ABSTRACT
Normal aging is characterized by a number of progressive changes in carbohydrate metabolism, which explains why the incidence of diabetes increases with age in genetically susceptible individuals. Despite the fact that there is a strong genetic predisposition to diabetes in the elderly, a variety of lifestyle factors contribute to the increased risk for diabetes in the aged. The prevalence of diabetes is higher in older individuals who have a diet that is high in simple sugars and saturated fats and low in complex carbohydrates. The presence of inflammation, as measured by C-reactive ptotein and other proinflammatory cytokines, such as tumor necrosis factor-a is associated with the development of diabetes in the elderly. Middle-aged patients with diabetes, whether lean or obese, have an increase in hepatic glucose production, a profound impairment in glucose-induced insulin release, and marked resistance to insulin-mediated glucose disposal.
