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Poster presentations / European Geriatric Medicine 6S1 (2015) S32
–
S156
S125
patients with malnutrition (MNA-SF ≤7/14) to those without
malnutrition, using appropriate statistics (chi
2
and t-tests).
Results:
The 44 diabetic patients with malnutrition (MNA-SF
5.8
±
1.6) – as compared to the 128 ones without malnutrition
(MNA-SF 10.7
±
1.7) – were similar in age, gender, co-morbidities
(e.g. hypertension 78%, ischaemic disease 62%, grade IV–V renal
failure 22%) and common geriatric syndromes (e.g. multiple
falls 49%, chronic pain 34%, visual impairment 33%, cognitive
decline 32%). Diabetic patients with malnutrition more frequently
presented with HbA1c
<
7% (62% vs. 46%, p = 0.004), which was less
frequently measured during the hospital stay (57% vs. 72%, p = 0.01).
They more frequently (p
<
0.05) had dependence (ADL
>
3/6: 54% vs.
34%), nursing home residency (36% vs. 10%) and high risk of
functional decline (ISAR ≥4: 70% vs. 46%). Their mortality rate in
January 2014 was also higher (34% vs. 19%, p = 0.05).
Conclusions:
Malnutrition was present in 1 in 4 older patients
with diabetes mellitus. This subgroup of patients with diabetes
and malnutrition deserves increased medical attention, as it shows
higher prevalence of inappropriately low HbA1c, as well as higher
risk of functional decline and mortality.
P-350
Easy-to-use clinical criteria for screening malnutrition in older
patients with type 2 diabetes mellitus
A.B. Christiaens
1
, M. Beeckmans
2
, M.P. Hermans
3
, B. Boland
4
1
Geriatric Medicine, UCLouvain, Brussels, Brussels, Belgium;
2
Geriatric Medicine, Clin. Univ. St-Luc, Brussels, Brussels, Belgium;
3
Endocrinology & Nutrition, Clin. Univ. St-Luc, Brussels, Brussels,
Belgium;
4
Geriatric Medicine, Cliniques Universitaires Saint-Luc,
Brussels, and Research Institute of Health a, Louvain-la-Neuve, Belgium
Introduction:
In the daily practice, the mini-nutritional assessment
short form (MNA-SF) is not systematically performed in geriatric
inpatients. This study aimed at identifying some easy-to-use and
effective clinical criteria for screening malnutrition in geriatric
patients with diabetes.
Methods:
Cross-sectional study in 172 older diabetic patients (83
±
4
years) admitted in a Belgian academic hospital. We compared
the patients with malnutrition (MNA-SF ≤7/14) to those without
malnutrition in terms of the five MNA-SF items (see below) and
mid-arm circumference (MAC), using
c
2
and t-tests.
Results:
The 44 diabetic patients with malnutrition (26%), as
compared to the 128 without malnutrition, were similar in age
and gender but presented smaller MAC (25.2
±
3 vs. 28.6
±
4 cm,
n = 151, p
<
0.001). MAC
<
27 cm (median value) was more frequent
in patients with malnutrition (68% vs. 32%, p
<
0.001) and offered
fair screening characteristics (sensitivity 68%, specificity 67%).
Comparing the MNA-SF items in patients with and without
malnutrition, we observed differences in mobility problems (scores:
0.84 vs. 1.25;
D
= 0.41), neuropsychological troubles (1.02 vs. 1.48;
D
= 0.46), body mass index (1.41 vs. 2.68;
D
= 1.27, n = 121) and
in reports of weight loss (0.82 vs. 2.13;
D
= 1.31), psychological
stress/acute disease (1.09 vs. 1.69;
D
= 0.60) and food intake decline
(0.59 vs. 1.46;
D
= 0.87) over the past 3 months.
Conclusions:
The largest score differences in MNA-SF items
between the two groups were body mass index (missing data
in 30%), food intake decline or weight loss over the previous three
months. Any of these three criteria or MAC
<
27 cm should prompt
further nutritional assessment in settings where MNA-SF is not
systematic.
P-351
Insulin sensitivity and secretion in older patients differ
according to age at diabetes diagnosis
A.B. Christiaens
1
, B. Boland
2
, M.P. Hermans
3
1
Geriatric Medicine, UCLouvain, Brussels, Brussels, Belgium;
2
Geriatric
Medicine, Cliniques Universitaires Saint-Luc, Brussels, and Research
Institute of Health a, Louvain-la-Neuve, Belgium;
3
Endocrinology &
Nutrition, Clin. Univ. St-Luc, Brussels, Brussels, Belgium
Introduction:
Little is known on insulin sensitivity and secretion in
older patients with type 2 diabetes mellitus (DM2), a heterogeneous
group of patients.
Methods:
Cross-sectional study of 210 consecutive older (≥75 years)
patients followed for DM2 at the outpatient diabetes clinic of an
academic hospital. DM2 was classified as habitual-onset diabetes
(HODM2) when diagnosed
<
65 years or elderly-onset diabetes
(EODM2) when diagnosed ≥65 years. Insulin sensitivity and
b
-cell
function were assessed by HOMA modeling. Statistical significance
(p
<
0.05) of differences was assessed using Student’s t-test, Welch’s
test or Fisher’s Exact test.
Results:
Patients with EODM2 (n = 88; 82.6
±
5 years), as compared
to HODM2 (n = 122; 81.2
±
6 years), had a shorter history of DM2
(10
±
5 vs. 26
±
10 years). Both groups were not different in terms of
cardio-vascular risk factors and DM2-related complications, except
at the micro-vascular level (EODM2 vs. HODM2: 45% vs. 72%).
Concerning metabolic profile, EODM2 significantly differed from
HODM2 in 4 anthropometric and metabolic characteristics:
lower BMI (26.6 vs. 28.2 kg/m
2
), lower prevalence of obesity
(18% vs. 27%), higher insulin sensitivity (66% vs. 53%) and
higher residual
b
-cell secretion (68% vs. 52%). Although HbA1c
was similar in both groups (7.31% vs. 7.62%), HbA1c
<
7% was
more frequently observed in EODM2 patients than in HODM2
ones (49% vs. 37%). EODM2 patients, as compared to HODM2
ones, received significantly less intensive anti-diabetic regimens,
specifically oral ones (bi- or tri-therapies: 28% vs. 59%) and
insulin (32% vs. 66%, p
<
0.001) at a lower mean daily dosage
(0.47 vs. 0.57 IU/kg).
Conclusion:
EODM2 patients had specific metabolic features and
differ from HODM2 ones. Thereby, because of their higher risk
of hypoglycemia, EODM2 patients should be treated with lighter
glucose-lowering therapy.
P-352
Citrulline and nutritional, functional and cognitive status in
healthy ageing SUVIMAX2 population
A. Cloppet-Fontaine
1
, A. Aregui
1
, E. Kesse-Guyot
2
, N. Neveux
3
,
P. Galan
4
, S. Hercberg
4
, L. Cynober
3
, J.-P. De Bandt
3
, A. Raynaud-
Simon
1
1
D´epartement de G´eriatrie, Hˆopital Bichat-Beaujon-Secteur
Ambulatoire de Bretonneau, APHP, Paris, France;
2
Unit´e de recherche
en Epid´emiologie nutritionnelle, U1153Inserm/Inra/Cnam/Universit´e
Paris 13, Bobigny, France;
3
EA4466, Facult´es de Sciences Biologiques
et Pharmaceutiques, Paris Descartes Sorbonne, Paris Cit´e, Paris,
France;
4
Unit´e de recherche en Epid´emiologie nutritionnelle,
U1153Inserm/Inra/Cnam/Universit´e Paris 13, Bobigny
Objectives:
As citrulline (Cit) supplementation increases lean body
mass and mobility in old rats, we hypothesized that a decrease
in plasma Cit could contribute to muscle alterations with aging.
The objective of this study was to describe temporal variations in
plasma Cit in aging volunteers. Therefore, we performed a cross-
sectional study in 2007 and a longitudinal study (between 1994
and 2007) on the association between plasma Cit and nutritional,
functional or cognitive status.
Methods:
Volunteers from the SUVIMAX2 cohort aged
>
65 in 2007
that had benefited from a complete nutritional, functional and
cognitive evaluation were identified (n = 337). Plasma Cit was