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Cited by 126Diabetes, Cardiovascular Risks, and LipoproteinsDiabetes Treatment and ManagementPancreatic function and diabetes

The DOI matches its Crossref record; 8 of the 8 references it cites were found in a registry or an index.

Metabolic alterations in middle-aged and elderly obese patients with type 2 diabetes.

Meneilly, G S, Elliott, T·1999·Diabetes Care
DOI 10.2337/diacare.22.1.112
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Abstract

OBJECTIVE: We conducted this study to assess the metabolic alterations in middle-aged and elderly obese patients with type 2 diabetes. RESEARCH DESIGN AND METHODS: Healthy control subjects (9 middle-aged, aged 42 +/- 2 years, BMI 33 +/- 1 kg/m2; 10 elderly, aged 71 +/- 1 years, BMI 29 +/- 1 kg/m2) and patients with type 2 diabetes (11 middle-aged, aged 43 +/- 2 years, BMI 34 +/- 2 kg/m2; 23 elderly, aged 73 +/- 1 years; BMI 30 +/- 1 kg/m2) underwent a 3-h oral glucose tolerance test (OGTT), a 2-h hyperglycemic glucose clamp, and a 3-h euglycemic glucose clamp study with tritiated glucose methodology to measure hepatic glucose production and peripheral disposal rates. RESULTS: Middle-aged and elderly control subjects and patients with diabetes were similar in percentage of body fat. Waist-to-hip ratio was greater in elderly patients with diabetes than in elderly control subjects (P < 0.01), but was similar in both middle-aged groups. VO2max was less in control subjects than in both middle-aged and elderly patients with diabetes (P < 0.05). Insulin responses during the OGTT were similar in elderly control subjects and patients with diabetes, but were less in middle-aged patients with diabetes than in control subjects (305 +/- 49 vs. 690 +/- 136 pmol/l, P < 0.01). Patients with type 2 diabetes had absent first-phase insulin responses during the hyperglycemic clamp. Second-phase (80-120 min) insulin values were similar in elderly patients and control subjects, but were reduced in middle-aged patients with diabetes compared with control subjects (285 +/- 35 vs. 894 +/- 143 pmol/l, P < 0.0001). During the euglycemic clamp, basal and steady-state (150-180 min) hepatic glucose output values were less in middle-aged control subjects than in patients with diabetes (basal, 3.03 +/- 0.10 vs. 3.69 +/- 0.09 mg.kg-1 lean body mass.min-1, P < 0.0001; steady-state, 0.72 +/- 0.10 vs. 1.84 +/- 0.20 mg.kg-1 lean body mass.min-1, P < 0.0001). Basal and steady-state hepatic glucose output values were similar in elderly patients and control subjects. Finally, steady-state (150-180 min) glucose disposal rates were higher in control subjects than in patients with diabetes in both the middle-aged (7.51 +/- 0.85 vs. 4.62 +/- 0.24 mg.kg-1 lean body mass.min-1, P < 0.01) and elderly (9.91 +/- 0.61 vs. 6.78 +/- 0.60 mg.kg-1 lean body mass.min-1, P < 0.01) groups. CONCLUSIONS: We conclude that type 2 diabetes in obese middle-aged subjects is characterized by impaired glucose-induced insulin release, altered regulation of hepatic glucose output, and resistance to insulin-mediated glucose disposal. In contrast, the primary defect in elderly obese patients with type 2 diabetes is resistance to insulin-mediated glucose disposal. Our findings may have important therapeutic implications for these patient populations.

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Metadata

Authors
Meneilly, G. S., & Elliott, T.
Affiliations
University of British Columbia (CA)
ORCID
Meneilly, G S
Venue
Diabetes Care
Publisher
American Diabetes Association
Published
1999-01-01
Volume
22
Issue
1
Pages
112-118
ISSN
  • 0149-5992 (ISSN-L)
  • 1935-5548
DOI
10.2337/diacare.22.1.112
OpenAlex
W1989181445
Cited by
126
References
8
Citations by year
2026: 1 · 2025: 3 · 2024: 4 · 2023: 4 · 2022: 7 · 2021: 8 · 2020: 2 · 2019: 8 · 2018: 5 · 2017: 6 · 2016: 2 · 2015: 10 · 2014: 3 · 2013: 7 · 2012: 2
FWCI
3.92
Type
journal article
Language
en
Open access
closed
Locations
  • Diabetes Care (publishedVersion)
  • PubMed (publishedVersion)
Topics
  • Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes, Cardiovascular Risks, and Lipoproteins
  • Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Treatment and Management
  • Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Pancreatic function and diabetes
Keywords
type 2 diabetes, obesity, middle-aged adults, older adults, hepatic glucose production, insulin resistance, first-phase insulin response, second-phase insulin response, hepatic insulin sensitivity, hyperinsulinemic-euglycemic clamp, oral glucose tolerance test, insulin secretion, insulin sensitivity, body fat distribution, waist-to-hip ratio, VO2max
MeSH terms
Adult, Age Factors, Aged, Blood Glucose, Blood Pressure, Diabetes Mellitus, Diabetes Mellitus, Type 2, Female, Glucose, Glucose Tolerance Test, Humans, Insulin, Liver, Male, Middle Aged, Obesity, Oxygen Consumption, Reference Values, Glucose Clamp Technique, Body Mass Index

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