Tolerance to glucose
Infringement of for glucose tolerance is a typical process for all elderly people. According to the data of different authors, the violation of glucose tolerance is revealed in 10-35%, and diabetes mellitus - in 20-30% of the population of the elderly. Studies show that age is the determining factor in the development of impaired glucose tolerance in healthy elderly people. With age, the concentration of fasting blood glucose rises, which is reflected in Fig.[Rochman H., 1988].
The change in the concentration of glycosylated Hb with age is shown in Fig.
The elderly also have an insulin response to the glucose load. The results of deviations in the diagnostic values of glucose and insulin concentrations after 75 g of glucose in young and elderly people are shown in Fig.12-12 [Reaven G. M. et al., 1989].
Fasting blood glucose concentration increases by 1-2 mg% every 10 years of adulthood. At the same time, the concentration of glucose in the blood after 2 hours after loading with glucose increases every 5 years by 5-10 mg%
Fig. Concentration of fasting blood glucose in different periods of life
Fig. Fasting blood glucose in different periods of life
Fig. The content of HbA1c in the blood at different periods of life
Fig. The content of HbA1c in the blood at different periods of life
Fig. Dynamics of blood glucose after glucose load in young and elderly people
Fig. Dynamics of blood glucose after glucose load in young and elderly people
Fig. Dynamics of insulin concentration in the blood after a load of glucose in young and elderly people
Fig. Dynamics of insulin concentration in the blood after a load of glucose in young and elderly people
[Riesenberg D., 1990].Relatively low tolerance to glucose is a constant sign in healthy elderly people( even in individuals with proper diet and active lifestyle).
HbA1c increases from 7% in 25-year-olds to over 9% in people over 70 years of age( healthy).One should remember this peculiarity of the elderly, as the HbA1c study is often used to monitor glycemia. The detection of an elevated HbA1c content does not always indicate a patient having diabetes mellitus.
The increase in the concentration of glucose in the blood after a load in the elderly is accompanied by a significant increase in the concentration of insulin. The cause, explaining such changes and violation of glucose tolerance in the elderly, is considered a violation of the sensitivity of peripheral tissues and their receptors to the action of insulin. Hyperinsulinemia in the elderly is an independent risk factor for IHD.