MODULE SUPPLEMENT: ENDOCRINE SYSTEM
Should Age-Related Changes in
Carbohydrate Metabolism Be Treated?

Recall the Glycosylation/Maillard theory of aging (see The Maillard Theory Of Aging--Note: this link will open in a new browser window). If increased glucose levels cause alterations in tissues and predispose to tissue and cellular damage, it may be important to focus on minimizing the changes that occur in glucose metabolism with age. Exercise can aid in this because it increases insulin sensitivity and promotes retention of lean body mass. In addition, prevention of obesity is important because obesity is also highly associated with insulin resistance. Thus, it remains important not to overlook prevention and early intervention in older adults.

What about diabetes and its diagnosis? Data now suggest that intensive life-style intervention can prevent the development of diabetes in high risk individuals (Hu, Manson, et al., 2001; Mensink, Feskens, et al., 2003; Tuomilehto, Lindstrom, et al., 2001). Currently, the American Diabetes Association guidelines suggest that diabetes should be diagnosed mainly through the use of fasting blood sugar levels. Elahi & Muller (2000) point out that, as compared with the WHO criteria, the ADA criteria would under diagnose diabetes in older individuals. It may thus be helpful to assess blood sugars in older adults two hours after a meal.