I was eighteen the first time I enjoyed a cup of coffee. My boyfriend Mike (who later became my husband) invited me to meet him for coffee at a cafe in downtown Jerusalem. I had just graduated from high school in Texas and in that pre-Starbucks era, coffee – to my mind – was something only old people drank. But there I was sitting with the coolest, handsomest guy I’d ever met, and to my shock and horror, he was ordering coffee. Please don’t say the word “decaf” like my grandmother, I thought. Please don’t ask for Sanka. Mike ordered a cappuccino. I vaguely knew what it was, and though my instinct was to go for a Diet Coke, I decided to try to be sophisticated. “I’ll have one, too,” I said to the waitress.
The cappuccinos arrived and looked lovely, but I stared at mine as if it had a fly in it. The first thing I said to Mike was, “What do I do with it?”
“Drink it,” he said.
“No, I mean, do I put sugar in it?”
“I don’t,” Mike said. “But you can.”
Since I liked coffee ice cream, I figured sugar was a good idea. I mixed in a packet, and took a sip. It was delicious. From then on I was hooked. In fact, I liked coffee so much I didn’t even want sugar with it. That was something I felt lucky about after my diabetes diagnosis– at least I didn’t have to change the way I drank my coffee. And coffee was the one thing I knew I wasn’t going to give up. I’ll give up all the carbs in the world in order to take care of my diabetes. But coffee isn’t negotiable.
In 1992, during a hospital stay after my diagnosis with diabetes, I was faced for the first time with a meal that, at that time, was institutionally considered nutritious: undressed turkey, steamed vegetables, a boiled potato, diet Jello. No salt, no butter, no sweets. Worst of all: no caffeine in the coffee.
Feeling all hope bleed out of me, I implored the dietician, “Could I just have one cup of real coffee? One?” (Insulin, I could deal with. But a life with no coffee?)
“Honey, have as much coffee as you like,” she said, to my great relief. “Everyone needs a vice, and this is not such a bad one.”
That’s become almost a mantra for me, and I’ve embraced coffee like a maniac.
What Are The Health Benefits of Drinking Coffee?
I, like Jane, embrace coffee like a maniac. I don’t usually worry about how it’s influencing my diabetes because over and over again I see studies that suggest drinking coffee has health benefits. Several large observational studies have shown that drinking coffee lowers risk of type 2 diabetes. An article on Web MD says coffee may counter several risk factors for heart attack and stroke, and higher consumption of coffee is also associated with a decreased risk of Parkinson’s disease. In May The New York Times reported men who are heavy coffee drinkers have a lower risk of prostate cancer. Last month Men’s Health ran an article that said drinking caffeinated coffee might help protect against Alzheimer’s disease.
This all makes me feel good about my coffee consumption, but I also stop and say, wait a minute, what does “might help protect” really mean? Does it mean anything at all? Are there really any health benefits in coffee, or could it be harming me? Sam Apple, editor-in-chief of The Faster Times, who drinks 3-6 cups of coffee a day says, “Generally speaking, I don’t give much credence to the small studies that make headlines. Often these studies only show correlations, and, if you’re not a scientist, it’s hard to evaluate the methodology. As for coffee, I’m going to keep drinking it unless there’s incredibly compelling evidence that it’s harmful. It’s just too good to give up.”
Should People with Diabetes Drink Coffee?
Some studies do suggest that caffeine affects blood glucose levels. Researchers at Duke University Medical Center found giving caffeine to a small group of people with type 2 diabetes caused their blood sugar levels to rise through the day, especially after meals. And caffeine is also sometimes associated with restlessness, anxiety, irritability and sleeplessness- things that can cause a rise in blood sugar levels. But what about caffeine consumption in people with type 1 diabetes? In 2000 a study published in the journal Diabetes Care concluded, “Ingestion of modest amounts of caffeine enhances the intensity of hypoglycemia warning symptoms in patients with type 1 diabetes without altering the prevailing standard of glycemic control or increasing the incidence of severe hypoglycemic episodes.”
Caffeine hasn’t just been shown to increase hypoglycemic awareness. A 2005 study investigated the effect of caffeine, in doses equivalent to normal daily ingestion, on rates and severity of hypoglycemia in patients with type 1 diabetes. Using continuous glucose sensing technology and simultaneous assessment of autonomic function with Holter monitoring, the investigators studied the effect of caffeine versus placebo in 19 patients with long-standing type 1 diabetes. The results of this study suggested that caffeine is associated with a significant reduction in nocturnal hypoglycemia. “The reduction in nocturnal hypoglycemia was not linked to the concomitant rise in parasympathetic activity associated with caffeine,” according to the study.
Unfortunately, after looking at these and other studies, I have not been able to draw any solid conclusions about how coffee consumption is influencing my diabetes overall. For clarification I turned to Dr. Zachary Bloomgarden, clinical professor at Mt. Sinai School of Medicine, who told me he neither recommends coffee to his patients nor tells them to limit their consumption. “I know about the research,” he said. “But it seems particularly to pertain to a protective effect of very high coffee intake, and one cannot be sure that this implies causality or is simply an association, and certainly would not suggest benefit in moderate coffee consumption. There’s also interesting evidence that it has some effects which might either be beneficial or harmful (depending on how you interpret) on hypoglycemia. Furthermore there are complicated and contradictory studies of filtered versus unfiltered coffee. “
“Should people with diabetes drink coffee?”
“I like coffee myself, and am enjoying my second cup now,” Dr. Bloomgarden said. ” I see no reason people with diabetes should not!”