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年的年度经济成本为1320亿美元。管理糖尿病及其许多严重的努力并发症的重点是控制葡萄糖水平和预防高血糖的特征疾病。我们在该项目中的研究发现了证据表明，Cafeine是许多流行的药物饮料，食物和药物会导致2型糖尿病的不健康高血糖。具体而言，咖啡因夸大葡萄糖和胰岛素的增加（餐后） 2型糖尿病的男性和女性高血糖和高胰岛素血症），并增加白天葡萄糖在正常日常生活活动中测量的水平。我们提出了两项新研究，以推动我们的了解这些咖啡因在糖尿病管理中的临床重要性。尽管我们已经表明咖啡因急性破坏餐后葡萄糖处置，但我们尚不知道从饮食中消除咖啡因将改善那些2型糖尿病患者的血糖控制栖息地食用该药物。我们将通过一项随机对照实验研究回答这个问题。一个 2周的密集投资将测试咖啡因戒酒减少葡萄糖的短期效率水平和餐后反应。继续进行3个月的持续随访将提供初步证据治疗效率。这项研究将结合葡萄糖控制的短期和长期生化测量在日常生活活动中，葡萄糖的卧床措施。我们还将比较一群沉重和光消费者可以测试剂量反应假设，那些消费更多咖啡份的人会收到退出药物会带来更大的好处。这项研究的结果将证明从饮食中消除咖啡因，这将指导更大的临床试验。咖啡因如何损害葡萄糖代谢也是健康年轻人的未知证据表明咖啡因的作用可以通过肾上腺素释放来介导。我们将在2型患者中检验该假设糖尿病。一项对照实验室研究将测试药物β-肾上腺素能阻断是否减弱或消除咖啡因对餐后葡萄糖和胰岛素的影响。建立这个合理的 Cafeine的生理机制将加强Cafeine因果关系的争论以及2型糖尿病中的葡萄糖控制受损。咖啡因是世界上最广泛使用的药物，dospite证据表明它的影响可以确定健康。拟议的研究将提高我们对咖啡因消费对葡萄糖的临床影响的理解 2型糖尿病的管理。结果可能会导致有关咖啡馆消费的建议可以改善临床结果并减少数百万此疾病患者的并发症。