P.J. Turnbull*, A.J. Sinclair**

* Birmingham Heartlands Hospital, United Kingdom. ** Section of Geriatric Medicine and Gerontology, University of Warwick, United Kingdom. Correspondence: Professor Alan Sinclair, Director, Successful Ageing Programme, Section of Geriatric Medicine and Gerontology, Centre for Health Services Studies, The University of Warwick, Coventry CV 7AL, United Kingdom. Telephone: +44(0)24 7652 3985. Facsimile: +44(0)24 7652 4963. Email: chssasi@wbs.warwick.ac.uk

BACKGROUND: Despite all that is known about diabetes mellitus, little is known about the nutritional status of older adults with this condition. OBJECTIVE: To determine whether older people with diabetes mellitus are malnourished when compared with non-diabetic subjects, to evaluate the MNA in this group, and to assess the possible relationship between nutritional impairment and function. DESIGN: A case controlled study. Community-dwelling volunteers were selected randomly from 2 general practice registers. 35 people over the age of 65, with diabetes mellitus, were age and sex matched with 35 control subjects without diabetes. The major outcome measures were: the MNA questionnaire, anthropometric measurements, serum albumin, transferrin, Barthel Index, Nottingham Extended ADL score and handgrip. RESULTS: The diabetic group scored significantly lower on the MNA than the control group (p< 0.01), but this was mainly indicative of many of the diabetic subjects scoring within the "at risk" category of the tool. Those in the diabetic group also had significantly lower albumin scores (P<0.05) when compared with the control group. Within the diabetic group, and in the study group as a whole, the MNA scores were significantly correlated with Barthel Index (p<0.01), Nottingham Extended ADL score (p<0.01) and handgrip (p<0.01). CONCLUSION: Community dwelling elderly subjects with diabetes may be at risk of malnutrition when compared with non-diabetic citizens. There is probably a causal relationship between malnutrition and functional decline in this group . Further research is needed, where the prevalence of malnutrition is higher, to fully evaluate the MNA in people with diabetes.

Keywords: Diabetes, nutrition, ageing, MNA, function, elderly.