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1 Divisions of Endocrinology and 2 Geriatric Medicine, Department of Internal Medicine, University of Michigan, Ann Arbor, Michigan 48109
Glucose tolerance progressively declines
with age, and there is a high prevalence of type 2 diabetes and
postchallenge hyperglycemia in the older population. Age-related
glucose intolerance in humans is often accompanied by insulin
resistance, but circulating insulin levels are similar to those of
younger people. Under some conditions of hyperglycemic challenge,
insulin levels are lower in older people, suggesting 
-cell
dysfunction. When insulin sensitivity is controlled for, insulin
secretory defects have been consistently demonstrated in aging humans.
In addition, -cell sensitivity to incretin hormones may be decreased
with advancing age. Impaired -cell compensation to age-related
insulin resistance may predispose older people to develop postchallenge
hyperglycemia and type 2 diabetes. An improved understanding of the
metabolic alterations associated with aging is essential for the
development of preventive and therapeutic interventions in this
population at high risk for glucose intolerance.
aged humans; -cell function
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