that it's too difficult is to give up before you begin.

-- Jim
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683664_tn?1330969924
Nope, nothing in Tela trial consent about coffee!
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568322_tn?1370169040
"You and CS are doing me some good."
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I think we make a good team.  He has a way of catching what I miss....and he keeps me from getting too excited about things I can't change.


"I suppose the diet and exercise regimen I was on must have got it under control pre tox. It is back though, so diet and exercise are also back."
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The 15 lbs weight gain and you saying you had gained weight the previous times you treated was a good indicator.  The diet and exercise really helped you but it looks like treatment makes things worse.

If you eat the typical high carbohydrate, large portion diet, you'll have leftover glucose in your blood....which insulin will promply convert into fat.  The fatter you get, the less responsive to insulin your cells become.  Once insulin resistance sets in, your body, in an effort to maintain its normal equilibrium, produces even more insulin to overcome the resistance.  Because the insulin can't carry much glucose into your cells to be burned as fuel, the glucose remains in your blood instead.  Insulin converts some of the excess sugar to fat.  You get fatter and you also feel tired all the time, partly because your cells aren't getting the fuel they need, and partly because the excess insulin causes your blood sugar to fall below the optimal range of 70 (hypoglycemia).....and of course that will make you crave more carbohydrates.

All the things that have been happening to you.  You gained weight, feel tired, your blood sugar went down to 66 and you crave carbs.

The advantage is that this time you recognized it and you're doing something about it.

Suggestions:
1.  Consider stopping the Omega 3 (with your doctor's okay, of course).  It can increase fasting blood sugar levels, especially since you have IR.  It can also increase the risk of bleeding....and you have low platelets.
2.  Five small meals a day instead of three large ones.  Don't eat fruit by itself.  Have a snack that contains protein half hour before bed....helps control the fasting blood sugar.  
3.  Get enough sleep.  Inadequate sleep may lead to/increase insulin resistance and it is associated with weight gain even in people with excellent diets who exercise regularly.  In one study, when sleep was decreased from 8 to 4 hours per night, the resulting alterations in glucose metabolism in some cases resembled those of patients with Type 2 diabetes.
4.  Be careful not to get dehydrated.  High protein diets increase the risk of dehydration.  (it can also lead to increased calcium excretion and if I remember correctly, your calcium is a little low).  Dehydration can also cause an increase in blood sugar.

Bast of luck to you.  CS and I will be over in the cheering section if you need us....LOL

Co
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568322_tn?1370169040
Thanks lapis.  Did your study nurse say anything to you about cutting down caffeine intake?  

Co
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233616_tn?1312790796
thanks for posting this...I've been trying with limited success to convince the caffienaholics to give it up. Alas the Java crowd won't give up them beans without a fight.

they can quote all day less fibrosis and cancer....but remember the tobacco lobby has their good research too.

when you factor in increases in heart anomalies, decrease in brain chemicals, overstimulation and burn out of neural signaling, dangerous chenges in electrolyete balances, decrease in blood and bone calcium, and now increase in insulin resistance, you would think the idea would be driven home.

caffiene is just a handful of bennys, or dexadrine, taken in liquid form. Coffee is just speed at it's essense, and it's not full of health benefits anymore than tobacco which "doctors recommended" was.

Studies pointing to one good oil in the coffee bean fail miserably at telling you what compounds and alkaloids that are harmful also exist in the "brew".

mb
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568322_tn?1370169040
I started a thread about coffee increasing glucose and insulin levels.  I don't see why I have to promote diet and exercise when I want to talk about coffee.

Plus, I don't have to....you do it every single time.


"My problem is not with valuable information you provice re the IR drugs , but that you tend skip over the base of the pyramid, and jump right into the drugs."
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And my problem is that you advocate diet, exercise and weight loss while encouraging people to eat a high fat diet twice a day to increase Riba absorption.  


"I thought you could do better than that :) "
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I got my point across to Baja, Willy and gauf.  I think I did really well.  

Co
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568322_tn?1370169040
"a high fat diet twice a day"

should say "a high fat meal twice a day"

Co
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Avatar_m_tn
You did and it is appreciated.  I don't think that the basics that Jim is advocating is going to get lost in the shuffle.

By the way Jim; I've drank coffee and run for years (although not simultaneously) .  I'm 55, a 5'-11" guy and a svelte 157 pounds.  I don't know how long I've had HCV but my damage is minimal.  My coffee  habit is probably my worst abuse.  Frankly, If I cut out coffee it would also eliminate half my sugar intake as well.  Even though I am pretty healthy I want to either stay healthy or become more healthy.  I'll have to admit that I drink way too much caffinated beverages.

We always look for something, anything that will give us an edge in TX and as much as I hate it I am starting to consider *limiting* my consumption.  I've also pulled back on the sugar some so that I may be 50-50 stevia.

I hated like hell hearing the bad news about coffee but when my NP mentioned it in the Vertex trial I paid attention.  When I saw this in another trial I also thought; huh!

I don't know what it means..... but I may have to cut down my consumption.

Thanks, Co...... I thought you'd be interested in that.
(but I have no recollection as to the reason I was given; it could have been hydration issues)

Willy
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619345_tn?1310345021
Most diet doctors will also put a nix on coffee and diet sodas as it acts like sugar
caffiene promotes hunger
Diets I have been on in the past work better for me and over eating when I cut my coffee intake   I do not drink diet sodas

Hep C has caused me to have panic attacks they have worsed so much the past 10 years  I would have to take and still do xanex  in order to work and drive

But since I have cut the caffeine with decaf I truly am not as anxious and do not have to take xanex as much

I love coffee really love it  and I was so excited when the latest studies showed that coffee was good for the liver  However like a relationship that is bad no matter how good the sex is you just gotta walk away if 90 percent of the time you feel bad

CO has really saved me as without her guidence to insist on a HOMA test I would have never known I was IR

Excercise is difficult I can only do slow walking but I am doing it and it is giving me more energy I have a problem with my blood pressure in a stress test I have had two both the same  my pulse or stolic pressure drops while my heart rate is very high I have passed out doing areobics
and this was when I was in my early 40's  so I switched to very low impact aerobics and weights

I tried that recently and could hardly go to work even walking fast on the tread mill does it to me as it has a plus meter so I really try to watch it but moving is important as is eating less  

Now that I know that I am insulin resistant

I am watching what I eat and keep low fat, low carb, and good protien I do drink a liter and a half of water a day it is not enough but it is a start

  I also have other issues with my stomach so I cannot eat acidy foods or a lot of roughage or high fiber carbs and veggies  bummer

Thanks for this thread  
Baja


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Avatar_m_tn
CO: And my problem is that you advocate diet, exercise and weight loss while encouraging people to eat a high fat diet twice a day to increase Riba absorption.
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Let's not put words in my mouth and then twist them around.

Yes, I advocated exercise and weight loss BEFORE and AFTER treatment -- that is if weight loss is needed to get down to a more ideal BMI and girth ratio.  

And no, I don't encourage weight loss DURING treatment as many of us have a hard enough time maintaining weight. I do advocate taking ribavirin with some fat during treatment to help increase riba absorption which is a topic we have talked to death before. How much fat someone wants to take based on the study material is up to them. As to my own diet during treatment it is well documented along with the reasons why which you are of course free to quote out of context as you have a tendency to do.  
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Avatar_m_tn
Your focus on Diet and Exercise as the first and foremost method of reducing IR is a little flawed in my view.
1. what comes first. Does IR lead to weight gain or does Weight gain lead to IR.
I am aware of several people who put on quite a lot of weight in a relatively short period of time. They didn’t change anything they just gained weight.

2. Not all people who are Insulin Resistant are overweight. Just ask the Japanese,.
While 90% of those with insulin resistance are overweight, what do the other 10% do?

3. I know drinking copious amount of Diet Pepsi didn’t do me any favors last Tx.

Wouldn’t a more sensible approach be to use as many methods as possible to reduce IR rather than to focus on only one.

Perhaps if you spent more time listening to what CoWriter has to say instead of confronting her at every opportunity then maybe your well documented weight distribution issues you acquired after Tx would not have taken so long to resolve. Is it resolved?
Diet and exercise weren’t that successful for you now was it.

Give up Coffee, what’s next?
This virus is so cruel. If I start chewing on alfalfa or Blue Green algae then life just aint gunna be worth living.

CS
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683664_tn?1330969924
No, nothing was said about caffeine intake during tx.  Next to nothing was said about diet at all, except to take all the oral meds with food.  (In fact, I was not told to take fat with my Riba, I learned that here on the site!!)

What's interesting in my situation is that the caffeine took care of itself.  I was only drinking one cup in the morning anyway (and very seldom drink other caffeinated beverages), and found that I could no longer tolerate it after a couple of weeks on triple tx.  My body began rejecting it, and I chose to forgo the coffee over dealing with the nausea and vomiting it caused.  I only miss the thought of it at this point.  : )
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568322_tn?1370169040
"thanks for posting this...I've been trying with limited success to convince the caffienaholics to give it up. Alas the Java crowd won't give up them beans without a fight."
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Welcome to my world....LOL.  I've been preaching about IR and coffee for the past 5 years and haven't gotten very far....but nobody's said I'm nuts in a while, so I figure I'm doing good....LOL

You are now an honorary member of the "Coffee Suucks SVR" club....LOL.  We don't have many members but I'm hoping that will change.

Co
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Avatar_m_tn
I am watching what I eat and keep low fat, low carb, and good protien
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Hope that is low bat fat. If not increase the good fats, you know Olive Oil Macadamia Nut Oil etc. Basically whatever MacDonalds dont use.

CS
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476246_tn?1310999221
I didn't know ppl were into extracting batfat.... ;-)

sorry, couldn't help it...

cheers my friend
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568322_tn?1370169040

"And third, there are other causes of insulin resistance, such as obesity and specifically mid-waist girth."
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Mid-waist girth doesn't CAUSE insulin resistance.  Too much abdominal fat is associated with a defect in the body's response to insulin.  In other words, the body doesn't respond to insulin the way it should.  If mid-wait girth caused IR, then removing it with liposuction would provide metabolic benefits and it doesn't.

Obesity can cause IR because it increases visceral (deep) fat ...which secretes inflammatory cytokines that contribute to insulin resistance.

Co
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568322_tn?1370169040

"what comes first. Does IR lead to weight gain or does Weight gain lead to IR. "
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Great point!  Thanks.

Co
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568322_tn?1370169040
"Hep C has caused me to have panic attacks they have worsed so much the past 10 years  I would have to take and still do xanex  in order to work and drive

But since I have cut the caffeine with decaf I truly am not as anxious and do not have to take xanex as much"
-----------------------

That's how they induce panic attacks in clinical experiments.  When panic disorder patients are given a dose of caffeine equal to 4-5 cups of coffee, about half of them experience a panic attack.

Co
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568322_tn?1370169040
"What's interesting in my situation is that the caffeine took care of itself.  I was only drinking one cup in the morning anyway (and very seldom drink other caffeinated beverages), and found that I could no longer tolerate it after a couple of weeks on triple tx. "
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I've heard other people say that.



"Next to nothing was said about diet at all"
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I'm hoping that in the future, diet will be included in pre-treatment education....along with insulin resistance education, of course.....LOL

Best of luck with yout treatment,

Co
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233616_tn?1312790796
caffiene clearance is another factor rarely discussed. As we age our caffiene clearance capacity goes down independant of kidney function.

I'm at the point that one cup of tea keeps me up 2 days (that's a cheap drunk!!)

This is spite of the fact that all my kidney numbers are fine.
For some reason this is the drug that just keeps on giving.

If this were not true there would be no such thing as decaf. Decaf is to keep the middleaged on a drinking a substance that has become toxic, by removing the worse offender in the brew. (that only leaves 2 dozen we still drink).

when you think about it, this is why meth is so popular....why take coke, gone in 20 minutes when the same amount of meth will last 12-24-36 hrs depending on your metabolism.

the truth is the body hangs on to caffiene like it does ribavirin....and turns us all into the wooley ones....(not to be fed after midnight).

By the way, did you ever read the PDR's description of caffiene withdrawal?? That's some scary stuff!!

mb
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Avatar_m_tn
You get drunk on Tea – Can I ask which Tea that is? -LOL
The reason why Tea is keeping you up for two days (slight over exaggeration me thinks) is that it contains caffeine,. although no where near as much as coffee.

Now Caffeine is metabolized by a particular P450 enzyme CYP1A2. Interferon inhibits this enzyme. So when CYP1A2 is inhibited your liver has less ability to metabolize caffeine. In other words it stays in you body longer.

That’s why you are such a cheap drunk. Has nothing to do with your kidneys.

CS
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Avatar_m_tn
CS: "what comes first. Does IR lead to weight gain or does Weight gain lead to IR. "

CO: Great point!  Thanks.
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I wouldn’t call it a great point but an obvious one that is now being used as part of a straw man argument. No one has said that IR can’t lead to weight gain -- of course it can. My point has been that it also can work the other way, but I"m sure you know that by now.


CO: Mid-waist girth doesn't CAUSE insulin resistance.  Too much abdominal fat is associated with a defect in the body's response to insulin
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Apparently the Mayo Clinic and numerous other authorities disagree with your statement.
http://www.mayoclinic.com/health/belly-fat/MC00054  

As you sometimes state -- as if you’ve discovered the concept  LOL– IR can cause belly fat, but it can also work the other way around, i.e. belly fat can be a cause of IR.


C0: If mid-wait girth caused IR, then removing it with liposuction would provide metabolic benefits and it doesn't.
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You’re correct that liposuction won’t provide metabolic benefits and that’s because the problem is deeper VISCERAL fat. But that doesn’t mean that belly fat – visceral or not – isn’t associated with type-2 diabetes. Studies suggest quite the contrary and efforts to remove belly fat – diet and exercise – are what is often recommended.  

To summarize for others --because I think you know where I'm coming from but it just doesn't suit your arguments LOL -- I believe IR is an important topic and an important intervention concept with HCV treatment among other health issues. My opinions on diet and exercise in no way suggest that Metaformin and other IR drugs do not have an important place where appropriate. I've been bringing up the diet and health issues -- weight loss before tx -- for years here and I now appreciate that you're keeping us current with the newer IR studies using drugs. This doesn't have to be an "either or issue" as you sometimes infer I'm making it but often think you're making it LOL. Hopefully, both people and their doctors will consider the best approach for themself.

-- Jim


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Avatar_m_tn
CS: Your focus on Diet and Exercise as the first and foremost method of reducing IR is a little flawed in my view.
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First, that’s not my point. My point was that diet and exercise are tried and true first line defenses on IR and I in no way exclude drugs like Metaformin when called for.


CS:  Not all people who are Insulin Resistant are overweight. Just ask the Japanese,.
While 90% of those with insulin resistance are overweight, what do the other 10% do?
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Again, you’re not reading what I’m saying. Of course not all people who are insulin resistant are overweight and do you really think I’m suggesting a skinny Japanese man to lose weight?  He might, however, change the compositiion of his diet toward healthier fats (without decreasing calories or weight) and he might add some exercise and he might need a drug like Metaformin. Let’s not oversimply either the issue or what I’ve said.

CS: Wouldn’t a more sensible approach be to use as many methods as possible to reduce IR rather than to focus on only one.
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But that’s been my point from the beginning  when I bring up the first line treatments of diet and exercise. Again, recommending diet and exdercise does not exclude pharmaceutical intervention when necessary.

In fact, I’ve just recently recommended Metaformin to others here as part of a pre-treatment  strategy and even suggested they get more info from your pal “CoWriter”.
http://www.medhelp.org/posts/show/710464 I’m not the Johnny One Note here.


CS: Perhaps if you spent more time listening to what CoWriter has to say instead of confronting her at every opportunity
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Really? I was one of the first to defend CoWriter here for what I perceived were unwarranted attacks both to her personally and to her credentials.  More so, I have referenced some of the studies she has posted here and given her due respect per the thread I posted above. You seem to confuse “confronting” with reasonable discussion and reasonable disagreement. No doubt, if you agreed with me and not her, then she would be the one "confronting".

CS: then maybe your well documented weight distribution issues you acquired after Tx would not have taken so long to resolve. Is it resolved?  Diet and exercise weren’t that successful for you now was it.
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In my three years at Med Help fortunately it’s quite rare that someone takes such  a personal and classless cheap-shot at someone’s disclosed medical issues with a such a mocking tone. This will be my last post to you. Life’s too short to roll in the mud.

But for others following the thread, yes, my post tx weight distrubtion issues post tx have been significantly improved by a diet and exercise program – issues caused by the interferon.  Or perhaps do you want me to take IR drugs as I’m not pre-diabetic.
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Avatar_m_tn
Jim - Really? I was one of the first to defend CoWriter here
However you twist it, diet and exercise are the first line defense against IR per accepted protocols. If you continue to fail to mention it, I will continue to.
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So what was your intention here. Its not like you were taking the opposing view.

As for diet and Exercise, the fact that me and you have decided that something like South Beach seems to work well does not mean it is universally accepted as the correct approach.

I will give you one piece of advice, Up to you what you do with it.
You may want to look into the Rosedale diet.
It is similar to South Beach but is more focused on Leptin resistance. It has a higher good oil content.

Jim - In my three years at Med Help fortunately it’s quite rare that someone takes such  a personal and classless cheap-shot at someone’s disclosed medical issues with a such a mocking tone.
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If you cant see that I was trying to point out that you have personal experience at how difficult diet and exercise can be in shifting excess weight. So be it.

Jim - This will be my last post to you.
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I never realised you were so sensitive. I had also given you more credit.
You are being childish, and if that’s how you want to be, Who Cares.

I wish I could spell placing your index finger to your lips and moving it thus making funny noises. At least the kids will laugh.

Jim - and even suggested they get more info from your pal “CoWriter”
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Cheap shot and you know it.

This place shouldn’t be about personalities. It’s the Ideas discussed that are important.
Not whether you like me. So get off your winged high horse.


As for the rest we seem to basically agree. So how did we misinterpret each other.
CS
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Jim - Or perhaps do you want me to take IR drugs as I’m not pre-diabetic.

How would i know wherther you are pre diabetic or not.
Whats your HOMA-IR score.

Whether you take an IR drug or not is up to you. I know I am not that fond of them.
But then i dont particularly like taking Aspirin net alone any thing else.
Which is not to say i wouldnt take them if i felt it would benefit me.
CS
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You know, I'm just a simple-minded old lady compared to you smarties but what I see here is you both have a crush on Co-writer and that's the real story.
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I have a question or two for those who knows.
Does some people with IR reach SVR?

I talked to my doc  the 10 of december at EOT and he said you can´t have it since you responded meaning I´ve got to UND, does IR worsen your chances to get SVR even if you have reach RVR?

ca

PS I think he the doc said responded so good I´ve got to UND at week 5 most likely had 10- 20 iuml week 4
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lol!
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Now excuse me since this is simply another one of those PRO-COFFEE type stories but I am confused about what may seem to be a contradiction (to a layman like myself)which pertains to diabetes and coffee consumption.  Mind you.......I'm not asserting that it is a contradiction but at first glance it seems to not make sense.  

Perhaps you can read this and explain it.  It is a large study contemporary study.

I'm not ready to start posting threads like; "Stop Drinking Coffee and DIE!!!!"
.....but perhaps if you'd be so kind explain how this all fits together.....

Best,
Willy
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http://www.hepatitis-central.com/mt/archives/2008/11/coffee_drinkers.html

November 21, 2008  

Hepatitis C Patients: Drink More Coffee for a Healthier Liver
Demonstrating a hepatoprotective effect against Hepatitis C, the world's number one morning beverage lands a victory in the debate over its healthfulness.

by Nicole Cutler, L.Ac.

People living with Hepatitis C have had just about every aspect of their lifestyle analyzed to determine what could facilitate or impede the progression of liver disease. While most indulgences have been implicated in a worsening of Hepatitis C, drinking coffee may be an exception to this trend.

Over the past few years, several studies have encouraged people with chronic liver disease to be faithful to their preferred morning beverage. Research into its health benefits has revealed some surprising associations with coffee consumption including decreased risks of:

· alcoholic cirrhosis
· type 2 diabetes     -----------------(this is what surprised me- Willy)
· gallstone development
· liver damage in those with liver disease
· liver cancer

While the studies bearing such conclusions were encouraging to coffee drinkers with liver disease, there had been little evidence specific to advanced cases of Hepatitis C – until now. As reported at the 59th Annual Meeting of the American Association for the Study of Liver Diseases in November 2008, an increase in coffee consumption may slow the progression of liver damage caused by Hepatitis C. Pertinent details of the reported study are listed below:

· Over 800 people participated in this observational study
· Participants had Hepatitis C with an Ishak fibrosis score of 3 or higher
· Participants were unresponsive to standard drug therapies
· 88 percent of participants drank zero to two cups of coffee a day
· 12 percent of participants drank three or more cups of coffee daily
· Those who drank the most coffee also consumed the most alcohol and cigarettes

Considering the known dangers that drinking alcohol and smoking cigarettes pose to a person with Hepatitis C, one would expect those with the highest consumption rates to also have the most advanced cases of liver disease. However, this study found the reverse to be true. Compared to those who drank zero to two cups of coffee per day, the coffee drinkers who consumed three or more cups of coffee showed the following indicators of liver health:

· Less steatosis as determined by liver biopsy
· Lower bilirubin levels
· Lower α-fetoprotein levels
· Lower aspartate aminotransferase/alanine aminotransferase ratios

(please visit the link for the complete article- Willy)
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Decreased risk of gallstone development ummm
Perhaps the study should have spoken to my GallBladder

Coffee consumption didnt decrease my risk one bit.
CS
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HaHa. You did make me laugh. -LOL
CS
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ROFL

CS lives too far.  Maybe I can take Jim out for a cup of coffee.  

Co
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"I have a question or two for those who knows.
Does some people with IR reach SVR?"
--------------------------

Yes, some do.  Some Type 2 diabetics reach SVR (although the rate is very low).  Diabetics are insulin resistant.   Treatment can sometimes improve blood sugar....so those diabetics would have a better chance of SVR.  But treatment can slso make the blood sugar worse.

A HOMA insulin resistance test below 2 is normal...that means they were not insulin resistant.  Those people have a higher SVR..... 60.5% in one study.

And the more insulin resistant people were, the lower the SVR....

HOMA between 2-4 .......40% reached SVR
HOMA greater than 4......20% reached SVR

So some do clear....but why treat for a 20% chance when there are things you can do to increase your chances?



"I talked to my doc  the 10 of december at EOT and he said you can´t have it since you responded meaning I´ve got to UND"
-----------------------------

Oh, I like your doctor.  Here's somebody who understands that if you're not IR your chances of SVR are better.



"does IR worsen your chances to get SVR even if you have reach RVR?"
----------------------------

Insulin resistance decreases your chances of reaching RVR.  More so on co-infected patients.  None of them reach RVR or EVR if they're insulin resistant.

Co
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Looks like you missed the discussion we had on that particular study.  You must have been absent that day....LOL

http://www.medhelp.org/posts/show/693469?camp=36


The study (and I use the term loosely), used patients from the HALT-C trial.  Of the 808 patients who responded to the questionnaire at baseline, 711 drank 0 to 2 cups of coffee a day, and 97 drank 3 or more cups.  Even though the group who drank the most coffee also consumed the most alcohol (but length of alcohol use was not noted.  Some may have been drinking for 20 years and others only for a short time) and cigarettes, they had slower progression of fibrotic liver disease.  In other words, they had healthier livers at baseline.

(BTW, caffeine clearance is accelerated in smokers....and the people who drank the most coffee also smoked more).

The study was based on a questionare at baseline.....and they didn't ask people what TYPE of coffee they drank....real coffee or decaf.  That means that the people who drank 3 cups/day either had 399mg of caffeine daily (if they drank real coffee) or only 15mg a day (if they drank decaf).

And all of them were put in the "more than three cups of coffee a day" group.  Call me crazy but I don't think they should have done that....LOL

Some may have had healthier livers because they were drinking only 15mg of caffeine daily while the other group was having 2 cups.  And maybe it was real coffee....or maybe not....LOL


Results at the end of the trial showed that liver disease had progressed in 208 patients (but they didn't say which patients).  

And you know how they came to the conclusion that "coffee consumption may slow the progression of fibrotic liver disease"?  Not by comparing the biopsies....oh no, no,no....LOL   They looked at "outcome rates".

Outcomes included...death, hepatocellular carcinoma, hepatic decompensation, variceal hemorrhage, ascites, spontaneous bacterial peritonitis, and encephalopathy.

And they came to the conclusion that the people who started with healthier livers at baseline, had less outcomes....LOL.    


And therefore, "coffee consumption may slow the progression of fibrotic liver disease"....


What do I think?  I think they should be ashamed of calling it a "study" and publishing it.

Co
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"Research into its health benefits has revealed some surprising associations with coffee consumption including decreased risks of:

· type 2 diabetes     -----------------(this is what surprised me- Willy)"

----------------

There are hundreds of controlled trials that have shown that caffeine increases blood sugar....and a few "observational" (questionare based) studies showing a decrease risk for diabetes.  I review patients blood sugar diaries...so I'm going to have to go with....caffeine increases blood sugar.

Co
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"and even suggested they get more info from your pal “CoWriter”. "
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And I tried to make you proud....LOL



"You seem to confuse “confronting” with reasonable discussion and reasonable disagreement."
------------------------

Perhaps "reasonable" is not the right word....LOL.  But if I can handle a "mocking tone"  I'm sure you can too.  

"As you sometimes state -- as if you've discovered the concept  LOL"

"I thought you could do better than that :) "

"which you are of course free to quote out of context as you have a tendency to do."

"because I think you know where I'm coming from but it just doesn't suit your arguments LOL"

"as you sometimes infer I'm making it but often think you're making it LOL."



"However you twist it, diet and exercise are the first line defense against IR per accepted protocols. If you continue to fail to mention it, I will continue to."
-------------------------

In the spirit of forum harmony and because the topic of diet and exercise seems to be very important to you, and I know what that's like, I'll make you a deal.  I will mention diet and exercise on ANY threads I start.....if you talk about insulin resistance on any threads you start.

Co
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