Practicing family physicians from the UNC Department of Family Medicine have teamed up with The Carrboro Citizen to bring you a weekly feature responding to your questions about health and medicine. Send your questions or comments to yourhealth@unc.edu
This week we respond to questions about caffeine and complications of diabetes.
Dear HOUSE Calls, How much caffeine is safe to consume in a typical day?
There is not a right answer to this for everyone. We really like our coffee, so we are not likely to err on the low side here. There are a few important side effects of caffeine, and by and large we recommend listening to your body. Caffeine can cause or contribute to reflux, heart rhythm abnormalities, high blood pressure, irritable bowel syndrome, bladder spasm, anxiety and insomnia. Most of these problems can be identified pretty easily. If you drink two cups of coffee and feel fine but drink four cups of coffee and have heartburn or diarrhea, you should take the hint. Insomnia is one of the tougher symptoms to deal with. People feel tired, so they have a cup of coffee in the afternoon, and six hours later they have trouble sleeping. Caffeine has a long half-life, which means it stays in your body for a long time. We recommend that people who are having trouble sleeping try to eliminate caffeine after lunch. Regarding hypertension, research has shown that if your levels of caffeine intake are relatively even day to day, it won’t have much effect on blood pressure. Sorry for the long answer. Here’s the short version: About two to three 8-ounce cups of coffee are fine for most people.
Dear HOUSE Calls, I have type 2 diabetes. I have heard it can cause people to go blind or lose a limb. How can it cause this type of thing?
That is a great question without a short answer. High blood sugar causes blockage and inflammation of small blood vessels throughout the body, including the blood vessels to the heart, eyes, kidneys, feet and muscles. High blood sugar also directly damages nerves, especially those in the feet and hands. The damage to the blood vessels is the common reason that diabetes is the leading cause of adult blindness and kidney failure in the U.S. as well as one of the leading causes of heart conditions. The issue with amputations is a little more complicated. As people with diabetes lose sensation in their feet, they are more likely to get sores that go undetected and get infected. Poor circulation caused by blood-vessel damage contributes to this problem, making healing less likely and more difficult. Wounds that get too deep, especially when they involve the bones, are more likely to result in amputation to avoid widespread and life-threatening infection. While all of this is quite scary, when you take good care of your diabetes with help from your family doctor, the chance of these complications is drastically reduced.
House Calls is a weekly column by Dr. Adam Goldstein, Dr. Cristy Page and Dr. Adam Zolotor on behalf of Your Health and the UNC Department of Family Medicine.