Early Detection of Malnutrition in Elderly Patients with DM: The Key Importance of Functional Examination

Introduction and Objective: Malnutrition in older patients with diabetes mellitus (DM) is a serious health problem. With increasing average life expectancy, the number of diabetics aged 65+ is also growing. Early and accurate diagnosis of malnutrition will be an essential part of proper DM treatment. The presence of malnutrition has a significant impact on quality of life and the choice of optimal DM therapy, especially when considering the full potential of glucagon-like peptid analogues.The main objective of the project is to evaluate the limitations of methods currently used for the early detection of malnutrition in patients with DM over the age of 65 (median age 73 years, 98 % DM2T, 52 % men). Methods: Patients underwent the following examinations: laboratory tests focusing on nutritional status, bioimpedance analysis (Inbody 270), Nutritional Status Assessment Questionnaire - PSNPO (movement, strength, nutrition, falls, illness), functional examination (sit-stand-sit test, 4m walking speed test, ability to walk for 20 minutes, feeling of weakness, need for rest during the day). Results: Laboratory results showed no abnormalities in terms of malnutrition. According to bioimpedance (median, 5th-95th percentile), the absolute amount of skeletal muscle mass was 35.8 kg (30.2-40.7) in men and 26.4 kg (22.4-32.0) in women, and total body fat percentage was 27 % (14.0-41.0) in men and 35 % (23.0-51.0) in women. The PSNOP Questionnaire revealed 6 % of malnourished patients. 16 % of people cannot manage a 20- minute walk, 40 % of people feel weak, and 56 % of respondents report feeling the need to rest during the day. Conclusion: In the early stages of malnutrition, standard laboratory tests are not sensitive enough for diagnosis, unlike functional tests. The conclusions of our study highlight the need to include functional testing of elderly diabetics. Disclosure: D.J. Zdarska: None. N. Stourac: None. R. Chloupková: None. T. Dianová: None. K. Hejcmanová: None. M. Kvapil: Advisory Panel; Ended; Abbott, Boehringer Ingelheim International GmbH, GlaxoSmithKline plc., Novo Nordisk. Funding: CZ.03.02.02/00/22_005/0000282