Abstract
Background:
Type II Diabetes Mellitus (T2DM) is a common condition managed by geriatricians. Drugs and treatment goals for T2DM are individualized to patient profile and physician preference. Some diabetic medications are also known to affect appetite and subsequently, nutrition. The authors examined whether there is a correlation between glycemic control and malnutrition in older adults.
Methods:
This cross-sectional study enrolled patients > 70 with T2DM in a teaching hospital in Singapore. Data was collected on age, sex, ethnicity, body-mass index (BMI), function (iADL-impairment), Barthel’s score and cognitive scores (Abbreviated Mental Test), as well as the last glycated hemoglobin (HbA1c) reading. Nutritional assessment was performed using Mini Nutritional Assessment (MNA) screen. Univariate analysis and logistic regression analysis were performed to determine predictors of malnutrition.
Results:
Overall, 135 patients were recruited (57.1% male, mean age 85.6 [6.1] years). 75 patients (56.7%) were classified to have moderate or severe disability by Barthel’s and 19 (14.1%) had a BMI classified as underweight. 76 (56.7%) patients were considered to have good glycemic control (HbA1c < 7%) and 58 (43.3%) were not on any medications. Prevalence of patients with or at risk of malnutrition was high with 105 (77.8%) scoring MNA < 12. On univariate analysis, factors such as age, BMI, Barthel’s score, iADL-impairment and AMT scores were significantly associated with malnutrition. Multivariate logistic regression analysis showed that there was no association between good glycemic control and malnutrition (aOR 0.95, [0.14, 2.47], p=0.467)
Conclusion:
Good glycemic control was not significantly associated with malnutrition after adjusting for confounders. Older adults at baseline have increased risk of malnutrition and more education delivered towards a proper diet.