Diabetes, Atherosclerosis, and Aging

There is a close and intimate relationship between advancing age, diabetes, and atherosclerosis. Atherosclerosis and its complications in the heart, brain, and lower limbs become more common with advancing age. Diabetes, especially non-insulin-dependent diabetes mellitus, also becomes increasingly prevalent with advancing age and predisposes to premature and accelerated atherosclerosis. Both aging and diabetes are associated with hyperglycemia, hyperinsulinemia, insulin resistance, and hypertension, and these four abnormalities are related to each other and, both individually and in combination, with atherosclerosis. Abnormal lipid levels are less consistently related to age but are found in both diabetes and atherosclerosis. There have been few studies of the effect of reducing cardiovascular risk factors in elderly people, but it is reasonable to advise regular physical activity and avoidance of obesity and cigarette smoking.