GLIM Criteria at Hospital Admission Predict 8‐Year All‐Cause Mortality in Elderly Patients With Type 2 Diabetes Mellitus: Results From VIDA Study

• Published in: JPEN. Journal of parenteral and enteral nutrition 2020-11, Vol.44 (8), p.1492-1500
• Main Authors: Sanz‐París, Alejandro, Martín‐Palmero, Angela, Gomez‐Candela, Carmen, García‐Almeida, Jose M., Burgos‐Pelaez, Rosa, Sanz‐Arque, Alejandro, Espina, Silvia, Arbones‐Mainar, Jose M.
• Format: Article
• Language: English
• Subjects: Aged; diabetes; Diabetes Mellitus, Type 2 - complications; Hospitals; Humans; Leadership; malnourished; Malnutrition; MNA‐SF; Retrospective Studies; survival
• ISSN: 0148-6071; 1941-2444
• DOI: 10.1002/jpen.1781

Background Diabetes and older age are associated with an increased risk of malnutrition and mortality. Recently, the Global Leadership Initiative on Malnutrition (GLIM) provided a 2‐step approach for the malnutrition diagnosis. In this study, we aimed to determine whether GLIM nutrition status at admission was associated with long‐term survival in elderly patients with type 2 diabetes mellitus (T2DM). Additionally, we aimed to identify which GLIM criteria were more able to become prognostic indicators of early or late death. Methods Our study included a convenience sample of 159 patients with T2DM older than 65 years and admitted to the internal medicine wards of different Spanish hospitals: the VIDA‐survival cohort. Nutrition status was retrospectively assessed with the new GLIM criteria. The main outcome was long‐term mortality in the cohort during an 8‐year follow‐up. Bivariate tables summarized the variables of interest. Kaplan‐Meier survival curves and adjusted Cox regressions were also performed. Results According to the GLIM criteria, we observed that the 35.8% and 16.3% of the VIDA‐survival cohort were categorized as having moderate and severe malnutrition, respectively. Severe malnutrition was associated with increased mortality (hazard ratio [HR] = 2.09; 95% CI, 1.29–3.38), compared with nonmalnourished participants. Moderate malnutrition had a neutral effect on all‐cause mortality (HR = 1.30; 95% CI, 0.88–1.92). Low plasma albumin levels, a surrogate marker of inflammation, were strongly associated with early mortality. Conclusion Our study provides evidence that severe malnutrition according to GLIM criteria is associated with increased long‐term all‐cause mortality among elderly individuals with T2DM.