Easy-to-use clinical criteria for screening malnutrition in older patients with type 2 diabetes mellitus.

INTRODUCTION. In the daily practice, the mini-nutritional assessment short form (MNA-SF) is not systematically performed in geriatric inpatients. This study aimed at identifying some easy-to-use and effective clinical criteria for screening malnutrition in geriatric patients with diabetes. METHODS. Cross-sectional study in 172 older diabetic patients (83±4 years) admitted in a Belgian academic hospital. We compared the patients with malnutrition (MNA-SF≤7/14) to those without malnutrition in terms of the five MNA-SF items (see below) and mid-arm circumference (MAC), using χ2 and t-tests. RESULTS. The 44 diabetic patients with malnutrition (26%), as compared to the 128 without malnutrition, were similar in age and gender but presented smaller MAC (25.2±3 vs. 28.6±4 cm, n=151, p<0.001). MAC<27 cm (median value) was more frequent in patients with malnutrition (68vs.32%, p<0.001) and offered fair screening characteristics (sensitivity 68%, specificity 67%). Comparing the MNA-SF items in patients with and without malnutrition, we observed differences in mobility problems (scores: 0.84vs.1.25; ∆=0.41), neuropsychological troubles (1.02vs.1.48; ∆=0.46), body mass index (1.41vs.2.68; ∆=1.27, n=121) and in reports of weight loss (0.82vs.2.13; ∆=1.31), psychological stress/acute disease (1.09vs.1.69; ∆=0.60) and food intake decline (0.59vs.1.46; ∆=0.87) over the past 3 months. CONCLUSIONS. The largest score differences in MNA-SF items between the two groups were body mass index (missing data in 30%), food intake decline or weight loss over the previous three months. Any of these three criteria or MAC