Insulin resistance (IR) and diabetes are common chronic conditions amongst elderly patients, that may lead to increase in abdominal adipose tissue deposits and pancreatic size.

A cross-sectional study was conducted in the geriatric OPD in a tertiary care hospital for a period of six months to correlate fasting C-peptide levels, abdominal adipose tissue thickness, and pancreatic size in poorly controlled diabetic elderly patients. Diabetic elderly patients with HBA1c level >7 % were enrolled with their consent. Body mass index (BMI), fasting C-peptide, abdominal adipose tissue thickness and pancreatic size were measured using standard laboratory techniques. The data obtained were assessed categorically and represented as [n (%)]. T-test was used to compare the two groups (p < 0.05).

A total of 101 patients were enrolled. The study results showed no significant correlation between subcutaneous fat and pre-peritoneal fat thickness; and fasting c-peptide levels (p = 0.801, p = 0.316). However, there was a significant correlation between the fasting c-peptide levels and pancreatic size (p = 0.001). It was also observed the study participants had a decreased pancreatic size, with the mean size being 4.837 cm in males, and 4.4418 cm in females.

Intra-peritoneal fat thickness and pancreatic size can be used as surrogate marker for IR along with C-peptide. All elderly with uncontrolled type 2 diabetes mellitus behaving like type 1 diabetes mellitus needs further evaluation and pathogenic process must be explored. Sarcopenic obesity evaluation must be a part of uncontrolled type diabetes mellitus management.