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

Introduction. Malnutrition is associated with a high mortality risk in older patients with type 2 diabetes mellitus, and can be diagnosed with the mini-nutritional assessment short form (MNA-SF). Nevertheless, in the daily practice, MNASF is not systematically performed in geriatric inpatients, partly due to lack of time and/or missing data. This study aimed at identifying some easy-to-use, easily gathered and effective clinical criteria for screening malnutrition in older patients with diabetes. Methods. Cross-sectional study in older diabetic patients admitted to medical or surgical wards in a Belgian academic hospital (2012-2013). The four inclusion criteria were met by 172 patients (83+/- 4 years old; sex ratio 1:1), i.e. older age (≥75 years), type 2 diabetes mellitus, risk of decline (ISAR ≥2) and comprehensive geriatric assessment (CGA) performed by the internal liaison team. Searching clinical criteria for screening malnutrition, we compared the patients with malnutrition (MNA-SF ≤ 7/14) to those without malnutrition in terms of mid-arm circumference (MAC) and MNA-SF items (scores for mobility and neuropsychological problems, body mass index; history over the past 3 months of weight loss, psychological stress/acute disease or food intake decline). Appropriate statistics were used (χ2 and t-tests) to test the observed differences. Results. Older diabetic patients with malnutrition (n=44, MNA-SF 5.8 +/-1.6), as compared to those without malnutrition (n=128, MNA-SF 10.7+/-1.7), were similar in age and gender but presented with smaller MAC (25.2 +/-3.3 vs. 28.6 +/- 3.9 cm, n=151, p<0.001). MACvs. 32%, ORatio=4.5, χ2 1df 13.7, p