Johannes D. Veldhuis, MD

Disclosures

March 15, 2000

In This Article

Aging and Diabetes Mellitus

At least 17% of individuals age 80 or older will develop type 2 diabetes mellitus. Adults with low insulin sensitivity (eg, relative insulin resistance) and reduced glucose effectiveness (eg, insulin-independent glucose removal rate) have approximately an 80% risk of developing type 2 diabetes mellitus over a period of 25 years.[15] In healthy-aging individuals, there is a progressive increase in fasting and especially in postprandial plasma glucose levels.[16] As we age, insulin secretion decreases to a variable degree and becomes disorderly.[17] Concomitantly, there is a progressive increase in peripheral resistance to insulin action.[18] In healthy individuals, the aging of enteroinsular axis shows remarkable between-subject heterogeneity; the underlying basis for this is not completely understood. For example, how the aging-related diabetogenic tendency is related to the aging-related increase in visceral obesity is not known. In addition, there are few data on how well glycosylated hemoglobin levels in healthy-aging individuals predict later development of clinical diabetes mellitus.[19]

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