Effect of caffeine on the recognition of and responses to hypoglycemia in humans
Kerr D, Sherwin RS, Pavalkis F, Fayad PB, Sikorski L, Rife F, Tamborlane WV, During MJ
Annals of internal medicine · 36 citas
Cómo se estudió
- Diseño
- Ensayo controlado aleatorizado (indexado por PubMed)
- Estudiado en
- Personas
- Resultado principal
- Marcadores de salud y funcionamiento
Quién lo pagó
- Financiación
- Financiación independiente
- Gobierno
- National Institute of Diabetes and Digestive and Kidney Diseases
- Gobierno
- National Center for Research Resources
- Gobierno
- NCRR NIH HHS
- Gobierno
- NIDDK NIH HHS
- Subvenciones
- National Institute of Diabetes and Digestive and Kidney Diseases (DK20495); National Center for Research Resources (RR00125); National Center for Research Resources (RR06022)
Según 4 financiadores declarados.
Publicación
- Publicado
- 1993-10-15 · Ann Intern Med · vol. 119 · número 8 · págs. 799–804
- Editorial
- American College of Physicians
- Citado
- 61 citas · más que el 84% de estudios similares · 1.6× el promedio de su campo
- Referencias
- 15 trabajos
- Acceso
- De pago
- Áreas de investigación
- Coffee research and impacts · Diabetes Management and Research · Blood Pressure and Hypertension Studies
- Palabras clave
- caffeine, hypoglycemia, cerebral blood flow, middle cerebral artery blood flow velocity, brain glucose metabolism, counterregulatory hormones, epinephrine, norepinephrine, cortisol, growth hormone, P300 evoked potentials, cognitive function, hyperinsulinemic-euglycemic clamp, hypoglycemic symptoms
- MeSH
- brain, humans, hypoglycemia, catecholamines, caffeine, hydrocortisone, growth hormone, glucose, blood glucose, double-blind method, cerebrovascular circulation, adult, female, male
8 autores
- David Kerr🇺🇸🇬🇧 · autor de correspondenciaYale University; Royal Bournemouth and Christchurch Hospitals NHS Foundation Trust
- Robert S. Sherwin🇺🇸Yale University
- Frank Pavalkis🇺🇸Yale University
- Pierre B. Fayad🇺🇸Yale University
- Lori Sikorski🇺🇸Yale University
- Frances Rife🇺🇸Yale University
- William V. Tamborlane🇺🇸Yale University
- Matthew J. During🇺🇸Yale University
Resumen
El texto original del estudio, en el idioma en que se publicó.
Objective
To determine whether two effects of acute caffeine ingestion--decrease in cerebral blood flow and increase in brain glucose use--alter the recognition of and physiologic responses to hypoglycemia.
Design
On two occasions, a hyperinsulinemic glucose clamp technique (2 mU/kg body weight per minute) was used to maintain plasma glucose at 5 mmol/L for 90 minutes, followed by 60 minutes at 3.8 mmol/L, and then 2.8 mmol/L. After 30 minutes at 5 mmol/L, participants consumed, using a randomized, double-blind design, caffeine-free cola with or without caffeine (400 mg) added.
Setting
Yale Clinical Research Center.
Participants
Eight healthy, nonobese volunteers (5 men; age range, 20 to 33 years).
Measurements
Middle cerebral artery velocity (V MCA), counter-regulatory hormone levels, hypoglycemic symptoms, and cognitive function (P300 evoked potentials).
Results
Caffeine caused an immediate and sustained 23% decrease in VMCA from 64 to 49 cm/s (point estimate of difference, +15 cm/s [95% CI, 10 to 21 cm/s], P < 0.001). At a glucose level of 3.8 mmol/L, only the participants given caffeine had warning symptoms and "felt hypoglycemic." Moreover, the level of epinephrine was 118% ([CI of point difference, 76% to 158%] [CI, P < 0.001]) higher after caffeine consumption compared with placebo. Similarly, levels of norepinephrine (41% [CI, 26% to 60%], P < 0.002), cortisol (65% [CI, 26% to 78%], P < 0.008), and growth hormone (60% [CI, 16% to 143%], P < 0.05) were higher after caffeine consumption compared with placebo. At 2.8 mmol/L, epinephrine (40% [point estimate of the percentage difference], P < 0.05), norepinephrine (27%, P < 0.05), and cortisol (24%, P < 0.05) levels were higher, participants were more aware (P < 0.02) of hypoglycemia, and P300 latency was prolonged in the group that consumed caffeine (7.2%, P < 0.05).
Conclusions
Acute ingestion of caffeine is associated with sympathoadrenal activation and awareness of hypoglycemia at a glucose level not usually considered hypoglycemic. Our data suggest that individuals who ingest moderate amounts of caffeine may develop hypoglycemic symptoms if plasma glucose levels fall into the "low-normal" range, as might occur in the late postprandial period after ingestion of a large carbohydrate load.
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