Insulin resistance in the elderly: The Rotterdam Study

Abstract

Insulin resistance is a diminished ability to keep the serum glucose low with insulin levels in the normal range. Subjects with raised insulin resistance therefore usually have increased serum insulin levels. When the B-cells of the pancreas are no longer able to produce these increased amounts of insulin, serum glucose increases and diabetes mellitus develops. Raised insulin resistance and the ensuing hyperinsulinemia increase with age. Because hyperinsulinemia is a risk factor for several (chronic) diseases which are common in the elderly, insulin resistance was assessed as part of a large population-based study to chronic diseases in the elderly, the Rotterdam Study. In this first chapter a general description of the Rotterdam Study is given, with an overview of the measurements of the glucose metabolism. This is followed by a review on the oral glucose tolerance test. Finally, the results of a validation study are reported on the nonfasting oral glucose tolerance test, as used in the Rotterdam Study