Analytical review: The pathogenesis of diabetes mellitus and its relationship to biological aging

Summary Recent studies on the pathogenesis of diabetes mellitus have been reviewed. The tendency to develop the disease is inherited, but other factors influence its expression, particularly aging. The hypothesis is advanced that diabetes is a heterogeneous disorder along a continuum of severity; its basis is a thrifty genotype that promotes survival both under conditions of privation, and in early stages of the lifespan, at the expense of accelerated aging later in the lifespan and/or under conditions of excess.Supported by grants from the Medical Research Council of Canada and the Canadian Diabetic Association Foundation Fund, during the tenure of a scholarship from the Medical Research Council.