We were very interested to read Lanza and Nair's article in a recent issue of the Journal in which they report on what touches on the fascinating subject of muscle mitochondria, aging, and the physiologic consequences of exercise (1). They also mention a related subject of insulin resistance in type 2 diabetes. Encouraging the elderly to exercise as well as patients with type 2 diabetes and the obese would appear to be obvious because a sedentary way of life is one of the risk factors associated with diabetes and obesity. Insulin resistance and the associated problems of decreased glucose transport and decreased muscle cell metabolism are symptomatic of diabetes (2) and suggest that the problem may be one of lowered substrate supply for metabolic function. This mitochondrial dysfunction would fit with the symptoms of aging as well as of diabetes (2).
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