Endocrine Abstracts

Objective: To test the reliability of the classic diabetic survey (DS) in the diagnosis of malnutrition in elderly patients with diabetes mellitus (DM).

Patients and Methods: Analytical study of 55 patients aged over 65 years who were hospitalized in the Endocrinology Department. A DS was performed for all patients. The diagnosis of malnutrition was established according to the criteria proposed by the HAS 2021. Two subgroups were compared: G1 (n=18) undernourished seniors. G2 (n=30) non undernourished senior.

Results: The mean age of the included seniors was 71.4±6.6 years with a female prevalence (53.7%). Very old patient with DM (>70 years) represented 46.3% of our population. The mean HbA1C level was 11.2±3.2%. Significant glycaemic imbalance (HbA1C>10%) was reported in 77.8% of cases. The majority of patients were treated with insulin (84.9%). The mean BMI was 26.7±5.5 kg/m^². The mean daily energy intake was slightly lower in G1 without statistical significance. The ROC curve study of the DS variable shows an area under the curve of 0.62 with CI95%=[0.44-0.81]. The DS is thus an unreliable tool for determining the nutritional status of elderly patients with DM with a very poor sensitivity (57.7%) and specificity (40%).

Discussion: Malnutrition is a pathology that accompanies and aggravates the various geriatric syndromes. The daily caloric intake estimated by a classic DS does not indicate the nutritional status of elderly patients with DM. To better detect malnourishment in the geriatric population, we recommend the use of more reliable clinical tools such as the Mini-nutritional Assessment (MNA) score.

References: 1. Cascio, Brooke L., and John V. Logomarsino. "Evaluating the effectiveness of five screening tools used to identify malnutrition risk in hospitalized elderly: A systematic review." Geriatric Nursing 39.1 (2018): 95-102.

2. Orsitto, Giuseppe, et al. "Nutritional status in hospitalized elderly patients with mild cognitive impairment." Clinical Nutrition 28.1 (2009): 100-102.