CHARACTERISTICS OF NON-INSULIN-DEPENDENT DIABETES-MELLITUS IN ELDERLYMEN - EFFECT MODIFICATION BY FAMILY HISTORY

Background. Heredity, obesity and fat distribution may interact with e ach other in their association with diabetes risk. Therefore we tried to elucidate the role of familial diabetes as effect modifier in the a ssociation of obesity, glucose metabolism and lipoproteins with non-in sulin-dependent diabetes mellitus. Methods. A cross-sectional study wa s carried out among 468 elderly men. Within strata of family history, men with diabetes and normal glucose tolerance were compared with resp ect to anthropometry, characteristics of glucose metabolism and serum lipids. Results. Of the participants, 14.5% were diabetic. In diabetic men a family history of diabetes occurred more often (22.1%) than in men with normal (6.8%, P < 0.001) or impaired glucose tolerance (8.5%) , In diabetic men with a family history, the ratio of fasting insulin to glucose and the ratio of areas under the insulin and glucose curves during oral glucose tolerance testing were lower compared to men with normal glucose tolerance, In men without a family history, these diff erences were smaller (interaction P = 0.06). In diabetic men without a family history, lasting insulin levels were markedly elevated (P < 0. 001), whereas in men with a family history there was only a slight ele vation. The presence of a family history resulted in more severe deter iorations in lipids, especially in lasting triglycerides (interaction P = 0.075). No interaction between indices of obesity and a family his tory was observed. Conclusions Our findings suggest that elderly diabe tic men with a family history of diabetes represent a different subgro up than elderly men without such a history, characterized by larger de teriorations in indices for beta-cell function and higher triglyceride levels.