Insulin Resistance and Diseases in the Elderly

In this prospective study we aimed to compare insulin plus acarbose with insulin plus gliclazide with respect to their effect on insulin requirement, lipid profiles and body mass index (BMI) while achieving good glycemic control. Forty patients with type 2 diabetes mellitus who were on conventional insulin therapy (subcutaneous insulin therapy consisting of regular and NPH insulin, two times a day) were included in the study. They were randomized to double blind treatment with insulin in combination with gliclazide or acarbose for 6 months. For both groups, acceptable glycemic control was achieved at the end of study period. The mean HbA(1c) levels decreased from 8.32+/-0.26 to 7.13+/-0.18% in acarbose group and 8. 6+/-0.15 to 7.48+/-0.21% in the gliclazide group. The difference between groups was not significant (P 0.29). In the acarbose group, total cholesterol and LDL concentration decreased significantly while other parameters did not change. In the gliclazide group, HDL levels decreased significantly from 46.6+/-2.48 mg/dl to 41.3+/-2.09 mg/dl (P 0.001) BMI increased significantly from 27.60+/-1.21 kg/m(2) to 28.69+/-1.26 kg/m(2). (P 0.003) Total daily insulin dose was not changed in the acarbose group significantly, but increased from 42.6+/-2.73 to 49.27+/-3.58 U/day, which was significant in gliclazide group of (P 0.016). In the acarbose group, there were no significant differences between responders and nonresponders with respect to fasting and stimulated C-peptide, HbA(1c) levels and baseline BMI values. But in the gliclazide group, baseline BMI values were significantly higher in the nonresponding group compared to responders (P 0.02). In conclusion, combination of insulin with acarbose can be a good alternative for type 2 diabetic patients on insulin therapy; seems more beneficial than combination with gliclazide; may have advantage of achieving good glycemic control without increasing insulin dose and BMI; also may have the advantage of providing a decrease in LDL level, which are all important to prevent atherosclerosis.

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Effect of Aging on the Development of Glucose Intolerance Induced by a Low-Carbohydrate Diet in Rats

Kaneko

Wang

et al. 2003

JOURNAL OF HEALTH SCIENCE

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The effect of aging on the development of glucose intolerance between 2 kinds of diets, a low-carbohydrate/ high-fat (LC/HF) diet and a control diet was investigated. A total of 20 eight-week-old S.D. rats were randomly divided into 2 groups of 10 rats each and at 10, 20, 40, 60 and 80 weeks of age, rats were switched to either control or LC/HF diet for 7 days. At 16:00 on the day following the 7th day of feeding, rats underwent an oral glucose tolerance test (OGTT). LC/HF feeding for 7 days impaired the glucose tolerance in rats. Moreover, insulin secretion decreased with age and insulin resistance increased after 60 weeks of age when rats were fed the LC/HF diet, and fasting plasma free fatty acids (FFA) concentrations increased with age. Thus, we speculated that the age-related impairment of insulin action through the glucose fatty-acid cycle might be closely associated with the onset and development of diabetes mellitus.Key words ---aging, carbohydrate, glucose tolerance, insulin resistance, insulinogenic index, rat age and diet on insulin secretion and insulin action in rats. However, the diets that they used were not isocaloric and the concentrations of nutrients were not constant. In this study, we gave test diets for 7 days to rats of various ages up to 80 weeks old, which corresponds to middle-age in humans, and we compared the effect of aging on the development of glucose intolerance between the 2 kinds of diets, a LC/HF diet and a control diet using a pair-feeding method.

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Insulin Resistance and Diseases in the Elderly

Cited by 3 publications

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Homeostasis model assessment of insulin resistance and the risk of cardiovascular events in middle-aged non-diabetic Japanese men

Homeostasis model assessment of insulin resistance and the risk of cardiovascular events in middle-aged non-diabetic Japanese men

Effects of combination of insulin and acarbose compared with insulin and gliclazide in type 2 diabetic patients

Effect of Aging on the Development of Glucose Intolerance Induced by a Low-Carbohydrate Diet in Rats

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