The impact of malnutrition and probable sarcopenia on mortality in older patients with type 2 diabetes.

AIM: Malnutrition and sarcopenia are prevalent yet underdiagnosed in older patients with type 2 diabetes mellitus (T2DM). This study investigates their independent and combined effects on all-cause mortality in an outpatient cohort.

METHOD: A total of 823 older patients with T2DM who underwent comprehensive geriatric assessment were included in this retrospective study. Nutritional status was assessed using the Mini Nutritional Assessment, and probable sarcopenia was defined according to EWGSOP2 criteria. Survival was analyzed using Kaplan-Meier and Cox regression models.

RESULTS

The mean age was 81.4 ± 7.3 years, and 71% were female. The prevalence of probable sarcopenia, risk of malnutrition and malnutrition was 39.6%, 43.4% and 16.7%, respectively. Probable sarcopenia was associated with shorter survival (50.1 vs 63.6 months, p < 0.001). Risk of malnutrition and malnutrition (16.7%) were also linked to reduced survival (57.9 and 45.7 vs 63.1 months, p < 0.001). Patients with both conditions had the poorest outcomes (42.9 months). Multivariate analysis identified probable sarcopenia (HR 2.33; 95% CI 1.77-3.06), malnutrition (HR 2.71; 95% CI 1.89-3.89), male sex, advanced age, and depression as independent mortality predictors.

CONCLUSION

Probable sarcopenia and malnutrition, independently and in combination, significantly increase mortality risk in older adults with T2DM. These findings support the need for routine nutritional and muscle function screening in geriatric diabetes care to improve risk stratification and outcomes.