Which factor(s) associated with aging contribute(s) to the high incidence of type 2 diabetes mellitus in older adults? (Select all that apply.)
a. Fewer T-lymphocytes
b. Less lean muscle mass
c. Decreased thyroid function
d. Decreased physical activity
e. Left ventricular hypertrophy
f. Decreased insulin sensitivity
B, C, D, F
Less lean muscle mass means that the body has fewer insulin receptor sites; thus glucose circu-lates in the blood stream longer, leading to hyperglycemia and type 2 diabetes mellitus. De-creased thyroid function decreases the metabolic rate. If the metabolic rate decreases without a corresponding decrease in caloric intake, then the body consumes more food than it needs for its metabolic rate and hyperglycemia occurs. Decreased physical activity contributes to type 2 di-abetes in two ways. First, a less active person has less lean muscle mass than an active person. Second, physical activity helps metabolize glucose; if activity decreases and food consumption does not decrease, then hyperglycemia occurs. Insulin sensitivity decreases with age and in-creases the need for insulin in older adults. To prevent hyperglycemia, the older adult must in-crease physical activity and decrease food consumption.
Fewer T-lymphocytes are associated with age-related changes caused by autoimmune reactions wherein the body recognizes itself as a foreign substance and works to destroy it. Type 1 diabetes mellitus is considered an autoimmune disorder. Left ventricular hypertrophy is not directly related to the increased incidence of type 2 diabetes in older adults; however, if hyper-trophy leads to exercise intolerance, then it can be related to an increased incidence of type 2 di-abetes.
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