[Clinical pathophysiology of the elderly onset diabetes mellitus]

Several studies have shown that fasting blood glucose rises about 1-2 mg/dl/decade and post-prandial glucose by about 15 mg/dl/decade, leading to mild glucose intolerance with insulin resistance associated with aging. There appears to be a distinct group of individuals on an accelerated trajectory to clinically impaired glucose intolerance or frank type 2 diabetes mellitus. There are several characteristics of elderly onset type 2 diabetes as describe below. The incidence and progression of retinopathy were suggested to be rare. Several studies of the association between body mass index and cardiovascular mortality suggested the increased mortality associated with weight loss and underweight. Hypoglycemia is an underappreciated and potentially fatal complication of insulin and sulfonylurea treatment.