Association between Degrees of Malnutrition and Clinical Outcomes among Non-critically Ill Hospitalized Adult Patients with Type 2 Diabetes Mellitus

Freyja Diana Ramos; Joy Arabelle Fontanilla; Reginna Emiliene Lat

doi:10.15605/jafes.036.02.12

Authors

Freyja Diana Ramos St. Luke’s Medical Center, Global City, Taguig, Philippines https://orcid.org/0000-0001-8395-3293
Joy Arabelle Fontanilla St. Luke’s Medical Center, Global City, Taguig, Philippines https://orcid.org/0000-0002-4807-694X
Reginna Emiliene Lat St. Luke’s Medical Center, Global City, Taguig, Philippines

DOI:

https://doi.org/10.15605/jafes.036.02.12

Keywords:

malnutrition, hospital outcome, diabetes mellitus

Abstract

Introduction. Malnutrition among hospitalized patients is highly prevalent. This adversely affects outcomes with longer length of stay (LOS), higher treatment costs and increased mortality. People with diabetes mellitus (DM) are particularly vulnerable to malnutrition and its consequences.

Objective. To determine the association of nutritional status with LOS and mortality among adults with Type 2 DM.

Methodology. This was a retrospective study of 439 adult patients with type 2 diabetes admitted in the medical ward of a tertiary hospital from January 1, 2018 to December 31, 2018. Demographics, anthropometrics, feeding route, LOS and outcomes were taken from the Clinical Nutrition Service database; biochemical data were taken from the Healthcare System, and were analyzed.

Results. In our analysis, 83.8% were found to be malnourished with 50.3% moderately-malnourished (MM) (Nutrition risk level 1-2) and 33.5% severely-malnourished (SM) (Nutrition risk level ³3). BMI category and malnutrition were the significant confounders for LOS. After controlling for BMI, LOS was longer by a mean of 2.2 days in SM compared to well-nourished (WN) patients (95% CI=0.49-3.95, p=0.012). Of the malnourished patients, 6.1% of SM and 0.5% of MM patients died. None of the WN patients died. Feeding route, admitted for neoplasm, low albumin levels and malnutrition were the confounding factors associated with mortality. After controlling for these factors, SM had higher odds of dying compared to MM patients [adjusted OR=8.91 (95% CI=1.04-76.18, p=0.046)].

Conclusion. Among hospitalized non-critically ill adult patients with type 2 diabetes, SM patients but not MM patients had significantly longer LOS compared to WN patients, and greater degrees of malnutrition were associated with higher mortality.

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Author Biographies

Freyja Diana Ramos, St. Luke’s Medical Center, Global City, Taguig, Philippines

Center for Diabetes, Thyroid and Endocrine Disorders

Joy Arabelle Fontanilla, St. Luke’s Medical Center, Global City, Taguig, Philippines

Center for Diabetes, Thyroid and Endocrine Disorders, St. Luke’s Medical Center, Global City, Taguig, Philippines

Head, Center for Weight Intervention and Nutrition Services, St. Luke’s Medical Center, Global City, Taguig, Philippines

Associate Professor,San Beda University College of Medicine

Reginna Emiliene Lat, St. Luke’s Medical Center, Global City, Taguig, Philippines

Center for Weight Intervention and Nutrition Services

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