ABSTRACT
The present work looks into the different aspects of glucose homeostasis in the elderly patients in comparison to healthy younger subjects and patients with type 2 diabetes mellitus, relying on intravenous glucose tolerance test. A clinicobiochemical study was carried out comprising forty apparently healthy non-diabetic non-obese old individuals [mean age 65 +/- 4.8 years]. Forty type 2 diabetic patients compared to thirty healthy young subjects. The senile group had no family history of diabetes. Cases with renal, hepatic, gastrointestinal, or endocrine abnormalities were excluded from the study. Intravenous glucose tolerance test [ivGTT] was done with sampling at 0, 5, 10, 15, 30, 45, and 60 min after glucose load and the following estimations were undertaken: glucose constant decay [KG], glucose and insulin area under the curve, insulnogenic index, first phase insulin response, insulin resistance index and fractional insulin clearance. The senile and diabetic groups, when compared to the control, had non-significantly different fasting plasma glucose in senile group but it was higher in diabetic patients, while fasting serum insulin was significantly higher in the studied groups than in healthy control group. The senile group showed significant reduction in glucose tolerance [KG 1.36 +/- 0.3%/min], decreased insulin sensitivity index [5.19 +/- 1.4 10[-4] min[-1] /[uIU/ml]] and marked reduction of first phase insulin response [2.45 +/- 0.78 uIU/ml per mg/dl], when compared with the control group. However, the degree of glucose intolerance and insulin insensitivity of the senile group was still significantly less than of type 2 diabetic patients. This study revealed that the insulin resistance seems to be characteristic feature of normal aging process and senility could be considered as an inevitable risk factor for glucose intolerance and metabolic syndrome with its accompanying health hazards. Insulin secretion, insulin clearance and interaction between insulin and target tissues are defective in elderly subjects. These functions are intermediate between healthy controls and type 2 diabetic patients and may predispose the elderly population to the risk of impaired glucose tolerance or diabetes mellitus with its attendant macrovascular and microvascular complications
ABSTRACT
Obesity is becoming a world - wide problem associated with a multitude of potential risks and complications was to study the prevalence of obesity, glucose intolerance and hypertension and their interaction in a rural community and to compare the rates with those reported in previous studies in / 985 and / 989, all carried out in a El Hasina village in Dakahlia province. 500 individuals, were subjected to thorough history taking and clinical examination. Blood pressure was measured with standard sphygmomanometer and hypertension was diagnosed according to the JNC VI criteria. Body mass index [BMI] was considered as an index of obesity. Fasting and postprandial blood glucose were assayed utilizing a portable reflectance apparatus. The prevalence of obesity in 2002 was found to be 56.2%: of them 28.8% were overweight, 26% were obese and 1.4% had morbid obesity. These figures are higher than those reported in the previous study carried out during 1985 [21.45%]. The increased prevalence of obesity from 1985 to 2002 denotes that obesity is becoming an over-endemic diseases in Egypt and a great challenge to health authorities. The prevalence of DM increased from 5.2% in 1989 to 1/6% in 2002, and the prevalence of IGT increased fro 6.2% in 1989 to 7.4% in 2002: probably indicating that JGT and DM are becoming an endemic problem in Egypt. Both DM and IGT were more common among obese [15.3% and 11.4%, respectively,] than non-obese [6.8% and 2.3%, respectively]. In our study. the total prevalence of HTN among the studied individuals was / 6.4%. Hypertension was found to be more prevalent among obese [24.9%] than non-obese [5.5%] individuals. and Increasing the degree of obesity was associated with an increased prevalence of hypertension