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NIDDM in the elderly

G S Meneilly1, T Elliott, D Tessier

  • 1Department of Medicine, University of Sherbrooke, Quebec, Canada.

Diabetes Care
|December 1, 1996
PubMed
Summary
This summary is machine-generated.

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Elderly individuals with non-insulin-dependent diabetes mellitus (NIDDM) show impaired insulin release and glucose disposal. Lean NIDDM patients have reduced insulin secretion, while obese NIDDM patients exhibit insulin resistance.

Area of Science:

  • Gerontology
  • Metabolic Medicine
  • Endocrinology

Background:

  • Non-insulin-dependent diabetes mellitus (NIDDM) is a prevalent metabolic disorder in the elderly population.
  • Understanding the specific metabolic alterations in elderly NIDDM patients is crucial for effective management.

Purpose of the Study:

  • To investigate the metabolic changes, including glucose production and disposal, in elderly individuals with NIDDM.
  • To differentiate metabolic profiles between lean and obese elderly NIDDM patients and compare them with healthy controls.

Main Methods:

  • The study involved healthy lean and obese controls, and lean and obese NIDDM patients.
  • Participants underwent glucose tolerance tests and hyperglycemic and euglycemic glucose clamp studies.
  • Tritiated glucose methodology was used to quantify glucose production and disposal rates.

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Main Results:

  • Elderly NIDDM patients, both lean and obese, exhibited a higher waist-to-hip ratio compared to controls.
  • Lean NIDDM patients showed significantly reduced insulin responses, while obese NIDDM patients had similar insulin levels but impaired glucose disposal.
  • Both lean and obese NIDDM patients demonstrated absent first-phase insulin release and reduced second-phase insulin release (lean only).
  • Hepatic glucose output was not elevated in either lean or obese NIDDM patients.
  • Glucose disposal rates were significantly lower in both lean (16% reduction) and obese (37% reduction) NIDDM patients compared to controls.

Conclusions:

  • Lean elderly NIDDM patients experience significant impairment in glucose-induced insulin release with mild insulin resistance.
  • Obese elderly NIDDM patients maintain adequate insulin levels but have marked insulin resistance.
  • Hepatic glucose production remains unchanged in elderly NIDDM patients, irrespective of body weight.