Nippon rinsho. Japanese journal of clinical medicine 2013-11-01

[Endocrinological aspects of diabetes mellitus in the elderly].

Kiyoshi Hashizume

Index: Nihon Rinsho. 71(11) , 1941-7, (2013)

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Abstract

Glucose-mediated energy production in central nervous system(CNS) reduces in the elderly. The reduction is also observed in young patients with diabetes mellitus(DM). Deviated endocrinological function is observed in both the elderly and young patients with DM. The deviation is characterized by mechanism of adaptation to the insufficient energy production in CNS. The decrease of glucose-mediated energy production is accelerated by decrease of the activity of growth hormone-insulin-like growth factor 1 axis and of conversion of thyroxine to triiodothyronine. These decreases are suitable for adaptation to the insufficient CNS activity induced by energy deficiency. Glucagon- and catecholamine-induced increases in plasma glucose level contribute to increase energy production. Parathyroid hormone action is activated in the elderly, which contributes to the inhibition of excess signal transduction in energy-deficient CNS. These deviations are considered as adaptations to the energy deficiency observed in aged patients with DM.