Loading…
Effect of caffeine on recognition of and physiological responses to hypoglycaemia in insulin-dependent diabetes
Summary Background For the patient with diabetes, hypoglycaemia unawareness—ie, the warning signs of falling blood glucose are missing—is potentially dangerous. One study has suggested that, in healthy volunteers, caffeine might be a helpful treatment. Our study looked at two effects of caffeine ing...
Saved in:
| Published in: | The Lancet (British edition) 1996-01, Vol.347 (8993), p.19-24 |
|---|---|
| Main Authors: | , , , |
| Format: | Article |
| Language: | English |
| Subjects: | |
| Citations: | Items that this one cites Items that cite this one |
| Online Access: | Get full text |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| cited_by | cdi_FETCH-LOGICAL-c642t-7998821879cd9ffe8c333dda5b62876e223b9351c2447bcfe29514385944a2753 |
|---|---|
| cites | cdi_FETCH-LOGICAL-c642t-7998821879cd9ffe8c333dda5b62876e223b9351c2447bcfe29514385944a2753 |
| container_end_page | 24 |
| container_issue | 8993 |
| container_start_page | 19 |
| container_title | The Lancet (British edition) |
| container_volume | 347 |
| creator | Debrah, K Murphy, J Kerr, D Sherwin, R.S |
| description | Summary
Background For the patient with diabetes, hypoglycaemia unawareness—ie, the warning signs of falling blood glucose are missing—is potentially dangerous. One study has suggested that, in healthy volunteers, caffeine might be a helpful treatment. Our study looked at two effects of caffeine ingestion (250 mg) on the brain—namely, a decrease in cerebral blood flow and an increase in brain glucose use—to see if the recognition of and physiological responses to hypoglycaemia were altered in patients with insulin-dependent diabetes mellitus (IDDM).
Methods 12 patients were studied twice. A hyperinsulinaemic glucose clamp was used to maintain plasma glucose at 5 mmol/L for 90 min, followed by 60 min at 3·8 mmol/L, and then 2·8 mmol/L for a further hour. After 30 min at 5 mmol/L, patients consumed, in a double-blind, crossover design, 250 mg caffeine or matched placebo. We recorded middle cerebral artery velocity (VMCA), counterregulatory hormone levels, and cognitive function, and patients recorded hypoglycaemia symptoms on a visual analogue scale.
Results Caffeine caused an immediate and sustained fall in VMCA of 10 cm/s, from 60 to 50 cm/s (95% Cl -5 to -15 cm/s; p |
| doi_str_mv | 10.1016/S0140-6736(96)91557-3 |
| format | article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_77901027</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><els_id>S0140673696915573</els_id><sourcerecordid>77901027</sourcerecordid><originalsourceid>FETCH-LOGICAL-c642t-7998821879cd9ffe8c333dda5b62876e223b9351c2447bcfe29514385944a2753</originalsourceid><addsrcrecordid>eNqFkU2LFDEQhoMo6-zqT1hoVBY9tOazk5xElvUDFjyo4C2kk-rZLD1Jm3QL8-9NO8McBFkoSEE9eaniQeiS4LcEk-7dN0w4bjvJute6e6OJELJlj9CGcMlbweXPx2hzQp6i81LuMca8w-IMnSnBiOB0g9LNMICbmzQ0ztY2RGhSbDK4tI1hDrWvIxt9M93tS0hj2gZnxwqUKcUCpZlTc7ef0nbcOwu7YJsQa5VlDLH1MEH0EOfGB9vDDOUZejLYscDz43uBfny8-X79ub39-unL9Yfb1nWczq3UWilKlNTO67qWcowx763oO6pkB5SyXjNBHOVc9m4AqgXhTAnNuaVSsAt0dcidcvq1QJnNLhQH42gjpKUYKTUmmMoHQSF5R7niFXz5D3iflhzrEYZSQhhRWrFKvfgfRbTSkgu6RokD5HIqJcNgphx2Nu8NwWaVa_7KNas5o2utcs0afnkMX_od-NOvo806f3Wc21IlDdlGF8oJo1pLoXDF3h8wqAJ-B8imuADRgQ_V-2x8Cg8s8gdOWr-i</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>198974524</pqid></control><display><type>article</type><title>Effect of caffeine on recognition of and physiological responses to hypoglycaemia in insulin-dependent diabetes</title><source>Applied Social Sciences Index & Abstracts (ASSIA)</source><source>Business Source Ultimate【Trial: -2024/12/31】【Remote access available】</source><source>ScienceDirect Freedom Collection 2022-2024</source><creator>Debrah, K ; Murphy, J ; Kerr, D ; Sherwin, R.S</creator><creatorcontrib>Debrah, K ; Murphy, J ; Kerr, D ; Sherwin, R.S</creatorcontrib><description>Summary
Background For the patient with diabetes, hypoglycaemia unawareness—ie, the warning signs of falling blood glucose are missing—is potentially dangerous. One study has suggested that, in healthy volunteers, caffeine might be a helpful treatment. Our study looked at two effects of caffeine ingestion (250 mg) on the brain—namely, a decrease in cerebral blood flow and an increase in brain glucose use—to see if the recognition of and physiological responses to hypoglycaemia were altered in patients with insulin-dependent diabetes mellitus (IDDM).
Methods 12 patients were studied twice. A hyperinsulinaemic glucose clamp was used to maintain plasma glucose at 5 mmol/L for 90 min, followed by 60 min at 3·8 mmol/L, and then 2·8 mmol/L for a further hour. After 30 min at 5 mmol/L, patients consumed, in a double-blind, crossover design, 250 mg caffeine or matched placebo. We recorded middle cerebral artery velocity (VMCA), counterregulatory hormone levels, and cognitive function, and patients recorded hypoglycaemia symptoms on a visual analogue scale.
Results Caffeine caused an immediate and sustained fall in VMCA of 10 cm/s, from 60 to 50 cm/s (95% Cl -5 to -15 cm/s; p<0·001). At a blood glucose of 3·8 mmol/L, plasma adrenaline levels were twice as high after caffeine than after placebo (difference 524 pmol/L). When glucose was lowered to 2·8 mmol/L, caffeine ingestion was associated with: greater awareness of hypoglycaemia in 9 patients, significantly more intense autonomic and neuroglycopenic symptoms, and higher levels of adrenaline, cortisol, and growth hormone. Cognitive function (latency of P300 evoked potentials) deteriorated to the same extent in both studies at this glucose level.
Interpretation The sustained fall in VMCA and augmented sympathoadrenal and symptomatic responses during moderate hypoglycaemia suggest caffeine as a potentially useful treatment for diabetic patients who have difficulty recognising the onset of hypoglycaemia.</description><identifier>ISSN: 0140-6736</identifier><identifier>EISSN: 1474-547X</identifier><identifier>DOI: 10.1016/S0140-6736(96)91557-3</identifier><identifier>PMID: 8531542</identifier><identifier>CODEN: LANCAO</identifier><language>eng</language><publisher>London: Elsevier Ltd</publisher><subject>Adrenal glands ; Adult ; Autonomic nervous system ; Biological and medical sciences ; Blood flow ; Blood glucose ; Blood Glucose - metabolism ; Brain ; Brain - drug effects ; Brain - metabolism ; Caffeine ; Caffeine - pharmacology ; Cerebral Arteries - drug effects ; Cerebral blood flow ; Cerebrovascular Circulation - drug effects ; Cerebrovascular Circulation - physiology ; Cognition - drug effects ; Cognitive ability ; Crossovers ; Diabetes ; Diabetes mellitus ; Diabetes mellitus (insulin dependent) ; Diabetes Mellitus, Type 1 - blood ; Diabetes Mellitus, Type 1 - physiopathology ; Epinephrine ; Epinephrine - blood ; Event-related potentials ; Factors ; Female ; Glucose ; Glucose - metabolism ; Growth Hormone - blood ; Growth hormones ; Hemodynamics - drug effects ; Hormones. Endocrine system ; Humans ; Hydrocortisone - blood ; Hypoglycaemia ; Hypoglycemia ; Hypoglycemia - physiopathology ; Ingestion ; Insulin ; Insulin - blood ; Insulin dependent diabetics ; Latency ; Male ; Medical sciences ; Middle Aged ; Patients ; Perception ; Pharmacology. Drug treatments ; Physiological effects ; Physiological responses ; Physiology ; Recognition ; Signs and symptoms ; Sympathetic nervous system</subject><ispartof>The Lancet (British edition), 1996-01, Vol.347 (8993), p.19-24</ispartof><rights>1996</rights><rights>1996 INIST-CNRS</rights><rights>Copyright Lancet Ltd. Jan 6, 1996</rights><rights>Copyright Elsevier Limited Jan 6, 1996</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c642t-7998821879cd9ffe8c333dda5b62876e223b9351c2447bcfe29514385944a2753</citedby><cites>FETCH-LOGICAL-c642t-7998821879cd9ffe8c333dda5b62876e223b9351c2447bcfe29514385944a2753</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,27924,27925,31000</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=2997580$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/8531542$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Debrah, K</creatorcontrib><creatorcontrib>Murphy, J</creatorcontrib><creatorcontrib>Kerr, D</creatorcontrib><creatorcontrib>Sherwin, R.S</creatorcontrib><title>Effect of caffeine on recognition of and physiological responses to hypoglycaemia in insulin-dependent diabetes</title><title>The Lancet (British edition)</title><addtitle>Lancet</addtitle><description>Summary
Background For the patient with diabetes, hypoglycaemia unawareness—ie, the warning signs of falling blood glucose are missing—is potentially dangerous. One study has suggested that, in healthy volunteers, caffeine might be a helpful treatment. Our study looked at two effects of caffeine ingestion (250 mg) on the brain—namely, a decrease in cerebral blood flow and an increase in brain glucose use—to see if the recognition of and physiological responses to hypoglycaemia were altered in patients with insulin-dependent diabetes mellitus (IDDM).
Methods 12 patients were studied twice. A hyperinsulinaemic glucose clamp was used to maintain plasma glucose at 5 mmol/L for 90 min, followed by 60 min at 3·8 mmol/L, and then 2·8 mmol/L for a further hour. After 30 min at 5 mmol/L, patients consumed, in a double-blind, crossover design, 250 mg caffeine or matched placebo. We recorded middle cerebral artery velocity (VMCA), counterregulatory hormone levels, and cognitive function, and patients recorded hypoglycaemia symptoms on a visual analogue scale.
Results Caffeine caused an immediate and sustained fall in VMCA of 10 cm/s, from 60 to 50 cm/s (95% Cl -5 to -15 cm/s; p<0·001). At a blood glucose of 3·8 mmol/L, plasma adrenaline levels were twice as high after caffeine than after placebo (difference 524 pmol/L). When glucose was lowered to 2·8 mmol/L, caffeine ingestion was associated with: greater awareness of hypoglycaemia in 9 patients, significantly more intense autonomic and neuroglycopenic symptoms, and higher levels of adrenaline, cortisol, and growth hormone. Cognitive function (latency of P300 evoked potentials) deteriorated to the same extent in both studies at this glucose level.
Interpretation The sustained fall in VMCA and augmented sympathoadrenal and symptomatic responses during moderate hypoglycaemia suggest caffeine as a potentially useful treatment for diabetic patients who have difficulty recognising the onset of hypoglycaemia.</description><subject>Adrenal glands</subject><subject>Adult</subject><subject>Autonomic nervous system</subject><subject>Biological and medical sciences</subject><subject>Blood flow</subject><subject>Blood glucose</subject><subject>Blood Glucose - metabolism</subject><subject>Brain</subject><subject>Brain - drug effects</subject><subject>Brain - metabolism</subject><subject>Caffeine</subject><subject>Caffeine - pharmacology</subject><subject>Cerebral Arteries - drug effects</subject><subject>Cerebral blood flow</subject><subject>Cerebrovascular Circulation - drug effects</subject><subject>Cerebrovascular Circulation - physiology</subject><subject>Cognition - drug effects</subject><subject>Cognitive ability</subject><subject>Crossovers</subject><subject>Diabetes</subject><subject>Diabetes mellitus</subject><subject>Diabetes mellitus (insulin dependent)</subject><subject>Diabetes Mellitus, Type 1 - blood</subject><subject>Diabetes Mellitus, Type 1 - physiopathology</subject><subject>Epinephrine</subject><subject>Epinephrine - blood</subject><subject>Event-related potentials</subject><subject>Factors</subject><subject>Female</subject><subject>Glucose</subject><subject>Glucose - metabolism</subject><subject>Growth Hormone - blood</subject><subject>Growth hormones</subject><subject>Hemodynamics - drug effects</subject><subject>Hormones. Endocrine system</subject><subject>Humans</subject><subject>Hydrocortisone - blood</subject><subject>Hypoglycaemia</subject><subject>Hypoglycemia</subject><subject>Hypoglycemia - physiopathology</subject><subject>Ingestion</subject><subject>Insulin</subject><subject>Insulin - blood</subject><subject>Insulin dependent diabetics</subject><subject>Latency</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Middle Aged</subject><subject>Patients</subject><subject>Perception</subject><subject>Pharmacology. Drug treatments</subject><subject>Physiological effects</subject><subject>Physiological responses</subject><subject>Physiology</subject><subject>Recognition</subject><subject>Signs and symptoms</subject><subject>Sympathetic nervous system</subject><issn>0140-6736</issn><issn>1474-547X</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>1996</creationdate><recordtype>article</recordtype><sourceid>7QJ</sourceid><recordid>eNqFkU2LFDEQhoMo6-zqT1hoVBY9tOazk5xElvUDFjyo4C2kk-rZLD1Jm3QL8-9NO8McBFkoSEE9eaniQeiS4LcEk-7dN0w4bjvJute6e6OJELJlj9CGcMlbweXPx2hzQp6i81LuMca8w-IMnSnBiOB0g9LNMICbmzQ0ztY2RGhSbDK4tI1hDrWvIxt9M93tS0hj2gZnxwqUKcUCpZlTc7ef0nbcOwu7YJsQa5VlDLH1MEH0EOfGB9vDDOUZejLYscDz43uBfny8-X79ub39-unL9Yfb1nWczq3UWilKlNTO67qWcowx763oO6pkB5SyXjNBHOVc9m4AqgXhTAnNuaVSsAt0dcidcvq1QJnNLhQH42gjpKUYKTUmmMoHQSF5R7niFXz5D3iflhzrEYZSQhhRWrFKvfgfRbTSkgu6RokD5HIqJcNgphx2Nu8NwWaVa_7KNas5o2utcs0afnkMX_od-NOvo806f3Wc21IlDdlGF8oJo1pLoXDF3h8wqAJ-B8imuADRgQ_V-2x8Cg8s8gdOWr-i</recordid><startdate>19960106</startdate><enddate>19960106</enddate><creator>Debrah, K</creator><creator>Murphy, J</creator><creator>Kerr, D</creator><creator>Sherwin, R.S</creator><general>Elsevier Ltd</general><general>Lancet</general><general>Elsevier Limited</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>0TT</scope><scope>0TZ</scope><scope>0U~</scope><scope>3V.</scope><scope>7QL</scope><scope>7QP</scope><scope>7RV</scope><scope>7TK</scope><scope>7U7</scope><scope>7U9</scope><scope>7X7</scope><scope>7XB</scope><scope>88A</scope><scope>88C</scope><scope>88E</scope><scope>88G</scope><scope>88I</scope><scope>8AF</scope><scope>8AO</scope><scope>8C1</scope><scope>8C2</scope><scope>8FE</scope><scope>8FH</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>8G5</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AN0</scope><scope>ASE</scope><scope>AZQEC</scope><scope>BBNVY</scope><scope>BEC</scope><scope>BENPR</scope><scope>BHPHI</scope><scope>C1K</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FPQ</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>GUQSH</scope><scope>H94</scope><scope>HCIFZ</scope><scope>K6X</scope><scope>K9-</scope><scope>K9.</scope><scope>KB0</scope><scope>KB~</scope><scope>LK8</scope><scope>M0R</scope><scope>M0S</scope><scope>M0T</scope><scope>M1P</scope><scope>M2M</scope><scope>M2O</scope><scope>M2P</scope><scope>M7N</scope><scope>M7P</scope><scope>MBDVC</scope><scope>NAPCQ</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PSYQQ</scope><scope>Q9U</scope><scope>S0X</scope><scope>PRINS</scope><scope>7QJ</scope><scope>7X8</scope></search><sort><creationdate>19960106</creationdate><title>Effect of caffeine on recognition of and physiological responses to hypoglycaemia in insulin-dependent diabetes</title><author>Debrah, K ; Murphy, J ; Kerr, D ; Sherwin, R.S</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c642t-7998821879cd9ffe8c333dda5b62876e223b9351c2447bcfe29514385944a2753</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>1996</creationdate><topic>Adrenal glands</topic><topic>Adult</topic><topic>Autonomic nervous system</topic><topic>Biological and medical sciences</topic><topic>Blood flow</topic><topic>Blood glucose</topic><topic>Blood Glucose - metabolism</topic><topic>Brain</topic><topic>Brain - drug effects</topic><topic>Brain - metabolism</topic><topic>Caffeine</topic><topic>Caffeine - pharmacology</topic><topic>Cerebral Arteries - drug effects</topic><topic>Cerebral blood flow</topic><topic>Cerebrovascular Circulation - drug effects</topic><topic>Cerebrovascular Circulation - physiology</topic><topic>Cognition - drug effects</topic><topic>Cognitive ability</topic><topic>Crossovers</topic><topic>Diabetes</topic><topic>Diabetes mellitus</topic><topic>Diabetes mellitus (insulin dependent)</topic><topic>Diabetes Mellitus, Type 1 - blood</topic><topic>Diabetes Mellitus, Type 1 - physiopathology</topic><topic>Epinephrine</topic><topic>Epinephrine - blood</topic><topic>Event-related potentials</topic><topic>Factors</topic><topic>Female</topic><topic>Glucose</topic><topic>Glucose - metabolism</topic><topic>Growth Hormone - blood</topic><topic>Growth hormones</topic><topic>Hemodynamics - drug effects</topic><topic>Hormones. Endocrine system</topic><topic>Humans</topic><topic>Hydrocortisone - blood</topic><topic>Hypoglycaemia</topic><topic>Hypoglycemia</topic><topic>Hypoglycemia - physiopathology</topic><topic>Ingestion</topic><topic>Insulin</topic><topic>Insulin - blood</topic><topic>Insulin dependent diabetics</topic><topic>Latency</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Middle Aged</topic><topic>Patients</topic><topic>Perception</topic><topic>Pharmacology. Drug treatments</topic><topic>Physiological effects</topic><topic>Physiological responses</topic><topic>Physiology</topic><topic>Recognition</topic><topic>Signs and symptoms</topic><topic>Sympathetic nervous system</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Debrah, K</creatorcontrib><creatorcontrib>Murphy, J</creatorcontrib><creatorcontrib>Kerr, D</creatorcontrib><creatorcontrib>Sherwin, R.S</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>News PRO</collection><collection>Pharma and Biotech Premium PRO</collection><collection>Global News & ABI/Inform Professional</collection><collection>ProQuest Central (Corporate)</collection><collection>Bacteriology Abstracts (Microbiology B)</collection><collection>Calcium & Calcified Tissue Abstracts</collection><collection>Nursing & Allied Health Database</collection><collection>Neurosciences Abstracts</collection><collection>Toxicology Abstracts</collection><collection>Virology and AIDS Abstracts</collection><collection>ProQuest - Health & Medical Complete保健、医学与药学数据库</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Biology Database (Alumni Edition)</collection><collection>Healthcare Administration Database (Alumni)</collection><collection>Medical Database (Alumni Edition)</collection><collection>Psychology Database (Alumni)</collection><collection>Science Database (Alumni Edition)</collection><collection>STEM Database</collection><collection>ProQuest Pharma Collection</collection><collection>Public Health Database</collection><collection>Lancet Titles</collection><collection>ProQuest SciTech Collection</collection><collection>ProQuest Natural Science Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>Research Library (Alumni Edition)</collection><collection>ProQuest Central (Alumni)</collection><collection>ProQuest Central</collection><collection>British Nursing Database</collection><collection>British Nursing Index</collection><collection>ProQuest Central Essentials</collection><collection>Biological Science Collection</collection><collection>eLibrary</collection><collection>ProQuest Central</collection><collection>ProQuest Natural Science Collection</collection><collection>Environmental Sciences and Pollution Management</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central Korea</collection><collection>British Nursing Index (BNI) (1985 to Present)</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Central Student</collection><collection>Research Library Prep</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>SciTech Premium Collection (Proquest) (PQ_SDU_P3)</collection><collection>British Nursing Index</collection><collection>Consumer Health Database (Alumni Edition)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>ProQuest Newsstand Professional</collection><collection>ProQuest Biological Science Collection</collection><collection>Family Health Database (Proquest)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Health Management Database (Proquest)</collection><collection>PML(ProQuest Medical Library)</collection><collection>Psychology Database (ProQuest)</collection><collection>ProQuest research library</collection><collection>ProQuest Science Journals</collection><collection>Algology Mycology and Protozoology Abstracts (Microbiology C)</collection><collection>ProQuest Biological Science Journals</collection><collection>Research Library (Corporate)</collection><collection>Nursing & Allied Health Premium</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest One Psychology</collection><collection>ProQuest Central Basic</collection><collection>SIRS Editorial</collection><collection>ProQuest Central China</collection><collection>Applied Social Sciences Index & Abstracts (ASSIA)</collection><collection>MEDLINE - Academic</collection><jtitle>The Lancet (British edition)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Debrah, K</au><au>Murphy, J</au><au>Kerr, D</au><au>Sherwin, R.S</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Effect of caffeine on recognition of and physiological responses to hypoglycaemia in insulin-dependent diabetes</atitle><jtitle>The Lancet (British edition)</jtitle><addtitle>Lancet</addtitle><date>1996-01-06</date><risdate>1996</risdate><volume>347</volume><issue>8993</issue><spage>19</spage><epage>24</epage><pages>19-24</pages><issn>0140-6736</issn><eissn>1474-547X</eissn><coden>LANCAO</coden><abstract>Summary
Background For the patient with diabetes, hypoglycaemia unawareness—ie, the warning signs of falling blood glucose are missing—is potentially dangerous. One study has suggested that, in healthy volunteers, caffeine might be a helpful treatment. Our study looked at two effects of caffeine ingestion (250 mg) on the brain—namely, a decrease in cerebral blood flow and an increase in brain glucose use—to see if the recognition of and physiological responses to hypoglycaemia were altered in patients with insulin-dependent diabetes mellitus (IDDM).
Methods 12 patients were studied twice. A hyperinsulinaemic glucose clamp was used to maintain plasma glucose at 5 mmol/L for 90 min, followed by 60 min at 3·8 mmol/L, and then 2·8 mmol/L for a further hour. After 30 min at 5 mmol/L, patients consumed, in a double-blind, crossover design, 250 mg caffeine or matched placebo. We recorded middle cerebral artery velocity (VMCA), counterregulatory hormone levels, and cognitive function, and patients recorded hypoglycaemia symptoms on a visual analogue scale.
Results Caffeine caused an immediate and sustained fall in VMCA of 10 cm/s, from 60 to 50 cm/s (95% Cl -5 to -15 cm/s; p<0·001). At a blood glucose of 3·8 mmol/L, plasma adrenaline levels were twice as high after caffeine than after placebo (difference 524 pmol/L). When glucose was lowered to 2·8 mmol/L, caffeine ingestion was associated with: greater awareness of hypoglycaemia in 9 patients, significantly more intense autonomic and neuroglycopenic symptoms, and higher levels of adrenaline, cortisol, and growth hormone. Cognitive function (latency of P300 evoked potentials) deteriorated to the same extent in both studies at this glucose level.
Interpretation The sustained fall in VMCA and augmented sympathoadrenal and symptomatic responses during moderate hypoglycaemia suggest caffeine as a potentially useful treatment for diabetic patients who have difficulty recognising the onset of hypoglycaemia.</abstract><cop>London</cop><pub>Elsevier Ltd</pub><pmid>8531542</pmid><doi>10.1016/S0140-6736(96)91557-3</doi><tpages>6</tpages><oa>free_for_read</oa></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 0140-6736 |
| ispartof | The Lancet (British edition), 1996-01, Vol.347 (8993), p.19-24 |
| issn | 0140-6736 1474-547X |
| language | eng |
| recordid | cdi_proquest_miscellaneous_77901027 |
| source | Applied Social Sciences Index & Abstracts (ASSIA); Business Source Ultimate【Trial: -2024/12/31】【Remote access available】; ScienceDirect Freedom Collection 2022-2024 |
| subjects | Adrenal glands Adult Autonomic nervous system Biological and medical sciences Blood flow Blood glucose Blood Glucose - metabolism Brain Brain - drug effects Brain - metabolism Caffeine Caffeine - pharmacology Cerebral Arteries - drug effects Cerebral blood flow Cerebrovascular Circulation - drug effects Cerebrovascular Circulation - physiology Cognition - drug effects Cognitive ability Crossovers Diabetes Diabetes mellitus Diabetes mellitus (insulin dependent) Diabetes Mellitus, Type 1 - blood Diabetes Mellitus, Type 1 - physiopathology Epinephrine Epinephrine - blood Event-related potentials Factors Female Glucose Glucose - metabolism Growth Hormone - blood Growth hormones Hemodynamics - drug effects Hormones. Endocrine system Humans Hydrocortisone - blood Hypoglycaemia Hypoglycemia Hypoglycemia - physiopathology Ingestion Insulin Insulin - blood Insulin dependent diabetics Latency Male Medical sciences Middle Aged Patients Perception Pharmacology. Drug treatments Physiological effects Physiological responses Physiology Recognition Signs and symptoms Sympathetic nervous system |
| title | Effect of caffeine on recognition of and physiological responses to hypoglycaemia in insulin-dependent diabetes |
| url | http://sfxeu10.hosted.exlibrisgroup.com/loughborough?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2025-01-01T06%3A25%3A00IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-proquest_cross&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Effect%20of%20caffeine%20on%20recognition%20of%20and%20physiological%20responses%20to%20hypoglycaemia%20in%20insulin-dependent%20diabetes&rft.jtitle=The%20Lancet%20(British%20edition)&rft.au=Debrah,%20K&rft.date=1996-01-06&rft.volume=347&rft.issue=8993&rft.spage=19&rft.epage=24&rft.pages=19-24&rft.issn=0140-6736&rft.eissn=1474-547X&rft.coden=LANCAO&rft_id=info:doi/10.1016/S0140-6736(96)91557-3&rft_dat=%3Cproquest_cross%3E77901027%3C/proquest_cross%3E%3Cgrp_id%3Ecdi_FETCH-LOGICAL-c642t-7998821879cd9ffe8c333dda5b62876e223b9351c2447bcfe29514385944a2753%3C/grp_id%3E%3Coa%3E%3C/oa%3E%3Curl%3E%3C/url%3E&rft_id=info:oai/&rft_pqid=198974524&rft_id=info:pmid/8531542&rfr_iscdi=true |