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Caffeine and Glucose Regulation

咖啡因和血糖调节

基本信息

批准号：
7623667
负责人：
James D. Lane
金额：
$ 43.23万
依托单位：
DUKE UNIVERSITY
依托单位国家：
美国
项目类别：
财政年份：
2004
资助国家：
美国
起止时间：
2004-07-01 至 2010-10-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/7623667
关键词：
Abstinence Activities of Daily Living Adrenergic Agents American Attenuated Behavior Therapy Biochemical Biological Caffeine Chemosensitization Chronic Clinical Clinical Trials Coffee Combined Modality Therapy Consumption Cross-Over Studies Daily Diabetes Mellitus Diet Disease Drug usage Economics Enrollment Epinephrine Etiology Food and Beverages Glucose Glycosylated hemoglobin A Health Hyperglycemia Hyperinsulinism Insulin Intake Intervention Investigation Laboratory Study Lead Life Light Link Measures Mediating Non-Insulin-Dependent Diabetes Mellitus Numbers Outcome Outcome Measure Patients Pattern Pharmaceutical Preparations Physiological Placebo Control Placebos Prevention Propranolol Public Health Randomized Randomized Controlled Trials Recommendation Research Testing Treatment Effectiveness Upper arm Week Woman adrenergic blood glucose regulation clinically significant cost diabetes management diabetic drinking follow-up glucose disposal glucose metabolism glycemic control improved men research study response trial comparing

项目摘要

According to the American Diabetes Association, more than 20 million Americans have diabetes, with a total annual economic cost in the year 2002 of $132 billion dollars. Efforts to manage diabetes and its many serious complications focus on control of glucose levels and prevention of the hyperglycemia that characterizes the disease. Our research in this project has found evidence that caffeine, the drug present in many popular beverages, foods, and medications, contributes to the unhealthy hyperglycemia of type 2 diabetes. Specifically, caffeine exaggerates the glucose and insulin increases that follow a meal (postprandial hyperglycemia and hyperinsulinemia) in men and women with type 2 diabetes and raises daytime glucose levels measured during the activities of normal daily life. We propose two new studies to advance our understanding of the clinical importance of these caffeine effects in the management of diabetes. Although we have shown that caffeine acutely disrupts postprandial glucose disposal, we do not yet know that eliminating caffeine from the diet will improve glycemic control in those patients with type 2 diabetes who habitually consume the drug. We will answer this question with a randomized controlled experimental study. A 2-week intensive investigation will test the short-term efficacy of caffeine abstinence for reduction of glucose levels and postprandial responses. Continued follow-up for 3 months will provide preliminary evidence of treatment effectiveness. This study will combine short and long-term biochemical measures of glucose control with ambulatory measures of glucose during the activities of daily life. We will also compare groups of heavy and light consumers to test a ¿dose-response¿ hypothesis, that those who consume more caffeine will receive greater benefit from quitting the drug. Results from this study will demonstrate the potential clinical benefits of eliminating caffeine from the diet that will guide the larger clinical trials to follow. How caffeine impairs glucose metabolism is also unknown Evidence from healthy young men suggests that caffeine¿s effects may be mediated by epinephrine release. We will test this hypothesis in patients with type 2 diabetes. A controlled laboratory study will test whether pharmacological beta-adrenergic blockade attenuates or eliminates the effects of caffeine on postprandial glucose and insulin. Establishing this plausible physiological mechanism for caffeine¿s actions will strengthen arguments for a causal link between caffeine and impaired glucose control in type 2 diabetes. Caffeine is the world¿s most widely used drug, despite evidence that its effects can be detrimental to health. Proposed studies will advance our understanding of the clinical impact of caffeine consumption on glucose management in type 2 diabetes. Results could lead to recommendations about caffeine consumption that could improve clinical outcomes and reduce complications in the millions of patients with this disease.

根据美国糖尿病协会的数据，超过2000万美国人患有糖尿病， 2002年全年经济损失为1320亿美元。努力管理糖尿病及其许多严重的疾病并发症集中在血糖水平的控制和高血糖的预防上，高血糖是疾病。我们在这个项目中的研究发现有证据表明咖啡因，这种药物存在于许多流行的饮料、食物和药物会导致2型糖尿病的不健康高血糖。具体地说，咖啡因会夸大餐后(餐后)血糖和胰岛素的增加 2型糖尿病男性和女性的高血糖和高胰岛素血症)，并升高日间血糖在正常的日常生活活动中测量的水平。我们提出了两项新的研究来推进我们的了解这些咖啡因在糖尿病治疗中的临床重要性。尽管我们已经证明咖啡因会严重干扰餐后血糖的处理，但我们还不知道。从饮食中去除咖啡因将改善那些患有2型糖尿病的患者的血糖控制习惯性地吸食毒品。我们将通过随机对照实验研究来回答这个问题。一个为期两周的密集研究将测试咖啡因戒除对降低血糖的短期效果水平和餐后反应。持续跟踪3个月将提供初步证据治疗效果。这项研究将结合短期和长期的血糖控制生化措施。在日常生活活动中动态测量血糖。我们还将比较重量级的和轻度消费者测试剂量-反应假说，即那些摄入更多咖啡因的人将获得戒毒会带来更大的好处。这项研究的结果将证明，在临床上，从饮食中消除咖啡因，这将指导后续的更大规模的临床试验。咖啡因如何损害葡萄糖代谢也是未知的来自健康年轻男性的证据表明咖啡因对S的影响可能是通过肾上腺素的释放来实现的。我们将在2型患者身上检验这一假说。糖尿病。一项对照实验室研究将测试药理上的β-肾上腺素能受体阻滞剂是否能减弱或消除咖啡因对餐后血糖和胰岛素的影响。建立这一看似合理的咖啡因的生理机制？S的作用将加强咖啡因之间因果联系的论点 2型糖尿病患者的血糖控制受损。咖啡因是世界上使用最广泛的药物，S，尽管有证据表明它的影响可能对健康有害。拟议的研究将促进我们对摄入咖啡因对血糖的临床影响的理解 2型糖尿病的管理。结果可能会导致关于咖啡因摄入量的建议可以改善临床结果，减少数百万患有这种疾病的患者的并发症。