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20 January 04 Annals of Internal Medicine Tip Sheet

Annals of Internal Medicine is published by the American College of Physicians, an organization of more than 115,000 internal medicine physicians and medical students. These highlights are not intended to substitute for articles as sources of information. For an embargoed fax of an article, call 1-800-523-1546, ext. 2656, or 215-351-2656.

Caffeinated Coffee Consumption Linked to Lower Risk for Type 2 Diabetes

Men and women who drank more coffee and other caffeinated beverages were less likely to develop type 2 diabetes than those who drank few or no caffeinated beverages (Article, p.1). Researchers based their conclusions on data from a study of more than 126,000 men and women who reported their intake of coffee and other caffeinated beverages every two to four years over a period of 12 to 18 years. Decaffeinated coffee consumption was not associated with type 2 diabetes. The association of coffee and type 2 diabetes was similar in strength to the association between consumption of tea and risk for diabetes. Authors caution that the study did not prove that drinking coffee lowers the risk for diabetes. And they say people should not increase their coffee drinking in order to prevent type 2 diabetes. However, the link between caffeine and glucose tolerance does warrant further study, the authors say.

Kidney Disease May Be Associated with New Metabolic Risk Factors for Heart Disease

Traditional risk factors for cardiovascular disease (CVD) include high blood pressure, diabetes and abnormal cholesterol levels. So-called newer or non-traditional risk factors include abnormal levels of several substances in the blood that indicate inflammation. A new study of data from a large national health study compared levels of these substances in groups of people with normal kidneys, mild chronic kidney disease or severe kidney disease. The authors found that the newer CVD risk factors occurred frequently in the two groups with kidney disease. Since the death rate from CVD is 10 to 20 times higher among patients with severe kidney disease than in those with normal kidneys, treating the new risk factors in people with kidney disease might lesson chances for developing heart disease. An editorial writer says, "(W)e don't know which if any, nontraditional risk factors account for the enormous risk for heart disease in patients with chronic kidney disease" but "aggressive management of traditional risk factors is a sensible, albeit largely unproven, strategy to prevent CVD in patient with chronic kidney disease." (Editorial, p. 60.)

Malpractice Reform Must Include Steps to Prevent Medical Injury

(Perspective, p.51)

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