CORK Bibliography: Diabetes and Substances Use

18 citations. 2009 to present

Prepared: March 2012

Amparo P; Farr SL; Dietz PM. Centers for Disease Control and Prevention, Atlanta, Georgia. Preventing Chronic Disease 8(6): a118, 2011. (28 refs.)

The magnitude of chronic conditions and risk factors among American Indian/Alaska Native women of reproductive age is unknown. The objective of our study was to estimate this magnitude. We analyzed data for 2,821 American Indian/Alaska Native women and 105,664 non-Hispanic white women aged 18 to 44 years from the 2005 and 2007 Behavioral Risk Factor Surveillance System. We examined prevalence of high cholesterol, high blood pressure, diabetes, body mass index (kg/m(2)) >25.0, physical inactivity, smoking, excessive alcohol consumption, and frequent mental distress, and the cumulative number of these chronic conditions and risk factors (>3, 2, 1, or 0). In a multivariable, multinomial logistic regression model, we examined whether American Indian/Alaska Native race was associated with the cumulative number of chronic conditions and risk factors. American Indian/Alaska Native women, compared with white women, had significantly higher rates of high blood pressure, diabetes, obesity, smoking, and frequent mental distress. Of American Indian/Alaska Native women, 41% had 3 or more chronic conditions or risk factors compared with 27% of white women (chi(2), P < .001). After adjustment for income, education, and other demographic variables, American Indian/Alaska Native race was not associated with having either 1, 2, or 3 or more chronic conditions or risk factors. Three out of every 5 American Indian/Alaska Native women aged 18 to 44 years have 3 or more chronic conditions or risk factors. Improving economic status and education for AI/AN women could help eliminate disparities in health status.

Public Domain

[Anonymous]. Abstracts of the 17th Annual International Conference: Diabetes and Alcohol: A Bad Mix. March 24-27, 2011, Ocho Rios, Jamaica. West Indian Medical Journal 60(Supplement 1): 23-49, 2011

Chang G; Fisher NDL; Hornstein MD; Jones JA; Hauke SH; Niamkey N et al. Brief intervention for women with risky drinking and medical diagnoses: A randomized controlled trial. Journal of Substance Abuse Treatment 41(2): 105-114, 2011. (52 refs.)

This is a randomized controlled trial of 511 eligible women treated for diabetes, hypertension, infertility, or osteoporosis on an outpatient basis to test the hypothesis that those randomized to a brief intervention (BI) will drink less than those in the control condition 12 months later. A secondary goal was to identify the characteristics associated with changes in drinking outcome. All 511 completed the initial alcohol assessment, and 96% completed the 12-month follow-up interview. Those receiving the BI also had 3- and 6-month interviews. Four outcomes were assessed: (a) mean drinks per drinking day, (b) percent drinking days, (c) binge episodes defined as four or more drinks per occasion, and (d) weeks of drinking exceeding the National Institute on Alcohol Abuse and Alcoholism sensible drinking limits. Overall, there were no differences in drinking outcome by treatment group. Characteristics associated with changes in drinking, however, were identified to provide possible direction for future investigation.

Geraci MJ; Cole M; Davis P. New onset diabetes associated with bovine growth hormone and testosterone abuse in a young body builder. Human & Experimental Toxicology 30(12): 2007-2012, 2011. (22 refs.)

Case: A 33-year-old male presented to the emergency department with complaints of polydipsia, polyuria, nausea, headaches, blurry vision and malaise. Lab work revealed a serum glucose level of 1166 mg/dl (64.8 mmol/L). The patient admitted to completing a cycle of androgenic anabolic steroids (AASs) for bodybuilding. His regimen consisted of supraphysiologic intramuscular injections of a bovine growth hormone, trenbolone acetate and testosterone. The patient received intravenous fluids and insulin to restore metabolic balance. Previously healthy with a non-contributory family history, he was diagnosed with new onset diabetes. Discussion: It has been demonstrated that AAS use, specifically growth hormone, can affect glucose homeostasis through increasing cellular insulin resistance and reducing glucose uptake. Excess growth hormone has been shown to cause symptoms of acronnegaly which predisposes up to 40% of patients to diabetes. As trenbolone acetate is not indicated for human use and athletes are known to use supraphysiologic doses of this underground, performance enhancing drug, the correlation of the timing of events and the use of this veterinary growth hormone likely exacerbated an underlying condition or caused this new onset diabetes. Conclusion: We report a case of a young bodybuilder with no significant past medical history who was diagnosed with new onset diabetes associated with supraphysiologic self-injections of the bovine growth hormone, trenbolone acetate, combined with testosterone. AAS have the potential to induce or exacerbate diabetic conditions due to decreased glucose tolerance and increased insulin resistance.

Gunji T; Matsuhashi N; Sato H; Iijima K; Fujibayashi K; Okumura M et al. Alcohol consumption is inversely correlated with insulin resistance, independent of metabolic syndrome factors and fatty liver diseases. Journal of Clinical Gastroenterology 45(9): 808-813, 2011. (44 refs.)

Background and Aim: The role of alcohol consumption in insulin resistance remains unclear. The aim of this study was to examine the association between alcohol consumption and insulin resistance in a large asymptomatic population. Methods: A total of 2463 asymptomatic Japanese men aged 28 years or above undergoing a comprehensive health checkup including an oral glucose tolerance test between May 2007 and April 2010 were recruited. Participants positive for hepatitis B or C virus, abstinent alcoholics, those taking hepatotoxic drugs, those with chronic renal or hepatic failure, and those under treatment for metabolic disorders were excluded. Fatty liver was defined ultrasonographically. Visceral and subcutaneous adipose tissues were measured with computed tomography. The homeostasis model assessment of insulin resistance (HOMA-IR) score was determined to estimate insulin resistance. The association between alcohol consumption and HOMA-IR score was investigated with multivariate regression analysis. Results: A total of 1902 participants were eligible for this cross-sectional survey. A significant difference in distribution of each drinking category was noted between 249 participants with insulin resistance (HOMA-IR >= 2.5) and 1653 participants without insulin resistance (HOMA-IR < 2.5; P = 0.001). Light (40 to 140 g/wk), moderate (140 to 280 g/wk), and heavy alcohol consumption was inversely associated with HOMA-IR scores (coefficients = -0.125, -0.127, and -0.162; P = 0.007, 0.011, and 0.006, respectively) with multivariate analysis after adjusting for potential confounding variables, including visceral and subcutaneous adipose tissues, metabolic profiles, fatty liver, and liver enzyme activities. Conclusions: Alcohol consumption was inversely associated with insulin resistance, independent of central obesity, metabolic profiles, and fatty liver diseases.

Hayes DK; Fan AZ; Smith RA; Bombard JM. Trends in selected chronic conditions and behavioral risk factors among women of reproductive age, behavioral risk factor surveillance system, 2001-2009. Preventing Chronic Disease 8(6): a120, 2011

Some potentially modifiable risk factors and chronic conditions cause significant disease and death during pregnancy and promote the development of chronic disease. This study describes recent trends of modifiable risk factors and controllable chronic conditions among reproductive-aged women. Data from the 2001 to 2009 Behavioral Risk Factor Surveillance System, a representative state-based telephone survey of health behavior in US adults, was analyzed for 327,917 women of reproductive age, 18 to 44 years. We calculated prevalence ratios over time to assess trends for 4 selected risk factors and 4 chronic conditions, accounting for age, race/ethnicity, education, health care coverage, and individual states. From 2001 to 2009, estimates of 2 risk factors improved: smoking declined from 25.9% to 18.8%, and physical inactivity declined from 25.0% to 23.0%. One risk factor, heavy drinking, did not change. From 2003 to 2009, the estimates for 1 risk factor and 4 chronic conditions worsened: obesity increased from 18.3% to 24.7%, diabetes increased from 2.1% to 2.9%, high cholesterol increased from 10.3% to 13.6%, asthma increased from 13.5% to 16.2%, and high blood pressure increased from 9.0% to 10.1%. All trends were significant after adjustment, except that for heavy drinking. Among women of reproductive age, prevalence of smoking and physical inactivity improved, but prevalence of obesity and all 4 chronic conditions worsened. Understanding reasons for the improvements in smoking and physical activity may support the development of targeted interventions to reverse the trends and help prevent chronic disease and adverse reproductive outcomes among women in this age group.

Public Domain

Imatoh T; Tanihara S; Miyazaki M; Momose Y; Uryu Y; Une H. Coffee consumption but not green tea consumption is associated with adiponectin levels in Japanese males. European Journal of Nutrition 50(4): 279- 284, 2011. (31 refs.)

Coffee is among the most widely consumed beverages in the world. Numerous epidemiological studies have reported a significant inverse association between coffee consumption and risk of type 2 diabetes mellitus, but the underlying mechanisms are still not fully understood. Therefore, we conducted an epidemiological study to clarify the relationship between coffee consumption and adiponectin levels in Japanese males. We also evaluated whether green tea consumption affected adiponectin levels. We carried out a cross-sectional study. The subjects were 665 male employees in Japan. Coffee consumption was assessed, using a self-administered questionnaire, as the number of times per week and cups per day respondents drank, and subjects were grouped into four levels (non, 1-5 times/week, 1-2 cups/day and a parts per thousand yen3 cups/day). The means of adiponectin levels were positively associated with coffee consumption. A dose-response relationship was found between coffee consumption and circulating adiponectin levels. The relationship remained significant after adjustment for potential confounding factors (P for trend < 0.05). However, green tea consumption was not significantly associated with adiponectin levels (P for trend = 0.90). We not only revealed that habitual coffee consumption is associated with higher adiponectin levels in Japanese males but also found a dose-dependent association between coffee consumption and adiponectin levels. Therefore, our study suggested that coffee components might play an important role in the elevation of adiponectin level.

Jankowich M; Choudhary G; Taveira TH; Wu WC. Age-, race-, and gender-specific prevalence of diabetes among smokers. Diabetes Research and Clinical Practice 93(3): E101-E105, 2011. (7 refs.)

A cross-sectional study using the US national 2009 Behavioral-Risk-Factor-Surveillance-System data (n = 425,846) demonstrates that diabetes prevalence was significantly increased after age 35 in ever smokers, irrespective of gender. Diabetes prevalence was significantly increased in white or Hispanic ever smokers after age 25, and in black ever smokers after age 35.

Kim J; Chu SK; Kim K; Moon JR. Alcohol use behaviors and risk of metabolic syndrome in South Korean middle-aged men. BMC Public Health 11: e-article 489, 2011. (48 refs.)

Background: It is thought that small volumes of alcohol may have positive effects on health. However, excessive drinking results in serious health problems. An accurate method to determine individual alcohol use behaviors are needed to assess objectively the extent to which drinking affects health. This study investigated the association between risk of metabolic syndrome (MetS) and alcohol use behaviors in middle-aged South Korean men using the Alcohol Use Disorders Identification Test. Methods: This study used data from the South Korea National Health and Nutrition Examination (KNHANES) IV (2008), which extracted the standard survey household by using the proportional systematic sampling method. Data of 714 participants from KNHANES IV, 2008 were analyzed using Surveyfreq and Surveylogistic regression to investigate the association between MetS and alcohol use behaviors in middle-aged South Korean men. Results: After adjustment for education, smoking, and physical activity, alcohol use behaviors were significantly associated with an increased risk of hypertension [ odds ratio (OR) = 2.54, 95% confidence interval (CI) = 1.5-4.06 in the hazardous group; OR = 2.99, 95% CI = 1.84-4.92 in the problem group]; impaired fasting glucose (OR = 2.15, 95% CI = 1.16-3.99 in the hazardous group; OR = 2.48, 95% CI = 1.42-4.33 in the problem group); dyslipidemia (OR = 2.19, 95% CI = 1.38-3.47 in the problem group); abdominal obesity (OR = 1.93, 95% CI = 1.17-3.19 in the hazardous group; OR = 1.85, 95% CI = 1.17-2.92 in the problem group); and MetS (OR = 2.16, 95% CI = 1.24-3.77 in the hazardous group; OR = 2.54, 95% CI = 1.41-4.58 in problem group). Conclusions: This study found that excessive alcohol use behaviors increased the risk of hypertension, diabetes, dyslipidemia, abdominal obesity, and MetS. Considering the rising rate of alcohol consumption and heavy drinking at single sittings, a culture of less risky alcohol consumption must be established to promote health among middle-aged men.

Lin WY; Pi-Sunyer FX; Chen CC; Davidson LE; Liu CS; Li TC; Wu MF. Coffee consumption is inversely associated with type 2 diabetes in Chinese. European Journal of Clinical Investigation 41(6): 659- 666, 2011. (35 refs.)

Background: Coffee consumption has been shown to be inversely associated to type 2 diabetes mellitus (T2DM), but evidence in Chinese populations is limited. We investigated the relationship between coffee consumption and T2DM in a population-based cohort of middle-aged Chinese. Materials and methods: We studied 2332 subjects who participated in the Taichung Community Health Study in Taiwan in 2004. The relationships between coffee consumption, T2DM and fasting glucose were assessed. Results: The prevalence of T2DM was 14 center dot 0% and 10 center dot 4% in men and women. After adjustment for age, body mass index, blood pressure, smoking, alcohol drinking, betel nut chewing, physical activity, income, education level, fat%, protein%, carbohydrate% and magnesium, coffee intake was inversely associated with T2DM. Habitual coffee drinkers had 38-46% lower risk of T2DM than nondrinkers. Compared to nondrinkers, the adjusted odds ratios (ORs) for T2DM according to subjects with habitual coffee consumption (< 1, 1-6, >= 7 times per week) were 0 center dot 77 (0 center dot 52-1 center dot 13), 0 center dot 46 (0 center dot 28-0 center dot 76) and 0 center dot 37 (0 center dot 16-0 center dot 83), respectively. The decreasing ORs indicate a dose-response effect of coffee consumption on the likelihood of having T2DM (P < 0 center dot 001). A similar relationship was also evident in newly diagnosed T2DM (P < 0 center dot 05). The adjusted mean fasting glucose levels gradually decreased as the frequency of coffee consumption increased (P < 0 center dot 05). Conclusions: Coffee intake is inversely associated with T2DM in Chinese. Coffee may be a protective agent for T2DM in Chinese.

MacAller T; Brown M; Black K; Greenwood D. Collaborating with diabetes educators to promote smoking cessation for people with diabetes: The California experience. Diabetes Educator 37(5): 625-632, 2011. (9 refs.)

Purpose: Smoking exacerbates the harmful effects of diabetes by increasing risk of diabetes-related complications such as cardiovascular disease, stroke, nephropathy, and neuropathy. To address the smoking cessation needs of people with diabetes, a partnership was formed among diabetes educators, the California Department of Public Health's Diabetes and Tobacco Control Programs, and the California Smokers' Helpline. Methods: A task force composed of 8 diabetes educators voluntarily designed and implemented a statewide educational campaign titled, "Do You cAARd?" The program aimed to promote referrals to the state's tobacco quitline by diabetes educators. Intervention activities included development of a "toolkit" for diabetes educators, presentations at American Association of Diabetes Educators chapter meetings, distribution of pocket-sized smoking cessation materials, and a print media campaign. Results: The campaign reached 170 diabetes educators directly via educational presentations. A post-campaign online survey of 46 diabetes educators showed 80% had referred clients to the Helpline for smoking cessation support, 76% knew the Helpline's phone number, and 70% had distributed Helpline materials. More than 700 toolkits tool chestwere downloaded, potentially reaching as many as 75% of California's 900 diabetes educators. The percentage of Helpline calls from people with diabetes and the proportion of callers referred by health care providers also increased over time. Conclusions: This program partnership serves as a sustainable, efficient, replicable outreach model for smoking cessation.

Machado LMM; da Costa THM; da Silva EF; Dorea JG. Association of moderate coffee intake with self-reported diabetes among urban Brazilians. International Journal of Environmental Research and Public Health 8(8): 3216-3231, 2011. (44 refs.)

Coffee has been associated with reductions in the risk of non-communicable chronic diseases (NCCD), including diabetes mellitus. Because differences in food habits are recognizable modifying factors in the epidemiology of diabetes, we studied the association of coffee consumption with type-2 diabetes in a sample of the adult population of the Federal District, Brazil. This cross-sectional study was conducted by telephone interview (n = 1,440). A multivariate analysis was run controlling for socio-behavioural variables, obesity and family antecedents of NCCD. A hierarchical linear regression model and a Poisson regression were used to verify association of type-2 diabetes and coffee intake. The independent variables which remained in the final model, following the hierarchical inclusion levels, were: first level-age and marital status; second level-diabetes and dyslipidaemias in antecedents; third level-cigarette smoking, supplement intake, body mass index; and fourth level-coffee intake (<= 100 mL/d, 101 to 400 mL/day, and >400 mL/day). After adjusting hierarchically for the confounding variables, consumers of 100 to 400 mL of coffee/day had a 2.7% higher (p = 0.04) prevalence of not having diabetes than those who drank less than 100 mL of coffee/day. Compared to coffee intake of <= 100 mL/day, adults consuming >400 mL of coffee/day showed no statistically significant difference in the prevalence of diabetes. Thus, moderate coffee intake is favourably associated with self-reported type-2 diabetes in the studied population. This is the first study to show a relationship between coffee drinking and diabetes in a Brazilian population.

Mookhoek EJ; van de Kerkhof PCM; Hovens JEJM; Brouwers JRBJ; Loonen AJM. Substantial skin disorders in psychiatric illness coincide with diabetes and addiction. Journal of the European Academy of Dermatology and Venereology 25(4): 392-397, 2011. (20 refs.)

Background: Dermatological diseases in psychiatric patients are common; however, epidemiological data on this subject are scarce and to our knowledge integral studies of dermatological disease in psychiatric inpatients are not available yet. Aim: The aim of this study was to describe the incidence of dermatological problems in psychiatric inpatients. Method: This study evaluates the consultations for new dermatological problems by inpatients of a general psychiatric hospital of over 700 beds during a 6-month period. Results: A total of 255 patients consulted their physician because of a new dermatological problem. Diagnoses (n = 360) included skin infections (32%), accidents (7%), decubitus ulcers (7%), complications of medical treatment (3%), auto mutilation (1%) and neoplasms of the skin (1%). Patients with skin infections were likely to have diabetes [odds ratio (OR) = 3.6; 95% confidence interval (CI): 1.56-8.40]. Patients with decubitus ulcers were likely to have an addiction problem (OR = 6.4; 95% CI: 1.46-28.00). Dermatitis was associated with affective disorder (OR = 2.5; 95% CI: 1.12-5.43) but not with psychosis (OR = 0.5; 95% CI: 0.23-0.90). Only a poor correlation existed between the length of hospital stay and skin problems. Conclusions: Dermatological problems are common in hospitalized psychiatric patients. Patients with diabetes mellitus are at high risk for skin infections. There are significant relationships between the psychiatric and the dermatological diagnoses. The length of the admission to a psychiatric hospital does not seem to play a major role in skin diseases.

Parry CD; Patra J; Rehm J. Alcohol consumption and non-communicable diseases: Epidemiology and policy implications. Addiction 106(10): 1718-1724, 2011. (47 refs.)

Aims This paper summarizes the relationships between different patterns of alcohol consumption and various on non-communicable disease (NCD) outcomes and estimates the percentage of NCD burden that is attributable to alcohol. Methods A narrative review, based on published meta-analyses of alcohol consumption-disease relations, together with an examination of the Comparative Risk Assessment estimates applied to the latest available revision of Global Burden of Disease study. Results: Alcohol is causally linked (to varying degrees) to eight different cancers, with the risk increasing with the volume consumed. Similarly, alcohol use is related detrimentally to many cardiovascular outcomes, including hypertension, haemorrhagic stroke and atrial fibrillation. For other cardiovascular outcomes the relationship is more complex. Alcohol is furthermore linked to various forms of liver disease (particularly with fatty liver, alcoholic hepatitis and cirrhosis) and pancreatitis. For diabetes the relationship is also complex. Conservatively, of the global NCD-related burden of deaths, net years of life lost (YLL) and net disability adjusted life years (DALYs), 3.4%, 5.0% and 2.4%, respectively, can be attributed to alcohol consumption, with the burden being particularly high for cancer and liver cirrhosis. This burden is especially pronounced in countries of the former Soviet Union. Conclusions: There is a strong link between alcohol and non-communicable diseases, particularly cancer, cardiovascular disease, liver disease, pancreatitis and diabetes, and these findings support calls by the World Health Organization to implement evidence-based strategies to reduce harmful use of alcohol.

Thiering E; Bruske I; Kratzsch J; Thiery J; Sausenthaler S; Meisinger C et al. Prenatal and postnatal tobacco smoke exposure and development of insulin resistance in 10 year old children. International Journal of Hygiene and Environmental Health 214(5): 361-368, 2011. (34 refs.)

In this study, we evaluated the association between prenatal and postnatal exposure to environmental tobacco smoke and the development of insulin resistance in 10 year old children. Fasting blood samples were collected from 470 children participating in two prospective birth cohorts. Of those 276 were selected population based and enriched with 194 children exceeding the 85th percentile of body mass index in this age group. Children already having diabetes type 1 or 2 at the age of 10 years were excluded. Fasting blood insulin and glucose levels and calculated HOMA index for insulin resistance assessment were analysed using generalised additive models. Potential confounders were adjusted for. Insulin resistance was increased by 24% in children frequently exposed to environmental tobacco smoke during childhood (MR(adj) = 1.24, p = 0.001), while glucose levels were not. Exclusion of prenatally exposed children did not attenuate the association (MR(adj) = 1.25, p = 0.006). After stratification, the effect sizes were identical within overweight children and the population based sample of children. Insulin resistance and fasting insulin levels were increasing with increasing numbers of cigarettes smoked in children's home. Maternal smoking during the third trimester of pregnancy increased children's insulin levels (MR(adj) = 1.19, p = 0.037), and even more so, if children were exclusively breastfed after birth (MR(adj) = 1.31, p = 0.016). Increased mean ratios were found for smoking of a third person in addition to maternal smoking. Positive dose-dependent associations and independent effects of postnatal exposure suggest involvement of environmental tobacco smoke in the risk for development of insulin resistance in children.

Wong ML; Holt RIG. The potential dangers of mephedrone in people with diabetes: A case report. Drug Testing and Analysis 3(7-8.special issue): 464-465, 2011. (8 refs.)

Zhang LX; Curhan GC; Hu FB; Rimm EB; Forman JP. Association between passive and active smoking and incident type 2 diabetes in women. Diabetes Care 34(4): 892-897, 2011. (25 refs.)

OBJECTIVE-Accumulating evidence has identified a positive association between active smoking and the risk of diabetes, but previous studies had limited information on passive smoking or changes in smoking behaviors over time. This analysis examined the association between exposure to passive smoke, active smoking, and the risk of incident type 2 diabetes among women. RESEARCH DESIGN AND METHODS-This is a prospective cohort study of 100,526 women in the Nurses' Health Study who did not have prevalent diabetes in 1982, with follow-up for diabetes for 24 years. RESULTS-We identified 5,392 incident cases of type 2 diabetes during 24 years of follow-up. Compared with nonsmokers with no exposure to passive smoke, there was an increased risk of diabetes among nonsmokers who were occasionally (relative risk [RR] 1.10 [95% CI 0.94-1.23]) or regularly (1.16 [1.00-1.35]) exposed to passive smoke. The risk of incident type 2 diabetes was increased by 28% (12-50) among all past smokers. The risk diminished as time since quitting increased but still was elevated even 20-29 years later (1.15 [1.00-1.32]). Current smokers had the highest risk of incident type 2 diabetes in a dose-dependent manner. Adjusted RRs increased from 1.39 (1.17-1.64) for 1-14 cigarettes per day to 1.98 (1.57-2.36) for >= 25 cigarettes per day compared with nonsmokers with no exposure to passive smoke. CONCLUSIONS-Our study suggests that exposure to passive smoke and active smoking are positively and independently associated with the risk of type 2 diabetes.

Zhang Y; Lee ET; Cowan LD; Fabsitz RR; Howard BV. Coffee consumption and the incidence of type 2 diabetes in men and women with normal glucose tolerance: The Strong Heart Study. Nutrition, Metabolism and Cardiovascular Diseases 21(6): 418-423, 2011. (39 refs.)

Background and aims: It was reported that high coffee consumption was related to decreased diabetes risk. The aim of this study is to examine the association between coffee consumption and the incidence of type 2 diabetes in persons with normal glucose tolerance in a population with a high incidence and prevalence of diabetes. Methods. and results: In a prospective cohort study, information about daily coffee consumption was collected at the baseline examination (1989-1992) in a population-based sample of American Indian men and women 45-74 years of age. Participants with normal glucose tolerance (N = 1141) at the baseline examination were followed for an average of 7.6 years. The incidence of diabetes was compared across the categories of daily coffee consumption. The hazard ratios of diabetes related to coffee consumption were calculated using Cox proportional hazards models, adjusted for potential confounders. Levels of coffee consumption were positively related to levels of current smoking and inversely related to body mass index, waist circumference, female gender, and hypertension. Compared to those who did not drink coffee, participants who drank 12 or more cups of coffee daily had 67% less risk of developing diabetes during the follow-up (hazard ratio: 0.33, 95% confidence interval: 0.13, 0.81). Conclusion: In this population, a high level of coffee consumption was associated with a reduced risk of deterioration of glucose metabolism over an average 7.6 years of follow-up. More work is needed to understand whether there is a plausible biological mechanism for this observation.