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568322 tn?1370165440

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."
46 Responses
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568322 tn?1370165440

"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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568322 tn?1370165440
"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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568322 tn?1370165440

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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568322 tn?1370165440
"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"
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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?"
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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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568322 tn?1370165440
ROFL

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

Co
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Avatar universal
HaHa. You did make me laugh. -LOL
CS
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Avatar universal
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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Avatar universal
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)
Helpful - 0
Avatar universal
lol!
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388154 tn?1306361691
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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Avatar universal
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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Avatar universal
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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Avatar universal
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.
---------------------------
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.
-------------------------
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”
------------------------
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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Avatar universal
CS: Your focus on Diet and Exercise as the first and foremost method of reducing IR is a little flawed in my view.
--------------------------------
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?
-----------------------------------------------------------------
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.
-------------------------------------------
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
-------------------------------------------
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.
-----------------------------
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 universal
CS: "what comes first. Does IR lead to weight gain or does Weight gain lead to IR. "

CO: Great point!  Thanks.
-----------------------------------------------------------------
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
------------------------------------------------------------------
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.
-------------------------------------------------------------
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 universal
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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233616 tn?1312787196
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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568322 tn?1370165440
"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"
---------------------

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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568322 tn?1370165440
"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?1370165440

"what comes first. Does IR lead to weight gain or does Weight gain lead to IR. "
----------------------

Great point!  Thanks.

Co
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568322 tn?1370165440

"And third, there are other causes of insulin resistance, such as obesity and specifically mid-waist girth."
-----------------------

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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476246 tn?1418870914
I didn't know ppl were into extracting batfat.... ;-)

sorry, couldn't help it...

cheers my friend
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Avatar universal
I am watching what I eat and keep low fat, low carb, and good protien
-----------------------------------------------------

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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568322 tn?1370165440
"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."
------------------------

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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