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Observational Study
. 2021 Jun:43:335-341.
doi: 10.1016/j.clnesp.2021.03.029. Epub 2021 Apr 15.

Malnutrition according to the 2018 GLIM criteria is highly prevalent in people with a diabetic foot ulcer but does not affect outcome

Patrick Lauwers  1 , Jeroen M H Hendriks  2 , Saskia Van Bouwel  3 , An Verrijken  4 , Kristof Van Dessel  4 , Carolien Van Gils  5 , Frida Peiffer  5 , Krishan Yogeswaran  6 , Christophe De Block  4 , Eveline Dirinck  4
Affiliations
Observational Study

Malnutrition according to the 2018 GLIM criteria is highly prevalent in people with a diabetic foot ulcer but does not affect outcome

Patrick Lauwers et al. Clin Nutr ESPEN. 2021 Jun.

Abstract

Objective: To estimate the prevalence of protein-energy malnutrition in people admitted for a diabetic foot ulcer (DFU) and to assess the relationship between malnutrition and DFU severity and outcome.

Methods: This prospective, observational cohort study included individuals consecutively admitted for a DFU between July 2016 and September 2019. The Global Leadership Initiative on Malnutrition (GLIM) criteria determined the prevalence of malnutrition. The SINBAD score reflected DFU severity. Outcome was evaluated at discharge and at 6 months. The independent contribution of nutritional status on DFU severity and outcome was investigated using logistic regression analysis.

Results: A total of 110 patients were included. Malnutrition, as defined by the GLIM criteria, was diagnosed in 26 cases; malnutrition was moderate in 9 and severe in 17. DFU severity differed significantly between subjects with malnutrition versus without malnutrition (SINBAD: 3.85 vs. 3.81, p = 0.012). Logistic regression analysis showed that severe malnutrition (p = 0.015) and hemoglobin level (p = 0.003) were independently linked to DFU severity. At 6-month follow-up, 39 DFU were healed, 36 patients had undergone an amputation (32 minor, 4 major) and 8 had died. No differences were noted in outcome at discharge or at 6 months according to nutritional status.

Conclusions: In 24% of patients, malnutrition was diagnosed. Severely malnourished individuals presented with more severe ulcers. However, malnutrition had no impact on the short-term outcome of a DFU.

Keywords: Diabetes; Diabetic foot; Diabetic foot ulcer; GLIM-criteria; Malnutrition; SINBAD classification.

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Conflict of interest statement

Declaration of competing interest The authors’ responsibilities were as follows: Patrick Lauwers, Eveline Dirinck, and Jeroen Hendriks conceptualized the study; Patrick Lauwers, Saskia Van Bouwel, Frida Peiffer, Krishan Yogeswaran, and Eveline Dirinck recruited patients and collected patient data; An Verrijken, Kristof Van Dessel, and Carolien Van Gils were responsible for nutritional evaluation of the patients; Patrick Lauwers, Eveline Dirinck, Jeroen Hendriks, and Christophe De Block contributed to data interpretation; Patrick Lauwers wrote the manuscript; all authors critically reviewed and approved the manuscript. The authors wish to thank dr Kristien Wouters for statistical support. This study was not granted with financial support. The authors do not have any conflict of interest.

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