Cited by 440Pancreatic function and diabetesDiabetes, Cardiovascular Risks, and LipoproteinsDiabetes Treatment and Management

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Mechanisms of the Age-Associated Deterioration in Glucose Tolerance

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Abstract

Glucose tolerance decreases with age. For determining the cause of this decrease, 67 elderly and 21 young (70.1 ± 0.7 vs. 23.7 ± 0.8 years) participants ingested a mixed meal and received an intravenous injection of glucose. Fasting glucose and the glycemic response above basal were higher in the elderly than in the young participants after either meal ingestion (P < 0.001) or glucose injection (P < 0.01). Insulin action (Si), measured with the meal and intravenous glucose tolerance test models, was highly correlated (r = 0.72; P < 0.001) and lower (P ≤ 0.002) in the elderly than in the young participants. However, when adjusted for differences in percentage body fat and visceral fat, Si no longer differed between groups. When considered in light of the degree of insulin resistance, all indexes of insulin secretion were lower (P < 0.01) in the elderly participants, indicating impaired β-cell function. Hepatic insulin clearance was increased (P < 0.002), whereas total insulin clearance was decreased (P < 0.002) in the elderly subjects. Multivariate analysis (r = 0.70; P < 0.001) indicated that indexes of insulin action (Si) and secretion (Phitotal) but not age, peak oxygen uptake, fasting glucose, degree of fatness, or hepatic insulin clearance predicted the postprandial glycemic response. We conclude that the deterioration in glucose tolerance that occurs in healthy elderly subjects is due to a decrease in both insulin secretion and action with the severity of the defect in insulin action being explained by the degree of fatness rather than age per se.

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Metadata

Authors
Basu, R., Breda, E., Oberg, A. L., Powell, C. C., Dalla Man, C., Basu, A., Vittone, J. L., Klee, G. G., Arora, P., Jensen, M. D., Toffolo, G., Cobelli, C., & Rizza, R. A.
Affiliations
  • Mayo Clinic (US)
  • University of Padua (IT)
  • Department of Information Engineering, University of Padua, Padua, Italy
Venue
Diabetes
Published
2003-07-01
Volume
52
Issue
7
Pages
1738-1748
ISSN
  • 0012-1797 (ISSN-L)
  • 1939-327X
OpenAlex
W2139834641
Cited by
440
References
58
Citations by year
2026: 8 · 2025: 23 · 2024: 22 · 2023: 17 · 2022: 23 · 2021: 27 · 2020: 19 · 2019: 22 · 2018: 17 · 2017: 14 · 2016: 24 · 2015: 18 · 2014: 16 · 2013: 26 · 2012: 22
FWCI
15.38
Type
journal article
Language
en
Open access
Locations
  • Diabetes (publishedVersion)
  • PubMed (publishedVersion)
  • Padua Research Archive (University of Padova) (submittedVersion)
Funders
  • American Diabetes Association
  • Mayo Foundation for Medical Education and Research
  • Novo Nordisk
  • U.S. Public Health Service (RR-00585)
  • National Institute on Aging (AG14383, P01AG014383)
  • National Institute of Biomedical Imaging and Bioengineering (P41EB001975)
  • National Center for Research Resources (RR-00585, M01RR000585)
Topics
  • Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Pancreatic function and diabetes
  • Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes, Cardiovascular Risks, and Lipoproteins
  • Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Treatment and Management
Keywords
insulin resistance, insulin secretion, beta-cell function, postprandial glycemic response, hepatic insulin clearance, fat mass, visceral fat, older adults, glucose tolerance test
MeSH terms
Insulin Secretion, Adult, Aged, Aging, Blood Glucose, C-Peptide, Eating, Fatty Acids, Nonesterified, Glucagon, Glucose, Glucose Tolerance Test, Humans, Hydrocortisone, Insulin, Body Mass Index, Palmitic Acid, Dehydroepiandrosterone Sulfate, Human Growth Hormone

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