Tuesday, 13 May 2014

Coffee and Blood Sugars

I read on what appeared to be a reasonably reputable site that coffee was implicated in increasing insulin resistance.  Given my blood sugar levels this is a bit of problem for me.  I love coffee but actually if it is going to elevate my blood sugars well maybe I need to re-evaluate.

So I did some quick research on line.  Here is a sample of what I found:

Caffeine Increases Blood Sugar In People With Type 2 Diabetes (http://www.medicalnewstoday.com/articles/95380.php)
  • A small US study suggests that people with type 2 diabetes who drink the equivalent of four cups of coffee or more a day may be causing their blood sugar levels to go up by 8 per cent (compared to non caffeine days), thus making it harder for them to manage their condition.
  • Other recent studies have shown that in habitual coffee drinkers with type 2 diabetes, caffeine appears to raise glucose and insulin after intakes of standardized carbohydrate loads. Lane and colleagues decided to investigate if this effect manifested after meals in the everyday life of type 2 diabetics and how it might undermine their efforts to manage their condition.

Habituation to caffeine decreases insulin sensitivity, making it difficult for your cells to respond appropriately to blood sugar.  High blood sugar levels lead to arterial deterioration and increased risk of mortality related to cardiovascular disease.

  • The effect of coffee on diabetes, when presented in the media can often be confusing. News stories can in the same week tout the benefits coffee can have on diabetes and shoot down coffee as being unhelpful for blood sugar levels. This doesn’t mean the articles are contradictory though. Put slightly more simply, coffee contains different chemicals, some of which have beneficial effects whereas others can have a less beneficial effect, such as caffeine which can impair insulin in the short term.
  • Caffeine has been shown to impair insulin sensitivity in people with type 2 diabetes, indicating that coffee may see higher blood glucose levels.
  • However, a regular high caffeine intake has been linked with improved insulin sensitivity.  Coffee and its effect on risks of developing type 2 diabetes have been studied a number of times and has indicated a notably lower risk of type 2 diabetes being associated with coffee drinkers.  A 2009 study of 40,000 participants noted that consumption of 3 cups of tea or coffee a day lead to a 40% lower risk of type 2 diabetes
  • Caffeine impairs insulin action, but doesn't necessarily affect blood sugar (glucose) levels in young, healthy adults. However, if you have type 2 diabetes, the impact of caffeine on insulin action may be associated with a small, but detectable rise in blood sugar levels, particularly after meals. About 250 milligrams of caffeine — or the equivalent of 2 to 2 1/2 cups (473 to 591 milliliters) of plain, brewed coffee — a day may cause this effect.
  • If you have type 2 diabetes and you're struggling to control your blood sugar levels, limiting the amount of caffeine in your diet may provide a benefit.
But then .....

Effects of Coffee Consumption on Fasting Blood Glucose and Insulin Concentrations - http://care.diabetesjournals.org/content/27/12/2990.full
  • Higher habitual coffee consumption was associated with higher insulin sensitivity (1) and a lower risk for type 2 diabetes (26) in diverse populations. In contrast, short-term metabolic studies showed that caffeine intake can acutely lower insulin sensitivity (79) and increase glucose concentrations (1015). Randomized intervention studies are needed to examine whether tolerance to these acute effects develops after longer-term consumption (16). We therefore examined the effects of coffee and caffeine on fasting blood concentrations of glucose and insulin over 2–4 weeks in two crossover studies in healthy volunteers.
  • After 2 weeks, coffee consumption tended to lead to higher fasting glucose concentrations, but no appreciable effect was observed after 4 weeks (Table 1). Fasting insulin concentrations, measured only after 4 weeks, were higher after the coffee period than after the no coffee period (Table 1). Tests for carry-over effects did not indicate that these existed (insulin: P = 0.79; glucose: P = 0.27).
  • Fasting glucose concentrations were similar after the caffeine, coffee, and placebo period (Table 1). Compared with the placebo period, fasting insulin concentrations tended to be higher after the coffee and caffeine periods (Table 1).
  • In conclusion, the present results indicate that tolerance to the adverse effects of high coffee consumption on insulin-glucose homeostasis does not develop within a 4-week period. This stresses that it is premature to advocate high coffee consumption as a means to lower risk for type 2 diabetes. Long-term trials of coffee consumption that include detailed measures of insulin sensitivity and glucose metabolism are warranted to elucidate the apparent discrepancy with studies that observed an inverse association between habitual coffee consumption and risk for type 2 diabetes.
Pretty much all of these sites quote the one study so while it is early days in understanding the impact.  That said, there has been a lot of reseach on the health effects of diabtesNot health benefits of antioxidants.  Here is an example - http://www.medicalnewstoday.com/articles/270202.php

So, What to do?  I love my coffee but perhaps it has to go.  My blood sugars are stable at the mid to los 7 area but I would like it to be lower.  Maybe I should stop drinking coffee but can I stand the headaches!!!

Monday, 24 March 2014

From the Jaws of Defeat.

About 8 months ago I decided it was time for me to arrange for income protection insurance.   I have been out on my own for nearly two years and while things had gone pretty well we were completely dependant on me turning up to work on a daily basis.   All went well.   I found a provider who had what I wanted and they seemed keen to help.   As with many personal  insurance products this one required medical checks to be completed. If you want to know your results then visit your doctor they said.   I didn't really want to know my results but after some prodding from my wife I went to see my doctor.

I'm not that fond of doctors. Maybe it's a bloke thing, but it's almost certain that if you see a doctor you will come out sick even if you were well when you walked through their door.   If only I had known because on this day in August 2013 I walked into the doctors office feeling fine and I walked out with type 2 diabetes.  Bugger! 

I honestly don't remember a great deal of what else was said that day except that none of it sounded good.   The best prognosis seemed to be we can slow down the inevitable progress to disaster.  The measurements were too extreme to consider reversal (I have now learnt that the key measure they look at is HBA1C which measures blood sugar levels over a three to four month period.   Mine was 91, healthy is under 53 or 48 depending on which organisation you are with).

Disaster was what I heard. Treatment starts with some pills now (metformin) but eventually you will need to inject insulin, you'll probably go blind and loose feeling in your limbs especially in your feet.  It's likely this will lead to amputation!  He probably didn't say this but total breakdown to a humiliating and painful death was what I heard with no possible reprieve. 

This prognosis was not something I could live with (pun intended) so after a relatively brief period of wallowing in self pity my natural contraian kicked in and I began to turn my attention to defying the odds and the doctor.   It was about then that Tom Rath released a book "Eat,  Move,  Sleep".  I bought it because the title intrigued me and I was a fan of the strengths work that Tom was a major part of.   The book was useful and set me moving but most importantly eat move sleep has become my mantra.

One blog is not enough to tell the full story to date. That will have to wait for future blogs but let's roll forward 8 months and report progress.  I am off metformin (which is a story of its own) and my latest HBA1C is 42.  A great start and my doctor is amazed, it is just a start though as dealing with this reality will take a (long and healthy) life time.

Thursday, 20 March 2014

Active Living

I hate exercise. It's not so much the doing of exercise I hate as the whole concept of putting aside time with the express purpose of torturing your body. While I know it's good for me it seems so unnatural.  And I reckon I have proof that it is unnatural. Well perhaps not proof but supporting observations.

A few years back our family went on a holiday to Africa. As I look back at that trip I don't remember seeing anyone, animal or human, exercising. What I saw was two things.   For the vast majority of the time everything moved slowly, very slowly.   While the movements were slow they were constant. You didn't see a lot of lazing around except for the lions maybe.

The second thing you saw very occasionally was full tilt sprints for a short period.  Sometimes this was a fright response to seeing us tourists, in natural settings it is more likely to be the food chain in action as hunter and prey burst into life.  I began to wonder.

Then last year sometime I watched a program on BBC called Horizon. On this particular episode they talked about exercise and it's impact. Simplistically their conclusion was that if you focused on moving constantly and then occasionally stressed to body to maximum (3 x 20 second sprints 3 x a week) then you would get the vast majority of benefits that exercise has to offer.  Seemed pretty consistent with what I saw I Africa.

Of course when I began to compare all of this to my life the difference was stark. I mainly sat and movement was typically limited to walking to and from the car or between meetings. I always thought that I needed to do more exercise but that hatred of it meant that it never happened. Slowly  however I began to realise that maybe I didn't need more exercise but rather what I needed was create an active lifestyle. A way of living that caused me to move naturally and often. So I have set about experimenting to do just that.

For me it started by putting the car away and walking.   Walking is a natural act we are designed for and now I only drive to work as a last resort. Instead I walk to and from. I have begun to organise my formal meeting commitments in a way that means I have time to walk there.  My phone has a pedometer built in so I can track how far I have walked. What a difference. 

Historically I have walked about 1500 to 2000 steps now on average I am doing about 8000 to 10,000 with a record of 17,000.  Interestingly I have more energy and better focus when I work and I sleep better.  The only down side was an early blister on my big toe and some fatigue in my legs occasionally.  The best thing however is I enjoy it,  it's becoming natural and it feels right.

Wednesday, 19 March 2014

Idea-Log is back.

We're back but perhaps a little different.  While I am still not going to give a blow by blow description of my life going forward this blog will capture my relatively unfiltered thoughts on issues and challenges I am currently focused on. There will be posts on all sorts of topics from personal and family to community and society to sport and business, whatever I'm thinking about at the time.

This blog will be a way for me to begin to actually clarify my ideas as I try to understand why things are the way they are (my favourite pursuit from a very young age) and if I don't like that answer then to try and find a better way.  There is always a better way. We just need to find it.

If you'd like to follow along, welcome, and I look forward your feedback comments and challenges.