Hyperglycaemia, impaired glucose tolerance and non-insulin dependent diabetes become progressively more common with advancing age. The mechanism is insensitivity to the actions of insulin at the postreceptor level. Inadequate secretion of insulin and decreased hepatic sensitivity to insulin's action in suppressing glucose output also occur. The age-related changes may be made worse by obesity, renal failure or the ingestion of certain drugs, or may be lessened by increased physical activity.
LaaksoMPyoralaK. Age of onset and type of diabetes. Diabetes Care1985;8:114–17.
2.
NeilHAWThompsonAVThorogoodMFowlerGHMannJI. Diabetes in the elderly: the Oxford Community Diabetes Study. Diabetic Med1989;6:608–13.
3.
HarrisMIHaddenWCKnowlerWCBennettPH. Prevalence of diabetes and impaired glucose tolerance and plasma glucose levels in US population aged 20–74 years. Diabetes1987;36:523–34.
4.
StengardJHPekkanenJTuomilehtoJChanges in glucose tolerance among elderly Finnish men during a five-year follow-up. The Finnish cohorts of the Seven Countries Study. Diabete Metab (Paris)1993;19:121–9.
5.
GaleEAMDornanTLTattersallRB. Severely uncontrolled diabetes in the over-fifties. Diabetologia1981;21:25–8.
6.
McConnellJGBuchananKDArdillJStoutRW. Glucose tolerance in the elderly: the role of insulin and its receptor. Eur J Clin Invest1982;12:55–61.
FinkRIKoltermanOGGriffinJOlefskyJM. Mechanisms of insulin resistance in aging. J Clin Invest1983;71:1523–35.
9.
RoweJWMinakerKLPallottaJAFlierJS. Characterization of the insulin resistance of aging. J Clin Invest1983;71:1581–7.
10.
MinakerKLRoweJWToninoRPallottaJA. Influence of age on clearance of insulin in man. Diabetes1982;31:851–5.
11.
PaolissoGD'AmoreADi MaroGEvidence for a relationship between free radicals and insulin action in the elderly. Metabolism1993;42:659–63.
12.
ChenMBergmanRNPaciniGPorteDJr. Pathogenesis of age-related glucose intolerance in man: insulin resistance and decreased beta-cell function. J Clin Endocrinol Metab1985;60:13–20.
13.
JacksonRABlixPMMatthewsJAInfluence of ageing on glucose homeostasis. J Clin Endocrinol Metab1982;55:840–8.
14.
McConnellJGAlamMHO'HareMJBuchananKDStoutRW. The effect of age and sex on the response of enteropancreatic polypeptides to oral glucose. Age Ageing1983;12:54–62.
15.
CameronCMKostyoJL. Influence of age on responsiveness to diabetogenic action of growth hormone. Diabetes1987;36:88–92.
16.
ChenMHalterJBPorteDJr. Plasma catecholamines, dietary carbohydrate, and glucose intolerance: a comparison between young and old men. J Clin Endocrinol Metab1986;62:1193–8.
17.
KohrtWMKirwanJPStatenMABoureyREKingDSHolloszyJO. Insulin resistance in aging is related to abdominal obesity. Diabetes1993;42:273–81.
18.
DallossoHMMorganKBasseyEJEbrahimSBJFentemPHArieTHD. Levels of customary physical activity among the old and the very old living at home. J Epidemiol Community Health1988;42:121–7.
19.
SealsDRHagbergJMAllenWKGlucose tolerance in young and older athletes and sedentary men. J Appl Physiol1984;56:1521–5.
20.
CoonPJBleeckerERDrinkwaterDTMeyersDAGoldbergAP. Effects of body composition and exercise capacity on glucose tolerance, insulin, and lipoprotein lipids in healthy older men: a cross-sectional and longitudinal intervention study. Metabolism1989;38:1201–9.
21.
PollareTLithellHBerneC. A comparison of the effects of hydrochlorothiazide and captopril on glucose and lipid metabolism in patients with hypertension. N Engl J Med1989;321:868–73.