In a study coming out of Duke University Medical Center, caffeine consumption in type 2 diabetics was found to interfere with insulin action and consequently cause some elevation of blood glucose immediately after a meal.  Two groups with type 2 diabetes were tested after consuming coffee.  One group consumed a drink with caffeine, while the other without caffeine.  The group consuming the drink containing caffeine had a 28% higher rise in blood glucose, than the group consuming a decaffeinated drink.  Interestingly, the magnitude of the effect was related to the number of years since diagnosis of diabetes.  This may have some merit, and diabetics should possibly consider moving to the decaffeinated version.

 

Macular Edema Less Common in Non-Hispanic Whites:

Macular edema is a well-known cause of blindness which recently has been found to occur more likely in blacks and Hispanics with type 2 diabetes compared with non-Hispanic whites.  This information is coming from the Veterans Affairs Diabetes Trial, where a subset of patients was followed with a retinal examination.  Of those patients, 10% had clinically significant macular edema.  It was present more in blacks (19.2%) and Hispanics (18.6%) compared with non-Hispanic whites (6.9%).  This information is vital for all care-givers who follow diabetics as well as for patients.  Please see a Retinologist annually!

 

Childhood Obesity and Maternal Hyperglycemia:

Presence of gestational diabetes (during pregnancy) is determined in all pregnant women by using a one hour 50-gram glucose tolerance test.  Women who fail the test go on to have more tests and may need to be treated.  In a study coming out of Hawaii, a group of 9,439 women were followed along with their five to seven year old child.  A direct association between maternal hyperglycemia and childhood obesity was observed.  Mothers who were treated during their pregnancy had children who were less obese.  Since obesity at age 5 to 7 years is more likely to result in adult obesity, mothers please be aware.

 

Alcohol and Diabetes:

Moderate daily alcohol consumption is considered beneficial.  In a study coming out of Israel, a group of 109 non drinking patients with type 2 diabetes were randomized to either 150 cc of wine or the same amount of nonalcoholic diet malt beer during dinner.  After 3 months, the alcohol group experienced a significant 9.2% drop in fasting glucose, with some patients' A1c dropping mildly as well, but no other significant changes.  Liver function was not altered.  Alcohol may inhibit liver glucose production - as does Metformin, thus explaining the drop in fasting glucose in the alcohol group. This information is music to the ears of all wine lovers.

 

High Blood Pressure and the Risk of Diabetes in Women:

Data coming out of the Women's Health Study which is following 40,000 women since 1993, points toward a higher incidence of type 2 diabetes in those with higher blood pressure (BP).  The incidence of diabetes was 1.4% in those with optimal BP, 2.9% in those with normal BP, 5.7% in those with normal-high BP, and 9.4% in those with high BP.  Women with baseline hypertension had a sevenfold increased risk of developing diabetes compared with women with optimal BP.  The association between hypertension and the risk of developing type 2 diabetes is complex, and will require more research-dollars to resolve.

 

Worldwide Adult Obesity:

A worldwide survey which excluded the United States and screened a total of 69,409 men and 98,750 women from all regions of the world is reporting a 25% overall rate of obesity and a 35% rate of overweight.  The survey indicated that in every region, except southern and eastern Asia, more than 60% of men and 50% of women were either overweight or obese.  The area with the lowest percentage of obesity was eastern Asia - 7%, and the highest in Canada - 36%.  These rates were determined using BMI (body mass index - m/kg2), however recently waist circumference measurement has been touted as being a more accurate representation of intra-abdominal adiposity (belly).  We are an obese planet, aren't we?

 

Pedometer Use:

Using a pedometer significantly increases a patient's physical activity level - by a magnitude of 1 mile of walking per day.  This leads to a reduction of weight and of blood pressure.  Pedometers count the number of steps a person walks each day.  The goal is to walk 10,000 steps daily.  Whether this is just a motivational tool, or of real benefit, makes little difference.  We should all be aware that our bodies were designed for walking, and they should therefore be utilized to that end.  Permanently sitting or lying bodies are unhappy!