Sex-related Differences in Insulin Resistance in the Geriatric Population

Abstract Background: Diabetes mellitus significantly impacts long-term cardiovascular disease, increasing elderly mortality and morbidity. Half of elderly diabetics are asymptomatic, with vague symptoms. Insulin resistance (IR) and pancreatic beta-cell dysfunction are central to diabetes pathophysiology. Gender differences in IR and beta-cell function are increasingly recognized in diabetes research. Methods: In 18-month observational cross-sectional study focusing on elderly patients (60+) done at tertiary hospital in North India included 32 diabetic and 32 healthy controls. Fasting blood sample of eligible subjects were sent for hemogram, hemoglobin A1c (HBA1c), blood glucose, and insulin. IR and beta-cell function were calculated using the homeostasis model assessment (HOMA) model and analyzed using SPSS, with P < 0.05. Results: The mean age of participants was 67.77 years and the average duration of having diabetes was 5.11 years. Median HOMA IR was significantly higher in cases compared to controls (4.23 vs 0.89, P < 0.05), while HOMA β was comparable. HOMA IR decreased with longer diabetes duration, with a more rapid decline in female subjects compared to males. Subgroup analysis showed IR increased with age and was higher in females. Conclusion: Our research highlights gender-based differences in IR in the geriatric age group. Elderly women had higher IR compared to men. These findings are significant in understanding gender-specific metabolic differences and tailoring interventions. Further research with a larger sample size is warranted to corroborate these findings. Clinical Implication: This study addresses the gap in research on IR and beta-cell function in the elderly, particularly in India. This research can be compared with past studies on other age groups, aiding in the development of tailored diabetes treatments and improving therapeutic strategies for the elderly.