Multiple Antihyperglycemic Drug Use is Associated with Undernutrition Among Older Adults with Type 2 Diabetes Mellitus: A Cross-Sectional Study

• Published in: Diabetes therapy Vol. 10; no. 3; pp. 1005 - 1018
• Main Authors: Tasci, Ilker, Safer, Umut, Naharci, Mehmet Ilkin
• Format: Journal Article
• Language: English
• Published: Cheshire Springer Healthcare 01.06.2019; Springer; Springer Nature B.V
• Subjects: Aged; Aging; Analysis; Cardiology; Cognition & reasoning; Complications and side effects; Cross-sectional studies; Diabetes; Diabetes therapy; Diabetics; Diet; Dosage and administration; Drug therapy; Drug use; Endocrinology; Food habits; Health aspects; Hypoglycemic agents; Internal Medicine; Malnutrition; Medicine; Medicine & Public Health; Mental depression; Nutrition; Nutritional status; Older people; Original Research; Pharmacology, Experimental; Physiological aspects; Polypharmacy; Product/Service Evaluations; Risk factors; Type 2 diabetes; Weight; Turkey; Antihyperglycemic medications; Diabetes overtreatment; Diabetes mellitus; Glycated hemoglobin; Diabetes undertreatment; Malnutrition; Elderly; Undernutrition
• ISSN: 1869-6953; 1869-6961
• DOI: 10.1007/s13300-019-0602-x

Introduction Undernutrition is prevalent in older age. Current management of type 2 diabetes mellitus (T2DM) requires modified diet patterns; however, older adults with diabetes may also be at the risk of undernutrition due to age, disease, and medication-related factors. Our objectives in this study were to examine the proportion and associations of undernutrition among community-dwelling older adults with T2DM. Methods This prospective, cross-sectional study involved older outpatient adults (≥ 65 years) with and without T2DM. We assessed the nutritional status using the Mini Nutritional Assessment-Short Form. Undernutrition referred to being either at risk of malnutrition or malnourished. Variables independently associated with undernutrition were evaluated by logistic regression analysis. Results Five hundred forty-six older adults [ n  = 215 with T2DM and n  = 331 control; mean (SD) age, 74.9 (6.3) years; 388 (71.1%) female] were included in the study. The frequency of undernutrition was 31.1%, which was higher in patients with T2DM than in those without (36.7% vs. 27.5%, p  < 0.05). However, the difference was no longer significant after adjustment for covariates (gender, lower education, lower body mass index, cardiovascular disease, multimorbidity, cognitive performance, functional performance, depressive symptoms, and polypharmacy). In the T2DM group, the ratio of multiple antihyperglycemic drug use (≥ 2) was higher in those with undernutrition compared with normal nutritional status (78.5% vs. 59.6%, p  = 0.005). On multivariable analysis, decreased functional performance, depressive symptoms, and use of multiple antihyperglycemic drugs were associated with undernutrition in patients with T2DM. Conclusions Undernutrition was more common among older adults with T2DM compared with the control group. Undernutrition was further dependent on chronic conditions and diabetes management.