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首页> 外文期刊>The journals of gerontology.Series A. Biological sciences and medical sciences >Prevalence and determinants of impaired glucose metabolism in frail elderly patients: the Belgian Elderly Diabetes Survey (BEDS).
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Prevalence and determinants of impaired glucose metabolism in frail elderly patients: the Belgian Elderly Diabetes Survey (BEDS).

机译：衰弱的老年患者中葡萄糖代谢异常的发生率和决定因素：比利时老年糖尿病调查（BEDS）。

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BACKGROUND: Although diabetes in elderly persons is generally type 2, the metabolic abnormalities associated with aging suggest that elderly persons may differ from younger persons with type 2 diabetes. In addition, nonobese elderly persons with type 2 diabetes show a marked impairment in insulin release accompanied by mild insulin resistance, whereas obese elderly persons have marked insulin resistance in the presence of "adequate" levels of insulin. Other factors that could adversely affect glucose tolerance in aging include drug use, associated disease, and other stressful conditions commonly encountered in geriatric inpatients units. The authors' objectives in this study were 1) to prospectively assess the prevalence of glucose homeostasis abnormalities among elderly hospitalized patients and the degree to which it reflects abnormalities in insulin secretion or insulin sensitivity using homeostasis model assessment of fasting glucose, insulin, and C-peptide; and 2) to define the social, functional,pathologic, and nutritional characteristics of persons with impaired glucose tolerance or diabetes. METHODS: Ninety-eight patients underwent a comprehensive geriatric assessment. Determinants of glucose homeostasis were assessed using the homeostasis model assessment, which provides estimates of beta-cell function (%B) and insulin sensitivity (%S). RESULTS: Twelve patients (12%) had fasting glucose concentrations greater than 110 mg/dl. Four patients had impaired fasting glucose levels greater than 110 mg/dl but less than 126 mg/dl (IFG group), and 8 patients had levels greater than 126 mg/dl (type 2 diabetes group). Except for a higher proportion of women in the IFG-diabetes group, the latter did not exhibit significant differences in functional, morbidity, or nutritional characteristics compared with the normal glucose tolerance group. The entire cohort (n=98) presented with a mean (+/-SD) %B of 71%+/-47% and a mean %S of 208%+/-198%. Compared with the normal glucose tolerance group, the IFG-diabetes group had a fasting glycemia level of 142+/-24 mg/dl (vs 92+/-9 mg/dl), a %B of 43%+/-21% (vs 74%+/-45%), and a mean %S of 126%+/-113% (vs 219%+/-205%). CONCLUSIONS: These data confirm the high prevalence of impaired glucose metabolism among elderly people, although the usual risk factors were not significantly increased. Marked beta secretory defects seem to be the rule, whereas a significant degree of insulin resistance is unusual.
机译：背景：尽管老年人的糖尿病通常为2型，但与衰老相关的代谢异常表明，老年人可能与2型糖尿病的年轻人不同。此外，患有2型糖尿病的非肥胖老年人在胰岛素释放方面表现出明显的损害，并伴有轻度的胰岛素抵抗，而肥胖的老年人在存在“适当”水平的胰岛素时具有明显的胰岛素抵抗。可能对衰老过程中的葡萄糖耐量产生不利影响的其他因素包括药物使用，相关疾病以及老年住院病房中常见的其他压力性疾病。作者在本研究中的目的是：1）前瞻性评估空腹血糖，胰岛素和C-稳态的稳态模型评估在老年住院患者中的葡萄糖稳态异常的患病率及其反映胰岛素分泌或胰岛素敏感性异常的程度。肽2）定义糖耐量受损或糖尿病患者的社会，功能，病理和营养特征。方法：98例患者接受了全面的老年医学评估。使用稳态模型评估来评估葡萄糖稳态的决定因素，该模型评估提供了β细胞功能（％B）和胰岛素敏感性（％S）的估计值。结果：12名患者（12％）的空腹血糖浓度大于110 mg / dl。空腹血糖水平受损的四名患者大于110 mg / dl但小于126 mg / dl（IFG组），而8名患者的空腹血糖水平大于126 mg / dl（2型糖尿病组）。除了IFG糖尿病组中女性比例较高外，后者与正常的糖耐量组相比在功能，发病率或营养特征上没有显着差异。整个队列（n = 98）的平均（+/- SD）％B为71％+ /-47％，平均％S为208％+ /-198％。与正常的葡萄糖耐量组相比，IFG-糖尿病组的空腹血糖水平为142 +/- 24 mg / dl（vs 92 +/- 9 mg / dl），％B为43％+ /-21％ （vs 74％+ /-45％）和平均％S为126％+ /-113％（vs 219％+ /-205％）。结论：这些数据证实了老年人中葡萄糖代谢受损的高发生率，尽管通常的危险因素并未显着增加。明显的β分泌缺陷似乎是规则，而相当大程度的胰岛素抵抗是不寻常的。

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