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The present study systematically reviewed the evidence of the effects of caffeine on blood glucose concentrations and\/or insulin sensitivity in people with diabetes.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Four databases, including <jats:styled-content style=\"fixed-case\">MEDLINE<\/jats:styled-content> and <jats:styled-content style=\"fixed-case\">EMBASE<\/jats:styled-content>, were searched up to 1 February 2012. Randomised controlled trials (<jats:styled-content style=\"fixed-case\">RCT<\/jats:styled-content>s) investigating the effects of caffeine on blood glucose and\/or insulin sensitivity in humans, diagnosed with type <jats:styled-content style=\"fixed-case\">I<\/jats:styled-content>, type <jats:styled-content style=\"fixed-case\">II<\/jats:styled-content> or gestational diabetes mellitus (<jats:styled-content style=\"fixed-case\">GDM<\/jats:styled-content>), were included. Quality assessment and data extraction were conducted and agreed by both authors.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Of 253 articles retrieved, nine trials (134 participants) were identified. Trials in people with type <jats:styled-content style=\"fixed-case\">II<\/jats:styled-content> diabetes demonstrated that the ingestion of caffeine (approximately 200\u2013500\u00a0mg) significantly increased blood glucose concentrations by 16\u201328% of the area under the curve (<jats:styled-content style=\"fixed-case\">AUC<\/jats:styled-content>) and insulin concentrations by 19\u201348% of the <jats:styled-content style=\"fixed-case\">AUC<\/jats:styled-content> when taken prior to a glucose load, at the same time as decreasing insulin sensitivity by 14\u201337%. In type I diabetes, trials indicated enhanced recognition and a reduced duration of hypoglycaemic episodes following ingestion of 400\u2013500\u00a0mg caffeine, without altering glycated haemoglobin. In <jats:styled-content style=\"fixed-case\">GDM<\/jats:styled-content>, a single trial demonstrated that approximately 200\u00a0mg of caffeine induced a decrease in insulin sensitivity by 18% and a subsequent increase in blood glucose concentrations by 19% of the <jats:styled-content style=\"fixed-case\">AUC<\/jats:styled-content>.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Evidence indicates a negative effect of caffeine intake on blood glucose control in individuals with type <jats:styled-content style=\"fixed-case\">II<\/jats:styled-content> diabetes, as replicated in a single trial in <jats:styled-content style=\"fixed-case\">GDM<\/jats:styled-content>. Larger\u2010scale <jats:styled-content style=\"fixed-case\">RCT<\/jats:styled-content>s of longer duration are needed to determine the effects of timing and dose. Early indications of a reduced duration and an improved awareness of hypoglycaemia in type I diabetes require further confirmation.<\/jats:p><\/jats:sec>","DOI":"10.1111\/jhn.12033","type":"journal-article","created":{"date-parts":[[2013,1,19]],"date-time":"2013-01-19T06:34:47Z","timestamp":1358577287000},"page":"111-125","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":35,"title":["Systematic review of randomised controlled trials of the effects of caffeine or caffeinated drinks on blood glucose concentrations and insulin sensitivity in people with diabetes mellitus"],"prefix":"10.1111","volume":"26","author":[{"given":"N.","family":"Whitehead","sequence":"first","affiliation":[{"name":"Department of Nutrition and Dietetics Leeds Metropolitan University Leeds UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"H.","family":"White","sequence":"additional","affiliation":[{"name":"Department of Nutrition and Dietetics Leeds Metropolitan University Leeds UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2013,1,19]]},"reference":[{"key":"e_1_2_9_2_1","first-page":"437","article-title":"A systematic review of randomised controlled trials for dietary interventions of cinnamon in the management of type 2 diabetes mellitus","volume":"23","author":"Akilen R.","year":"2010","journal-title":"J. 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