[Epidemiology of elderly diabetes mellitus in Japan]

Glucose tolerance progressively declines with age, and there is a high prevalence of type 2 diabetes and post challenge hyperglycemia in the older population. Diabetes in the elderly is not a single entity, but a heterogeneous group of conditions. A further 9% may have undetected/asymptomatic hyperglycemia. Several studies have also shown that fasting blood glucose rises with age (about 1-2 mg/dl/decade) and postprandial glucose by about 15 mg/dl/decade, leading to a mild glucose intolerance. Age-related glucose intolerance in humans is often accompanied by insulin resistance. The relative contribution of decreased insulin secretion vs. increased insulin resistance to the pathogenesis of type 2 diabetes mellitus has been the subject of long-standing controversy.