Nutritional Screening of Outpatient Type 2 Diabetes Mellitus Patients

Objective: To examine the parameters affecting the existence and prevalence of malnutrition in type 2 diabetic patients at initial presentation Design: Cross-sectional study Setting: Department of Internal Medicine, Sakarya University Research and Education Hospital, Turkey Subjects: Nutritional screening of 580 outpatients with the diagnosis of type 2 diabetes who presented to an outpatient clinic Intervention: Medical treatment of diabetic patients Main outcome measure: The parameters affecting the existence and prevalence of malnutrition in type 2 diabetic patients Results: Mean +/- standard deviation age of the patients was 54.6 +/- 10.7 years. Of the 580 patients, 327 were women (56.4%). Malnutrition prevalence was 11.4% with Subjective Global Assessment and 9% with Mini Nutritional Assesment and Malnutrition Universal Screening Tool. Body mass index (BMI), albumin, fat%, mid-arm circumference and calf circumference were significantly lower and glycated hemoglobin (HbA1c) was significantly higher inpatients with malnutrition, compared to patients without malnutrition. Malnutrition was significantly associated with weight loss, change in dietary intake and diminished physical activity (p = 0.005). Logistic regression model, including BMI <= 30.35 kg/m(2), HbA1c >= 8.69 mmol/mol, fat% <= 35.85% cut-off values, presence/abscence of change in dietary intake and diminished physical activity as independent predictors of malnutrion revealed that patients with HbA1c >= 8.69 mmol/mol, fat% <= 35.85%, who had change in dietary intake or had diminished physical activity were 3.7, 2.9, 29.2 and 4.4 times more likely to have malnutrition. Conclusion: Type 2 diabetic patients are often obese and thus higher cut-off for BMI and fat% may be necessary to detect malnutrition. Poor glucose control, decreased fat%, change in dietary intake and especially diminished physical activity are independent predictors of malnurition in this population.