Physiopatology of diabetes in the elderly

The main physiopatological causes of type 2 diabetes in the elderly are related to a decline in insulin secretion and a rise in insulin resistance. With regard to insulin secretion a deficiency in pancreatic B-cell response is restrained to glucose stimuli while it is still unchanged the response to aminoacids and to lipids. As far as the decline in insulin sensitivity is concerned, several causes may be identified. Among them a primary evidence should be on age-related changes in body weight and body composition (mainly accumulate of fat ad abdominal level), in life style and in neuro-hormonal levels. Finaly a possible role of iatrogenic causes can be ruled out.