Caffeine ingestion before an oral glucose tolerance test impairs blood glucose management in men with type 2 diabetes
Caffeine ingestion before an oral glucose tolerance test impairs blood glucose management in men with type 2 diabetes
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DOI：
10.1093/jn/134.10.2528
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发表时间：
2004-10-01
影响因子：
4.2
通讯作者：
Graham, TE
中科院分区：
文献类型：
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作者：
Robinson, LE;Savani, S;Graham, TE
在瘦削和肥胖男性的口服葡萄糖耐量试验(OGTT)中，摄入咖啡因对胰岛素敏感性有负面影响，但这一点尚未在2型糖尿病患者中进行研究。我们研究了摄入咖啡因对肥胖男性2型糖尿病患者胰岛素和血糖稳态的影响。12例男性2型糖尿病患者(年龄=49+/-2岁，BMI=32+/-1 kg/m(2))在随机双盲设计中进行了间隔1周的2个试验。每个试验都是在停用咖啡因、酒精、运动和口服降糖药48小时后进行的，并彻夜禁食。受试者随机摄入咖啡因(5 mg/kg体重)或安慰剂胶囊，1h后开始3h 75g OGTT。与安慰剂相比，咖啡因在OGTT期间增加了(P<；0.05)血清胰岛素、胰岛素原和C-肽浓度。与服用安慰剂相比，摄入咖啡因后胰岛素曲线下面积增加了25%(P<；0.05)。尽管如此，在咖啡因试验中，血糖浓度也增加了(P<；0.01)。摄入咖啡因后，血糖在糖负荷后3h(8.9+/-0.7 mmol/L)仍高于基线(6.7+/-0.4 mmol/L)(P<；0.01)。摄入咖啡因后的胰岛素敏感指数低于摄入安慰剂后的胰岛素敏感指数(14%，P=0.02)。总体而言，尽管摄入咖啡因后胰岛素原、C肽和胰岛素反应升高且持续时间延长，但血糖也升高，这表明咖啡因导致男性2型糖尿病患者血糖管理的急性损害。
Caffeine ingestion negatively affects insulin sensitivity during an oral glucose tolerance test (OGTT) in lean and obese men, but this has not been studied in individuals with type 2 diabetes. We examined the effects of caffeine ingestion on insulin and glucose homeostasis in obese men with type 2 diabetes. Men (n = 12) with type 2 diabetes (age = 49 +/- 2 y, BMI = 32 +/- 1 kg/m(2)) underwent 2 trials, 1 wk apart, in a randomized, double-blind design. Each trial was conducted after withdrawal from caffeine, alcohol, exercise, and oral hypoglycemic agents for 48 h and an overnight fast. Subjects randomly ingested caffeine (5 mg/kg body weight) or placebo capsules and 1 h later began a 3 h 75 g OGTT. Caffeine increased (P < 0.05) serum insulin, proinsulin, and C-peptide concentrations during the OGTT relative to placebo. Insulin area under the curve was 25% greater (P < 0.05) after caffeine than after placebo ingestion. Despite this, blood glucose concentration was also increased (P < 0.01) in the caffeine trial. After caffeine ingestion, blood glucose remained elevated (P < 0.01) at 3 h postglucose load (8.9 +/- 0.7 mmol/L) compared with baseline (6.7 +/- 0.4 mmol/L). The insulin sensitivity index was lower (14%, P = 0.02) after caffeine than after placebo ingestion. Overall, despite elevated and prolonged proinsulin, C-peptide, and insulin responses after caffeine ingestion, blood glucose was also increased, suggesting an acute caffeine-induced impairment in blood glucose management in men with type 2 diabetes.