The incidence of the metabolic syndrome, which is associated with visceral fat accumulation, hyperlipidaemia, hypertension, and type 2 diabetes mellitus, is raising with age. Insulin resistance and hyperinsulinaemia have been proposed as the causal link between the elements of the metabolic cluster mentioned above. The decrease in insulin action and insulin secretion can be explained by increased fat mass, decreased muscle mass, and by general endocrine changes related to ageing. Due to the increased incidence of cardiovascular diseases with the metabolic syndrome, lifestyle modifications including weight loss achieved by a low-calorie diet and physical activity should be promoted to increase insulin sensitivity and to prevent glucose intolerance and type 2 diabetes mellitus in ageing subjects.