Evaluation of the relationship between polypharmacy and malnutrition in diabetic elderly

Abstract

Aim: Type 2 diabetes mellitus (T2DM) is one of the most common chronic diseases in older adults. With advancing age, polypharmacy and proteinenergy malnutrition associated with chronic diseases can be seen frequently in T2DM patients due to metabolic causes and may adversely affect the prognosis. In this study, it was aimed to evaluate the relationship between polypharmacy and malnutrition in T2DM patients. Materials and Methods: Three hundred and twenty-one patients aged 65 years and over, diagnosed with T2DM and receiving oral anti-diabetic drug therapy, who applied to the Internal Medicine and Geriatrics outpatient clinic between February and November 2021, were included in the study. The data of the patients were obtained retrospectively from their medical files. The use of 5 or more drugs was considered as polypharmacy. Mini Nutritional Assessment-short form (MNA-SF) was used for nutritional status assessment. Results: The median number of concomitant medications used in patients followed up with the diagnosis of T2DM was 5. Polypharmacy was found in 209 (65.1%) patients, and severe polypharmacy was found in 21 (6.5%) patients. Malnutrition was found in 43 (20.6%) patients with polypharmacy, while 17 (80.1%) of 21 patients with severe polypharmacy had malnutrition. A positive correlation was found between the number of drugs and HbA1c, and a negative correlation with the MNA-SF score (r=0.792, p<0.001, r=-0.317, p<0.001, respectively). According to the logistic regression analysis, the presence of HbA1c and polypharmacy were found to be effective factors in the development of malnutrition (p=0.009, p=0.002). Conclusion: Current findings show that polypharmacy is quite common in elderly T2DM patients and often accompanies malnutrition. It is important to review the drugs used in each visit and to evaluate malnutrition that may be related to newly started or currently used drugs so that intertwined polypharmacy and malnutrition are not overlooked in elderly patients.