Changes in glucose tolerance in elderly

Glucose tolerance declines with age, resulting in a high prevalence of type 2 diabetes and impaired glucose tolerance in the elderly population. The pathogenesis of the age-related glucose intolerance is multifactorial; includes the interaction of many variables associated with aging including increased visceral adiposity, decreased physical activity, the use of diverse medications, coexisting illness, diminished insulin secretion and sensitivity, however the age-related effect over glucose metabolism is still controversial. In Mexico glucose intolerance is present in 15-20% of the population older than 60 years and increases the risk for developing diabetes and cardiovascular disease. Patients diagnosed with diabetes at an advanced age have particular characteristics; tend to be less obese, have more beta cell dysfunction and may be diagnosed with a hyperosomolar state. Lifestyle modifications are particularly effective in preventing diabetes in this age group.