Diabetes & Coffee

Consuming beverages that contain caffeine may not be a good idea if you have type 2 diabetes, researchers report. In a small study, Duke University scientists found a link between caffeine at mealtime and increased glucose and insulin levels in people with type 2 diabetes. The finding suggests diabetics should reduce or eliminate caffeine in their diets, according to the report in the August issue of Diabetes Care. "Caffeine seems to impair the metabolism of carbohydrates in patients who have type 2 diabetes," said lead author James D. Lane, an associate research professor of medical psychology at Duke University Medical Center. "So it seems to make diabetes worse."

Levels of glucose -- blood sugar -- are elevated in people with diabetes after a meal because the body isn't able to metabolize the glucose, Lane said. "If your blood glucose goes higher after every meal, then your average blood glucose level is going to be higher, and that could aggravate diabetes or increase the risk of complications," he said.

Diabetes is a disease in which the body doesn't produce or properly use insulin, a hormone needed to convert glucose into energy for the body. In their study, Lane and his team recruited 14 regular coffee drinkers who had had type 2 diabetes for at least a six months. These subjects took medications for their diabetes, but did not require insulin. The researchers looked at how much caffeine the people consumed over a week. The subjects were also given two 125-milligram caffeine capsules or a dummy drug, which were taken with a commercial liquid meal (BoostR) that has 75 grams of carbohydrates.

Lane's team measured the patient's blood glucose levels before and after eating and taking the caffeine pills. The researchers found caffeine did not affect glucose and insulin levels after fasting. However, the study participants who drank the liquid and then took a caffeine pill experienced a 21 percent increase in glucose and a 48 percent rise in insulin levels, compared to the other study subjects getting the placebo. Lane's group also compared the effect of caffeine with the medications diabetics take to lower glucose after a meal. "We found that the size of the increase in glucose due to the caffeine is as large as the decrease that occurs when people take medications to lower glucose," he said. Based on the findings of this small study, Lane believes that "people who have type 2 diabetes may be better off if they avoid caffeine." Curiously, a study released earlier this year found that coffee can help to prevent the onset of type 2 diabetes, reducing the risk by almost 50 percent. However, the protective effects didn't become significant until people drank at least four cups a day. Tomas de Paulis, a research assistant professor from the Vanderbilt Institute for Coffee Studies at Vanderbilt University, said, "It is well known that caffeine has a detrimental effect on glucose tolerance."

"What is less known is that coffee also contains compounds with the opposite effect. It is not coffee but the caffeine that should be avoided by diabetes patients," he added.

Oral health & diabetes

 Is There a Link Between Gum Disease and Diabetes?
New research is suggesting a link between gum disease and diabetes. While it's established that people with diabetes are more prone to developing gum disease, this new research implies that chronic gum disease may be a risk factor for diabetes.

How does this happen? Gum disease can cause bacteria to enter the bloodstream and activate cells that produce inflammatory biological signals that have a destructive effect throughout the body. In the pancreas, the cells responsible for insulin (blood sugar) can be damaged or destroyed. Once this happens, it may trigger Type 2 diabetes - even in a healthy individual with no other risk factors for diabetes.

The Surgeon General's Report on Oral Health states that good oral health is integral to general health. So be sure to brush and floss properly and see your dentist for regular checkups.

If I Have Diabetes, Am I at Risk for Dental Problems?
If your blood glucose levels are poorly controlled, you are more likely to develop gum disease and lose more teeth than non-diabetics. Like all infections, gum disease can be a factor in causing blood sugar to rise and make diabetes harder to control. Other oral problems linked to diabetes include: thrush, an infection caused by fungus that grows in the mouth, and dry mouth which can cause soreness, ulcers, infections and cavities.

How Can I Help Prevent Dental Problems Associated with Diabetes?
First and foremost, control your blood glucose level. Then, take good care of your teeth and gums, along with regular checkups every six months. To control thrush, a fungal infection, maintain good diabetic control, avoid smoking and, if you wear them, remove and clean dentures daily. Good blood glucose control can also help prevent or relieve dry mouth caused by diabetes.

What Can I Expect at My Checkup? Should I Tell My Dentist About My Diabetes?
People with diabetes have special needs and your dentist is equipped to meet those with your help. Keep your dentist informed of any changes in your condition and any medication you might be taking. Postpone any non-emergency dental procedures if your blood sugar is not in good control.

The wright job & diabetics

A diabetic who does just a bit of exercise during the workday can reduce the risk of dying from a heart attack or other cardiovascular condition, a Finnish study finds. Tracking more than 3,300 people with type 2, or adult-onset, diabetes for 18 years, researchers at the National Public Health Institute in Helsinki found those whose jobs had them on their feet and lifting light objects were 9 percent less likely to die of cardiovascular disease than their compatriots who spent the working day behind a desk. This was the case after the researchers took into account other risk factors such as smoking, blood pressure and cholesterol levels. More strenuous work, such as heavy lifting and manual labor, was associated with a 40 percent reduction in such deaths, said a report in the July 27 online issue of Circulation by a group led by Dr. Jaakko Tuomilehto, a professor at the institute's Diabetes and Genetic Epidemiology Unit. This is the first large-scale study to compare the effects of on-the-job, leisure and commuting activity in diabetes, the researchers said.

"People with diabetes need to look for ways to build activity into their work, their commuting and their leisure time," Tuomilehto said.

As many other studies have found, the Finnish trial showed leisure-time physical activity by diabetics brought even greater cardiovascular benefits. Those who engaged in moderate leisure activity, defined as more than four hours a week of walking, cycling or gardening, reduced their risk of cardiovascular death by 17 percent compared to people whose idea of exercise was pushing buttons on the TV remote. The risk reduction was even greater, 33 percent, for people who led an active leisure-time life, defined as more than three hours a week of such things as swimming, running or jogging.

But the benefits of working-time activity can't be ignored, Tuomilehto said.

"Too often people only think of leisure-time physical activity or other aerobic activities," he said.

However, one of Tuomilehto's suggestions, that "physical activity during commuting is one of the easiest, least time-consuming ways to promote health," would be difficult to implement in the United States. More than 40 percent of the Finns in the study get to work on foot or by bicycle, the researchers said -- a lot less than in China, where an estimated 90 percent of people hoof it or cycle to the workplace, but unquestionably more than in America. According to 1990 U.S. Census statistics, 73 percent of people in the nation's 50 largest metropolitan areas traveled to work alone in a car. Another 6.5 percent took public transportation, which would presumably mean a walk to a bus stop or train station, and 7.6 percent took "other means," including bicycling and walking. The study results are no great surprise, said Dr. JoAnn E. Manson, a professor of medicine at Harvard Medical School and a spokeswoman for the American Heart Association. "There is compelling evidence that exercise lowers the risk of cardiovascular disease in the general population, and people with diabetes are at high risk and have the most to gain from preventive strategies." But this study is different in a couple of ways, Manson added. First, "there have been surprisingly few studies of physical activity in populations with type 2 diabetes," she noted, and "most previous studies have addressed recreational activity. It is important to note that occupational activities have a similarly beneficial role."

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