Decrease in glucose-stimulated insulin secretion with aging is independent of insulin action

Diabetes. 2004 Feb;53(2):441-6. doi: 10.2337/diabetes.53.2.441.

Abstract

While the incidence of diabetes increases with age, a decrease in beta-cell function independent of age-related insulin resistance has not been conclusively determined. We studied insulin secretion (by hyperglycemic clamp) in 3-, 9-, and 20-month-old chronically catheterized, awake, Sprague Dawley (SD) rats (n = 78). Insulin action was modulated in a group of old rats by caloric restriction (CR) or by surgical removal of visceral fat (VF-). During the first 2 h of the clamp (11 mmol/l glucose), insulin secretion and insulin resistance (S(i hyper clamp)) demonstrated the characteristic hyperbolic relationship. However, after hyperglycemia for an additional 2 h, the ability to maintain insulin secretion, commensurate with the degree of insulin resistance, was decreased in all aging rats (P < 0.05). Increasing plasma glucose levels to 18 mmol/l glucose, after clamp at 11 mmol/l, increased insulin secretion by approximately threefold in young rats, but failed to induce similar magnitude of response in the aging rats ( approximately 50%). However, elevation of plasma free fatty acid (FFA) levels by twofold (by intralipid infusion during 11 mmol/l glucose clamp) resulted in a robust, approximate twofold response in both young and old rats. Thus, prolonged stimulation by hyperglycemia unveiled a functional defect in insulin secretion with aging. This age-related defect is independent of insulin action and is specific to glucose and not FFAs. We suggest that prolonged hyperglycemic stimulation can be a tool to identify functional defects in insulin secretion, particularly in the context of the hyperbolic relationship with insulin action, in elderly subjects or those at risk for type 2 diabetes.

MeSH terms

  • Aged
  • Aging / physiology*
  • Animals
  • Blood Glucose / metabolism*
  • Diet, Reducing
  • Fatty Acids, Nonesterified / blood
  • Glucose / pharmacology*
  • Glucose Clamp Technique
  • Humans
  • Hyperglycemia
  • Insulin / blood*
  • Insulin / metabolism*
  • Insulin / physiology
  • Insulin Secretion
  • Models, Animal
  • Rats
  • Rats, Sprague-Dawley

Substances

  • Blood Glucose
  • Fatty Acids, Nonesterified
  • Insulin
  • Glucose